What do you consider progress from therapy to be?

Well, for me personally, it was helpful and no, for me personally, I do not believe that I could have achieved any of the things I talked about without the support, empathy and understanding of psychology and development that my three very good therapists provided. Did I see other therapists for a "test drive" and feel that they would have been helpful? Yes, and I got out of the relationship immediately. Personally, I knew on a deep level that he/she would NOT be helpful to me.

I am a very private person and I don't talk about my personal issues with friends or family members on a deep level. I love them. I know they care about me and would attempt to help, but basically, I know that they have their own issues and troubles bearing down on them. I, personally, would much rather pay someone to assist me in getting a clearer picture of how I want to handle things. I don't want to talk in-depth about these issues more than once a week because living and wallowing in my difficulties more than that is tiresome and difficult. Better for me, personally, to pay someone and go in and talk about my issues and then leave them there when I leave until the next session. I do not think or feel that this is a solution for everyone, but it definitely works for me!

A simple answer of how I evaluate my progress in this most recent round of therapy (about 6 years) is a significant increase in well-being. I recently read an article by a research-oriented neuroscientist summarized the factors that resonate with me in terms of understanding well-being:

The Four Keys to Well-Being | Greater Good

1. Resilience. I am more resilient now, the negative life events over which I have no control or problematic interactions with the people in my life do not bother me as much as they did before therapy. I think this is because therapy gave me a safe space to discuss how much I was bothered by these things, the ability to realize where my own destructive actions were causing me pain, how to change the things I wanted to change and how to accept the people and situations I was facing if I couldn't or wouldn't change them. Therapy also helped me reach out to others, including my spouse, for support, because my T showed me that even when her reactions weren't perfect, they were still useful. I became more willing to accept what people offered rather than what I thought they should offer.

2. Outlook. As a naturally critical person, including of myself, therapy has helped me learn to appreciate the good and positive more in people, including my family and friends and experiences that are not always what I anticipate they might be-- from unrealistic expectations about vacations to realistic expectations that my wife can meet my needs if I communicate them in a way she can understand. In general, I see things and people as less positive or negative, most seem like a thoroughly mixed bag, and I enjoy myself and my life more than I have in the past. I am more willing to try new things and ways of doing old things rather than be so stuck on it must be my way or the highway. The people in my life appreciate my increased openness. I think a lot of this is because my T has very subtly encouraged me to accept the positive in myself as well as the negative (which I was much better at before therapy) and has taught me how to hang onto the positive more than the negative. She encourages me to accept responsibility for what is mine and to question whether others' perceptions of what is mine is really the case. Somewhat paradoxically, as I have learned to accept the positive in myself, it is easier to acknowledge the negative to others and take responsibility for pain I have caused, while also being willing to let go of the negative feelings about making mistakes or being less perfect than I'd like to be. Self flagellation greatly reduced.

3. Attention. I have suffered from severe to mild PTSD for much of my life, coming to this latest round of therapy with a lot of symptoms, including flashbacks and nightmares and triggers for anxiety and panic. My symptoms have all but disappeared, and I can be present for sustained periods of time in my life in ways I couldn't before. Although I came to therapy practicing meditation, I also started Tai Chi about 4 years ago. Therapy with a T who knows mindfulness has enhanced my meditation practice, and Tai Chi has reinforced and developed my mindfulness as well. Although I've always had good focus in work, I now experience much less anxiety and far greater flow, especially in the public nature of some of my work. In my life, I feel more grounded in relationships and conversations and my kids especially say I pay better attention to them when they talk than I used to. The reduction of PTSD symptoms comes from speaking about the past in therapy with a T who created a calm and centering and mindful place for me. When I first started, I couldn't talk about my past without dissociation and generally freaking out with panic. She encouraged me to go slow and helped me develop better grounding skills that we practiced in the last minutes of session. Now I can actually say what happened to me in words that resemble normal English, with emotional resonance and staying present.

4. Generosity. For me this is not about "charity" or doing volunteer work, both of which I have always done, but developing a state of mind where I don't always see threat and danger and hostility from other people. I give other people the benefit of the doubt, not for their sake or because I "know" what is true, but because therapy has helped me realize that behavior I interpret as negative towards me just often really isn't. My T has helped this directly by being willing to discuss my negative experiences with her and share her perspective with me about an interaction, even if it's just a "look on her face." I have realized that I don't always "read" people right, even if it's an email, and that knowing what's inside another person's mind and heart is pretty much impossible to know unless they share it with me.

If people question whether I know how I've made progress and how I can interpret it as a result of therapy in ways that aren't explained above, I would answer that I know what is true for myself. Just as those who have been harmed by therapy know that this is true for me.

I got me a long list of both, which amazes me. Perhaps even more amazing to me is how much more that already long list needs to grow!

My t made suggestions about specific things that I haven't considered.

Both I and t come from the same culture and have similar experiences growing up as well
as experiences with immigration. At this point in my life I don't associate much with other immigrants with similar experiences as mine. I mostly associate with local people. Some immigrants that I do encounter are the types that don't assimilate, remain
within their own culture and overall have very negative outlooks ( which isn't my experience). I went through immigration without ever stopping to think or acknowledging effect on ones health etc i was just too busy. I don't have anyone in real life to discuss it with as others might not fully relate or aren't neutral third party.

We all do have different experiences. I do imagine that t might not be all that helpful ( I saw someone about 10 years ago and although she was fun talking to it wasn't helpful n a long run, she just couldn't relate ).

But I don't know how can t could be damaging. I do understand on intellectual level from reading on here and I do sympathize. I just cannot relate and it does seem bizarre paying someone who isn't good for more than few appointments. I had appointment with bad hair dressers, once with bad dentist etc but i never ever went back.

I do understand why people might not leave etc I am just bringing this example to show that we have different experiences. You can't relate to paying t for one hour of talking same way others might not relate paying t ( beyond few sessions)who is damaging in any shape or form.

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It has been concrete for me. I have learned how to internalize people. I have learned how to set boundaries in relationships. I have learned how to talk more and identify my needs. I have learned strength. I have made a lot of positive changes in my life. My therapist has taught me so much and so has our therapeutic relationship.

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.