How Can I Tell if Therapy is Working?

Therapy is an investment of time, money, and emotion. As with any investment, it’s worth stepping back once in a while from therapy to assess how it’s working. The question then becomes: What feels different than when you started?

The psychoanalyst and teacher Nancy McWilliams writes brilliantly about therapy. One of her many great ideas is what she calls “Vital Signs,” which are evidence of good therapy, and in turn, improved mental health. Below is my take on her ideas. Many of these signs of progress might seem obvious. Some may hit home more than others.

Progress in therapy is rarely linear; there are ups, downs, and in-betweens. Many times, things get worse before they get better. But there are multiple ways that consistent work with a therapist you trust can help bring a sense of what I’ve come to think of as ‘okay-ness.’

Feeling better about your relationship with yourself and others.

It could be that you have more trust in yourself and the people you care for. Maybe you’re having an easier time getting on with colleagues. Perhaps you feel increased interest in getting to know new people. Maybe you’re starting to have more confidence around intimacy.  

A stronger sense of purpose and effectiveness.

This might show up as being less anxious speaking in a group or feeling more verve the next time you walk into an audition. Could be that your focus on tasks is improved or your motivation to set goals for yourself has increased.

Accepting who you are and feeling better about yourself.

Perhaps you find that negative self-talk isn’t as persistent as it used to be. You might have weathered a disappointment, and self-soothing comes a bit sooner than it has before. Maybe you’re starting to be more realistic about what’s possible.

Feeling more balanced emotionally.

Here, there can often be an improved ability to bounce back, stand back, observe, and reflect. Do you notice that you’re less moody or short-tempered? Is it becoming easier to take a broad view of a tough situation? Could it be that you’re able to give yourself a few beats to take stock what you feel and think…instead of immediately reacting?

Increased insight about yourself and others.

Lots of times, this means a better ability to take a step back and look at yourself, as well as an easier time putting yourself in someone else’s shoes, imagining how they might feel or react.

Finding it easier to be alone, with others, or both.

Taking pleasure in your own company is an experience that’s soul-building. Perhaps it’s the first time you’ve lived alone after the end of a tumultuous relationship. In the wake of such a rough spell, you may find unexpected contentment hanging out at a coffee shop reading and taking in the scene or listening to music and daydreaming at home…rather than doomscrolling. Maybe you’re having an easier time listening to others and taking in what they have to say.

Feeling stronger and more alive.

Along with feeling better can come added energy. Maybe you’re more motivated to go on walks or find yourself extending your exercise routine by a few minutes. Perhaps you have more of an impetus to make it to a jewelry-making class, invite someone for coffee, or go on errands. Maybe a fog is lifting and it’s easier to notice and even enjoy the sights, smells, and sounds around you.

A greater ability to forgive yourself and others.

Acceptance of your own humanity—and that of others—translates to better relationships with yourself and those around you. There’s less harsh self-talk targeting at yourself or other people. This can also result in feeling more at home with the act of expressing gratitude.

More ease and space to love, to work…and to play.

Play is a big deal. Sure, who doesn’t like to have more fun? Turns out there are seven circuits in the brain that inform our emotions, and they’ve been mapped by neuroscientists. Among them is a Play circuit. (Here’s more on all the circuits). Play is a rich source of social learning for children and makes for powerful bonding experiences. The joy that comes from play can be a powerful antidepressant.

If you’re struggling, why not text or give me a call at 213-807-6021 to arrange a free consultation for depression therapy or anxiety therapy.

References

McWilliams, N. (2021). Psychoanalytic Supervision. Guilford Press, New York.

Panksepp, J. and Biven, L. (2012). The Archaeology of Mind: Neuroevolutionary Origins of Human Emotion, W.W. Norton & Co., New York.

(Photo: Artem Sapegin @Unsplash)