Why You Feel Worse Before You Feel Better in Therapy
Is It Normal to Feel Worse After Therapy?
If you’ve been wondering “why do I feel worse after starting therapy?” - you’re not alone. Many people enter therapy expecting instant relief and feel justifiably scared when they feel more emotional, anxious, or irritable between sessions instead of happy and calm. Starting therapy is a big step for all clients, but it also means that they’re starting to talk about topics and experiences that they have either been avoiding or functioning around (as opposed to addressing them head-on).
Why Therapy Can Make You Feel Worse Before You Feel Better
We all develop ways to cope with distress, discomfort and trauma and for most people, those ways include avoidance. Avoidance isn’t necessarily a bad thing - for example, it would not benefit you to think about the sadness you’re feeling about a recent loss or break up while you’re at work, so you need to avoid thinking about it in order to do your job effectively. Some people use these mental or cognitive avoidance strategies to manage distress - distraction, storing the feelings away in a proverbial box in their “mental closet,” thinking about work instead of emotions, etc. Other people use more behavioral avoidance strategies to keep the distress at bay, whether that be with food and exercise or substance use. Eventually, these strategies become less effective and people enter therapy, whether that is traditional talk therapy or EMDR therapy in particular. This also means talking about the experiences that these mechanisms have been protecting them from, and that is often incredibly painful.
When I’m starting EMDR with a client, I’m not only assessing what happened to them, but I’m also assessing how they have managed. How have they been protecting themselves from feeling? How have they been connecting (or disconnecting) from people in their lives who may or may not be supportive? How are they viewing themselves as a result of what has happened to them? Usually as I start asking these questions, clients start to understand their defense mechanisms, protective parts of them who are trying to keep them safe, happy, and healthy. When these parts of themselves move aside to talk about the pain, people may start feeling more distress between sessions, like the flood gates have opened and all the things they’ve been avoiding thinking about or feeling have now come to the surface.
What’s Happening in Your Brain and Nervous System
When my clients start to experience this, whether we are doing memory reprocessing in EMDR or not, I like to explain the concept of memory networks. By gently asking protective parts to step aside, we are activating deeply rooted memory networks, quite literally a series of memories tied to a theme, usually in one of three categories: defectiveness, safety, and control. When this happens, it is common to start thinking between sessions about past experiences in this network, as we are making the implicit connections more explicit, and the brain is likely to pick up on connections to the present. For example, if I am working with a client who has a strong belief that they are worthless and we are exploring this memory network in sessions, they might start noticing this more in their relationships or at work between sessions, which may bring up a variety of emotions for them. These emotions are likely not solely based in the present, but present memories exacerbated by past experiences. As my EMDR trainer Deany Laliotis says, your brain looks at a present-day experience and in a split second decides, “this looks like, sounds like, feels like my past experience with ____” which can lead to a surge of emotion before you even realize what is happening. Part of my work with clients is noticing this and then reprocessing past memories so that they are not feeling hijacked by the past, but this will likely include emotional discomfort before relief really sets in.
When to Talk to Your Therapist About It
I would argue - always! With my clients, I have no expectations about their progress and we always talk about how progress is not always comfortable. Telling your therapist about your distress between sessions does not mean you are a failure or you’re not “the perfect client,” which I hear about once a week! It means you’re being honest and vulnerable and building trust with your therapist, and that is half of what therapy is all about - the process of relationship building. It’s not just about the content of your sessions, talking about what happened to you and how you adapted to those experiences. It’s also about how you share with your therapist, how they respond to you, and how you navigate your emotional experiences together.
How to Take Care of Yourself After a Hard Therapy Session
Self-care is really important, especially when engaging in intense conversations in therapy, whether that is through talk therapy or EMDR. I have some clients who schedule space in their schedule after reprocessing sessions in particular to either take a nap or go for a quick walk. If you have a partner, talking to them about how you’re feeling can be really helpful; hopefully they can give you some grace if you’re a little “off” and can support you to the best of their ability. I also like to tell clients that they don’t need to be actively digging through their memory networks between sessions, instead just noticing when they get activated so we can discuss it together and then move on with their days. Sometimes this is playing with their kids, walking the dog, cooking dinner. Choosing activities with strong sensory input is helpful, as it is likely to keep you grounded in the present as opposed to stuck in the past mentally.
You’re Not Alone
If you’re feeling more emotional after starting therapy, you really aren’t alone. It’s an incredibly common experience and is truly nothing to feel ashamed or embarrassed about. When in doubt, talk to your therapist about it; I’m sure they’ll tell you the same things I am!
