When Therapy Feels Like It’s Making Things Worse

Susan Smith

There are moments in therapy that don’t feel like healing.
Often, many of them.

They can feel like:

• more anxiety, not less
• old memories getting louder
• emotions stirred up that don’t settle as quickly
• a sense of being more raw, more exposed

And quietly, a question begins to form:

“Is this actually helping me… or making things worse?”

Most people don’t ask this out loud.
But many feel it.

I sat with a client recently who was under significant financial stress. She was acutely aware of the investment she was making in therapy—and unsure if it was helping.

She had a strong problem-solving part. It worked tirelessly to reduce discomfort by looking outside of her. She found herself wishing for:

• a partner who could compensate for her perceived weaknesses
• a mother figure who could repair past absence
• a life so controlled and structured that stress could be avoided altogether

Using Internal Family Systems, I sat with this part—not trying to fix it, just listening.

As we did, its intention became clearer: to eliminate discomfort entirely. To smooth out every bump so she wouldn’t have to feel wrong, overwhelmed, or inadequate. So she could finally feel secure.

Many people with complex trauma or emotional neglect carry this quiet, relentless search for home—not just externally, but internally.

And often, we miss it.

Not because it isn’t there—but because so much energy is devoted to avoiding the very feelings that would lead us back to ourselves.

This pattern often starts early.

For some, it’s subtle disruptions to early development:

• medical stress in infancy
• feeding difficulties
• interruptions in bonding

For others, it’s more overt relational trauma:

• abuse
• neglect
• attachment disruptions
• adoption or major transitions

Over time, the nervous system adapts.

We develop protective strategies—parts of us that work tirelessly to manage:

• disconnection
• fear
• shame

These strategies are not flaws.
They are intelligent adaptations.

But they come at a cost.

• Therapy dropout rates range from 20–40%, often early in treatment
• Symptom worsening can occur, especially in trauma work
• Clients often leave because they feel:
  • misunderstood
  • overwhelmed
  • unclear about progress

You are not the only one who has wondered if therapy is making things worse.

Sometimes, therapy does feel worse before it feels better.

Not because something is going wrong—
but because something meaningful is beginning.

However…

If chronic stress has become your normal, you deserve relief.

It’s important to say this plainly:

Therapy should not feel consistently overwhelming, destabilizing, or unsafe.

There is a difference between:

• productive discomfort (stretching, feeling, integrating)
  and
• unsupported dysregulation (flooding, shutdown, lingering confusion)

Good therapy works near the edge of your Window of Tolerance—where you are challenged, but still supported.

One way a lead Internal Family Systems trainer describes this is through three circles:

• Inner circle: completely protected—nothing gets in or out
• Middle circle: safe enough—where trauma can be processed
• Outer circle: overwhelmed and activated—where processing isn’t possible

The goal is not perfect comfort.

It’s “safe enough.”

Not pushed beyond your capacity—
but also not avoiding the edges where growth happens.

A grounded therapeutic process makes space for both:

• contact with pain
• and support in integrating it

It includes:

• careful pacing
• returning to regulation—not just insight
• adjusting when something feels like too much

Healing is not forced.

In fact, one of the most important principles is this:

It goes as fast as you can tolerate—and as slow as you need.

If therapy is repeatedly leaving you:

• unable to function
• more disconnected from yourself
• or alone in what’s coming up

…it’s important to bring that into the room.

This is where Rupture and Repair becomes essential.

No therapist attunes perfectly all the time. Misattunements happen.

What matters is how they are handled.

A good therapist will:

• respond with curiosity, not defensiveness
• take responsibility when they miss something
• remain grounded in your experience—not their agenda

These moments—when worked through—can become some of the most meaningful parts of the process.

There is a difference between discomfort that supports growth and experiences that feel harmful.

It may be time to reconsider if your therapist:

• repeatedly invalidates or judges your experience
• becomes defensive when you raise concerns
• does not adjust pacing when you feel overwhelmed
• blurs or violates professional boundaries

You deserve a space that is both honest and emotionally safe.

Many people carry a quiet fear:

“If I start to feel worse, I might fall apart.”

So they:

• hold back
• stay on the surface
• or leave just as something important begins

Naming this fear—out loud, with a therapist—creates:

• collaboration
• transparency
• trust

And that is where deeper healing begins.

Instead of asking:

“Why do I feel worse?”

You might gently ask:

• What is coming into awareness that hasn’t had space before?
• Do I feel supported in this process?
• Is this hard—or is this too much?

There is wisdom in your answers.

The Therapeutic Alliance—the relationship between you and your therapist—is the strongest predictor of change.

If something feels off, it’s worth exploring:

• What’s getting in the way?
• Is this part of my process—or something happening in the room?

Both are valid places to look.

If therapy feels harder right now, it doesn’t automatically mean something is wrong.

But it also doesn’t mean you should ignore your experience.

Both can be true:

• something important may be opening
• and you may need more support, pacing, or adjustment

A good therapist will not dismiss this.

They will be willing to say:

“If therapy is making things worse, we need to talk about that.”

And then stay with you—curiously, honestly, and without judgment—as you find your way forward.