When Therapy Doesn’t Work (Yet): Understanding Setbacks, Stuck Points, and the Hope Ahead
Psychotherapy can be an extraordinary space for healing, growth, and insight. For many, it offers relief, clarity, and renewed strength. But what happens when therapy doesn’t seem to work? What if you feel stuck, disappointed, or even more confused than when you began?
This experience can feel disheartening and isolating—but it’s far more common than we often talk about. Importantly, a lack of immediate success in therapy doesn’t mean therapy is inherently flawed, or that you are. It may mean the timing isn’t quite right, the approach needs adjusting, or something vital has yet to fall into place. Therapy is not a one-size-fits-all process. And just because it hasn’t worked yet, doesn’t mean it won’t work—or that it can’t work beautifully, when the conditions are right.
Let’s explore why psychotherapy might not always “work” the first time, and why that doesn’t signal failure—just a different kind of beginning.
1. Therapy is a Relationship—And Relationships Take Time
At its core, psychotherapy is not just a service; it’s a relationship between two people. And like any meaningful relationship, it requires trust, mutual understanding, and time to deepen. It’s not unusual for people to feel uncertain or emotionally guarded early in therapy, especially if past relationships have involved hurt or betrayal.
Research consistently shows that the therapeutic relationship is one of the strongest predictors of success in therapy (Norcross & Lambert, 2019). But building that rapport can take time—and sometimes, a particular therapist-client match just isn’t the right fit. If you didn’t feel fully seen, heard, or understood, it may not be that therapy “didn’t work,” but that the alliance wasn’t strong enough to support the work you needed to do.
Finding the right therapist is a little like dating—it can take a few tries. And that’s okay.
2. Readiness Matters—But Readiness Isn’t Just Willpower
Therapy often requires emotional vulnerability, reflection, and the courage to face things we might have avoided for a long time. But timing is key. If someone begins therapy during a time of crisis, or when they’re under intense stress (such as caregiving, financial strain, or trauma activation), they may not have the emotional bandwidth to engage deeply. That doesn’t mean they’re resistant or unmotivated—it just means survival is taking precedence over introspection.
Moreover, people may enter therapy with unconscious fears about change, loss, or even what healing might mean. Psychodynamic literature refers to this as “resistance”—but rather than being a sign of failure, resistance is often a meaningful communication from the psyche (Freud, 1926; Schafer, 1976). It suggests that part of us is scared, unsure, or needs time. Readiness, in this light, is something that grows.
3. Therapy Isn’t Linear—And Sometimes Things Get Worse Before They Get Better
One of the lesser-discussed truths of psychotherapy is that progress often looks messy. Some people feel a sense of relief early on, but for others, therapy initially stirs up discomfort, confusion, or even distress. This isn’t a sign that therapy is failing—it may be that long-buried feelings are beginning to surface.
In trauma therapy, this is known as the “window of tolerance” (Siegel, 1999; Ogden et al., 2006). If difficult material emerges too quickly or without sufficient regulation tools in place, clients can feel overwhelmed or shut down. A skilled therapist will monitor this carefully and help clients build emotional resilience before delving into deeper work—but sometimes this delicate balance is missed.
It’s also worth noting that certain diagnoses—such as complex PTSD, personality disorders, or attachment-related injuries—can require long-term, consistent therapy. In these cases, it may feel like therapy “isn’t working” simply because healing is taking longer than expected. But slow progress is still progress.
4. Therapy Models and Methods Vary—And Not Every One Suits Every Person
There are many therapeutic modalities—CBT, psychodynamic therapy, EMDR, ACT, somatic therapies, and more—and each has its own philosophy, tools, and way of working. Some people thrive in highly structured, goal-oriented therapy like CBT. Others need a more open-ended, relational space to explore their history and emotions.
If therapy hasn’t worked for you, it may be that the modality wasn’t a good match for your needs or preferences. For example, some clients feel frustrated with CBT if their deeper emotional wounds aren’t being addressed. Conversely, others may find psychodynamic therapy too abstract or slow-paced.
It’s okay to explore different approaches—and sometimes it takes experimentation to discover what really resonates.
5. Therapists Are Human—And Sometimes the Fit Just Isn’t Right
While most therapists aim to work ethically and compassionately, they are not immune to limitations. Some may lack experience with specific issues (such as gender identity, neurodiversity, or complex trauma), or may inadvertently replicate patterns that feel invalidating.
A therapist might, for instance, seem overly clinical when what you need is warmth—or too passive when you crave guidance. Others may unintentionally bring bias or assumptions into the room. If you’ve had a bad experience in therapy, you are not alone—and it does not mean that therapy as a whole is flawed.
It’s important to remember that the therapeutic process should always feel collaborative, respectful, and safe. If it doesn’t, it’s absolutely valid to seek another professional.
6. Our Inner Narratives Can Sabotage the Process (But That Too Can Be Explored)
Sometimes, we come into therapy with an unconscious expectation that it won’t help—or that we can’t be helped. This belief may stem from a deep sense of shame, helplessness, or a history of unmet emotional needs. These internal narratives can subtly shape the therapeutic process: maybe you hold back from sharing, avoid vulnerability, or dismiss small signs of progress.
This is not your fault. These beliefs are often survival strategies formed early in life. The beauty of therapy is that it can help unpack these very narratives. But initially, they can feel like roadblocks—and if therapy doesn’t feel productive, it’s easy to interpret that as evidence of our worst fears: “I’m too broken,” “No one can help me,” or “Nothing works.”
Therapy that allows space to explore these narratives gently and with compassion can be incredibly transformative (Gilbert, 2009).
7. External Pressures Can Undermine the Process
Sometimes therapy “doesn’t work” because it’s entered under pressure—from a partner, a court order, a family member, or even as a requirement for work or school. While these may be well-intentioned, change that’s imposed from the outside often lacks the personal agency needed to drive lasting transformation.
Similarly, logistical factors like cost, session frequency, transportation, or inconsistent attendance can interrupt the therapeutic process and create a sense of stagnation. These structural issues are real and deserve compassion—not judgment.
8. Cultural Mismatch or Marginalisation in the Therapy Space
For many individuals—particularly people from marginalised backgrounds—therapy can feel alienating or unsafe if cultural context, systemic injustice, or identity are not acknowledged. A therapist who overlooks the impact of racism, queerphobia, ableism, or religious trauma may inadvertently reinforce the very wounds a client is seeking to heal.
If your therapy experience didn’t include space for your full identity, it may not be because you weren’t “ready” for therapy—but because the therapy wasn’t ready for you.
Thankfully, there is growing awareness of this issue, and more therapists are integrating culturally responsive, intersectional frameworks into their work (Sue & Sue, 2016; Singh & Chun, 2010).
A lack of immediate success in therapy doesn’t mean therapy is inherently flawed, or that you are
So… What Now?
If you’ve had a difficult or disappointing experience in therapy, it’s valid to feel disheartened. But it doesn’t mean the door to healing is closed.
Here are a few ways to reflect on and move forward:
Ask yourself what didn’t work—and what you might need instead. Was it the therapist’s style? The pace? The goals of therapy? Or something internal?
Explore different modalities. Somatic therapy, art therapy, EMDR, group work, or integrative psychotherapy might resonate more deeply than your first approach.
Interview potential therapists. It’s okay to ask direct questions about their training, values, and approach. You deserve to feel comfortable.
Give yourself credit for trying. Even if it didn’t go as planned, the fact that you showed up for therapy matters. It’s a sign of courage—not failure.
Stay open. Healing is rarely linear. Sometimes we’re planting seeds that bloom later in ways we couldn’t predict.
Conclusion: Therapy Isn’t a Magic Wand—It’s a journey
Psychotherapy isn’t always easy, and it isn’t always instant. Sometimes it’s messy, frustrating, or uncertain. But even when it doesn’t seem to “work,” something meaningful may still be unfolding beneath the surface.
Healing is not about perfection—it’s about movement. And movement is always possible.
If you’ve been burned by therapy, know this: you are not alone, you are not broken, and it is not too late. There is still hope, still help, and still healing to be found. Therapy may not have worked for you yet—but that doesn’t mean it never will.
References
Freud, S. (1926). Inhibitions, Symptoms and Anxiety. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XX.
Gilbert, P. (2009). The Compassionate Mind. New Harbinger.
Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work III. Psychotherapy, 56(4), 423–426.
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. Norton.
Schafer, R. (1976). A New Language for Psychoanalysis. Yale University Press.
Siegel, D. J. (1999). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press.
Singh, A. A., & Chun, K. (2010). “From the Margins to the Center: Moving Beyond Multicultural Competence.” Journal for Social Action in Counseling and Psychology, 2(2), 1–21.
Sue, D. W., & Sue, D. (2016). Counseling the Culturally Diverse: Theory and Practice (7th ed.). Wiley.
