On Making Progress In Therapy
At the end of a session last week, someone I worked with asked: “how do I know that our sessions are doing anything?” They went on to share that it’s hard to tell whether they’re making any progress in our months of working together: what even are the signs of improvement and change to look for? Fair questions, I responded, and ones that I will continue to ruminate on here.
Progress in therapy looks different for everyone, with many variants that shape its impact on a person’s life. These include the reasons the person seeks out therapy in the first place, their goals and expectations, and how comfortable they feel with the therapist. Each therapeutic journey is nuanced and can be hard to quantify, but bearing the following in mind can increase the chances of success.
1. Making the most of the therapeutic alliance
Psychologist Donald Winnicott described the bond between mother and child as a “safe holding environment” that plays a crucial role in a child’s physical, social and emotional development. This bond is maintained by the mutual transmission of verbal and non-verbal cues between mother and child, which creates a sense of stability for the child to explore and grow as they gain independence over time. It is the home base a child returns to to recover from the world before re-engaging with it anew.
Hopefully our therapist isn’t our mother, but the relationship we share with our therapist (otherwise known as the “therapeutic alliance”) is also a safe holding environment.
Like an attentive mother, a therapist listens without judgment, helping us make sense of our experiences, whilst guiding us to new choices based on what we need and want.
Progress in therapy certainly hinges on what we learn about ourselves within sessions themselves, but also how we apply these learnings into daily life. It’s a dynamic cycle that requires regularly sharing, experimenting with change, and pausing to reflect with support until we feel confident enough to do it on our own.
2. Giving it time
Because of the role that time and trust play in forming a therapeutic alliance, one-off therapy sessions are rarely helpful for more than letting off steam. To get the most out of therapy and see more lasting change over time, investing in a journey of multiple, regular sessions offers better chances for trust to form and progress to be made.
3. Checking in with ourselves and our therapist
Asking ourselves how free we feel to share difficult feelings or stories with our therapist can be a good gauge of whether trust is building between us.
Is there anything we might be holding back? Anything making us uncomfortable? Being honest about these questions can help us understand what's working and not working, so that we can proceed with a sense of direction. It also contributes substantially to forming an alliance with our therapist.
4. Keeping a record
Because so much can change over a course of a therapy, keeping track of key moments can maximise its impact. I like to use the metaphor of repotting a plant: as we find new ways to nurse a plant back to health, it’s useful to take note of changes in light, temperature, and water to see how the plant is responding. We may not see a difference in a day or two, even a week. But a few weeks in, if the conditions are right, a new leaf or budding flower might appear.
Some people I work with find it helpful to take notes during or after sessions, so that key words, questions, or discoveries that resonate with them can be captured and further explored in their own time. Mood logs or journals can also assist with recalling significant events and details worth bringing up in sessions.
Having a record to look back on is particularly handy for a busy lifestyle or patchy memory. Think of it as data collection: it doesn’t have to be elaborate, but reflecting outside of therapy means tuning into the ups and downs of the process and clarifying what we still need support with. Record-keeping lends coherence to therapy, and highlights progress along the way.
Overall, if we’re seeing positive shifts in our mood, relationships, and capacity to both feel and regulate difficult emotions, then we’re likely making progress. This could look like fewer arguments with our partner after practicing new ways of communicating; better sleep at night after changing up our routine; less stress at work as we clarify our purpose.
While seemingly small, these changes are the new blooms that just may catch our eye, and hopefully when we’re very much expecting it.
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