Why Does Good Therapy Take So Long?

Embedded in therapy is the idea that good therapy usually takes time to work. But why? The answer is because of one, very important reason.

When thinking about starting or continuing therapy, it’s common for people to consider the time-investment required for therapy to be helpful. And, most commonly, people find themselves wishing therapy worked more quickly.

In fact, I believe the internal pressure we all feel to find results as quickly and efficiently as possible has led to the rise of cognitive-behavioral, self-help, motivational, and coaching methods for helping people solve their psychological problems.

Unfortunately, many people find that, while these methods can provide immediate results, those results are not long-lasting and don’t produce substantial emotional and psychological changes. In other words, what the short-term, problem-focused therapies make up for in speed, they lack in substance. The individual who is looking for therapy to have a long-term, profound impact on their lives has to be willing to devote time and work to achieving this goal.

But why?

We often say “therapy takes time” like it is an unavoidable truth about the endeavor. But why does therapy take time? Why can’t we just condense all of that work into a shorter time-frame? I’ll explain why.

Meet Rebecca*

Rebecca is a college student and who says that she is consistently unhappy. Externally, she is an energetic, positive, warm person – and she says that people would probably describe her as happy. But internally, Rebecca carries a pervasive sense of being unhappy, and this unhappiness is due to being dissatisfied with her relationships and, by extension, her life in general.

There is a disconnect between who Rebecca is on the outside and how she feels on the inside. And upon further investigation, it becomes clear that this disconnect, and this unhappiness, seems to stem from her strong drive to be accommodating to everyone around her. In social situations, Rebecca has adopted the role of “going along with anything” and “not causing any waves.” In relationships, she would adopt her partner’s interests and passions as her own. She believed that she needed to like and want the same things her partner liked and wanted because that would ensure a happy relationship.

This continual accommodation and adoption of other’s interests has left Rebecca feeling like she doesn’t know who she is. She has been so focused on being like others so that they would accept her that she has lost touch with her own internal sense of herself; she can’t tap into her own wishes, desires, fears, anxieties, etc.

Rebecca has tried therapy, but has been displeased with the results. She reports that she tried cognitive-behavioral therapy, and was given exercises, tools, and homework to “reframe” her thinking. She felt like her therapist was a wonderful person who really cared, but found that the therapy couldn’t reach the depths of her difficulties.

The reason short-term therapies didn’t help Rebecca is that their tools and techniques aren’t able to address the core of Rebecca’s problems. These tools focus on surface-level changes.

Rebecca grew up in a single-parent home, with a mother who was very overbearing. Her mother wanted Rebecca to dress, walk, and talk a certain way, and if Rebecca didn’t go along with her mother’s wishes, her mother would be angry and disappointed. Sometimes, Rebecca’s mother was so intensely upset, that she wouldn’t talk to Rebecca for a whole day, or even two.

Early on in life, Rebecca learned that she needed to “go along with anything” her mother wanted because if she didn’t, her mother would be get upset and the relationship would fall apart. Young Rebecca adopted the firm commandment that the only way to maintain relationships was to become the person with whom she was in a relationship.

Fast-forward to present day, and Rebecca is still laboring under this commandment. But as an adult, this belief is no longer serving the same purpose. As a child, the commandment to be accommodating maintained Rebecca’s relationship with her mother. But as an adult, it has led Rebecca to feel unhappy, unsatisfied with relationships, and out of touch with herself because she is so focused on molding herself to be like those around her.

Picture this situation like a favorite childhood shirt. When you are younger, this shirt is the best, and it fits perfectly. But once you become an adult, you have to grow out of that shirt into other clothing.

Many people aren’t able to identify and grow out of old, internal beliefs and dynamics. These dynamics, like the childhood shirt, used to be a perfect fit and serve an important purpose. But what once helped as a child can become a hindrance in adulthood—the shirt might no longer fit.

For Rebecca, she needed help identifying her childhood dynamics of accommodation, and how she had needed to adopt this mindset in order to maintain a positive relationship with her mother. Rebecca needed help understanding the origins of this dynamic, and needed help seeing how, because this dynamic is still playing out in the present, that it is contributing to her unhappiness. Once this dynamic has been understood, Rebecca could work on ways of changing it for a better fitting one.

If Rebecca had known about this dynamic, she very well could have changed it on her own – or in her earlier therapy. The problem is that these types of dynamics are unconscious – meaning that they take time to uncover, and that we usually cannot become aware of them without help.

Because many therapies focus on quick results, and utilize tools to change thinking as fast as possible, they aren’t able to help people get to these deeper, more important dynamics. And since these deep, unconscious dynamics are the ones that control our thoughts and feelings on a daily basis, people find that therapy doesn’t always make as big of an impact as they would like.

But once Rebecca had the time and guidance to see and work through her unconscious dynamics, she was able to begin changing her life for the better. She was able to tap into her own sense of herself: her passions, wishes, desires, fears, etc. And she was be able to start living a fuller life.

In summary, the reason effective therapy takes so long is because the problems we are experiencing today have their roots in earlier life. We carry these roots with us in our unconscious mind, which dictates how we think, act, and feel on a daily basis. And if we want to change how we feel, we have to uncover and understand these unconscious dynamics. But the process of coming to understand our unconscious mind takes time. It takes time to work through the thoughts and feelings we are not aware of, but that we carry with us from a lifetime of interactions with others.

But the good news is that, once these unconscious dynamics are uncovered and understood, the possibilities for positive change are nearly limitless.

*Rebecca is a fictional individual. Any similarities to real individuals is purely coincidental.