The Secret All People Should Know but Few Therapists Share

Two women whisperingSo, you made it through the hardest part– you made the decision to seek therapy. You asked for recommendations, sorted through therapist profiles and websites, maybe even spoke to a few. Finally, you selected a therapist who you believe can help you, and you are ready to get started. You think you’re on your way to feeling better, but then a strange thing starts to happen; you find yourself feeling worse. How can this be? You’re seeing a therapist and working hard to get through things. How can you be feeling worse, rather than better?

Believe it or not, this is a common phenomenon in the beginning stages of therapy. Taking a deeper look at the situation, it is easier to understand why you might feel worse before you feel better. When you make the decision to enter therapy, it is often because you haven’t been able to work through a particular issue yourself, and your friends and family haven’t been able to help you come to a resolution, so you call on a professional. This probably means a couple of things; the issue is complex and it has been troubling you for some time. Now that you have entered therapy with a trained professional, you are for the first time, exploring this issue and perhaps other issues in a deeper, more meaningful way. Therapy often involves cutting through the defense mechanisms you have used to protect yourself from difficult feelings, and this can be a painful experience.

At this point, you’re probably asking yourself, why should I go to therapy if it is just going to make me feel worse? Good question. And the answer is that while you may experience more pain in the beginning, this process is necessary in order to fully explore your situation in a way that will lead to new insights. These new insights often come with some much needed relief. But wait, it gets even better. Once you’ve made it this far, your therapist will be able to help you parlay your insights into action. Now, you’ve hit the jackpot. You came into therapy feeling lost and overwhelmed and now, with a deeper understanding of your situation, you are actively taking steps towards improving it and moving on to live the life you desire.

Certainly, if therapists began each initial session with new clients by telling them that they should expect to feel a whole lot worse before feeling any better, they probably wouldn’t keep too many clients. However, one of the most critically important elements of therapy is the development of a relationship between the client and the therapist. Skilled therapists can usually establish a solid rapport with clients within a few sessions. Once this rapport is established, therapists should warn clients that the process of psychotherapy can be very painful, especially in the beginning. This conversation may be a difficult one to have, but when a client is really ready to embark on the therapeutic journey, truthful dialogue opens the door to a secure therapist-client relationship– a relationship in which the client knows the therapist will be honest with him or her, even when it is not easy.

© Copyright 2010 by By Sarah Noel, MS, LMHC, therapist in Brooklyn, New York. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • eliza

    September 27th, 2010 at 4:10 PM

    I know that when I first started therapy I felt awesome like I was really going to make some headway in my life. But the deeper that we delved into the things that I needed to talk about I felt awful about myself and everything in my life. It has taken me time to be able to take that step back and realize that this had to be normal, that anytime when you are finally able to see things for what they really are it may be a little more difficult than what you initially imagined that it would be. But I promise that it is all for the greater good. You get such a clearer vision of life and are totally more focused on the important things and the direction that you would like to see your life move in. And that’s a good thing.

  • JACOB

    September 27th, 2010 at 7:00 PM

    Its not easy for a person to let out everything about himself to a new person and this is exactly what happens with a therapist.You need to give the therapist all the details that you can think of,but then it can get a little uncomfortable.This has to be understood by the client or there will be no comfort in the client-therapist relationship.

  • naro

    January 27th, 2017 at 3:38 AM

    “Its not easy for a person to let out everything about himself to a new person and this is exactly what happens with a therapist.You need to give the therapist all the details that you can think of,but then it can get a little uncomfortable.This has to be understood by the client or there will be no comfort in the client-therapist relationship.”

    It’s not the client who needs to understand this, it’s the therapist who needs to understand this issue that actually causes a power imbalance where one exposes themselves completely and the other doesn’t(the therapist doesn’t reveal anything about their personal life). The whole system for that matter needs to change and only people who actually specialize in certain issues and experienced those issues themselves as well should expose their personal issues on a platform such as youtube so that potential clients can get to know the therapists beforehand and already get a hint of whether they like that person or not so they dont have to go therapist shopping before they find the right person and meanwhile have allowed themselves to be unnecessarily exposed to x amount of strangers and pay for their psychological rape before finding someone they click with. This would also eliminate the problem of power imbalances and the bad feelings it creates as a result. On top of that, it will keep narcissistic ego tripping people out of the business if clients no longer accept this old fashioned model of being psychologically probed by someone who isn’t willing to open up about their own issues towards them.

  • becker

    September 28th, 2010 at 4:02 AM

    this compares best with this-even for a diamond to change from a stone to diamond,it has to go through pain and cutting and many other things that are not too desirable.
    if you wanna achieve something,then you have to work hard for it and go through many a pain…NO PAIN NO GAIN.

  • Bonnie s

    September 28th, 2010 at 4:19 PM

    I would bet that there are many patients who do not return to therapy after the first session or two precisey due to this point. All the more reason why the therapists should bring this up with their patients and talk with them about it. It may actually make people continue to return for their treatment instead of giving up on it so quickly.

  • KP

    September 29th, 2010 at 6:56 AM

    Bonnie s-that’s exactly what I thought too!
    But you can’t really help it can you? There will always be a considerable percentage of people who will quit therapy because of these problems but the ones who stick on are the ones that are actually capable of going all the way and actually getting rid of their problems,the actual reason why they are seeing the therapist in the first place!

  • runninfast

    September 30th, 2010 at 4:48 AM

    The good therapists will talk to their patients about this issues. They will be honest with them that this may be a difficult journey, but that to come out the other side of this thing healthy and strong they have to be willing to confront the good along with the ugly and the bad. And they should stress to them that once they are able to look all of that in the eye, know what made them who they are today, and give them valuable lessons about how to turn it into the life that they deserve, that journey will so be worth it in the end.

  • anonymous

    November 22nd, 2010 at 2:36 PM

    For me, mine waited until he “had me” and then came a flood of therapist induced abandonment, rejection etc. conversations and/or actions. He knew based on my pathology (borderline traits) that this is what he needs to do I suppose.

    Now four years later, I am terrified of finishing what was started. I hate therapy, hate the process, and feel that therapists need to warn clients because the way to supposed healing is through hell and losing him.

  • Sue

    January 5th, 2012 at 10:24 AM

    I found the therapeutic theory to be complete myth. “Insight” freed me from nothing, only encouraging victimization, passivity and self-pity. Psychotherapy was perfect training how to work into a stultifying depression not existent before so-called treatment. It’s only through critiquing this fallacy am I emerging from it.

    Of course, if therapists ever start to question their “feeling worse=doing better” pacification, that unravels far too much.

  • Liv

    August 13th, 2012 at 12:18 PM

    I agree with Sue. All this, ‘it gets worse before it gets better’ kind of covers the therapists backs doesn’t it? They never have to examine if what they are doing is damaging someone and making them feel bad while they line their pockets. I did therapy for two years and i have come out of it totally alone, less friends, less confidence. It brought me to a child state where I felt helpless and beleived my own self pity. Awful. Worse than I have ever felt in my life. Some things should be left in the past. I also know a lot of slightly nutty people who want to be therapists, study to become one and it frightens me that they are allowed to ‘treat’ people. It seems very godlike and controlling, to believe you can ‘fix’ other people. It’s better to just accept ourselves as we are, develop through personal growth and move forward. Rumination and navel gazing is stunting our true happiness. And therapy tells us it’s all ok, it’s ok to feel bad, your supposed to! The worse you feel, the more progress you are making. To me that’s morally wrong.

  • david

    March 25th, 2015 at 4:37 PM

    Hahaha very good; I couldn’t agree more. 😁

  • Sasa

    September 23rd, 2013 at 6:19 AM

    I have to agree with the last two comments. I’ve gone around this bend repeatedly. Not happy with things, but getting by, so I try to take responsibility for my own happiness and get myself into therapy. Inevitably it takes me from not to happy about things (but not actually doing too bad in life considering), to rehashing an abusive, loveless childhood which makes me start to feel more alienated and desperate to the point of having no will to live. Therapists saying you’re suppose to feel worse is a total cop-out. Is that the goal of therapy then?

    On top of that it is expensive, so you may have to sacrifice some of life’s small pleasures to pay your therapist, which makes it worse.

    For anyone reading this who feels the same way I’ve been through 8 therapists and the only one who helped me was a cognitive behavioral therapist, so I would recommend that. Unfortunately I’m in Buenos Aires where they still believe the bs of the misogynist, coc-addict Freud and psychotherapy is all that is available. Psychotherapy is a joke — if you feel that way and have it confirmed by experience, trust me you are not alone.

  • disequilibrium1

    December 23rd, 2013 at 9:45 AM

    Sasa, you describe my experience. Psychotherapy pulled me into a disillusioned candyland I saw myself going through some magic transformation, became obsessed with my the (normal) injustices life has dealt me, alienating friends and colleagues. It was a true folie aux deux with the therapists.

    Therapists who manipulated me into relating to them as parents were even more damaging because they gave me a distorted view of human interaction.

    There are some blogs on the subject. Mine is:
    BAD THERAPY? A DISGRUNTLED EX-PSYCHOTHERAPY CLIENT SPEAKS HER PIECE, which has a long ongoing discussion.

    I also like:
    trytherapyfree blog wordpress

    And several “therapist types”
    psychgripe blogspot therapist types December 2010

  • Will

    March 30th, 2014 at 8:15 PM

    For what it’s worth, here are my two cents. After years of psychotherapy with several different therapists, I’ve come to the conclusion that therapy makes my depression worse than before. Therapists have always asked me the same questions, for example “How are you feeling today? Have you always felt that way? As a child, how were your relationships with friends and family?” When I answer these questions truthfully I feel even worse, because I relive bad life experiences over and over in my mind. I think psychotherapy has given me false hope, and I’m always disappointed at the results. Apparently, other people have benefited from therapy, but I don’t understand how or why.

  • Brittaney

    January 16th, 2015 at 2:02 PM

    She ask’s me questions I cannot answer.
    Then I’m not cooperating.
    What do I want to work on? Honestly. Im almost homeless. My husband and I are separated but he doesnt want a divorce but he doesnt want to live together either so we are seeing a MC. I have 2 small kids and no job. I have PTSD from a terrible childhood and whats becoming a horrifying life altogether. I have no self- esteem, no desire to live half of the time I just go through the motions of my life.

    Her great advice is to ask for help.

    What do you think I’m doing here?!?!

  • Beverly M., LPC, PC

    January 16th, 2015 at 7:56 PM

    If your therapist is not helping you, go to another therapist, Not all therapists are trained the same or knowledgeable enough to help you with your problems. Try to Google “marriage therapist” in your area and see if Good Therapy or Psych Today lists anybody. Ask the therapist for a consultation. Then ask the therapist how he/she would work to help you. Don’t pay someone who is not helping you.

  • Maua

    November 27th, 2015 at 4:38 PM

    Hi it is very true. Recently my mother passed from cancer, I have been through a lot. I have a feeling she will be moving soon. So when I talked to her it was very unhelpful. I just wanted a human being(they are human I know) to talk to me in that moment. If anything I wanted someone to talk to the person in which I have been sharing my thoughts and experiences sharing my past past wounds including present. Is it wrong that I have this expectation? of comfort.. Honestly I feel like continuing therapy will be waiting my time.

  • Tamm

    March 22nd, 2016 at 7:06 PM

    The same thing happened to me. As well sorry for your loss. Mine has recently left had her for two years. Then she was being generic , told me a few days later that life was going to be a journey not helpful honestly. She kept saying that obviously I don’t see it as a journey I think it crashed therapy now that I reflect. You aren’t wrong to have that expectation. I always was curious is that how they are trained. Straight bs. since its not helping then you should look else where. Waisted time is never good.

  • millicent t

    December 4th, 2015 at 3:05 AM

    I started therapy this past Tuesday it well but right the next day I felt worse than I expected but I’ve told myself I’ll continue with therapy and see where it’ll take me I am hopeful I’ll get better its just that it will take time I’m only 25 a student and a mother of two to a 5 year old and an 8 months baby both boys they need their mother and I’ll do just about anything to get better this article sure did help me make sense of how I’m feeling right now thanks

  • Heather

    July 14th, 2016 at 10:14 PM

    Just wondering how you are doing now? If you are still on therapy. My mother has been on me for yrs. to go. So I started therapy two days ago. I’m an emotional wreck now. It’s like it brought everything to the top again. I have three kids. I need to get better. Right right now though… I feel like I can barely function. Everyone keeps reassuring me that it will get worse before it gets better. I hope you are doing well.

  • jayna r.

    January 1st, 2016 at 11:35 PM

    Just started seeing a therapist and hate how the first session made me feel. I cried for the duration of the hour long talk, cried all day even after the appt, and am highly considering seeking a new one elswhere. She convinced me to explain my life story in one stationary moment… which was impossible to do in just one hour ( esp while sobbing over the painful memories that I have never shared with a stranger ). My perception might be warped due to my depression, but I feel like she literally was getting entertained by my life woes… I even caught her cracking an ill-timed, non sympathetic smile as I was explaining an extremely painful incident from my past. She was listening objectively at first, but then her vibe became uncomfortable to me. I felt a bad vibe with her, which I don’t feel with many people. Everyone in my circle of close friends keep telling me to give her more of a chance, but I have a gut feeling she isn’t a good counselor for my personal needs. I would advise people to go with their intuition. Yes, it is normal to feel worse at first when starting with therapy sessions; this article was very spot on and intelligent, but still… not all therapists are the right fit for every type of personality.

  • Jocelyn

    March 22nd, 2016 at 1:00 PM

    My husband has been seeing a therapist for close to a year, it has pretty much destroyed our relationship completely, I am on the verge of leaving. he has closed down completely to any conversations, lies about continuing to see this person, and refuses to discuss anything that he learns or has help him grow, in anyway. It is very scary and threatening. He has changed where he gets the bills for this guy, no longer coming to the home. He refuses to discuss any part of his therapy saying it is personal. It just makes me sick to my stomach even writing this. Anytime I ask a question he says it’s personal about travel, trips, etc.,

  • Tamm

    March 22nd, 2016 at 7:18 PM

    I just hate how it got me to view relationships in a distorted way. When other people who seemed to have conflict with me she supported them. Which I didn’t understand. I am mellow never bothers starts conflict. Extremely chill. I felt it was bullsh$t now I am my views are in lala land. Im planning on seeing a new therapist but I don’t want to. I grew a lot afterwards.

  • AS

    March 30th, 2016 at 2:19 PM

    Sorry-This article does not display true insight. Therapy hurts at the beginning,middle, and end. Therapy has given me some of the worst moments of my life. Well designed meta studies demonstrate its limited effectiveness.Many therapeutic practices cross the line into abuse, in a large part because narcissists and the personality disorderd individuals dominate the profession.Severe mental illness is for the most part untreatable and it’s an open secret. One needs to be very cautious and dare I say it, suspicious. We need to look deeper and not make easy generalizations. I say this as both a therapist and a patient. These are not off hand comments. I have pondered this for many years.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    March 30th, 2016 at 2:50 PM

    Dear AS,

    Thank you for sharing. We are sorry to hear you have had a difficult time in therapy. We at GoodTherapy.org work to promote the idea that therapy can be helpful for a wide range of mental health concerns, even serious ones. We recognize that some therapists may not be ethical and may do more harm than good, but GoodTherapy.org is committed to connecting people with ethical helping professionals and providing quality mental health information and resources on a number of topics.

    This blog article, “50 Signs of Good Therapy,” may help outline aspects of the more positive therapy experience we hope everyone can achieve:
    http://www.goodtherapy.org/blog/50-signs-good-therapy-0110119

    Kind regards,
    The GoodTherapy.org Team

  • Nathan

    June 2nd, 2016 at 8:46 PM

    This is usually the sentiment of helping professionals when therapy feels more destabilizing than helpful. “Sorry you had a hard time, look out for bad therapists” there is no indications bad therapy experiences happen with just bad therapists. It is the therapy experience that makes some people lose a lot in therapy. If things are supposed to get worse, tell people! Not doing so is crazymaking. If they dont get better, dont further pathologize clients instead of reflecting on whether therapy is helpful for the client and help them access other kinds of support. If therapy is potent, it will affect some people negatively. Its a risk many will take if informed, and if it does happen, dont blame clients!

  • naro

    January 27th, 2017 at 4:18 AM

    I’m glad to read more people recognizing the BS that therapy is. It’s also very abusive to make blanket statements that “talking about your issues helps” as if that counts for everyone. I also agree that it doesn’t take a bad therapist to make therapy ineffective at best. It’s the power imbalance for one that causes someone to feel bad where one is expected to emotionally expose themselves to a stranger who doesn’t reveal anything about themselves and as if they are somehow above you (not having those issues which is quite easy if you didn’t experience the same things) and can therefore fix you, rofl. On top of that, the more you talk about and focus on your problems, the more you become them, the more you identify them an that is the problem. Anybody who wants to “help” others is in reality only helping themselves (their ego). Everybody should be wary of people wanting to help, because it requires them to view the object of their help as a victim and it’s precisely victimhood that feels bad, therefore you can never feel good from going into therapy because you will be treated even more so like a victim. It doesn’t make it any better just because the therapist has good intentions.
    The only solution is to shift your thoughts and feelings so as to not feel like a victim. No therapist can do this for you. Look into the Law of Attraction and how to attract what you want. Therapy is only good for therapists and you should never accept the idea of feeling bad/worse as “good” for you, that is patronizing. Whoa re they to tell us what’s good for us anyways?

  • just a guy

    February 21st, 2017 at 11:29 AM

    have to say I agree with many of the commenters here. in my experience the “it gets worse before it gets better” is an almost exclusively psychodynamic phenomenon. re-traumatizing people is not helpful imo. i found a cbt therapist and finally am actually doing much better because they give patients what they ask for…effective, timely treatment…and you’re also not, on top of your illness, dealing with this hellish, circuitous, never-ending, pointless psychodynamic relationship anymore. my experience is this is when most psychodynamic therapists chime in about how their treatment gets to the root of the problem. after almost 10 years of psychodynamic therapy with little movement, i spent one week in a group with normal people and voila….depression lifted.

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