Therapy has been a part of Katerina Kelly’s weekly routine since elementary school, when a teacher suggested counseling for the 8-year-old.
At the time, Katerina’s autism was affecting their ability to manage time, make decisions and socialize. And for many years, the therapist seemed helpful. But once college rolled around, things changed.
“I always left counseling feeling either worse than I started — or numb,” said Mx. Kelly, 29, who lives in Natick, Mass, and uses they/them pronouns.
The skills that Mx. Kelly’s therapist had taught them in childhood weren’t translating as well now that they were older. In other words, they had hit a rut — the therapy, and the therapist, were not producing the desired results.
A therapy rut can feel disheartening, but it doesn’t have to end your pursuit of better mental health. We asked psychologists how to identify whether you’ve reached a sticking point and what to do about it.
What exactly is a therapy rut?
If you’ve hit a rut, you may feel as if your therapy sessions have stalled or become unhelpful, said Jameca Woody Cooper, president of the Missouri Psychological Association.
You may be emotionally disconnected from your therapist or less trusting of their plan. Perhaps you’re uncomfortable and tense during therapy, or you’ve started to dread or miss appointments, Dr. Woody Cooper added.
A rut can translate into “increased irritability while you’re in session, or a feeling of being misunderstood,” she said.
There are many reasons a rut can happen, the experts said:
You’ve made as much progress as you can in therapy at this time.
You would benefit from a different therapist or approach.
You need a new therapy goal.
You don’t need sessions as frequently as you did in the past.
Your expectations aren’t aligned with those of your therapist.
You’re not ready to explore past trauma or a difficult issue.
Mx. Kelly had experienced some of these roadblocks in their relationship with their childhood therapist.
“When I did try to bring up new things I was told we could work on it in the ‘next session,’ but that never came to be,” they said. “I hit a point where I started feeling so low.”
So Mx. Kelly began searching for a new therapist — it took more than six months, but they found someone who took their insurance and was a better fit.
If you’re feeling stuck, your therapist will ideally sense it too, said Regine Galanti, a therapist in Long Island who specializes in treating anxiety with exposure therapy.
“When I’m having the same conversations for more than two weeks in a row — that makes my warning bells start to go off,” she said.
That’s when it’s time to re-evaluate a client’s therapy goals, she added.
What can you do about a rut?
Don’t jump the gun by quitting therapy after one or two unproductive sessions, experts said.
“It’s unfortunately not uncommon to occasionally have a therapy session that feels like a dud,” said Alayna Park, an assistant professor of psychology at the University of Oregon.
But if after three or four sessions you feel like you haven’t learned any new coping skills or gained a better understanding of your problem, then it’s time to speak up, either during the session or in an email.
Dr. Park suggested a few ways to kick off the discussion: “I feel like my progress has stalled,” or “I would like to transition to learning new or different coping skills,” or simply: “I feel like I’m in a therapy rut.”
It’s also valuable to ask your therapist how many sessions you might need, what your progress ought to look like and how your therapist is measuring it, said Bethany A. Teachman, a professor of psychology and the director of clinical training at the University of Virginia.
Although it can make some people feel uneasy to voice their concerns, the experts said, a good therapist will not get angry or annoyed.
“Good therapy empowers patients” to do hard things, Dr. Teachman said.
How do you know if it’s time to take a break?
If you’ve talked with your therapist about your concerns and nothing has changed, you may want to consider taking a break.
Stepping away can offer “a sense of agency, and time to evaluate if the current therapeutic relationship is the correct one,” Dr. Woody Cooper said.
During this break, you can take time to think about your feelings and behavior, explore different types of therapy or try out another therapist, she added.
Annie Herzig, an author and illustrator who lives in Fort Collins, Colo., decided to take a step back after a few months of seeing a new therapist, when she hadn’t noticed any improvement in her mood.
Ms. Herzig, 43, finally sent her therapist an email saying she wasn’t getting what she needed from their sessions.
Taking time away was helpful — Ms. Herzig found a different therapist who she has now been seeing for four years.
“I feel energized at the end,” Ms. Herzig said of their sessions together. “Even if I cry my eyes out.”
