How can you tell if therapy is working?

[Izzi0909]

I’ve been seeing a psychodynamic psychotherapist for 5 months now..I feel like I’ve developed a greater understanding of why I feel the way I do and why I’ve engaged in certain self destructive behaviours in the past etc...but I still don’t know how to feel better about things.

It’s delved into past trauma and neglect from my childhood which I suppose it’s good to talk about but I still feel bad about it and if anything now that I understand more about how it’s shaped me I feel less hopeful and more like a ‘lost cause’. My therapist says a lot about how the first few years in a child’s development are critical...mine were awful so am I not permanently broken in that respect? I’m so tired of feeling so anxious and having much hatred for myself..I feel fine during the day when I’m busy but as soon as my daughter is put to bed I just feel this sinking heaviness and spend the rest of the evening with terrible anxiety. I don’t even feel I can concentrate on films or tv.

Should I not feel some improvement after 5 months? I tried 3 therapists (single sessions) before finding this one and clicked with her right away, she’s very experienced so I don’t think it’s her but maybe it’s not the right style for me. I just don’t feel like it’s going anywhere and feel ‘stuck’.

I work in specialised mental healthcare although not in the uk. I’m not a therapist myself mind! I have colleagues who offer psychodynamic psychotherapy and assessing the results is part of my job. It’s usually a very long course of therapy, hugely effective but not fast. It’s often what works when nothing else has helped much, IME. So, yeah, I’d say you’ve made excellent choice for complex, long term issues. Good instinct!

Honestly 5 months is is really very, very much the beginning. It’s normal to feel better about some stuff and worse about other stuff at this stage. Have you discussed what you’ve said in your op with your therapist? It’s important to.

Keep on keeping on.

5 months is short for therapy to effect total change but what you have done is very positive. You know why you are as you are (I was about the same at that stage in therapy) but feel like its defining you and thats all you'll be? I'm a year on from that and looking back I still needed to keep acknowledging that for a bit. I gradually got to the point in the last few months where I didn't need to keep talking about it in therapy sessions.

For the evening I found journalling and writing it down a huge help. I would just ramble in my journal and it helped to reread it and for me to see what was coming out. Sometimes that connected to therapy sessions too (both before and after the journalling) but not always.

Can you try walking or meditating to a you tube guided meditation or try yoga to a youtube video. They can help to releave anxiety.

Honestly - its well worth it to keep going. I no longer feel my childhood issues define me, and that brings me contentment every day.

@OwlBasket I haven’t yet mentioned this to my therapist but you’re right I think I need to. We never really had a discussion about how long it can take up front. I do feel better about some things, some of the less complex issues like setting firmer boundaries with people I feel improved quite quickly but issues around my mother and childhood I just feel quite stuck.

@Rathmobhaile thank you for sharing it’s a relief to hear you also felt a similar way at this stage. I definitely feel like it defines me at the moment and in a way that makes me feel worse because before I just felt bad but didn’t necessarily know why. I think the journaling is a great idea...I tend to vent to my husband otherwise and I know this isn’t fair on him and he doesn’t really ‘get’ anxiety so finds it draining, understandably. This would be a good way to vent...

yy, please do discuss all this with her! Journaling sounds like a good plan, I’d talk that through with her too. She may well have other suggestions for emotional regulation strategies if she knows you need them.

mine were awful so am I not permanently broken in that respect? I’m so tired of feeling so anxious and having much hatred for myself.

Research neuroplasticity - this is a good guide and core beliefs