The best therapy requires hard work from both the therapist and the patient rather than quick fixes
On my way to Tribeca Therapy, I saw a sign, which, in a twist on the old saying, “Good things come to those who wait,” read, “Good things come to those who work their asses off and never give up.” To me, this sign says it all, especially about therapy. Therapy can be gut-wrenching, painstaking, and arduous work. It can be full of blood, sweat, and tears, often from returning (several times) to experiences and feelings we’d rather not.
Granted, a lot of people shy away from this level of hard work both in their lives and in therapy. Many search for quick fixes or more pleasing short-term solutions. This is understandable. Most people who show up to therapy are experiencing so much suffering that they want relief as soon as possible. It can be daunting to consider taking on the more difficult work of looking beyond what we’re feeling in the moment to discover what may be under these experiences. Yet, it’s exactly this strenuous work that is essential to processing—and ultimately, relieving—pain and making significant changes within ourselves and our relationships.
Some of the hardest work in therapy is tolerating the unknown
People come into therapy in a moment of challenge—a trying time when something isn’t working. Usually, someone arrives wanting to work on an immediate need; they have a crisis happening that requires solving and relief. What often happens is we discover together that there is something deeper at work that needs attention. We find that we’re staring at the top of an iceberg, so to speak, and have to keep diving under the water to look at the whole thing—both what is known and unknown.
This isn’t simple work. Most people want things to be known and resolved. Yet, in order to see and deal with what is below the surface, the patient and therapist must be willing to roll up their sleeves, be curious and patient, and tolerate not knowing. This way, we can discover together what is not yet fully understood. We have to ask the questions: Where did this current struggle come from? How come I keep finding myself here or doing this or that again and again? Why do I keep feeling this way? Why am I doing these things in my relationships or within myself? Working through these questions to better understand the roots of issues, as well as expose what needs to be grieved and accepted, isn’t easy but is essential to shifting towards building something new.
It can also surprise people just how deep things are buried and how long it can take to unpack these firmly rooted experiences. Frequently, we have to work around these long-standing issues many times before they can be fully felt and understood.
No pain, no gain: Sometimes hard work in therapy can seem counterintuitive
One of the most difficult parts of therapy is not rushing to quickly relieve pain. Instead, we have to do the tougher work of learning to be curious about the pain, both past and present hurts, as well as coming to respect this pain and how we’ve developed defenses to avoid it.
At times, this work can seem counterintuitive, challenging long-held defenses or entrenched protective patterns. These are defenses that may have previously been necessary for an individual to survive to make it where they are. These can be pleasant defenses, such as people-pleasing or deflective humor. Other times, they can be unpleasant like explosive anger. All, though, have worked to keep them from being vulnerable in the world, whether in childhood, in their hometown, with their family, or at school. It can hurt to confront how deep the well of feelings are that we have tried to avoid, push away from ourselves, or keep out of reach.
Sometimes this means that we feel the pain deeply for a while. Therapy requires working through and integrating everything that happened—the good, the bad, the happy, the sad, the tragic, the mistakes, the losses, and the wins—and feeling each one, fully. With therapy, these feelings, however bad, don’t have to be experienced alone. A therapist can be relied on to take this task on as slowly as needed. Therapy can act as a location where these feelings can be safely felt and explored with another person rather than feeling ungrounded, disorganized, or alone.
What are the good things that come from all this hard work?
In therapy, good things come slowly. Yes, there can be immediate relief that you’re not “crazy” or that you have the tools to manage the panic, anxiety, and depression. But that’s not the payoff for all the hard work. The hard work can expose good and complex pieces/things that you may not even have thought were possible, that you didn’t know you needed, or that you didn’t know how to get.
It’s not just about making life more tolerable. Therapy should strive for bigger. What is the thing you don’t know how to do emotionally but want to learn? What is the career you want to create but don’t know how? What is the way you want to change how your family relates but you always resort to the excuse, “They won’t change”? How do you want to create your relationship with yourself, your partner, or your child? All of these can be achieved by digging your heels in and getting to work.
