You are not broken, and there is nothing wrong with you. I want to honor it might not feel that way, especially if you’ve tried several therapists, interventions, and daily practices and still find yourself struggling with hopelessness. But whether you’ve been in therapy for years or are just starting out, there is hope for you to feel better.

Navigating mental health care challenges can be tough, especially because therapy isn’t a one-size-fits-all solution. This post explores ways to deeper healing with a trusted therapist, particularly if you’re feeling stuck during treatment. Let’s explore the way forward:

Our mental health care challenges are not your fault

First, let’s talk about the systematic stuff that’s outside of your control. Our mental health care system can be tricky to navigate, and it’s not your job to fix it. Challenges include:

• High costs and insurance barriers
• Shortage of professionals and suitable interventions, including long wait lists
• Crisis-focused system with limited prevention and early intervention support
• Stigma around severe conditions and lack of compassionate care (patients treated like they did something wrong or bad)
• Misdiagnosis or no diagnosis, leading to inappropriate care
• Fragmented care between providers, lacking a holistic perspective
• Emphasis on medication, neglecting social and community support

With intentional effort, both you and your therapist can navigate systematic barriers that are getting in the way of feeling better.

Match with the right therapist

I would love to create a match.com for clinicians and clients that goes beyond specialties, modalities, and logistics, factoring in the nuances such as personality, relational styles, and so on. Why is this so crucial? Research shows that the connection between you and your therapist, often called the therapeutic alliance, plays a significant role in positive outcomes of therapy. Without a secure bond, you may start to feel things are stagnate, no matter how good the clinician or interventions are.

Look for a therapist who is thoughtful about building rapport, understands and supports your true self, adapts therapy to you, and is open to your feedback. If you ever feel less connected to your therapist, talk to them about it. Sometimes, a repair or deeper exploration can get y’all back on track. The client-therapist relationship is unique, but like any healthy relationship, it involves openly sharing all of your feelings towards the relationship and process. True healing occurs within trusted relationships, where being seen and witnessed by others is paramount.

Therapies work at different stages of healing

Evidence-based mental health therapies form interconnected approaches that address specific to broad problems. It’s important to understand different modalities’ strengths, limitations, and when they are most effective for whom. For instance, if a client experiences constant dysregulation, it wouldn’t be wise to immediately jump into CBT or EMDR. First, the client must learn self-regulation, how to feel resourced, and expand their tolerance. Additionally, if you’ve had success with a type of therapy and therapist but you are currently feeling stuck, consider exploring a different modality and therapist for continued growth.

Support your window of tolerance

The “window of tolerance” concept helps us understand how we handle emotions and stress, aiming for our optimal zone. Inside this window, we feel balanced, open to learning, think clearly, and make good decisions. Going above is “hyperarousal,” feeling overwhelmed and distressed, and going below is “hypoarousal,” feeling numb and shut down.

With a therapist’s support, avoid staying in hyper or hypoarousal too long, use coping strategies to return to the window, and improve emotional regulation and well-being. Expanding your window will feel uncomfortable, but it leads to positive change without overwhelming yourself.

Engage in the stages of change

In therapy, two common expressions are: 1) “Meet your clients where they’re at,” and 2) “Insights do not lead to change.” A therapist’s role is to honor the client’s stage of change, encourage deeper reflections, and foster bravery. However, change, even positive change, is challenging and scary. Active participation and consistent engagement from both client and therapist are essential. The stages of change are:

1. Pre-contemplation – denial of a problem
2. Contemplation – acknowledge the problem but unsure about change
3. Preparation – getting ready for change through research, information gathering, and seeking support
4. Action – changing behaviors through seeking support and trying different techniques
5. Maintenance – continuing progress each day

It’s worth exploring with your therapist if there are any unconscious barriers preventing you from turning insights into even the smallest of actions and change.

Embrace second-best growth

At times, we can get stuck in perfectionism and trigger our inner critics, feeling like we aren’t doing things right, including our mental health process. If your inner critic beats you up for not showing up perfectly in sessions, or not feeling better after coping exercises, or getting through what feels more like a to-do list of self-care, then it may be time to slow down.

Instead, notice your thoughts, feelings, sensations, and behaviors, and explore compassionate ways to give all parts of yourself grace. Some weeks, simply attending therapy or reaching out to a friend is the best you can do, and that’s absolutely okay. We are imperfect humans and that’s what makes us so interesting and endearing.

Face the roots of your complex world

While working in an intensive outpatient program (IOP) for high-risk teens, young adults, and families, I noticed a pattern of families moving between different programs, therapies, and clinicians. During a group session, we focused on CBT, and more than half of the teens were so well-versed in it that we let them teach the others (and they did an impressive job). However, what I rarely saw was the deeper work of healing attachment wounds and trauma responses in these teens and families. A trauma-focused IOP was necessary.

If you feel stuck, it might be time to explore the complex roots of your life, such as attachment disruptions, unresolved grief, and developmental trauma. This often requires resourcing, patience, bravery, and specialized, longer-term therapy with a highly skilled and compassionate provider. It is the part of therapy that can be the most vulnerable, yet deeply moving and transformative.

Acknowledge external factors that hinder internal work

If your external environment is full of daily stressors, entering your internal world might not feel safe. Defense mechanisms and protector parts serve an essential purpose in coping with life. Additionally, if you are grieving the death or loss of a loved one, relationship, pet, job, identity, health issue or any significant life event, it’s crucial to take time to honor the present-day impasse and allow yourself the necessary time to move through it. Seek support that frees up space in your external environment, allowing you to delve into the internal work with greater focus and ease.

Trust your instincts on what you need

If you are questioning your current mental health process, then trust those feelings! Maybe you’re feeling like talk therapy isn’t taking you far enough and want to try a somatic-based approach. Or perhaps you desire more time with peers in a group setting. Whatever the case, if you have a part of you itching for something new or to make a change, talk about it with your therapist. Honor those feelings and explore what might land and feel right for you. Always embrace new opportunities for growth and discovery in your healing journey.

Reflection

Photo by me, Alli.

Through my work with others, some of the most heartbreaking moments is when clients share their negative experiences within the mental health care system, often interpreting it as if they are “irreparable.” My desire is for people to realize their feelings and responses are normal, given the flawed medical system we live in. I hope the brokenness of the mental health system doesn’t infiltrate the inner worlds of those seeking support. Know you are whole and lovable as you are, with compassionate clinicians available to guide you toward feeling this truth. May you be well. May you be healthful.