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Writer's pictureDr. Jeff Mandelkorn, PhD

Has Your Progress in Therapy Stalled? What You Can Do About It.



It’s been a challenging path, but you’ve finally found a counselor you connect with, and you’ve been working hard in your therapy journey. You’ve worked through some unresolved issues and have practiced some adaptive coping skills. You feel good about how you’ve approached therapy and you feel good about your therapist.


But lately your therapy sessions seem to lack the zest they once had. Perhaps the motivating and insightful appointments have started to feel repetitious? Or maybe they lack the personal connection they once had? Or maybe there is some internal resistance that has emerged recently and is running interference in your therapy. 


Or worse yet, you might be feeling as if you are disappointing your therapist, fearing you are no longer presenting as the “good client”.

 

These are indications of a therapeutic impasse. Experiencing a slow down or impasse in counseling is normal. And if you are feeling it, chances are your therapist is as well. Why do impasses in therapy occur? 


Below are a few common situations that can ultimately lead to an impasse and potentially a dissatisfactory experience in therapy.


Poor Fit Between Therapy Goals and Client Skills: 


As a therapist, goal-setting and progress tracking are extremely important components of my work. It’s crucial I keep track of how clients are progressing towards their individualized goals. As they progress, their goals often need to be adjusted to reflect their growth and where they are in their therapy arc. A poor fit between the therapy goals and the client’s skills can often lead to confusion, frustration, even disappointment. Having been both the clinician and the client at times in my life, it can feel quite frustrating to see the hard work not translate to continued gains in therapy. 


Resistance & Self-Sabotage:


A common precursor to a therapeutic impasse is resistance. As a person continues on their therapy arc, the content of the sessions tends to become more emotionally-laden or involve more vulnerability. It’s common for individuals to experience some degree of resistance to this increase in vulnerability. Some individuals find ways to control the narrative of the therapy session, seemingly involved and engaged but really making sure certain topics aren’t broached. Other people conveniently “forget” to do therapy homework or engage in procrastination (or self-sabotage) which slows the progress of therapy. 


Trust: 


A third common consideration is trust within the therapy relationship. As a therapy client, you are encouraged to be vulnerable, face fears, and find meaning and hope in pain and suffering. Trust is a crucial component, trust your therapist will hold your vulnerability carefully, trust they will know how to manage it and help you heal through it. 


Unfortunately, this trust can be challenged, even broken. While not common, disagreements or conflict can emerge between the therapist and client. The therapy relationship is not immune to intentions being misinterpreted. For example, what I intend to be a gentle and respectful challenge to a client’s motivation may be experienced as a direct attack on that person’s character and a violation of their trust in me as a supportive, helpful influence in their life. Lack of trust leads to lack of genuineness and vulnerability in therapy, which in turn leads to stagnation.


While not an exhaustive list, the above captures some of the common situations I’ve worked through in my private practice. A therapeutic impasse is often not pleasant; however, there are strategies to prevent and manage future obstacles to therapeutic progress. 


If things start to feel stale in your therapy, say so. Talk with your counselor about what you are feeling and explore what might be connected to those feelings. 


Ask yourself some questions like:


  • Are the therapy goals clear and how do they relate to your reasons for seeking support?  

  • Are there topics of therapeutic discussion might you be avoiding or unwilling to discuss?

  • Has something happened during the course of your therapy that has shaken the trust? 


The path to resolving an impasse in therapy is through communication. Talk about any changes you might be feeling with respect to trust or motivation. Develop a collaborative plan to address the impasse and try not to personalize any negativity you might feel. Growth and change is a process, and an impasse is an opportunity to discuss and refine that process.


If you’re feeling stuck or stagnant in any areas of your life, I’d be happy to discuss how I can help. Give me a call at 954-391-5305 for your complimentary consultation. 


I provide mental health therapy for adults at our beautiful offices in Fort Lauderdale and Coral Springs, Florida.


I also offer online therapy via our secure telehealth platform.


For more information about my approach to counseling, click here

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