Sophie Frost on Why Therapy Feels Worse Before It Gets Better

In her essay "Why Therapy Feels Worse Before It Gets Better: The Psychological Desert", Berlin-based psychotherapist Sophie Frost explains how therapy can feel worse when meaningful change begins.

"One of the most common things I hear from my patients is: “I thought therapy was supposed to make me feel better.” As a therapist, I cannot offer timelines or guarantees. I can only say that sometimes therapy feels worse before it gets better, and that this is not a failure, but a sign that something real is shifting. The task is not shallow reassurance, but the courage to remain in discomfort long enough for expansion to occur."

"[W]hen familiar structures begin to shift, identity destabilises. We may no longer recognise ourselves or our role. As mirroring fades, it can feel like a loss of existence, a profound emotional disorientation. Guilt may emerge. Shame may surface. So too may a loneliness that feels far deeper than ordinary solitude. We may feel disloyal to our families or strangely unrecognisable to ourselves. We may even miss the way we used to be. What follows can often be misread as failure, when in fact it may be the beginning of change.

"Even the most skilled therapist cannot lead someone further than they are willing to go, and for some, that is far enough. They either end or sabotage the treatment in some way. Especially when the culture around encourages immediate relief: “If it doesn’t feel good, leave.” I help many people realistically observe their limits and say, without shame, this is as far as I can go right now. Change is rarely absolute and more often than not it is incremental. I think about this often, not in a negative way, but as a realistic assessment. When we are holding generations of inherited patterns, transformation may not look like demolition, it may look like expansion, a widening of the walls rather than their collapse."

"As I consider the role of modern day psychotherapy in the transformation process, I often see it as replacing, or at least substituting something that we have lost. As shared ritual weakens in contemporary culture, individuals often enter desert states privately, without symbolic scaffolding. This is where I see the use of the psychotherapeutic endeavour. When we begin we are usually hopeful that therapy will help us to change something. Crossing the threshold means looking at the defences we use to avoid the parts of ourselves that may need help. The first experience is not transformation, but barrenness. And psychotherapy is here to contain it, not eliminate it."

"Disorientation is common, but there is no path forward except the one we are already on."

"Discernment can feel profoundly lonely, especially when we no longer recognise ourselves."

"We do not know how long this phase will last. That uncertainty is part of the pain. There may be weeks of confusion, anger or shame, even feeling that the therapy itself might be to blame. Shame is particularly difficult to bear: the shame of not knowing ourselves, of feeling weak, helpless or confused, states we are highly skilled at defending against. Without containment, it can feel endless.

Yet this is precisely the terrain where real psychological change becomes possible.

The task, then, is not to escape the desert, but to stay in it long enough that something truer can emerge."

The full essay can be found: https://theprimrosepractice.com/why-therapy-feels-worse-before-better/

Further information about Sophie Frost and her practice in Berlin and online is available at https://theprimrosepractice.com

Photo by Brittney Strange