A Year To Change – eBook
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Should Psychotherapy Sessions Hurt?

“No pain, no gain!”

Is psychotherapy supposed to hurt?  Is it necessary

to wear waterproof mascara to every session?

Are you going to be a royal mess after you spill your

guts out on the floor and have to scoop them back

up after “our time is up?”  What’s it really like to be

in therapy, anyway?  What’s it supposed to be like

if it’s really working? Does good therapy have to hurt?

Great questions deserve some answers!

Physical Therapy for the Body

One way to think about it is to consider how

physical therapy is used to help physical problems.

Some people see physical therapists after a trauma like

a car accident or after they have “yanked their back out.”

They may work with a physical therapist in a rehabilitation

center or outpatient clinic to regain their former

physical capabilities, to help prevent long-term

physical problems that can happen as a result of how

the body tries to adapt to injuries, and to help them

achieve complete physical independence.

Sometimes physical therapy is prescribed to deal with

a chronic or progressive physical condition like

arthritis or degenerative disc disease…not because

the PT is going to heal or “cure” the problem, but to help

the person learn ways to lessen symptoms and keep

what mobility and range of movement they can in spite

of the disorder.

 Physical Therapy for the Non-Body

Psychotherapy is like physical therapy for the mind,

the heart, the soul, the spirit…the non-body parts of you.

It helps a person after a traumatic childhood or an

immediate crisis to heal and be able to function normally.

It helps a person to achieve their full potential cognitively,

emotionally, socially, spiritually, and in their community.

It helps a person who has a mental health diagnosis that

must be managed for a lifetime (chronic depression, bipolar

bipolar disorder, addictions are a few) to learn

ways to cope with their disorders better.  The goal is not

a “cure”, but to learn how to manage the disorder and get

the best quality of life possible with it.

Does Good Therapy Have to Hurt?

If you’ve ever come back from a physical therapy

appointment and not been sore, like you’ve been pushed

past a limit you’d rather not have gone past, then you’re

likely not going to get much out of your physical therapy.

Growth, change, and healing depend upon stretching

beyond the norm you’ve been limiting yourself to

either because you’re in pain, you’re afraid, or you don’t

know what to do to make any positive change.

  Out of Your Comfort Zone

So, yeah, the short answer is that unless you are

willing to feel uncomfortable, get into some feelings

that you normally don’t want to feel, talk about things

that you don’t want to talk about…therapy probably

isn’t going to help you much.  But a good therapist is

not going to emotionally dismantle you and then leave

you to pick up the pieces at the end of a session and

carry on…he or she will carefully assess how much

time there is to get into certain issues and topics,

and will pace interventions appropriately.  Just like

a good cardiac surgeon doesn’t do open-heart surgery

in his outpatient clinic, a good therapist won’t ask you

to do more therapy work than can be done in an hour.

Good Therapy is Like PT, not Massage

Good psychotherapy should be like good physical therapy.

You should feel challenged and stretched emotionally,

but not so much that it’s causing more damage.  It should

not be as gentle and soothing as a relaxing massage…

because as good as that may feel, it’s not therapeutic

enough to create the kind of change you’re looking for.

You should be asked questions you don’t want to answer.

You should be told things you don’t really want to hear.

But you should be allowed the space to be who you are.

Therapy should be just challenging enough that you

afterwards you find yourself thinking differently,

questioning yourself or old outdated modes of perception,

being more aware of your feelings, your wants, your needs,

your dreams, and your goals.

In short, it should be creating the right environment

for change, for growth, and for healing.

It’s the kind of hurt that heals…


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