Why Does Therapy Take So Long? And when it doesn’t?

Photo by Jeremy Lapak on Unsplash

As a mental health therapist, one of the most common questions I hear from clients and potential clients is, "Why does therapy take so long?" This is a valid concern, and I want to shed light on the reasons behind the duration of therapy and why, in some cases, therapy might yield positive results more quickly.

Building Trust and a Safe Space

The foundation of effective therapy is trust. Many clients come to therapy with deep-seated issues and vulnerabilities that are not easy to share. Building a trusting relationship takes time. While the therapist continue to assess client’s issues, the client is also continuous “assessing” —on the conscious and unconscious levels— if the therapist is trustworthy and able to understand the client. While therapists’ effectiveness in building a safe space varies, clients’ willingness to trust (aka, take risks) all vary. Therefore, this process cannot be rushed. The time spent building this connection is crucial for the effectiveness of the therapeutic interventions that follow.

Imagine a client who is burdened by a lot of shame as a result of their trauma. Talking about their struggles can be uncomfortable and even triggering. Therefore, the therapist will slow down the pace to ensure that client is maintaining a sense of control over the process. This is crucial because trauma treatment is essentially focused on restoring a sense of control and safety in the present moment (i.e., the client moves on from living and reliving in the trauma stage). Client being rushed will further confirm the loss of control, which would be counterproductive.

It might take several sessions for a client to get familiar with the process and feel safer with their therapist, thus begin to open up about their deeper feelings and experiences, allowing the therapy to become more effective.

The Complexity of Human Psyche

Human emotions and behaviors are complex and often rooted in past experiences and long-standing patterns. Unraveling these patterns and understanding their origins takes time. Therapy involves exploring these complexities, which is not a quick fix but a gradual process of self-discovery and healing.

For example, a client struggling with depression might discover through therapy that their feelings are linked to unresolved grief from childhood. Exploring these deep-seated issues and their impact on current behavior takes time and careful, step-by-step work.

In many cases, people develop avoidance and numbness as a coping strategy when nothing else worked for them. Avoidance and numbness (on both the conscious and unconscious levels) also make it harder to get a clear picture of these patterns in a short time. Figuring out patterns is like discovering the inner map/landscape. Sometimes, clients (esp. those who have a higher need for control and efficiency) get frustrated or confused by the lack of direction during this exploration stage. In that case, therapist would also spend time to provide more support to help client relax and build trust in this stage. This in itself is also an intervention because learning to be curious and open-minded is a part of the healing process. It leads to a stronger sense of safety, which contribute to one’s resilience.

Creating and Reinforcing New Neural Pathways

Change in therapy often involves creating new neural pathways in the brain. This means developing new ways of thinking, feeling, and behaving. The nervous system needs time to build and reinforce these pathways. While clients might see positive changes early on, it takes consistent practice and reinforcement over time to consolidate these changes and make them permanent. This is no difference from any kind of learning —walking, driving, cooking… It takes time to become a natural.

For example, A client working to overcome anxiety might learn new coping strategies and thought patterns in therapy. While they might see some improvement in a few weeks, consistently practicing these new skills helps reinforce them, leading to lasting change.

Personalized Pace of Progress

Each individual’s pace of progress in therapy is different. Factors such as the nature of the issues being addressed, the client’s readiness for change , and external life circumstances (risk factors and protective factors) all play a role. Some clients might experience breakthroughs quickly, while others might need more time to work through their challenges. Two clients with similar issues might progress differently. One might quickly adopt new coping strategies, while the other might need more time due to additional stressors in their life, such as job pressure or family responsibilities.

Short-Term Success vs. Long-Term Healing

While it is possible to see positive results in a short period, especially with specific techniques or interventions, lasting change often requires a longer commitment. Short-term success can provide immediate relief, but therapy aims for long-term healing and resilience (personality changes), which necessitates a more extended journey.

When Therapy Doesn’t Take As Long

In some cases, therapy might not take as long. When the client is in the preparation or action stage of change, where they are more ready to take in the therapist’s support effectively, more active in creating corrective experiences outside of therapy to help their nervous system to continuously strengthen new neural pathways, more effective in utilizing resources and varying support for their mental wellbeing, more compassionate with themselves so inevitable stress in this learning process is tolerated, therapy can indeed do magic in a short time.

In short, therapy is a deeply personal and transformative process. While it can be time-consuming, the investment of time is essential for building trust, understanding complex issues, and creating lasting change. It’s important to remember that the goal of therapy is not just quick fixes but profound and enduring healing. By allowing the necessary time for therapy, clients can achieve meaningful progress and long-term well-being. Whether the journey is short or long, each step taken in therapy is a step towards a healthier, more fulfilling life.