What Patients Really Mean When They Ask "How Long Will Therapy Take?"

“How Long Will Therapy Take?” Often Really Means “Can I Be Cured?”

A common question patients ask me, typically toward the beginning of treatment, is: “How long will therapy take?” The question is natural enough. Therapy is a commitment that takes time away from other things, and patients want to organize their lives accordingly. However, while these logistical concerns are certainly valid, patients that ask, “How long will therapy take?” usually really mean, “Can I be cured?”

This is also an understandable question. Many people have been to therapy before. Sometimes they’ve had good experiences, and other times, they’ve had bad ones. Other patients have been in distress and feeling terrible for years. Often they are in such intense pain by the time they reach out for therapy that they just want it to end. It is fair to want to know when, for example, the crying will stop, being alone after a death won’t feel so lonely anymore, or “those thoughts” will go away.

Good Therapy Is More Than Just Symptom Remission

The answer to both “Can I be cured?” and “How long will therapy last?” isn’t that easy. This is because good therapy is more than just symptom remission, though it does involve that. Good therapy also involves examining the content and structure of your thoughts, feelings, relationships, and personality. It’s not enough to know that you’re in pain, but also where the pain comes from, how to get out of it, and how to prevent it from coming back.

I often use the analogy that treating therapy is like a cast for a broken leg. The cast will heal the leg, but if you keep the same diet, maintain an infrequent exercise regime, and engage in the same bone-snapping risky behaviors, that leg is almost certainly going to break again.

Therapy Is Also An Opportunity To Figure Out Who You Are And Want To Be Without That Pain

Therapy also involves figuring out who you are and want to be without the pain that brought you into therapy. This is often the trickiest part. No matter how distressing, we can become familiar with our trauma or symptoms. A person who has suffered from serious abuse or trauma, who is learning to live again after the loss of a loved one, who is struggling with a relationship, or who shudders with anxiety at the slightest provocation needs to also develop themselves, independent of this pain. Therapy often involves learning to integrate, rather than completely abandon, these feelings in a way that feels safe, while no longer allowing them to define who you are. 

Beyond Being Cured, Therapy Is A Process Of Becoming

Even for patients who come into therapy with a clear goal or seeking a definitive cure, they frequently find that, upon resolving a specific issue, something new emerges. It’s as if they have a wall in front of them that they’ve tried so hard to get over, they no longer can see anything else. Once they get over it, though, things initially feel open and expansive, unencumbered by that obstacle. However, before long, another wall appears (maybe something that was ignored while focusing on that first wall), and then another, and so on.

In this way, therapy becomes more like a process of becoming–becoming more loved, more successful, more adaptive, more comfortable and more in control–rather than defining an end when everything will fit together perfectly.