How long will it take to get better

One of the questions I get asked in the early stages of working with clients, is ‘How long will it take to get better?’ When you are suffering from anxiety and depression, coping with a phobia or dealing with stressful situations, you want to get better as quickly as possible.

The traditional view of psychiatry is that you go and see your ‘shrink’ every Tuesday afternoon over a period of 2, maybe 3 years. You lie on her coach and tell her everything. How your mother didn’t love you. You father dropped you on the head when you were 6. All the traumatic experiences you endured, and of course every sexual encounter you have ever had. Through this the therapist has you come to some realisation that immediately makes you see the world differently. However once you often have that realisation you still need to work with it and come to terms with it.

Two or three years is a long time to be in pain, or confusion, or under stress. During this time, life goes on. You still have to go to work. There are children to care for. You have a relationship to maintain.

Wouldn’t it be wonderful if you could just change instantly?

Sometimes it happens like that naturally. No therapists, no interventions, no couch. You wake up one day and you think ‘right, that’s enough of that’ and you become a different person. Sometimes there is a flash of realisation – a St. Paul on the way to Damascus moment. Other times it is really hard to know what made the difference. A small change of habit can be very powerful too: daily meditation; breathing exercises, taking up running; even getting up an hour earlier..

If some people can change overnight, why does it take years for others?

One possible reason is your ‘expectations’. You expect it to take a long time, so it does. There are several different ‘reasons’ why we get the expectation that it will be a long process.

1. You got told you would be in therapy years.
   The traditional view of therapy comes from films, books and the actual experiences of many people. Some people talk about their therapist like their bank manager or their accountant. It is a long-term relationship. It’s also just nice to have someone you can trust that you can talk to about anything.
2. Your problem is far too big, significant or overwhelming to overcome it any quicker.
   Sometimes when we have some issue, particularly if we have been experiencing it for a long time, we assume that it will take a long time to overcome. Even when we look for a quick fix like hypnosis, or Neurolinguistic Programming (NLP) we suspect on some level that it won’t work quickly for us because we are too far gone, or too bad.
3. You don’t actually want to get better, even though you think you do.
   There is a factor in change work called ‘Secondary Gain’. Sometimes a behaviour or a way of dealing with things has a hidden benefit of which you are not aware. This is a part of my early questioning of new clients. I want to find out if there is a benefit to the behaviour that might hold a client back from changing too soon, or at all. If there is, then it helps to find other ways to fulfill that benefit.

How long do YOU think it will take?

Sometimes I like to turn the question around and ask the client, what their expectations are. ‘How long do YOU think it will take?

They may say a year, or six months. They rarely say a week or a month. Part of my job is to manage their expectations. I could say, ‘it will just take one short session’, and in some cases this can actually be true. It is a risk though, because then someone who needs a little more time, or has not revealed something on a deeper level, could go away disappointed and feeling that the therapy has failed when they just need more time.

In my experience, six sessions can be a bit of a magic number for many. It can be very effective to raise expectations this high. It is often a surprise that I think it can be this quick, but six sessions is long enough that the client can adjust to the idea of rapid change.

It is based on experience too, the vast majority of my clients do experience at least some level of improvement in this time, and for many it is enough for them to be significantly better. If there is more to do, or the client simply wants to peel back more of the layers of self-awareness, then we can go on working together. On the other hand, if they recover more quickly, it’s hardly something to complain about, is it?