Nobody wants to start therapy and end up feeling worse than before. And yet, that’s exactly what some people experience in the first weeks or months. More crying. More anxiety. Dreams about things they haven’t thought about in years.

If you’re worried about this happening to you, it helps to understand why it happens and when it’s actually a problem versus when it’s just part of the process.

Most people come to therapy because something isn’t working in their life. But they’ve also developed ways of coping with that thing. Pushing it down. Staying busy. Avoiding certain conversations or memories. These strategies aren’t great long term solutions, but they do keep the discomfort at a manageable level.

Therapy disrupts all of that. You start paying attention to the stuff you’ve trained yourself to ignore. You talk about things out loud that you’ve only thought about privately. You notice patterns you never saw before.

When all of that comes to the surface at once, it can feel like things are getting worse. But what’s really happening is that you’re finally seeing what was already there. The mess was always in the closet. Now you’re just looking at it.

Not all discomfort in therapy is the same. Some of it means you’re doing real work. Some of it means something needs to change.

Productive discomfort might look like feeling drained after sessions. Crying more than you expected. Thinking about your childhood on a random Tuesday. Recognizing behaviors in yourself that you don’t love. This kind of discomfort tends to come in waves and usually gets easier over time.

Actual problems look different. Feeling consistently worse for months without any relief. Dreading sessions so much you start canceling. Feeling judged by your therapist or like they don’t understand you. Being pushed into topics you’ve said you’re not ready for. These are signs that something in the therapy itself needs to shift.

Therapy works best when certain conditions are in place. When those conditions are missing, therapy can actually be harmful.

The most common issue is a bad fit between you and your therapist. If you don’t feel safe or understood, you won’t be honest. And therapy without honesty doesn’t go anywhere. Sometimes a therapist is perfectly good at their job but just not the right match for you. If that’s the case, finding someone else isn’t giving up. It’s being smart about your care.

Another issue is using the wrong approach for your situation. Someone dealing with trauma needs a therapist trained in trauma work. Someone with OCD needs someone who understands exposure therapy. A general talk therapy approach can sometimes stir things up without giving you the tools to actually process them.

Pacing matters too. Good therapists pay attention to how much you can handle. If you feel like you’re being pushed into deep territory before you’ve built enough trust or coping skills, that’s worth bringing up. Therapy should stretch you, but it shouldn’t break you.

There’s no exact timeline, but the intense discomfort of early therapy shouldn’t drag on indefinitely. Most people start feeling some relief within a few weeks to a couple months, even if they’re still working through difficult material.

If you’ve been going for several months and feel consistently worse with no windows of progress, something probably needs to change. That might mean adjusting the approach, addressing something in the therapeutic relationship, or trying a different therapist altogether.

Even during the hard parts, you should be able to notice small signs that therapy is working. Maybe you handled a conversation differently than you would have six months ago. Maybe you caught yourself in a pattern before it played out. Maybe you feel more aware of your emotions, even when that awareness is uncomfortable. Progress doesn’t always feel like happiness. Sometimes it just feels like clarity.

If you’re worried that therapy is making things worse, say so. This might feel awkward, like you’re complaining or being difficult. But a good therapist wants to know how you’re experiencing the process. Our therapists in Philadelphia appreciate when clients bring this up because it helps them slow down, try something different, or figure out what’s actually happening.

If you don’t feel comfortable enough to have that conversation with your therapist, that tells you something too. The relationship might not be the right fit, and that’s okay. Finding the right therapist sometimes takes a few tries.

The possibility of temporary discomfort shouldn’t stop you from starting therapy. The things you’ve been avoiding don’t disappear just because you’re not looking at them. They show up in your relationships, your sleep, your health, your mood. Therapy gives you a chance to actually work through them instead of just working around them.

If you’re considering therapy, a free consultation is a low pressure way to see if a therapist might be a good fit. You can ask questions, get a sense of their style, and decide if you want to move forward before committing to anything.

We offer in-person therapy in Philadelphia and Haddonfield, with online sessions available throughout Pennsylvania and New Jersey.

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