How to Tell Your Therapy is Working, According to a Therapist

Illustration of a hand pulling threads from a woman's head

Getty Images

Here’s what will change in your life as your work pays off.

If you’ve ever had a friend or family member who had a successful experience in therapy, you’ve probably heard them talk about the positive changes they’ve made and the mental clarity they’ve achieved. But what does “making progress” with a therapist actually look like in your day-to-day life?

In observation of Mental Health Awareness Month, we’re spending May chatting with Kier Gaines, a licensed therapist and a fount of wisdom about how to get your mental health on track. He’s already told us what you should know before starting therapy, and this week he weighs in on how you’ll see yourself change during the process — and why it’s important to lay it all out there in your sessions, including the things you’re most ashamed of.

What does “making progress” in therapy actually look like?

First things first: It’s essential to appropriately set your expectations. As powerful and life-changing as therapy can be, it most likely won’t solve every single problem you’re dealing with — and the changes you will see won’t happen overnight.

“You can’t think of change as a jump from 0 to 500. Your therapist is going to help you understand that change is a jump from 0 to .001,” Gaines says. “That’s still change, and it’s amazing.”

But one thing that may surprise you is how far back you’ll need to go as you investigate the reasons behind what’s bothering you in the present. Gaines tells us many clients come to therapy aiming to work on a specific problem, which could be anything from dealing with a bad breakup to struggling with addiction, but the progress happens when you begin to understand the things that got you there in the first place.

“Whatever you think you’re going into the room to solve, that may not be where the conversation starts,” Gaines says. “We may start talking about something that contributed to that. We may start talking about your early childhood experiences. We may start talking about how your grandfather might have struggled with similar things, and those warning signs are there, and there may even be something genetic in your thoughts, feelings, and behaviors.”

The reality is that our memories, experiences, and personal hang-ups make up what amounts to a “gigantic ball of yarn” in our brains, and Gaines says the real accomplishment you’ll make in therapy is untangling it all and understanding how your past influences what’s happening to you right now.

“Maybe you start with ‘I get anxious when people raise their voices,’ and we talk about that. And as we unravel that string, so much stuff comes out, and you never really know what it’s going to be,” he says. “But when something falls out of the closet, we tackle it. It’s one thing to expect to have a certain conversation when you go in. It’s a different thing when you’re experiencing words coming out of your mouth about past experiences that maybe you didn’t even remember or you never verbalized out loud.”

How do I know if my relationship with my therapist is on the right track?

Your therapist won’t expect you to be an open book about the most sensitive parts of your inner life as soon as you walk through the door. These trained professionals understand that their relationship with you needs time to grow. But getting to a place of wholehearted trust with your therapist unlocks benefits that can completely change how you see the world.

“The things you’re ashamed of within yourself, about things you’ve done or things you think — you hold them secret because you think these things make you a bad person,” Gaines explains. “I encourage you to share them once you feel comfortable in a therapeutic relationship because your therapist is like a mirror. You’re able to see yourself in a very different way when someone with this training, this knowledge, and this experience holds it right in front of you.”

You’ll know your therapist is working for you when you find yourself trusting them enough to go there in a way you wouldn’t with other people in your life. And when you do, you’ll be met with a great reward — what Gaines describes as “literally the safest space you’ll ever be in with a person who you didn’t grow up with.”

But just as your therapist is there to challenge you, you shouldn’t be afraid to challenge them, either. Complete and total honesty is the only worthwhile way to approach this kind of intimate relationship. 

“Sometimes we have to pause the session and say, ‘Hold on. Is the energy weird? Is something different?’” Gaines tells us. “I told a client one time, ‘I feel like you’re upset with me for some reason.’ She said, ‘Yes, you totally pissed me off the last session.’ We spent an entire hour talking about that, we got to the bottom of it, and it was an amazing session.”

What signs can I look for in my life that this work is paying off?

Now that we’ve talked about what therapeutic progress looks like and how to stay on the right path, how exactly does this change generally manifest once you’ve done the work to make it happen?

“It comes out in your interactions in real life when things are fear-inducing or anxiety-inducing,” Gaines explains. “Instead of panicking and reacting, you’re able to step back and observe your emotions, as opposed to being a passenger to them.”

To make that idea concrete, imagine that you’re having an issue with your mother, and every time you bring up those concerns with her, she gets defensive and shuts down, which leaves you feeling emotionally low. 

Your therapist will explore that reaction with you and interrogate why your interactions with your mother set you off. That could include questions like: What does “feeling low” mean for you? What are the warning signs that you’re headed in that emotional direction? What hole are you trying to fill when you ask your mother for something she’s not giving you? And what do you need to feel OK?

Being able to independently investigate your own wants and needs and assess them in the context of what’s actually available to you is a sign that your conversations with your therapist are paying off — and that you’ve achieved a heightened emotional awareness that will allow you to navigate those problems on your own.

“It’s not so much that you’ll hear your therapist’s voice in your head outside of the office,” Gaines says. “It’s that you’ll find parallels to the conversations you have in that room, and you see them unfolding in your actual life.”