Why Therapy Doesn’t Work for Everyone (And How to Make It Actually Transform Your Life)

It’s something I hear often — and quietly — from clients:

“They’re in therapy, but I don’t see any change.”
“If anything, they seem worse.”
“I don’t understand. Aren’t they ‘doing the work’?”

These are uncomfortable observations, but they’re honest ones. And they point to a conversation that needs to happen more openly in our culture:

Therapy does not create change on its own.
The outcome of therapy depends heavily on how a person shows up to the process — not just whether they attend sessions.

As a therapist with decades of experience, I can say this clearly:

The clients who get the most out of therapy are not the ones who are the most articulate, insightful, or emotionally expressive.
They are the ones who are genuinely willing to ask,
“What might I be missing?”

Therapy Isn’t About Telling Your Side — It’s About Seeing Your Blind Spots

Many people enter therapy believing the goal is to:

• explain what happened

• be validated in their feelings

• have someone confirm they were right

• feel understood and supported

Those things have a place — especially early on. Feeling safe and seen matters.

But therapy stalls when it stays there.

If sessions become a weekly retelling of stories where:

• you are consistently the reasonable one

• other people are always the problem

• your reactions are endlessly justified

• responsibility is externalized

Then therapy quietly turns into ego reinforcement, not growth.

And that’s when people say:

“I’ve been in therapy for years, but nothing is really changing.”

The Question That Changes Everything in Therapy

The clients who experience real transformation almost always ask some version of this:

“Where might I be getting this wrong?”
“What am I not seeing about my role in this?”
“What patterns am I repeating without realizing it?”

That question requires:

• humility

• emotional maturity

• tolerance for discomfort

• willingness to be corrected

And it changes the entire direction of therapy.

Because now the work isn’t about defending an identity —
it’s about expanding awareness.

Why Some People Get Worse in Therapy

This is hard to say, but it’s true:

Therapy can sometimes entrench unhealthy patterns when clients are not honest with themselves — or when they unconsciously use therapy to justify behavior rather than examine it.

This can happen when:

• defensiveness goes unchallenged

• insight is mistaken for change

• emotions are explored without accountability

• the therapist is positioned as an ally against others rather than a mirror

Research consistently shows that client factors — such as openness, readiness for change, and willingness to self-reflect — are among the strongest predictors of successful therapy outcomes, often outweighing the specific modality used.

In other words:

Insight without self-examination doesn’t heal. It hardens.

The Clients Therapists Love Working With (And Why)

This might surprise you, but the most rewarding clients to work with are not the “easy” ones.

They are the ones who:

• want honest feedback

• invite challenge

• ask to be shown their blind spots

• can hear hard truths without collapsing into shame

• are oriented toward growth, not approval

These clients understand something essential:

Being wrong is not a failure — it’s information.

They don’t need their ego stroked.
They want to evolve.

And therapy works beautifully for them.

If You’re in Therapy and Not Seeing Progress, Ask Yourself This

Rather than assuming:

• therapy doesn’t work

• your therapist isn’t effective

• other people just won’t change

Pause and reflect on how you’re engaging the process.

Here are some honest questions worth asking:

• Am I presenting situations in a way that protects me from scrutiny?

• Do I mainly want agreement, or am I open to correction?

• Do I ask my therapist what they see that I might be missing?

• Am I more focused on what others are doing wrong than on my own patterns?

• When I feel defensive in session, do I get curious — or shut down?

These are not accusatory questions.
They are empowering ones.

Because the only part of the equation you truly control is your own willingness to look inward honestly.

How to Make Therapy More Impactful (Practical Shifts)

If you want therapy to actually change your life, try this:

1. Lead with curiosity, not conclusions
   Instead of “Here’s what happened and why I’m right,” try
   “Here’s what happened — help me understand my part.”

2. Invite feedback explicitly
   Say: “I want you to tell me if you think I’m missing something.”

3. Notice when you want validation — and pause
   Validation feels good. Growth feels destabilizing at first.

4. Let discomfort be data
   Feeling challenged doesn’t mean therapy is failing.
   Often, it means it’s finally working.

5. Remember: awareness without behavior change isn’t healing
   Insight matters — but what you do differently afterward matters more.

The Truth About Real Therapy

Real therapy is not about being affirmed in who you already are.

It’s about becoming more conscious of:

• your patterns

• your defenses

• your blind spots

• your impact on others

And learning how to respond differently.

That process requires courage.
It requires honesty.
And it requires a willingness to be wrong — in service of becoming wiser.

If you’re in therapy and truly asking,

“Where am I getting it wrong?”

You are already doing the most important work there is.