How Can I Tell If Therapy Is Working?

It can seem like the goal of therapy is to be happy all the time, or to no longer freak out or make bad decisions on impulse, or to find a nice cruising altitude above life’s problems.

But no one, no matter how much therapy they’ve had, avoids all of life’s pitfalls. You can get triggered back into old habits by stress, trauma, or pain. Something can fall into your blind spot. You can make one bad decision that undoes all the progress you’ve been carefully making for months. Sometimes, chaos or misfortune can throw you off course through no fault of your own.

One of the surest signs of recovery is that when you do make mistakes or have bad days (or weeks, or months), you don’t let it defeat you. You don’t decide, “Well, I broke my perfect streak, so I might as well just stop trying now.”

You’ve learned that the worst part of making mistakes is not the mistakes themselves, but what you do afterward when you’re thinking about them and defenses kick in. It’s easy to let a bad day turn into a bad week when you’re feeling discouraged. It’s a sign of progress when you don’t let that happen.

When you start to heal, you find it easier to forgive yourself for mistakes, and you find it easier to get back on track. This means that something that maybe would have led to a long span of regressive behavior in the past now only lasts a day or two. And that can make a huge difference.

You may come into therapy with big goals. And you may achieve them! But at first, progress is more likely to show up in small ways. Sometimes, the changes are so small that it’s easy to dismiss them as insignificant at first. But you shouldn’t, because they’re always how big change begins.

For example, you might come into therapy with a goal to fully recover from depression. Maybe you’ve been battling depression for years. While you’ll probably feel at least some relief right away after you start therapy, it will probably take some time and effort before you experience a fundamental shift in your outlook and mood.

At first, it might be hard to tell anything’s changed at all, but look closer. It often starts in your thinking. You might still have negative thoughts, for example, but maybe there’s a little more room around them. Maybe they’re a little less negative or you believe them a little less.

Or if you have a goal of making major improvements to a troubled relationship, you might still be fighting after you’ve been in therapy a while, but maybe the fights are a little less intense or they’re more productive. Maybe you actually get somewhere and are able to resolve them.

These small changes eventually add up to the bigger changes you were hoping for. Depending on how big the change is you want to make, you might finally get there after weeks, months, or even a year or two. After all that time you spend making slow progress, the day will come that you’ll realize: I did it!

Learning how to mark and appreciate the small changes can help you get there by keeping you from giving up before the big changes can happen.

Therapy can feel awkward at first, especially during the first few sessions when your therapist is peppering you with tons of questions. It can also feel awkward to open up about certain topics, especially if it’s the first time you’ve ever talked about them.

So, it’s not unusual to feel a little anxious before your sessions at first, or even to dread them.

But over time, if you’ve found the right therapist, this should change. After a few sessions, something will click. Talking about the things you talk about in therapy will start to feel normal, even welcome. It will be a relief to finally be able to tell the truth and to talk to someone who doesn’t judge you for it—ideally, someone who seems to get it, too.

Looking forward to your sessions is a sign of progress because it shows that you’re no longer avoiding subjects you might have spent a long time avoiding. You’re no longer afraid of thinking or talking about things you might have kept secret for years. You’re willing to let yourself feel and remember some of the stuff that hurts.

Looking forward to therapy is a sign you’re opening up. And that’s when therapy really starts working and helping you make big changes—when you’re completely open to the process.

Don’t be discouraged if it takes you a while to open up and trust your therapist. It’s part of the process. And the effort it takes to get there can make it feel more meaningful when you do. Reaching that place of trust and comfort with your therapist—that moment when therapy starts to feel good—is often one of the first big milestones you reach in therapy.

You probably came into therapy wanting to feel better. But part of the reason you might not have felt so good before therapy is you weren’t feeling much at all. In your effort to avoid pain, you distracted and numbed yourself, muting your positive as well as your negative emotions.

Good therapy helps you break up these emotional blocks. The difference will probably be small at first, such as finding yourself smiling a little more often, or it might not be exactly what you were looking for. Maybe, instead of feeling more joy, the first sign you’re dissolving emotional blocks will be that you feel more anger or sadness.

Once you’ve cleared the blocks that kept them stuck and frozen, emotions can come and go as normal. Getting healthy means getting to a point that emotions can move through you instead of getting blocked, and as you heal, negative emotions will become lighter and pass more quickly.

At some point, not only will difficult feelings be less disruptive, but you’ll also start feeling more joy. If that joy doesn’t show up right away, don’t be discouraged. It will come. Just give the other emotions more time to get moving first.

One of your goals going into therapy might be to get yourself together. Maybe you imagine a future life where you’re more organized.

Maybe you dream of being more graceful, elegant, and put together. Maybe you dream of having a productive, busy life where you’re always getting tons of stuff done.

That could happen. But it might not be what you actually want to happen.

As you start to heal, you may start to see that the fantasy of a fitter, happier you comes from wanting to feel less ashamed. The trick of therapy is that it heals you from the inside out so that your happiness and self-worth aren’t as dependent on what other people say. So, that fantasy might stop being so appealing after you’ve been in therapy a while.

As you grow more comfortable with yourself and start to like yourself more, you become less self-conscious or ashamed of the parts of you that feel messy and that used to embarrass you.

One of the gifts of therapy is gaining the ability to be yourself—to know who you are and to stop feeling like you have to hide or apologize for it. You grow into who you really are and stop trying to be who you aren’t.

This might start with your appearance. You might feel more comfortable dressing the way you really want to dress. You might dress up more or dress up less. You might not bother as much with trying to look good when you just need to do a quick errand or worry so much if people see you when you’re having a bad hair day.

You might find it easier to let yourself be loud in public when you’re feeling great. You might find it easier to let yourself cry in public when you’re not feeling great. It might be easier to tell your loved ones when you’re actually not doing that well and need some help or support.

The inner freedom to be true to yourself in every moment will come to mean a lot more to you than the image you once wanted to have. You might realize that you don’t need to be perfectly put together and that you don’t need to hide your natural, human, messy side. It’s a side we all have, and your refusal to hide it anymore will probably have a different effect than you expect.

When you’re able to be messier in public, you might find that people gravitate toward you more, appreciate you more, and befriend you more easily, because your comfortability with yourself is a little contagious, and it just feels good to be around you.

You know therapy is working when you look for the people who will love you for who you really are instead of wasting your energy trying to impress the people who will never get it.

You might go into therapy with the goal of wanting to improve your relationships. You might imagine this would look like less fighting, less friction, and more pleasant time together.

However, therapy might improve your relationships in a different way. You might find that you still fight with people, or even fight more.

But if therapy is working, those fights will be less repetitive and more productive. You’ll figure out what you’re actually fighting about a lot faster, and the reconciliation and improved mutual understanding that is the ideal goal of a fight will come more easily.

Of course, you might fight less. Good therapy will help you improve your communication skills. It will help you understand what you want and need in relationships and how to communicate those needs and get them met with less conflict and struggle.

The healing you do in therapy makes it easier to let go of relationships that are harmful or just plain unsatisfying. After going to therapy, you might find you have better boundaries, that it’s easier to stand up for yourself, or that you’re drawn to different kinds of people and relationships than you were before.

Most importantly, your relationships will get deeper. You’ll want to hide less. You’ll want to share the real you. You’ll want to be real with people and be with people who are real with you. As a result, you’ll be more likely to find yourself in relationships that are emotionally satisfying and supportive.

There’s an important moment in the healing journey that happens before you fully emerge into the light: you see it. You’re not there yet, but you can see that you’re getting there. That’s the moment you recover your sense of hope. And that’s a really important moment in therapy.

A lot of the changes you might want to make are long-term changes that could take years to fully realize. Goals like building a better support system, having a deeper and more satisfying relationship with a partner, changing your career, or completing a creative project aren’t quick or easy to achieve.

You might start therapy without much hope. (One of the symptoms of depression is hopelessness.) Or you might have some hope, but not a whole lot. You might regularly have crises of faith in yourself and give up temporarily, pausing or losing progress toward your long-term goals until hope dawns again.

Therapy will help you shift this process. One of the signs that therapy is working is that you feel more hope, and you feel it more consistently. You gain more faith in yourself. Your sense of possibility expands. You start to see that you have more options than you once thought you did.

This growing sense that you can do and be more might not seem like a huge change, but it is. It might “only” be happening on the level of thought and feeling at first, but that’s where change begins.

This different, more hopeful perspective is rocket fuel for change and will power you through challenges you never thought you could manage.

The hope therapy gives you can bring you all the way to the threshold of your dreams.

Most people come into therapy wanting to feel different. You’re probably one of them. And that’s good, because therapy can help you do that. In fact, it’s what therapy is for!

However, changing how you feel takes time, and you might notice that before you feel all that different, something else is changing: the way you think.

Those changes in thinking might be subtle at first. But after some time in therapy, you’ll probably notice that you don’t jump to the same conclusions as easily.

You see more sides of yourself and the situations you find yourself in. Situations that you once would have thought were hopeless now seem to have more potential.

You might get different ideas. You might consider trying things you’ve never thought of trying before. You might be less ready to judge others—or yourself. That openness and flexibility of thought is one of the greatest gifts of therapy, and it starts out slow and subtle.

But if you keep at it, those changes will build. Over time, you may find that your thinking has changed so much that you’re willing and able to make some major changes in your life. In the meantime, make note of any small way you find yourself thinking just a little bit differently about things. It’s the first sign of bigger shifts yet to come.

One of the hardest changes to make is to instill a new habit. It takes time and trial and error to start doing totally new things, and it takes even more time and effort to do them consistently.

So, before you build consistent new habits, something else will probably happen first: you won’t react to the things that happen to you the same way you always have.

The shifts might be small at first. You might hold back from saying the first angry thing that comes into your head. You might put that unhealthy snack that upsets your stomach back on the shelf and pick something else. You might decide to put down your phone and go for a walk.

This can seem so small at first, but it can actually make a huge difference. So many of the things we want to change are things we do because we can’t help but react to certain things in certain ways. You know therapy is working when there’s at least one less thing you can’t help but do.

When life’s disappointments or frustrations don’t immediately throw you into your worst habits and impulses, you don’t have to spend as much time in damage control. You have more time and energy to do things that bring you joy and help you make progress on your goals.

There’s a good kind of risk-taking and a bad kind. The bad kind might be something you come to therapy wanting to stop. That’s good, because therapy can help you slow down and eventually stop the self-destructive behavior that’s harming you.

But one of the surprising signs therapy is working is that you take more of the good kinds of risks. You approach people and start conversations when you might not have in the past. You go on first and even second dates.

You don’t go to as much, if any, trouble to hide your weird habits and differences. You look for people who like you for who you are and are content to let the people who don’t get it just scratch their heads.

You might pick up a pen, a paintbrush, or an instrument and learn to do something new. Maybe you even show someone what you’ve been working on—and maybe even before you’ve perfected it. You just want to share your joy in what you’re doing, even if you’re not all that good at it yet.

You realize some of your dreams aren’t impossible to achieve, so you go out there and take a first class, ride, or trip. Each adventure emboldens you for the next. Each little step toward being yourself in public brings you closer to living the life you’ve always known you can live.

You know therapy is working when you take even the smallest steps toward being braver and bolder in your daily life.

One of the first ways you might notice you’re changing from therapy is that you start to loosen up a bit. You’re more willing to do frivolous things. You’re less self-conscious about doing them with or in front of other people.

You also start feeling less guilty about doing the things that fill your own well. If you’ve been the kind of person who doesn’t take much time for yourself, that might start to change.

It might start with something as simple as setting aside fifteen minutes to read a book you’ve been meaning to read or asking your family to leave you alone for a half hour while you play a video game.

You might be willing to spend a little more money on yourself to have the things or experiences that give you pleasure. You might ask your partner or your friends to do some of the things you like instead of just always doing what they like.

You know you’re making progress in therapy when you start to value your own time more and want to fill it with more of the things that mean something to you—more of the things that bring you joy.

You might think that how it will go is that you’ll go to therapy, you’ll fix the problems you went to therapy to fix, and you won’t need or want to come to therapy anymore.

That is one possibility, but there’s also another one: you might stop wanting to get through therapy as fast as possible. You might start enjoying it so much that you don’t care how long it takes. You might want to keep going longer than you thought you did, even after you achieve your initial goals, because you’re finding more to work on and new ways to heal.

As you make progress in therapy, problems that might have seemed small and easy to fix might reveal deeper issues underneath. Or you might realize you don’t want what you thought you wanted and that you want to take your life in a completely different direction than you thought you did at the start of therapy.

When therapy is working, you don’t want to quit when you find out things are more complicated than you thought. You want to keep going. You want to get to the root of what’s going on and want to heal, even if it means you need to spend more time and do more work in therapy than you thought.

You know therapy is working if you realize there’s more you need to do, and not only are you willing to do it, you want to do it. You like how it feels to heal and get freer inside, and you’re willing to do as much work as you need to heal yourself on the deepest level.

One of the weird signs that therapy is working is that it’s not just your mental health that improves, but your physical health, too.

Many health issues can be caused or worsened by stress, trauma, depression, or anxiety. Mental health issues can make you tired and drain your energy. They can make it harder to do the things you need to do to take care of yourself, and they can take energy away from your body’s healing process.

The more your mental health improves, the less likely you are to want to reach for the coping behaviors that have negative effects on you.

There’s no guarantee that therapy will improve your physical health, but chances are good it will make you feel physically better in at least some small way.

As your mental health improves, you may find you’re sleeping better, waking up with more energy and a clearer head, and doing more things that are good for your health. This can lead to an upward spiral as you reinvest that extra energy and good feeling into doing things that make you feel even better.

As you heal and grow, the things you want change. So, an early sign that therapy is working is that you start craving different things.

You might want to eat different food, do new things to relax, or spend your days off differently. You might find you’re craving substances and distraction less and craving deeper connection more.

So many of the habitual things we do to “relax” aren’t actually relaxing. Therapy can help you notice this. You might start to see how the things you do to get hits of dopamine are inherently dissatisfying. Those cravings don’t die overnight, so you might still do those things, but that’s okay. It’s progress just to do them less.

When your mental health isn’t good, it can be hard to find the hope, energy, or motivation to do things that feel great at the end but that don’t feel great right away and take a lot of time and effort to pay off.

As you heal and recover, you might find that you’re able to start doing those things again. Your efforts might not be consistent at first, but that’s okay. The more you do them, the more you notice how much better you feel. As the positive feedback loop continues, you may find that you’re making them regular parts of your routine again.

So, even if the only change you’ve noticed is that you don’t buy that one really awful snack anymore, don’t put it down as meaningless. It could be the start of something huge—a movement away from dissatisfying habits and toward the things you find more fulfilling.

One of the weirdest signs that you’re making progress in therapy is that things might actually feel worse for a while.

Of course, if you’ve been going to therapy for months and you’re only feeling worse, it’s probably a sign you’re with the wrong therapist or not getting good therapy.

But the way therapy works means you have to turn toward what feels bad and face it so you can work through it. And the part where you’re facing it doesn’t always feel so great.

The good news is that in good therapy, this phase doesn’t tend to drag on. Part of your therapist’s role is to support and guide you through these moments so you don’t get stuck in them. Eventually, things will turn around again, and you’ll notice something has changed—you feel lighter. You’re not putting energy into resisting what you feel, so you have more energy.

This is when things can really start changing for you. As you increase your ability to tolerate negative emotions and states of mind, you have more energy for other things and bounce back from setbacks faster. You can face and work through what you’re feeling. As you do this more and more, anxiety and depression lose their grip.

So, if you’ve had a few tough sessions and your anxiety or depression are worse, don’t give up or think you’re doing something wrong. It might just be part of the process, and you might be really close to a major shift in how you feel.

You might be surprised to find that good therapy makes you less nice.

Don’t get us wrong—if therapy is working, it shouldn’t make you an asshole. But it might help you learn how to fawn less and be less of a people-pleaser. It might help you stop being polite or “nice” in ways that get you hurt. It might make it easier for you to stand up for yourself and say “No” when “No” is the most appropriate response.

As you stop censoring yourself or making yourself smaller, you stop sending people the signal that only their needs matter.

This might cause you to shed some bad relationships early in the healing process, but ultimately, it will make it easier to attract and build relationships where you feel valued and get your needs met.

When you act as if you are worthy of dignity and respect, you may find you get more. In fact, it might be a bitter realization at first: people are actually nicer to you now that you’re not trying so hard to please them. Your authenticity is warm and inviting and draws people who want to experience a genuine connection with you even if sometimes you’re gruff or weird.

So, if you’ve been in therapy for a while, examine the ways you relate to others. A sign therapy is working is that you realize it’s not your job to make everyone happy at your own expense, and if that means you’re less “nice” than you were, you’re okay with that.

Good therapy can help you learn the difference between people-pleasing and genuine kindness. Healing and reclaiming your sense of self-worth can have you apologizing less just for taking up space in the world or for being who you are. This can make you seem less nice to people who were used to you not standing up for yourself.

However, that’s only half of what happens. Part of the healing process is opening your heart. As you heal your wounds, they become less raw and tender, so you don’t have to close down as much to guard them. As a result, not only do you become more willing to be vulnerable and more likely to reach out for connection, but you also start to experience unforced feelings of kindness toward others.

As you compress yourself less, you develop a sense of spaciousness. Giving yourself more room makes it easier to give other people room to be who they are. As you gain insight into the causes of your suffering, your sense of compassion naturally grows. So does your patience.

Kindness that comes from compassion feels different than people-pleasing because it doesn’t feel forced or pressured. You don’t feel like you have to help; you just want to help. And when you don’t want to help, that’s okay. You’re better able to judge how full your tank is and to say “No” when you’ve got nothing to give. You’re nicer to yourself, too, and forgive yourself more easily.

One of the most important gifts that therapy can give you is self-knowledge. So, one important sign that you’re making progress in therapy is that you know yourself better.

One way this happens is that you become familiar with your reactions and emotional patterns. Good therapy will give you tools to change them if and as you want to, but simply learning what they are goes a long way.

And yes, many kinds of therapy will help you learn how your childhood, your parents, and other important caregivers and figures in your life affected you. You’ll learn how to recognize what’s truly yours and what beliefs or habits you picked up or absorbed from people around you, especially when you were young and impressionable.

Healing helps you let go of baggage that was never yours to carry in the first place. It can be hard, and hurtful, to realize how you carried shame or fear your whole life because someone made you believe something about yourself or the world that wasn’t true. But that realization sets you free.

And not all self-knowledge is difficult knowledge. Good therapy also helps you learn what you really like and what fills your well. It helps you find the courage and inspiration to move toward those things and cultivate a life that has more of them. As you learn what really nourishes you, you start to develop good habits and to reach for them over the bad.

There’s a lot that a little self-knowledge can do. And good therapy can give you a lot of it. So, if you’re not sure if you’re making progress, ask yourself: do you understand yourself more than you did? If you do, that’s no small thing.