How You Will Know if You Are Progressing in Psychotherapy

Therapists and patients alike hope that treatment will help every psychotherapy patient both to behave and to feel better. We know, though, that even in the most successful, best conducted treatments, progress is not linear but may happen in fits and starts, or involve periods of progress and regression, or may cause some people to feel worse before they feel better. These phenomena may sometimes make it difficult for a person to judge whether genuine progress is occurring. Here are some indications that a person is making progress:

• You know yourself better, even if the knowledge is painful.
• If you have been numb or cut off from your feelings, you are beginning to be able to feel a greater range and depth of feeling.
• If you have been overwhelmed by your feelings, then you may begin to feel a bit less overwhelmed by them.
• If you have tended to withdraw, then you may be a little more willing to come out of your room, or to let others know when you are having a hard time.
• If you are becoming more likely to use words to express feelings or needs, rather than retreating into silence or using actions to express yourself.
• You begin to feel connected to peers and/or staff and that others know you and you know them.
• You notice that your relationships with important others, including your family, are changing- this may be that they feel more genuine or real and that things are beginning to feel more resolved or it may be that, for the moment, the relationships are more tense or conflicted.

It may be apparent from the above signs of progress, why it is that sometimes a person engaged in a meaningful and useful psychotherapy may feel worse before things improve: approaching those things that have been avoided, while an essential part of recovery, almost inevitably is uncomfortable or frightening or painful in some way. If a person has tended to avoid conflicts, then beginning to address these is likely to raise anxiety and discomfort; if a person has used drugs or alcohol to manage their own emotions, then being sober may leave a person with intense feelings that they may not yet know how to handle well; if a person has had a history or trauma and denied or minimized its impact, beginning to face what happened and the toll it has taken will, of course, be a painful process.

It is perfectly legitimate and in fact useful to ask yourself and your therapist:

“Is this discomfort or pain that I am experiencing consistent with what is expected, considering the work we are engaged in?” This may well help you to put what you are feeling in perspective and also to tolerate it better, if it is part of the process of making progress.

Learn more about our emerging adult Assessment Center.