What do you consider progress from therapy to be?

Many therapists tell clients it will feel or get worse before it gets better so some cling to that hope with the false belief that the therapist has some kind of clue what they are doing. I think that is one explanation why people stay. You kind of think the therapist is a professional who has some understanding of what they are doing.

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For me progress is very concrete - an improvement in my overall quality of life, relationships, communication, etc.

I don't think that therapy in itself is the source of improvement, I think improvement comes from using therapy and therapists in a way that helpful. Sometimes I use therapy with my pdoc to say things u can't in other people. Sometimes I ask for advice as well, sometimes not. Either way that's only every six or eight weeks so that's no big deal. If I were going to therapy every week or even bi weekly, however, I'd be addressing an issue I wanted to change. Otherwise I wouldn't see the point of going.

I have been with this therapist for about 7 months, and i've seen some concrete progress. I was sliding way downhill in depression, and she helped me see that (because i am stubborn and don't like to believe i am depressed, even now), and suggested medication for me. I've been on meds before to little avail, and I am still pretty ambivalent about it, but she swears that a few weeks after i started meds, I improved.

She also encouraged me to start a hobby that i had been wanting to do for years, and the funny thing was she brought this hobby up on her own as something she thought i might like, and i was all like HOW DID YOU KNOW!? haha. It took a couple of months, but i did begin it, and so far, so good. That has helped in that i am less isolated, meeting new people and getting exercise. All good for depression.

Other than that, nothing much. Part of it is I don't have any concrete goals I want to meet. I am not sure what I want in my life, and waver back and forth with "I am fine, everything is ok, why am i even here?!!?" to "This is hard, i need help," but i easily forget the latter.

My therapy never fell worse or made me feel worse about anything. My t never told me if it will feel one way or the other. I think it depends what issue one is working on

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For me personally, I am pretty isolated. I live alone, and have 1 friend in my town, and although we are great friends, she doesn't know the self-harm or how dark my thinking can be. My therapist is there to talk about the stuff I can't talk about with anyone else, but more importantly, she is there outside of that hour if I am feeling bad. She is encouraging of me doing things that are good for me (like in my post, the hobby she continually advocates me to keep doing, as i have almost quit a few times out of fear). She is a tiny internal voice in my head that can help me choose to do something positive for myself.

She is an outside person who can say "I have seen depression for years and years, and I can say you have it," over and over when I tell her it is just *me*, and not a mental illness.

I have not had any progress that I could point to either. Has been either benign or harmful. When I have had individual sessions where I felt somewhat better afterward (for a short while) I think what was achieved was just basic human connection.

For me maybe the ultimate sign of concrete and lasting progress would be -- being done with therapy. And that includes talking about it, posting about it, thinking about it.

I have the same sort of bemused reaction that you do. I never quite comprehend what is the catalyst for all these transformations, and why a therapist was necessary. Is therapy so ingrained in the culture that people see it as a prerequisite to overcoming life's challenges? I pretty much assumed that until recently.

Maybe for some people, in some subsets of culture. Where I come from, a therapist is someone you have to lie to about your drinking problem so the judge will let you see your kids.

I'll sing therapy's praises all day long, but I can only loosely speculate as to why a therapist might be necessary or how the process acts as a catalyst for life changes. All I know is I tried to make all the same changes without a therapist many times without much success. Again, gift horses and mouths.

Definitely not for me. I struggled for years before I went to therapy. Even now, I am still a little circumspect about the whole thing, but that doesn't mean that I think it is a completely flawed institution. All "institutions" are flawed, because well, nothing is perfect. That doesn't take away from the fact that my T has helped me, as I have posted above, and I'd say those are concrete things.

Also, what you said about feeling better just because of the human connection, to me that IS therapy in some respects. I don't get a lot of real human connection, so it does feel good to connect a little deeper, and if it takes therapy for me to get that right now in my life, so be it.

I know I tried for years on my own to "overcome life's challenges." I didn't seek out therapy on my own actually. It was recommended to me by someone who could see how much pain and depression I was in. I had no assumption that therapy was the way to "overcome life's challenges."

I needed help, and someone or something outside myself was absolutely necessary at the time or I probably would have ended up dead. There seems to be an assumption that we can just figure this out on our own without a therapist, that a person's problems must not be serious enough to warrant the help of a therapist, that we should just pick up a book and figure it out on our own or something? I'm not sure what exactly is being suggested.

The changes and progress I found were most definitely with the help of my therapists. I would say they provided different things at different points along the way. I had three therapists I worked with long-term -- one in college for a couple of years; one around age 30 for about the same length of time; the most recent in my 40's which was my longest at around 8 very full-time therapy years.

The "catalyst" for transformation with my first therapist was that he helped me understand what I was going through; he educated me in a way that was validating for me. I was quite young and very much alone in what I was going through. I really didn't understand what was happening to me. That therapist, besides just helping me to survive, helped me understand those things. He also assisted me in finding safety from an individual who was still abusive to me at the time.

The "catalyst" for transformation with my second therapist was including me in a therapy group for survivors of childhood sexual abuse which, for the first time, helped me find empathy for myself, to see myself as someone worthy of the same compassion and validation as any other survivor.

The "catalyst" for transformation with my most recent therapist was very specifically the teaching of skills that allowed me to reduce my anxiety, almost completely reduce all signs of PTSD, and bring my level of depression to a place where I can now manage it on my own.

How I could have done all of that myself while seriously depressed, experiencing constant PTSD symptoms, dangerously suicidal, occasionally manic and even psychotic, I have no idea. I needed the assistance of someone to help me find my way. I was not going to survive much longer on my own. I don't know who else, besides a therapist with training in dealing with such severe symptoms and abuse, would have been at all equipped to give me the level of information and support I needed.

Interesting point. I think that makes a lot of sense.

I consider it progress that I no longer



And yes, by the time I landed in therapy, I'd tried just about everything else -- meditation, exercise, talking to friends, journaling etc.

I don't like the idea of giving therapy credit for my progress. The way I view it I am working on myself, and therapy is something I do because I want to, I enjoy it, I think it might be useful. It's not to say I don't think my therapist is helpful, but I don't think I ever look at progress in my life and say that was therapy and not just me. In the end it's me making the progress, perhaps partially assisted by therapy.

I eat. Thats huge progress.
I rarely self injury anymore. Huge progress, as i started it as a young child.
I have good boundaries.
I take care of myself.
I have friends.
I laugh again sometimes.

That's interesting and I suspect there are others who feel similarly. Maybe I missed it, but I don't think anyone has suggested they just passively sat there while the therapist/therapy did all the work. I would guess most, including me, would agree with you--that we had to make the progress ourselves. What I do hear people saying is that they were unable to successful initiate that progress on their own, and therapy was the support or guidance or lifeline (could probably fill in the blank in endless ways depending on the individual) that they needed to make that progress. Is that going to apply to everyone? No, therapy is a very individual experience. That's for sure.

I was indoctrinated from childhood to think psychiatry was quackery. It wasn't simply a tactic of the family secret keeping and isolation, though it served that goal. Before marriage, my mother worked for a VA psychiatrist who displayed "eccentricities" in the office, and I grew up on her stories. So much for the idea that therapy would ever be a good idea. It kept me away from any thought of telling anyone anything until my 30's--and then I was driven by pain with no other ideas of what I could do.

And I do credit therapy as embodied in my T for my healthy life. I can't say therapy in general because I didn't experience therapy except as practiced by my T, and I was in relationship with my T, not therapy. My therapy wasn't about learning techniques to survive; it was about experiencing a bond that had been denied me in my life. And that bond was infused with the wisdom, expertise, compassion and caring of my T. It wasn't a quick fix, nor an easy process--much like life.

I can now experience sadness, despair and even depression as transient emotions. I am much less afraid of unpleasant feelings because I can grasp that they are not forever. Consequently, I have more energy for my life because I'm not always paddling furiously to stay ahead of depression. I also can more often maintain an awareness of my feelings so that I don't need to act on every thing I feel.

Sometimes I'm having a problem, a difficult memory or an unpleasant thought and I can say to myself "oh, hey, that seems like something to address in therapy." Knowing it will get dealt with in due course, I can often put it down for awhile and go about my business less distracted.

I have a more realistic sense of what is my responsibility and what lies within my control in relationships. When things don't go well, I am not (usually) 100% to blame and I cannot repair a relationship without the effort, consent and goodwill of the other person. I cannot do their work for them.

There is still a long way to go developing all these skills but I'm much better at all of them than I used to be.

I am less self-critical and self-attacking. I still have all the emotional conflicts but i can see why and be more understanding towards myself. I know that when I feel overwhelmed and I think there's no way out, it will pass and the situation will change or move on one way or another. I might feel powerless sometimes but I know I am not.

If it's as simple as that, then seems a lot of space is taken up unnecessarily with theoretical models and techniques and such. If people go to therapy as a sort of last resort, to get out of isolation or crisis, acute care basically, that I can understand. It's partly why I went and why I sometimes consider it again.

However that strikes me as an awfully risky proposition. To me it implies that the client is in a desperate and vulnerable state, and thus susceptible to all manner of abuse and exploitation. Would seem to be the starting point for many of the cases of harmful and abusive therapy.

This sounds a LOT like what can happen with mindfulness- or insight-based meditation. It was working for me several years ago, was turning a corner, until physical illness and a difficult living situation and some huge stressors made it unworkable (for now).

Part of what is so tragic to me about the therapy/coaching/advice culture is that I think people are sold short by the idea that healing requires external intervention, some sort of paid "expert". Everything is a "disorder" that requires "treatment".

Very concrete.

I am med free. I got out of a job that was sucking my very soul and into one that I love. I published my first book of poems, a life-long dream. For the first time in my adult life, I have a group of friends based on our shared spiritual interests, where before my only friends were met through work. Also for the first time in my life, I can say that I am beginning to love myself. I'm still a work in progress there, but getting better at it all the time. When I look back at the closed up little person I was when I first walked into t's office over 4 years ago.... I can't believe how far I've come. Today my t told me, while we were talking about my lazy eye (I hate that description, but I guess it best describes how my bad eye is, and I was saying I hate my eye that it makes me uncomfortable) "your eyes are so beautiful, they aren't guarded like they used to be." I think that is one of the best compliments she's ever given me. So much else I could say here but don't want to hog the thread.

I don't feel sold short. It's like have a private tutor in the art of mindfulness. I have learned a lot from books and other sources too, but this skill takes time and practice. It's nice to learn a skill by seeing someone else demonstrate it. Compassion is best taught by example.

I feel like my T brings a skill set, a gentle presence and and some perspective to the table. I don't feel that she's treating me for a disorder. I'm not offended by the notion of having a disorder, but that isn't the framework that she and I use.

I had a college professor who used to rail against this very issue. He used to frame every human difficulty imaginable in existential terms, then talk about how tragic it was that "authenticity" got pathologized as illness in our culture.

I spent three years convinced I could solve my problems if only I read enough Kierkegaard. I got worse.

People have the right to couch their issues in whatever terms they'd like. Not everybody finds the idea that they have a "disorder" requiring "treatment" offensive. For some, it's an incredible relief to finally be able to think about their problems as caused by a medical condition rather than an existential inevitability or moral failing.

Undeniable concrete benefits for me.

My PTSD has gone.
I am in control of my life (as opposed to being controlled by my dissociative responses to triggers).
I am grounded, stable, calm, effective. I can make choices, and fully experience their benefits and consequences.
I have personal power. I can and do stand up for myself in all situations that require it, instead of actively punishing myself for daring to exist. I am my biggest ally.
I own myself. Instead of belonging to others.

I can't list all the ways my life has changed because of my experiences and work in therapy. My life now is one worth living.

I find it interesting about the divide in wanting a disorder and treatment versus not.

I fall on the don't pathologize usual responses (grief or sadness after a loved one dies for example. I might go see a therapist to talk about it, but I would not consider it a disease that needed treating.) I don't go to see a therapist because I have a disorder that needs treating - I do not nor would such a label be useful to me. Having the woman try and label it as such would not be reassuring to me but galling in the extreme. I don't use insurance because I don't see it as a health issue for me (among other reasons like I don't want insurance companies involved in my life at all).

I am not going to tell someone else they don't have some disorder if they find some use for it - but I don't think it is something that needs to happen as often as those guys like to do it. I do think therapists and our society tend to make things into illness that are not or don't have to be considered such.