Why Therapy Might Not Be Helping and What You Can Do
If you’ve been in therapy for years with little progress, it’s important to ask why. Sometimes therapy is used for support rather than change, which is a valid approach. But in other cases, lack of results may signal deeper issues: a poor therapeutic fit, lack of safety in the relationship, or a missed diagnosis. For people with dissociative identity disorder (DID) or OSDD, symptoms often go untreated because therapists focus only on anxiety, depression, or PTSD. If therapy hasn’t helped after years of work, it may be time to consider dissociation as part of the picture.
Is this you? You’ve had years of therapy. With few results. The length of time may vary. It’s important to understand that a prolonged period of in terms of years with little to show for it is something to pay attention to. This is especially true if you’ve worked with several therapists for long periods of time and have little to show for your efforts.
Some people use therapy, as a source of support rather than as place to make progress on mental health concerns. This is a valid approach to therapy, and can be one reason a person may be in therapy for years without much evidence of progress or change.
Aside from this, though, the only other reasons I can figure are indications of problems. Years of therapy without results might be an indication of poor therapeutic rapport. That is, a person might feel that their therapist isn’t a great fit for them, or worse, they might believe that the therapist isn’t very invested in trying to help. A person might find that therapist to be judgmental or cold instead of compassionate or supportive.
These all feed into the second potential problem, a lack of safety. If someone experiences their therapist as judgmental or cold or dismissive they are very likely to be lacking a sense of safety in the relationship. Without some sense that you can be vulnerable without being hurt, it’s hard to take small risks and experiments that can lead to big personal growth and healing in therapy.
A third issue that they underlie years of therapy with few results is therapy that didn’t treat the root cause. I see this a lot in my work associate identity disorder. For instance, if the therapist is unaware their client has DID, they may focus on the client’s anxiety, PTSD, or depression. These are issues that, of course, have huge impacts on a person’s life and they definitely deserve to be addressed, but treating anxiety or PTSD won’t address the weird experiences that people with DID have. Such as finding themselves across town, or the state, without knowing how they got there.
If you’ve been in therapy for years and then it seems like you should have made more progress than you have, it’s worth considering that perhaps you have dissociative disorder which has gone undiagnosed and untreated so far.
This is especially true if over the years you’ve worked with multiple therapists and have nothing to show for it. If you have a therapist that you have good rapport with, you might want to bring this up. You can ask if they can assess you for dissociative disorder or refer you to someone who is skilled in this. If you’re currently in therapy but don’t believe your therapist is someone you can discuss this with, my first response would be to get a different therapist. This is an indication that you don’t have a sense of safety or a good therapeutic relationship. You deserve to have that. And I encourage you to look for that. If you aren’t ready to move to a different therapist, I would encourage you to at least find a therapist who is knowledgeable about dissociative disorders and meet with them.