Dear Therapist: Why Do I Still Feel Like This?

Dear Readers:
It takes a lot of courage and commitment to enter therapy. For many, the decision to seek help can take months, or even years. Admitting that you’re struggling and need professional help can feel daunting. It’s not always easy to acknowledge our vulnerabilities, but it’s an essential first step toward healing.
 
While this isn’t the case for everyone, many clients enter therapy during a time of significant distress. There’s often a major disruption in their quality of life, which leads to high motivation for treatment. But as we go through the therapy process, some may wonder, “Why do I still feel like this?” or “When will I feel better?”
 
It’s essential to recognize that therapy is not a quick fix; it’s a process that may take time, and not every approach resonates with every person. But it’s also important to acknowledge that even if therapy doesn’t bring immediate relief, it can still offer valuable insights and tools to help you in your journey.
 
In this article, we will explore therapy as a process, the role of emotions in progress, and how to navigate your personal journey with awareness and intention.
What's in this article:
Dear Therapist
Dear Therapist

First Step to Feeling Better: Getting Started

When I ask clients what they hope to gain from therapy, the specifics vary, but there a common underlying theme: they want to feel better and to be happy. It’s a simple goal, but one that requires deep work.

I try to be upfront with clients from the start. While you may come to therapy with specific issues and symptoms, it’s important for us to understand your story, your history, and the context of your life. Therapy isn’t just about addressing symptoms; it’s about understanding where they come from and addressing the root causes, so you don’t let the past control your present and can live the life you choose.

I understand that starting therapy takes courage, and building trust can take time. I’ll ask you questions you may have never considered, and some topics may bring up difficult feelings. I encourage you to push through the discomfort, but we can work together to adjust the pace and structure. Therapy is a collaborative process and a space where you can be open and voice your opinions. Your defenses and feelings of resistance often point to areas of your life that require more attention. Working through these emotional barriers is a key part of progress.

Why Do I Still Feel Like This?

It’s common for clients to feel frustrated after several months of therapy, especially if they feel they haven’t made the progress they expected and hoped for before starting. They often ask, “Why do I still feel like this?” and may jump to the conclusion that “therapy isn’t working for me.”

But what does progress actually mean to you?

For some clients, they walk into my office with the education, the job, the family, and the money they’ve always wanted, yet still feel stuck. They’ve spent their lives chasing external markers of success—professional achievements, relationships, wealth—believing that once they check those boxes, life will magically feel better. They focus on the outside, thinking that if they can just get things right in those areas, everything will fall into place. However, it’s not uncommon for high-achieving individuals to feel even more disconnected and anxious when their emotional needs aren’t addressed (Schwartz et al., 2010).

If you’ve been struggling with depression, anxiety, or other emotional issues, it’s natural to want to reduce the symptoms. And if you’re not able to list instant improvements, it’s easy to think therapy isn’t working. While having treatment direction and definition of progress are important, consider whether there’s similarity between how you’ve measured success by external achievements and societal expectations, and how you now view progress in therapy as a list of tangible things to check off before you can say, “I’m cured.”

But if that external approach is what got you here, it’s the one you need to let go of. A study by Diener et al. (2003) found that life satisfaction is more strongly linked to internal factors—such as relationships, emotional expression, and self-acceptance—than to external accomplishments.

Understandably, internal experiences are harder to quantify. But often, the hardest work is emotional work—the internal stuff that’s been buried for years. One sign of progress is being able to express emotions you’ve been holding back. For example, I’ve seen clients who couldn’t cry when they first started therapy, but as they process their feelings, they begin to shed tears. That’s huge! It means you’re connecting with your emotions and allowing yourself to feel them, rather than shutting them down

Other clients are able to cry, but judge themselves as “too emotional” or “weak” for doing so. This internal criticism often leads to shame and a negative self perception. In this case, accepting that all emotions are valid is part of building self compassion and self acceptance. 

Emotional Release: Why It Feels Worse Before It Gets Better

I want to acknowledge that, yes, sometimes therapy makes you feel worse before it gets better. In the past, you might have numbed your emotions to protect yourself, but now, as you begin to feel them, it’s painful. You might think, “I was fine before I started feeling this way!” But allowing yourself to express these emotions is crucial for your healing. The simple act of expressing emotions, such as crying or confronting anger, is an important step towards healing (Greenberg, 2002). 
 
When we bring up painful memories or emotions—like unresolved anger or grief—it can feel incredibly uncomfortable. But the alternative is to keep those feelings buried, where they’ll continue to fester and affect your life in ways you don’t even realize. Part of therapy is learning to sit with discomfort and process emotions. According to a study by Horvath et al. (2011), emotional discomfort during therapy is not only common but necessary for clients to work through and process the underlying issues that are affecting their well-being.
 
It might feel overwhelming at times, but this is the work that will help you heal in the long run.

The Risk and Reward of Therapy

It’s important to recognize that therapy involves both risk and reward. There’s no guarantee that therapy will work for everyone, and some people might not see immediate results. Research shows that while psychotherapy can be highly effective for many (Cuijpers et al., 2016), it’s also true that not everyone experiences the same level of success.
 
At the start of therapy, I tell clients, “Your inner critic sounds like you, but it’s really the cacophony of voices from your family, friends, and society.” You’re in therapy because the beliefs, strategies and behaviors you’ve tried in the past haven’t worked. In therapy, we’re doing things differently. We’re processing the emotional baggage you’ve been carrying for years, and while that may make you feel like you’re taking a step backward, it’s actually a necessary part of the process.
 
Even if you’ve been in therapy for a while and haven’t yet experienced the breakthrough you’re hoping for, don’t lose hope. Together, we can untangle the web of external expectations and peel back the layers to help you rediscover your own voice. Because at the end of the day, the most important relationship you have is with yourself, and that’s where the real work begins.

It’s About the Process, Not the End

I know it’s frustrating when you don’t feel better right away. You might wonder, “When will this end? When will I stop feeling so stuck?”
 
I want to remind you that therapy is a journey, not a destination. A study by Laska et al. (2014) found that the effectiveness of therapy can vary widely depending on the individual’s history, therapeutic relationship, and their personal willingness to engage in the process.
 
The truth is, I can’t predict what your path will look like. I can guide you, support you, and help you make sense of where you’ve been and where you’re headed, but you have to do the work. Healing takes time, and there are no shortcuts. It’s about feeling your way through the process, not rushing toward an idealized outcome. Each step you take, each emotional hurdle you overcome, is a victory.
 
The most significant progress often occurs when you allow yourself to fully experience and understand your emotions, rather than rushing to “fix” them.

No Set Timeline

Sometimes, we want to get over things quickly. We wish there was a concrete timeline that would tell us, “You’ll feel better by this date.” But that’s not how healing works. It’s important to acknowledge that there’s no set timeline for healing. There’s no magic formula. The process takes time, and you can’t rush it.
 
Setting a timeline exerts pressure onto the process. While this can have both positive and negative impacts (De Geest et al., 2019), much evidence suggests that a long-term course of therapy may be especially helpful not only for symptom reduction but also improving comprehensive psychosocial functioning (e.g. Leichsenring and Leibing 2003).
 
The beliefs you carry about yourself—those feelings of unworthiness or self-doubt—weren’t created in a day, and they won’t disappear in a day either. These beliefs have been with you for a long time, shaped by your environment, your upbringing, and your experiences. It takes time to undo them, but it’s possible.
 
I believe clients deserve more than short-term gratification, temporary gains, and band-aid solutions. I hope the process leads you to an improved quality of life, and that takes time (Levy, 2008).  Lasting and transformational change comes from commitment, practice, and action.  A joyful, authentic, and fulfilling life does not mean a life without struggle or pain. It’s a one where you trust yourself to respond with intention and integrity, decide with clarity and confidence, and walk this road with faith and resilience. 

Self Expression Is Key

One of the fundamental principles of therapy is the power of expression. As human beings, we often repress our emotions as a way of coping with pain, trauma, or discomfort. Studies indicate that people who are able to express their emotions—through verbal communication, art, music, or movement—are better equipped to process their feelings and experience emotional relief (Pennebaker, 1997).
 
Therapy one of the best ways to learn to express yourself. It’s a safe space where you can talk openly and be heard without judgment. A good therapist does not (nor should they promise to) have all the answers, but they’ll help you see things in a new light, make connections, and give you the tools to navigate your emotions. When we give ourselves the freedom to express, we let go of control and allow our feelings to be what they are—without trying to change them.
 
In what ways do you find time to express yourself?
How does it help you let go?
How can you incorporate more expression into your life?

Therapy: Metaphor for Life

Here’s something I’ve realized through my personal therapeutic journey, which has only been solidified by my years of clinical experience:

Therapy is not just about reflection and insight—it’s about practicing and rehearsing new ways of thinking, feeling, acting, and relating. Research supports this view, showing that therapy functions as an experiential learning process where clients can practice new skills in a safe space and then apply them to real-life situations (Lambert, 2013).

Change is neither easy nor predictable. Barriers, resistance, and setbacks are inevitable. Therapy provides an opportunity to develop new skills, challenge limiting patterns, and prepare for real-life challenges. Just like athletes practice to ensure peak performance in competitions, my clients use weekly sessions to anticipate challenges and prepare solutions.

At the core of my therapeutic approach is contemporary psychodynamic theory, which fosters relational learning within the therapeutic alliance—not just intellectual insight (McCarthy et al., 2025). Studies examining therapist-client interactions show that therapist behaviors like empathy and exploration encourage client disclosure and emotional processing, which support psychological change (Chen et al., 2026). 

Since challenges are an inevitable part of life, and all emotions (yes, even the uncomfortable ones) are core to being human, you can expect that your therapeutic journey will have its valleys and peaks. Moments of discomfort may lead to frustration and doubt, but these moments signal growth.

As life’s ups and downs unfold, therapy is a place to refine and solidify the skills you’ve learned, turning insights into real-life applications. This consistent practice builds self-confidence and trust so it works when it counts.

Don’t let this opportunity pass you by.

This Is Your Journey

Here’s something else I’ve realized through my personal therapeutic journey combined with years of clinical experience:

I get it. It’s easy to say, “Follow your passion, and you’ll get there.” But the truth is, your path is unique to you. Even if I give you advice, it’s not about what I say—it’s about what you want and how deep you’re willing to go.

There’s no judgment, nor is there a right or wrong way. Changing your thoughts or behaviors can help, but true emotional confidence comes from within. My wish is that you shape your dreams into reality.

You can hear all the praise in the world, but if you can’t internalize it, there’s no real progress. Without truly believing in and appreciating yourself, external validation will always be fleeting. Therapy, therefore, is about more than just achieving goals—it’s about creating a deeper, more authentic connection with yourself and learning to manage the emotional challenges that arise, regardless of your external circumstances.

But here’s the good news:

You can get there.

It may take time, and will require feeling your emotions, personal expression, and patience. Remember, you are not alone in this journey, and you don’t have to go through it in silence. As your therapist, I’m here to walk with you every step of the way.

Remember: The only way out is through. If you’re open, curious, and willing, I’m here to support you every step of the way.

References

Chen, A., Jin, S., Wang, C., Swartz, H., Wu, T., Kraut, R. E., & Zhu, H. (2026). Empirical modeling of therapist–client dynamics in psychotherapy using LLM-based assessments (arXiv:2602.12450). arXiv. https://arxiv.org/abs/2602.12450
 
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G. (2016). Psychotherapy for depression in adults: A meta-analysis of comparative effectiveness studies. Journal of Affective Disorders, 202(6), 511-522.
 
De Geest, R. M., & Meganck, R. (2019). How Do Time Limits Affect Our Psychotherapies? A Literature Review. Psychologica Belgica, 59(1), 206–226. https://doi.org/10.5334/pb.475
 
Diener, E., Lucas, R. E., & Oishi, S. (2003). Subjective well-being: The science of happiness and life satisfaction. In C. R. Snyder & S. L. Lopez (Eds.), Handbook of positive psychology (pp. 63-73). Oxford University Press.
 
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy: Theory, Research, Practice, Training, 48(1), 9-16.
 
Greenberg, L. S. (2002). Emotion-focused therapy: Coaching clients to work through their feelings. Psychotherapy Networker, 26(6), 32-37.
 
Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. Journal of Clinical Psychology, 69(3), 127-155. https://doi.org/10.1002/jclp.21976
 
Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of the “common factors” model: A meta-analysis of the contributions of the therapist-client relationship to therapy outcomes. Journal of Counseling Psychology, 61(2), 221–232

Levy, Kenneth. (2008). Psychotherapies and Lasting Change. The American journal of psychiatry. 165. 556-9. 10.1176/appi.ajp.2008.08020299.

Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. The American journal of psychiatry, 160(7), 1223–1232. https://doi.org/10.1176/appi.ajp.160.7.1223

McCarthy, K., Capone, C., & Leibovich, L. (2025). The evidence for psychodynamic psychotherapy: A contemporary introduction. Routledge. https://doi.org/10.4324/9781003323167

Schwartz, B., Ward, A., Montgomery, K., & Lyubomirsky, S. (2010). The paradox of choice: Why more is less. HarperCollins Publishers.
 
Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162-166.
 

Werbart, A., & Lagerlöf, S. (2022). How much time does psychoanalysis take? The duration of psychoanalytic treatments from Freud’s cases to the Swedish clinical practice of today. The International Journal of Psychoanalysis, 103(5), 786–805. https://doi.org/10.1080/00207578.2022.2050463

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