Is Feeling Worse After Therapy Normal?

When experiencing emotional discomfort after therapy sessions, some people may ask, "Why do I feel worse after therapy?" As a process that can involve addressing painful memories or difficult emotions, therapy can sometimes feel uncomfortable, even as you take steps to heal and feel better. 

Examining difficult life experiences or unhealthy patterns can be stressful and draining, so it may be natural to experience challenging emotions during the therapy process. If you're experiencing a sense that you feel worse after therapy, there are a few ways to cope and figure out what might be occurring for you. 

Possible reasons for challenging emotions

Therapy may cause challenging emotions or thought patterns to arise after sessions. Below are a few reasons this response might occur. 

Examining old patterns

For instance, if you are seeking therapy for depression, talking about how low you are feeling and how depression has been negatively affecting your life might be painful. If you seek couples therapy for conflicts in your relationship, dredging up these concerns and putting them out in the open might seem uncomfortable and awkward. Bringing up past challenges, painful memories, unhealthy patterns, or unresolved conflicts can be difficult—but it may be a crucial part of addressing those concerns and moving forward. 

In therapy, you may be presented with new coping strategies and ways to look at a situation, which can be a difficult adjustment. Change, even when positive, is often not a straightforward process. It can present challenges to your comfort zone, causing discomfort. However, over time, challenging conversations can lead to growth. Some people may refer to these challenges as "growing pains." 

Stress 

In addition to prompting you to explore and address difficult emotions and memories, therapy may be emotionally challenging if you are asked to face a situation you would rather avoid. For example, in some forms of cognitive-behavioral therapy (CBT), like exposure and response prevention therapy (ERP), clients may be asked to face challenging thoughts and stimuli. 

In exposure therapy, a therapist creates a safe environment for clients to face situations they fear and want to avoid. Exposure to fear may initially cause higher anxiety levels, which is part of the treatment. As anxiety levels rise, they begin to even out, eventually reducing as a client sees that inciting events for fear is not as much of a threat as they may have perceived initially.  

With an exposure therapist, someone with social anxiety may be tasked with giving a presentation to a large group as part of their treatment. With repeated exposure, they may start to be more comfortable. This type of therapy may be most effective for those living with panic disorder, social anxiety disorder, obsessive-compulsive disorder, and specific phobias. 

Suppressed emotions 

Suppressed emotions that have been pushed back or buried because an individual perceived them as too uncomfortable to face can be challenging to discuss. Over time, these emotions may resurface at inopportune times. Suppressing these emotions can be a way to try to cope with them at the moment, but doing so can have a range of adverse effects. Research has linked suppressing emotions with an increased risk for mental health conditions like depression and anxiety.

When the mind suppresses emotions, it can put stress on the mind and the body, and emotional stress has been linked to adverse mental health impacts as well as heart disease, headaches, insomnia, and intestinal problems.   

Therapy sometimes aims to examine suppressed emotions, bringing them out in the open. However, the process of tapping into these feelings may be complicated. Navigating uncomfortable feelings in the treatment process might be stressful, and some people have traumatic events associated with their emotions. 

When addressing the experience of trauma, revisiting painful memories can be challenging, stirring up feelings and memories. When addressing these emotions in therapy sessions, your body may initially react by signaling it's under stress. Talk to your therapist about sensations that arise in the session to devise a plan to cope.  

Learning to cope with challenging emotions

When embarking on a therapeutic process, one may feel disappointed or frustrated at times when another layer of stress or challenging emotions presents itself while seeking therapy. If this happens, it may be helpful to consider some of the tips and strategies detailed below for reducing stress and addressing feelings when they arise. 

Ways to reduce stress

If you are experiencing stress related to therapy, a few approaches may help alleviate your symptoms, such as deep breathing techniques, mindfulness meditation, and time in nature. 

Deep breathing techniques

For stress and anxiety, you may try deep breathing techniques. According to specialists, deep breathing has been shown to calm the body's natural fight-flight-freeze response and elicit relaxation. Lowering this biological response to stressors may stabilize blood pressure and slow a racing heart. Deep breathing involves gently filling your belly with air, taking slow deep breaths through your nose, exhaling through your mouth, and repeating this process until you start calming yourself.  

Mindfulness meditation

Mindfulness meditation has been shown to reduce symptoms of anxiety and stress. Mindfulness-based interventions have also been shown to improve physical health by reducing pain and fatigue. As an ancient spiritual practice backed by science, mindfulness is based on the concept of "attention" and "acceptance." 

Attention refers to training the mind to focus on the present moment, bodily sensations, thoughts, and feelings while anchoring them through deep breathing. Acceptance can involve accepting what may happen to your body and mind without judgment. The intention is to be aware of your sensations, thoughts, and feelings while letting them come and go. 

Walk in nature

Another way to reduce stress is to go for a walk in nature. A short walk in an urban park has been linked with providing tangible health benefits. One of these immediate benefits is to lower stress. Green spaces have also been shown to improve cognition which may affect one's ability to focus and retain information. If you struggle to work or be present because of your emotional state, going for a walk can be one way to reset your mind quickly. Walking has also been shown to reduce symptoms of mental health conditions like depression and anxiety.

Addressing feelings when they arise

If you are concerned about what you are experiencing during therapy, consider talking with your therapist about these thoughts. If your symptoms worsen or you consistently feel bad after your sessions, you and your therapist may determine that another treatment approach may be more effective. 

If you are not in therapy or looking for a new therapist, there are a few options you can consider. Online therapy through a platform like BetterHelp may benefit those seeking support. Through an online platform, you can change your therapist at any time, ask questions over messaging, and choose between phone, video, or chat sessions. 

If you're unsure whether online therapy would be effective for you, looking at research on the topic may be helpful. One study found that 71% of online therapy participants found it more effective than in-person therapy, with 70% reporting it more cost-effective.