Ten Years of Therapy. Why Are You Still Here?

You liked her. That is the part that makes this hard to say out loud.

You went for years. You were not lazy about it, you did not skip, you did the reading. You understand your family now in a way you did not before. You can explain yourself accurately and at length.

And your Tuesday looks exactly the way it looked nine years ago.

This is the most common reason people telephone me, and almost nobody who telephones has worked out which of the three things went wrong. They usually suspect it was them.

It generally was not.

Nobody ever asked you to do anything

This is the most common by a wide margin.

You talked. She listened, and she listened well. You arrived at real understanding together. Then the hour ended and you went back to your life and did the same things you had always done, and the next week you came back and reported on having done them.

Insight was the entire product. Nothing was ever required of you between Tuesdays.

I have written elsewhere that understanding your marriage and coming home an hour earlier are two different acts, and that almost everybody would rather do the first one. Ten years of the first one is a very good education and it is not a treatment.

How to tell this is yours. Think back over the whole run and try to name one specific thing you were asked to do, in the world, before the next session. If nothing comes, you have found it.

Nobody ever told you the truth

Harder to detect, because the sessions felt warm and useful.

There was something about you that a competent professional would have seen inside a few months. Something in how you talk about your wife, or the job, or your mother. She saw it. She never said it, or she said it so gently and so hedged that it went past you as a pleasant observation rather than landing as a fact.

This happens for decent reasons. Nobody wants to rupture a good working relationship. A patient’s anger is unpleasant to sit with. It is easier to stay useful and warm than to be useful and briefly unwelcome.

How to tell this is yours. Ask whether you have ever left a session annoyed. Not devastated. Annoyed, at something that turned out to be right. If in ten years you were never once irritated on the drive home, you were probably being handled.

A decade of good sessions can leave a person superbly educated about their own history and no better at Thursday. Understanding clears the ground. Something still has to be built on it.

I want to be careful here, because this is easily misread. The answer is not a therapist who says whatever occurs to him. Most of what I notice about a person in the first month is never said aloud, and the restraint is the work itself, and it costs something to hold. The question is whether they are ever said at all.

It was the wrong fit and everyone was too polite to say so

Two reasonable people, no chemistry, and a decade of appointments.

Fit matters more than almost anything else in the room. The relationship is what does the work, and if it never quite caught, no amount of technique compensates. A couple came to me having gone through four therapists before, spending a great deal of time and money and arriving nowhere. There was nothing wrong with the four therapists.

How to tell this is yours. If you have caught yourself editing before you speak, deciding which version of the week to present, then you were performing rather than being treated, and you will have been the last person to notice.

What I understood about the woman who asked me this

She had ten years behind her and she opened by apologizing for wasting them.

What I could see was that she was doing in my office exactly what she had done in the last one. She was being an excellent patient. Prepared, articulate, generous about her previous therapist, quick to take the blame.

So I did not begin with her history. I said that she had just apologized to a man she had met four minutes earlier, and asked who taught her to do that.

I chose the word apologize because it was hers, from her own first sentence. Borrowing a person’s own word is the difference between an observation they can take in and one they defend against. And I said it early only because she had handed it to me early. Most of the time I would have waited months.

She has since described that hour as the first time in a decade anyone put anything to her that she had not already thought of herself.

What the first session looks like

More questions than you are expecting, and quite personal ones sooner than feels normal. That surprises nearly everybody.

I will ask what you actually did last week, not only how you felt about it. I will probably ask you to do something before you come back. And I will tell you if I think you should stay where you are, because sometimes the answer is that the treatment is fine and the person simply needed to hear that from somebody else.

An Invitation

If you have years behind you and nothing to show for them, that is worth one honest consultation with a person who has no stake in defending what came before.

Bring the ten years. They are usually why the next part moves quickly.