SELF | Patia Braithwaite
If you're in therapy, you might be familiar with the dread that can bubble up when you're not looking forward to a session. You know, like when your therapist asked you to spend the week setting boundaries in your personal relationships, and you have to explain why you absolutely did not.
The good news is that this sense of dread isn't always unusual or even necessarily a bad thing. On the other hand, sometimes it can signal that your therapy sessions aren't going as well as they should. Here are the most typical reasons why therapy dread happens, plus how to know when it's a sign you should break up with your therapist—and when you might want to just stick it out.
Therapy is work, and work doesn’t always feel good.
When you decided to look for a therapist, you probably had some idea that talk therapy is basically the act of chatting with a qualified professional in a confidential environment. But holy hell, that is such a simple way to put something that can be incredibly draining. Let's be honest: You're probably not in therapy to run through a list of why your life is so great for 50 minutes.
Instead you might be in therapy to treat mental health issues such as anxiety, depression, bipolar disorder, obsessive-compulsive disorder, or another condition. Or maybe you wanted to see someone to resolve conflicts with people you love, cope with life changes, manage unhealthy reactions to stressors, or recover from trauma. No matter what brings you to your therapist’s couch, the process of working through your shit can sometimes make you feel, well, shitty. Mining through your most vulnerable thoughts and feelings in front of a professional—even for the sake of eventually feeling better—can be uniquely awful.
“Some people go into therapy and don’t yet know that there’s going to be pain,” Morton Rosenbaum, Ph.D., assistant professor of psychiatry at Mount Sinai Hospital, tells SELF. “Just as many people go in knowing that pain is involved in healing. But knowing is different than actually experiencing it.”
So yeah, it’s absolutely normal to find yourself upset during therapy, which might make you feel drained afterward and less than excited to come back to do it all over again.
Still, while dread can be part of the therapeutic process, it shouldn’t be the entire process, Rosenbaum says. “I’m not a believer that just because therapy is painful, it’s working,” he explains. “It can mean it is working very deeply, but it can also mean it’s too painful to work.”
How can you tell the difference? If you feel judged, silenced, or ignored by your therapist, your dread might signal that they aren’t right for you, Kara Lowinger, L.C.S.W., director of Adult Outpatient Care at MedStar Georgetown University Hospital, tells SELF. “Therapy, more than anything, is about the therapeutic relationship,” she says. “Feeling accepted, cared for, and responded to in a way that you need (or finding ways to feel responded to in the way that you need) is part of what makes it effective.”
On the other hand, if you’re dreading therapy because you know you’re going to talk about painful things—even if you feel ready and even if you trust your therapist—that can just be part of the process, Rosenbaum says.
To figure out where you stand, put the dread aside for a second and evaluate how therapy is going generally: Do your sessions make you feel better overall, even if you have some uncomfortable moments? Does your therapist challenge you while also respecting your boundaries? Are they culturally competent? If you can easily answer yes to these types of questions, dread might be a sign that you’re putting in the work of exploring your pain points, which is just going to suck sometimes.
Talk about dreading therapy with your therapist.
We know what you’re thinking: Bringing up the dread will make things weird between you and your therapist. It shouldn’t.
Any good therapist should be able to separate your feelings about therapy from your feelings about them, Rosenbaum says. (And even if you do have negative feelings about your therapist, part of their training involves being able to receive your criticism without getting defensive.) “If you tell us, ‘This is what I’m worried about,’ your therapist [should] acknowledge your worry and try to help you have the full experience that you’re paying for,” Rosenbaum says. In short, talking through your concerns and feelings might help you get exactly what you need in order to dread therapy a bit less.
When it comes to finding the right words here, your best bet is to express yourself truthfully. There’s no good or bad way to bring it up. Even blurting out something like, “I dread coming here” is as a very clear invitation for your therapist to help you explore what’s up, Lowinger says.
Depending on the root cause, your dread might be a red flag about your sessions or a metal detector that helps you find treasure, Rosenbaum explains. Expressing how you feel—along with any reservations you might have about bringing it up, for example, that you’ll hurt your therapist’s feelings—can help you both examine your emotions more clearly.
It’s OK to break up with your therapist if you need to.
So you’ve thought about your dread, discussed it with your therapist, and realized it’s a sign that the two of you might not be the best fit. That’s perfectly OK.
“Most of us go through life slipping away from difficult moments and relationships because we don’t think they’re possible [to address directly],” Rosenbaum says. “There’s something very valuable and empowering about saying to a therapist, ‘This is why I want to leave.’ ”
Beyond learning how to confront difficult situations, being honest allows your therapist to give you some suggestions or even a referral for another professional who might be a better fit. So if you share that you want to break up and your therapist suggests a few more sessions, don’t feel like they are trying to trap you. “Taking a couple of rounds to talk it through is a good way to feel that your decision is coming from a clear place,” Rosenbaum says.
Ultimately, dread (and every other emotion imaginable) is pretty natural as you work through issues with a therapist. “I like to use the analogy of exercise,” Lowinger says. “If you haven't been to the gym in a long time and you go, it's going to be painful. But as you go more often, it gets easier. You learn to tolerate the discomfort when you're in the moment, and you're stronger in the long run.”