When Therapy Makes You Feel Terrible Before It Makes You Feel Better

Three and a half years ago I started seeing two women at about the same time: Sarah, who would become my girlfriend, and Laura, my therapist. Sarah and I fell deeply in love and moved in together fairly quickly. Laura was with me for every mile, treating my anxiety and depression, forged during a childhood rife with love and provisions from my family, confusingly mixed with a lack of acceptance.

The first couple years of my relationship with Sarah, including the latter one during which we cohabitated, were pock-marked by small, occasional squabbles, but generally it brought extraordinary happiness. In sessions with Laura, I became far more in tune with my emotions, understanding their roots and allowing myself to experience and work through them. Things slowly began to fall apart between Sarah and me, though. Arguments became more frequent and virulent; I’d get minor panic attacks hearing her footsteps coming up the stairs to our apartment. At that point—more than two and a half years into our relationship—there was either going to be a lifetime commitment or dissolution.

So I moved out. It was the worst.

What followed was the stuff of R&B songs and sitcoms: without-warning crying spats, sometimes triggered by Sarah-centric memories at places like the grocery store, in the meat aisle. I’d toss chicken breasts and a steak into my basket, resisting the muscle memory of grabbing salmon, too. I don’t eat fish, but cooked it for Sarah all the time. The produce section was a whole other adventure.

In a recent session with Laura, one of my most hardcore breakdowns had me, uncontrollably, weepily repeat, “I miss her! I miss her so much!”

Knowing my history of burying my feelings, Laura pointed out that the pain I was channeling—at 38 years old—was actually very new to me, compliments of all the work I’d been doing in therapy. “In fact,” she continued, “because you’re so much more self-aware, I don’t think you’re just sad about the loss of Sarah. You’re mourning all your exes.” Apparently, therapy had opened some enormous emotional flood gates.

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It’s moments like those that, for me and many others in treatment, illustrate a therapy paradox of sorts. Patients seek psychoanalysis to find comfort, to feel better emotionally. However, during sessions, and even outside the therapist’s office, diving into the deep end of the fears, self-esteem issues, trauma, and other foundational causes of one’s mental illness is anything but pleasant. In fact, it can be like opening a wound and then irrigating it before it gets to heal.

“People are motivated to avoid pain,” says Roger Moore, a North Carolina-based psychotherapist. “Of all the pains we have, emotional pain is the most acute.”

Moore says that over time people can develop “perhaps maladaptive, but functional ways to modulate their emotions,” repeatedly ignoring pain as a means of coping. But such an approach isn't healthy, and the buildup of all that unaddressed discomfort, according to Moore, can lead to ulcers, distress, high blood pressure, pain and fatigue, not to mention a variety of mental illnesses.

For their part, therapists must get their patients to confront what’s truly ailing them, even if that method of avoidance has in some ways—and for many years—served them well.

“In most good therapy, [therapists] are, at a minimum, pushing clients to be uncomfortable,” says Noelle Lefforge, a Nevada-based psychotherapist. Therapists, Lefforge adds, “really have to believe there’s going to be value in doing that…even though you see some suffering that comes from it.”

Lefforge, who’s also assistant director of The PRACTICE, the mental health training clinic at the University of Las Vegas, instructs her students to approach clients as though they’re going to “hold their feet to the fire, but not burn them.”

Moore says that, once his clients enter therapy, “a straight, upward slope in terms of feeling better,” is ideal. But he explains to them that “oftentimes there’s a dip, initially, and then we hope that it feels better as time passes.”

Such dips in his clients’ well-being, spurred by their fresh confrontations with emotions, were difficult for Moore to observe early in his career. He says he had to alter his thinking, telling himself to always have empathy for his patients, while making sure he compartmentalized his feelings appropriately.

My therapist, Laura, tells me that going for analysis (a.k.a. therapy) is sometimes reminiscent of a visit to the dentist: You’re in pain, and then you pay for the privilege of experiencing more of it. She says she’s inspired by clients who push through merely the fear of attending a session—much less the daunting task of dealing with one’s emotions—perhaps for the first time as an adult.

The aftermath of my split with Sarah meant an overflowing of sadness, resentment, regret, loneliness, and all the other classic feelings that come with the end of a long-term relationship—just multiplied sevenfold, one time for each significant other I count since I started dating, including one wife.

I had never let the pain of those breakups flow through me. I even recall thinking, proudly, about a year after my divorce, that I hadn’t cried once, and was clearly handling it all really well.

This post-breakup period, approaching its ninth month, is still challenging. Writing this wasn’t easy, and there’s still both therapy and food shopping to be done this week. Still, there’s the promise that therapy brings positive results, if only eventually. Allowing ourselves to feel emotions, no matter how bitter, “lets us live genuinely and fully,” Moore tells me. “We can’t have up if we don’t have down, satiation if we don’t have hunger, warmth if we don’t have cold.”

Therapists provide a safe space for patients to healthily encounter those hard-to-bear emotions. But they can’t offer any promises that you’ll like being there. “As a psychologist, my primary goal is to help people better function in their lives,” Lefforge says. “My job is not to remove suffering from anybody’s existence, but it is to make them able to function despite what life throws at them."

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