How to Know If Therapy Is Working (Even When It Feels Hard)
Many people wonder how to know if therapy is working, especially when it feels hard.
Starting therapy often comes with a quiet hope: I’ll feel better soon.
So when sessions feel emotionally intense, confusing, or even uncomfortable, it’s natural to wonder:
Is this actually helping… or am I doing something wrong?
The truth is, meaningful therapy doesn’t always feel good right away. In fact, some of the most effective work can feel challenging before it feels relieving. Here’s how to tell the difference between therapy that isn’t working—and therapy that is working, even when it’s hard.
Why therapy can feel worse before it feels better
Therapy often involves slowing down patterns you’ve relied on for years—avoidance, perfectionism, control, reassurance-seeking, people-pleasing—and looking at them honestly.
That can lead to:
Increased emotional awareness
Temporary spikes in anxiety or self-doubt
Feeling more sensitive or vulnerable than usual
This doesn’t mean therapy is failing. It often means you’re no longer numbing, suppressing, or rushing past your internal experience.
Think of it like physical therapy: activating muscles that haven’t been used in a while can be uncomfortable at first—but that discomfort is part of rebuilding strength.
Signs therapy is working (even if it’s uncomfortable)
You may notice subtle shifts before big relief shows up. Signs of progress can include:
1. You’re noticing patterns you didn’t see before
You start recognizing:
The thoughts that drive your anxiety
The rules you hold yourself to (“I should be able to handle this”)
The ways you avoid discomfort—even when avoidance backfires
Insight alone isn’t the end goal, but it’s often the first sign that change is possible.
2. You feel challenged—but not judged
Effective therapy isn’t just validating—it’s collaborative and appropriately challenging.
You might feel:
Gently pushed to question old beliefs
Encouraged to sit with uncertainty instead of fixing it
Supported and stretched at the same time
That balance matters. Growth happens when you feel safe enough to be honest and brave enough to try something new.
3. Your reactions are changing before your circumstances do
Your anxiety may still show up—but you respond differently:
You recover more quickly after a spike
You don’t spiral as long
You make choices based on values instead of fear
These internal shifts are often early indicators of real progress.
4. You’re tolerating feelings instead of trying to eliminate them
A major goal of therapy isn’t to get rid of anxiety, sadness, or doubt—it’s to increase your capacity to handle them.
If you’re learning to:
Stay present during discomfort
Let emotions rise and fall without panicking
Stop treating feelings as emergencies
That’s meaningful work, even if it doesn’t feel immediately soothing.
Signs therapy may not be the right fit
While discomfort can be part of growth, therapy shouldn’t feel consistently unsafe or misaligned.
It may be time to reassess if:
You feel repeatedly dismissed or misunderstood
Your therapist avoids structure when you’ve asked for it
Sessions feel stagnant with no clear goals
You don’t feel comfortable giving feedback
A good therapist will welcome these conversations—and help adjust the work, not take it personally.
What to do if you’re unsure
If you’re questioning whether therapy is helping, try asking yourself:
Am I clearer about myself than when I started?
Do I feel supported, even when challenged?
Can I imagine how this work could help me long-term?
You can also bring these questions directly into session. Therapy works best when it’s transparent and collaborative.
A final thought
Progress in therapy isn’t always linear—and it’s rarely instant. Sometimes growth looks like learning to stay, rather than escape. Sometimes it looks like feeling more before feeling better.
If therapy feels hard and purposeful, you’re likely on the right track.
And if you’re considering starting therapy and wondering what the process is really like, know this: you don’t have to feel “ready,” and you don’t have to do it perfectly. You just have to be willing to begin.
Thinking about starting therapy?
We offer individual and couples therapy for anxiety, OCD, perfectionism, and life transitions.
A brief consultation can help you decide if working together feels like the right fit.