Why You Might Feel Worse Before You Feel Better in Therapy
Estimated time to read: 6 minutes
Starting therapy is an important step toward healing and growth. Many people come to therapy with the hope of finding relief, and often that relief does come, but not always right away. In fact, some people notice they feel a little worse before they feel better, and that experience can be confusing or discouraging if you are not expecting it.
Let us explore why that happens, and what you can expect along the way.
1. Therapy Brings Up Difficult Feelings
In daily life, we often push painful experiences or uncomfortable emotions aside. Often this isn’t conscious, we go about our busy days and by the end of the day, it’s not until our heads hit the pillow that our thoughts and emotions come up. Other times it’s intension and we keep shoving and shoving things down that we don’t want to deal with until we have to.
Therapy is a safe space where those feelings can finally come to the surface. Talking about what hurts may stir up sadness, anger, or anxiety, especially if you haven’t been allowing yourself to feel those emotions. While that can feel heavy at first, it is part of the healing process, much like cleaning a wound before it can heal.
2. Insight Can Be Unsettling
When you start to see patterns in your relationships, choices, or coping strategies, you may have a mix of relief and discomfort. It can be relieving to feel like you finally understand why you do or feel what you do. One of the most common questions I hear in therapy is: “Now that I know this, what do I do with it?”
For some people, simply having the insight into their patterns is enough to create change. For others, it takes more intentional and effortful shifts. The important thing to remember is that we do not know what to do until we know there is something to be done. Gaining awareness is the first and essential place to start.
3. Change Takes Adjustment
Even positive changes can feel destabilizing. If you are used to putting everyone else first, setting boundaries or creating time for self-care might initially feel selfish. If you are used to numbing emotions, learning to sit with them may feel overwhelming. This adjustment period can be uncomfortable, but it is a sign that you are actively reshaping old patterns.
Neuroscience shows us that this is not just metaphorical. Through neuroplasticity, therapy can actually help you rewire your brain. Each time you practice a new skill or respond differently to a familiar situation, your brain is creating and strengthening new pathways. And each time you’re able to catch yourself before you slip into old habits, you’re teaching your brain to let go of that outdated wiring that isn’t serving you anymore.
4. The Therapy Process Is Not Linear
Healing does not usually happen in a straight line. Some weeks you will leave a session feeling lighter and clearer. Other weeks, you may leave with more questions than answers. Both are normal.
I often describe therapy progress as looking like a stock ticker. The line goes up and down, sometimes sharply, but over time you can see the overall trend moving upward. Progress often looks like two steps forward and one step back. Those steps still move you closer to your goals.
A lot of therapists use “assessments” or “surveys” to document symptoms over time. If you’ve ever been in therapy with me, or if you’re planning to, you know that I send out a measure of anxiety (GAD-7) and a measure of depression (PHQ-9) every 2 weeks. One of my favorite things to do once we’ve made progress in therapy is to look at the graph of scores over time together. It often does look like a stock ticker, where you can see a gradual improvement over time but some big spikes when something significant happens. I find it can be really helpful to look at that data together as it helps to drive home the message that hard stuff will happen and you will feel worse at times, but you can tangibly see your ability to bounce back and feel better eventually.
5. Support Makes the Difference
It is important to remember that you do not have to go through this process alone. Your therapist is there to help you pace the work, provide grounding tools, and celebrate the progress you might not see in yourself yet.
If you feel safe enough, it is also important to tell your therapist if you are feeling worse. Sometimes this signals that pacing needs to be adjusted, or that you need more coping skills in place before diving deeper. Therapy is a journey, and your therapist can only support you fully if they know what areas feel overwhelming.
6. When to Re-Evaluate
A temporary dip in how you feel is often part of the therapeutic process. However, if after several sessions you notice you are still feeling worse, it is worth checking in with yourself about the relationship with your therapist.
You might feel worse but also feel deeply supported, which is normal and can still be part of the healing process. But if you are continuing to feel worse and you do not feel comfortable with your therapist, it may be time to consider whether a different therapist might be a better fit. Not every therapist is the right match for every client, and that is okay.
Final Thoughts
If you ever feel discouraged by the ups and downs of therapy, remember: feeling worse before you feel better does not mean therapy is not working. It usually means you are facing the very things you came to address. Healing is rarely instant, but the discomfort often signals that you are moving through the heart of the work.
Disclaimer:
The content on this blog is for educational purposes only and is not a substitute for professional therapy or medical advice. For personalized care, please consult a licensed therapist or healthcare provider. For more details, please read our full Blog Disclaimer.
