Therapy Isn’t Helping. Is My Therapist Stringing Me Along?
I am hoping you can give me an honest answer here. I have been seeing a therapist for nearly three years now and I just don’t feel like it’s working for me. I don’t feel any different than when I started. In some ways, I feel even worse, because I am discouraged about therapy not helping. It makes me wonder what is wrong with me that I can’t get better. I have read that it is highly unusual for someone to be in therapy as long as I have.
I guess I should provide some background about my “issues.” As a kid, I was molested for years by an uncle, saw my parents die, and was bullied incessantly. I have been told I have major depression and have tried about half a dozen kinds of medication, none of which have made a shred of difference. I have self-esteem problems. I can’t seem to hold down a job. I haven’t been in a relationship for five years; women won’t even look at me, and I don’t blame them. I hate my life and I have no friends. Yes, I have considered suicide. No, I am not currently suicidal. I know that distinction is important to people who do what you do.
Because therapy isn’t helping me and hasn’t helped in all the time I’ve been in it, I want to stop. I feel like I am throwing away money. I feel un-helpable. I must be one of the few cases out there for whom there is no relief, whose problems are just too many and too major. I might be a lost cause. But I do not want to be a fool. My therapist has encouraged me to continue with therapy and to not give up hope. She says she has seen signs of progress but cannot seem to articulate them in a way that allows me to see them too. Maybe that is my failing, but I am starting to feel like maybe I’m just a paycheck for her. I don’t think she is necessarily a bad therapist. She is a nice person and she tries. She seems to truly care. I just think she isn’t helping me, I think she knows she’s not helping me, and I no longer really think anyone can.
What are your thoughts? Is she just stringing me along? Are there other people like me who don’t seem to get any better, and if so, what do you recommend in those cases? Please answer these questions. Thank you. —Lost Cause
What a great question regarding a terribly painful situation. I’m glad to hear from you about this, while so sorry to hear about all you have endured. Let me first give you my impressions in a way that “cuts to the chase,” then flesh things out a bit.
First, it is not unusual for it to take a while to find the right medication or combination of medications. (For instance, some people respond better to an older generation of medications, while others respond to SSRIs.) Have you tried more than one psychiatrist? I would encourage you to keep trying, discouraging as it has been. I have worked with a few people in therapy who were as discouraged as you, but managed to find an effective medication plan that helped them enormously.
You have been through hell and back. The fact you are still standing says something about your resilience. You have suffered enough trauma for several lifetimes, so it’s understandable you would feel this way. Your life experience has, I sadly observe, given you no tangible reason to hold onto hope. It does not mean there is none to be found, however; in fact, your letter indicates you are searching for it, itself is a glimmer of something positive.
As to your therapy question: Any therapist worth their salt would welcome any and all the feedback you have put forth here. My impression is it is time to have a blunt and honest conversation with your therapist regarding your feelings; if you’re still dissatisfied afterward, it may well be time to seek out someone new.
I would guess you had no source of true comfort after seeing your parents die. How unspeakably sad! I can hardly imagine a more hellish experience, in that the people you may have relied on most for comfort are the ones you lost. This, in addition to the other psychological injuries you experienced, leads to my amazement at your resilience. My great hope is you find, sooner rather than later, the kind of therapeutic “holding” and healing you deserve.
In the meantime, you seem to know intuitively you’re not getting what you need. I would be curious to know what keeps you in therapy with your current therapist. Have you tried telling her directly what you say in your letter? If not, why not? Is it possible she has helped as much as she can and now it’s time for a new approach? It is not uncommon, after all, to seek a second opinion medically; I believe this applies to psychotherapy also.
Sometimes people in therapy are afraid that, because they are not the “authority,” they do not have the last word on their own experience. You sound almost convinced it’s time to move on or ask directly that your therapist change her approach; I encourage you to follow your intuition. Whether or not it’s worth one last conversation with your therapist is obviously your call. Such a conversation could prove healing or just add fuel to frustration. If you feel you would benefit somehow from clearing the air, it’s worth a try. If, however, you feel it’s a foregone conclusion, you might want to move on.
Is it possible you doubt your own perceptions (not unusual with depression) in that she sees progress while you don’t, leading you to wonder if she is “right”? If the latter is true, she needs to find a way to convey her observations in a way that is meaningful to you. If your therapist insists you “hang in there” for no reason that feels solid, that’s simply not good enough; the direct experience of the person in therapy is, in my view, always front and center in therapeutic inquiry and exploration.
I don’t expect the people I work with in therapy to understand everything that flows from my lips. I have to learn a person’s language—and, to paraphrase Carl Jung, each of us speaks differently. I cannot insist on calling anything “progress” if the person in therapy feels or perceives otherwise. In the absence of mutual resonance regarding progress and therapeutic aims, the person in therapy feels dangerously alone.
Given your dwindling (or absent) faith in the process, it makes sense you are feeling alone in this relationship. It almost seems this alone-ness may even echo or parallel earlier suffering with the traumatic isolation and self-doubt you describe. I can’t shake the feeling you sense painful distance or discrepancy between you and your therapist, that she is missing something essential. I am not blaming her—nor you, for that matter. Do you somehow feel pressured to “live up to” her seeing progress? Are you concerned that if she feels disappointed or anxious about “progress,” it could be a bad sign?
Therapists seek a tricky balance between instilling hope and validating a person’s pain—mostly because, in so many cases, the latter has never been permitted or acknowledged by caregivers. Strangely, the more a pain is accepted as valid in the context of a person’s experience—with a safe other who can stay with you during and through that pain—the more healing the process becomes.
Therapists seek a tricky balance between instilling hope and validating a person’s pain—mostly because, in so many cases, the latter has never been permitted or acknowledged by caregivers. Strangely, the more a pain is accepted as valid in the context of a person’s experience—with a safe other who can stay with you during and through that pain—the more healing the process becomes. It’s when we begin to fear that emotional pain is “too much” for us or the other, or that it’s a sign of weakness on our part—that we need to “get over it already,” etc.—that it lingers like an unwelcome guest.
I believe people are entitled to all of their feelings, including and especially about therapy, because no one knows your experience better than you. I can’t imagine anything more important in your therapy than what you have bravely expressed in your letter. I am grateful you are not suicidal, but it sounds bad enough that an adjustment needs to happen, either within the current therapy or with someone new. (If thoughts of hurting yourself do resurface, please call 911 go to your nearest emergency room immediately.)
You sound very certain your therapist “knows she’s not helping me,” though I would urge you to not jump to the conclusion that no one can. The latter can be a hallmark or emotional symptom of depression—the sense one is cosmically alone in the universe, unable to connect with anyone. This feeling is, sadly, more common than many people realize. But this feeling is not objective “truth.” Your situation is not hopeless, and the fact you wrote your letter suggests you may leave room for hope, too. It is vital your therapist help you believe this more expansively.
When it comes to feedback, vital in any therapy, I try my best to listen nondefensively to where a person is or is not happy with me or how things are going with the two of us. My aim is to do no harm and be as helpful as possible. I do not assume I am always on the right track, or that no feedback means everything is fine and dandy.
There needs to be, more often than not, some mutually understood “map” of where we are going, and why—in your case, that would plainly include relief from traumatic anguish. The work can be difficult, even painful, at times, but for the sake of a treatment plan (ethically required), the “plan” needs to be something the person in therapy understands, endorses, and trusts as desirable.
Once a person begins to feel overly “protective” of the therapist’s feelings, which the therapist might tacitly encourage, the process is in danger of shutting down or becoming overly burdensome to the person, adding to their trauma and emotional isolation. Maybe the person has never had a chance to be fully honest with another, which can feel scary or even risky. The very act of sharing this disappointment can be healing, which is why I do my best to encourage it.
I would be curious to know if you are getting help with managing painful or traumatic emotions or emotional states between sessions. Do you need concrete help dealing with feelings of despair or low self-worth? There are cognitive behavioral approaches, dialectical behavior therapy (DBT), mindfulness, and other techniques to help with such moments.
Please do not give up. I wish you the best of luck in your pursuit of much-deserved relief.
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FarrahApril 28th, 2017 at 11:35 AM
I am guessing that you are probably staying with your current therapist because the idea of going through all of your past with another person all over again feels like it would be very daunting. I can understand where you are coming from. I know that it is hard but recovery does tend to take a long time especially when we are thinking about how many years you have been going through some of these things
These are not issues that popped up over time, they have grown over a great length of time, so to the defense of the therapist, things are not always unfortunately going to change overnight.
RexApril 29th, 2017 at 10:25 AM
Do you think that in some ways you are undermining your own treatment because you have these feelings? Like you are living up to the very low expectations for this experience that you have.
BradyApril 30th, 2017 at 7:47 AM
Have you tried some things on your own outside of your therapy sessions?
NicoleApril 30th, 2017 at 6:56 PM
It would be wise to re-visit a psychiatrist to find a psychotropic medication-which could take some time- that provides enough benefit to outweigh the side effects. Therefore, you would be a better candidate for effective psychotherapy. Also, I would recommend EMDR or IFS for trauma treatment of the SA and loss of your parents. Finally, look at your history of attachment patterns to best understand what keeps you in a therapeutic relationship that you pereceive as fruitless. Hope this is helpful, Best of luck.
rhettMay 3rd, 2017 at 11:50 AM
now why would you believe that some one in a position like this would string you along? for their benefit?
SaraiMay 4th, 2017 at 8:49 AM
Have you tried brief therapy or narrative approach? It seems you also have bought the label “LOST CAUSE”, and is so dominant you cant see other things you are. You are not the problem, the problem is your depression, which has took you and is not letting be you. If the depression had a figure, a personalty? How would she? Have you wonder?
DonMay 5th, 2017 at 4:16 AM
All valid points, but I would like to mention the dealing with/resolving complex trauma can takes years, so in some cases 3 years wouldn’t necessarily be outside of what may be considered an “appropriate time frame”.
KimMay 23rd, 2017 at 3:53 PM
I too have felt a sense of obligation to continue with a therapist who was a genuinely nice and caring person, but who couldn’t help me (a gut level feeling that I chose to respect over the opinion of an outsider). While I dislike ascribing nefarious agendas to therapists who want to continue unproductive relationships, it is a fact that their livelihoods are based on patients paying for their services. And if I’m not getting the service I want, then something has to give. In my years of therapy I have either stood up for myself and ended the relationship or simply run away (i.e., not scheduled another session or canceled one that was scheduled never to return). I certainly feel better about standing up for myself. However, running away may be necessary if the therapist has narcissistic tendencies and triggers my survival issues. I have also learned that talk (“yack”) therapy cannot even touch my preverbal, early childhood trauma. I knew it on a subconscious level, but didn’t understand it until I did the research online and discovered people like Bessel van der Kolk, Peter Levine, Albert Pesso, and Pete Walker, who are making huge inroads in the field. Bessel has expressed wonderfully frank criticisms of cognitive (verbal) therapies, including “Trauma has nothing whatsoever to do with cognition . . . It’s not something you can talk yourself out of.” [See the article “A Revolutionary Approach to Treating PTSD,” New York Times, May 25, 2014.] I encourage you to look outside the talk therapy box for a resource that will make your flame of home burn brighter. For me, body-oriented and expressive art therapies appear to be the tools I need to resolve the trauma stored in the very fabric of my being.
P.S. Please remember that you are not alone!
cindy bAugust 4th, 2017 at 7:05 PM
With my therapist I might as well be talking to a wall.
CapApril 30th, 2018 at 6:32 AM
I know how you feel (though not the sexual abuse part). I feel my therapist isn’t helping any but haven’t gone as long as you. I was bullied all 12 years of school every day, at age 16-22 handled about 100 dead bodies in a hospital as part of my job, lost 2 brothers, father, and my wife (3 of those in the past 3 years). My brother and my wife were the two closest people in my life. When my brother died having my wife was the only thing that got me through it. 3 years later when my wife died (now 1 1/2 years ago) my life was completely destroyed, still at that point in my life right now. Only thoughts that keep me from killing myself is my mom doesn’t need to lose a third son, and it would be a horrible lesson to teach my son. I only worry about waking up one day and those two thoughts no longer stop me.
April 30th, 2018 at
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3yearsintherapytooOctober 25th, 2021 at 1:57 PM
Why is everyone talking about medication? Lost Cause never mentioned psychiatry. Not once. Yet everyone keeps bringing up “oh, you just haven’t found the right medication”? Medication is not therapy. Therapists are psychologists, not psychiatrists, although they can possibly be both, this is rare. In fact, it could be said that if therapy worked, medication would not be necessary. I went into therapy for a trauma and explicitly stated my treatment goals in terms that could not possibly be misunderstood that my goals were to AVOID medication, and to AVOID hospitalization. If I end up needing either of these more intrusive treatments, by definition, my talk only therapy has failed. I got into therapy to avoid psychiatry, and I have never waivered that this is my goal, nor have I forgotten why I went to therapy. Medication is for when therapy isn’t enough. I’m currently working and supporting myself. Hospitalization is out of the question. There is no medication that directly addresses my symptoms. Benzos are dangerous and have killed my friends. SRIs use the same mode of action as cocaine, a drug that is a core to one of my early childhood traumas. If I wanted a drug habit, I’d call a dealer, not a therapist. I am in therapy for trauma. My goal in therapy is to avoid becoming an addict, not to get new drugs to become addicted to. No means no, it doesn’t mean “ask me later when I’m in a better mood” or “wait until I get frustrated and bring it up again even though I told you no and I meant it.”
However, when I bring up being frustrated that three years of therapy have been very painful to me and not yielded a single articulable benefit, my treatment goals of 1: avoiding medication and 2: avoiding hospitalization BOTH get disrespected.
What happened to “least restrictive form of treatment”? What happened to “respecting patient autonomy’? What part of “no” does my therapist not understand? No drugs. No IOP. No hospitalization. If I wanted medication pushed on me, I’d be seeing a psychiatrist that can prescribe. I specifically chose a therapist without prescription writing authority. However, meds keep getting pushed, and they keep getting pushed by people not qualified to push them. This is not ethical. This is not okay.
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