What to do when therapy does not work?

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I have been approached by many, they tell me therapy is not working for them and they don’t know what else to do. They have tried combining therapy with medicines and still see no change. Mental illness is still considered a first world problem. It takes time for someone to finally agree to seek therapy and when it doesn’t yield results; it can break you.

I am here to tell you that therapy might not work the same for everyone. But this does not mean that you cannot be helped.

We will first tackle the question – Why?

Why is it that therapy might not work for everyone?

There are a couple of reasons!

  • Your therapist might not be taking the right therapeutic approach:
    Different people respond to different types of therapy and the same approach might not work the same over a wide spectrum. It could be that your particular therapist lacks the training required to tackle your issue and is not able to adjust his/her approach based on the individual’s problem. This is okay. You can always change your therapist and ask for a recommendation.

 

  • The client only wants to rant:
    A lot of people think of therapy as a place to go and vent out one’s problems. While discussing one’s problem is a huge part of therapy, therapy is also about the client working on those problems and wanting to make progress. It’s about change! This could be with the help of exercise, therapy homework, lifestyle changes or simply listening to your therapist.

 

  • Therapist and client don’t share a good rapport:
    Therapists are always asked to practice empathy and have a positive transference towards their clients. There have been instances where the therapist and client are simply not a good fit for each other. The therapist may realize that he/she is not able to help this person progress any further and will then refer them to someone who can be a better interpersonal fit.

 

  • The client doesn’t open up:
    Therapy is considered as a last resort by a lot of people because of the stigma. Sometimes, people are forced to go for therapy and don’t actually want to be there. They don’t cooperate with the therapist and don’t talk about their issues with honesty. People also experience shame or anxiety when discussing their problematic behaviour and divulge only a part of the story. People need to understand that this is a safe space, it is a place where you don’t have to pretend. You can be vulnerable without being ashamed.

 

  • Clients drop out of treatment:
    There could be many reasons for a client to drop out of treatment. It could be because they don’t have the money to afford therapy, believe that therapy is not helping or that it is hard work. They might also stop taking medication and this may lead to a relapse which can be very dangerous.

 

  • Negative associations with therapy:
    People who have never been to therapy might have a negative preconceived notion about it. This can sabotage therapeutic success. For e.g. if the client thinks that it is the therapist’s job to “fix” him or “cure” him within a few weeks, this will affect their perception of therapy and lead to failure.

 

What do we do if we feel that therapy is not working for us?

  1. Talk to your therapist:
    It is very important to be honest with your therapist about your progress. If you feel that the current approach has left you stagnant, tell your therapist about it. Do not rant about it to your friends and family members, they wouldn’t know what to do. The best person to give you directions would be your counselor. He/she may change their treatment approach or refer you to another therapist.

 

  1. Do your homework:
    Therapy is not magic. It requires diligence and hard work from the therapist as well as the client. If the client doesn’t want to get better, he will never try and this would be a wastage of time for everyone involved. You will never learn Math or English and get better at it if you don’t do your homework. Similarly, you will not see results if you don’t do your therapy homework. Complete all assignments and exercises given to you by your therapist. If they are not giving you homework, ask for it!

 

  1. Have patience:
    Therapists can’t remove all the problems from your life. This is not how therapy works. It doesn’t make your problems disappear, rather it equips you to go out there and solve those problems for yourself. It takes time and effort. The results also differ for different people. You need to work on yourself and your emotions, you need to be ready to open up about your actions and problematic behaviours. You need to be patient with yourself and the process. You need to trust your therapist.

 

  1. Pursue lifestyle changes:
    This has helped me the most. My therapist told me that I will never get better and my medications would never stop if I don’t make some major lifestyle changes. I used to sleep around 3 AM and would wake up at noon. This had been going on for a while and it took a major toll on my body and mind. I started suffering from insomnia which in turn led to me experiencing consistent anxiety attacks.
    Medication works as a short-term fix. I had to make some tough lifestyle changes in order to get better. This included:

    • Sleeping and waking up on time.
    • Getting a good night’s sleep (7 – 8 hours)
    • Eating better
    • Taking some time out to develop a proper schedule and planning my day.
    • Exercise!
    • No screens before bed (keeping the phone away 1 hour before getting into bed)
    • Meditation or yoga! or just taking out 5 mins to slow down and focus on my breathing.

 

  1. Try a new therapist:
    I understand that it’s frustrating to change your therapist and talk about your issues all over again with someone new. But mental illness is just like any other health condition. If you have a heart disease and a particular treatment doesn’t work for you, do you throw a fit and decide to give up? No, you try another treatment because you WANT to get better. It should be the same with therapy. Why would you want to compromise with your mind? If one type of therapy fails, there are plenty of other options. Yes, it is work but you will find your match eventually.

    Change your therapist if the following has not been established:

    • Realistic goals and milestones haven’t been set in order to measure progress.
    • They have not talked to you about the treatment and what is in store for you.
    • They haven’t had a conversation with you about medication or if it’s needed.

 

  1. Talk to your doctor about medication:
    If therapy alone is not working for you, you might need to start taking medicines along with that. If you are already on medication and it’s not getting better, you may have to increase the dosage, take a combination of medicines or switch medicines completely. Talk to your doctor about the next steps, do not stop taking medicines on your own.

 

REMEMBER:

  • If one treatment doesn’t work, don’t give up!
  • Don’t resist the idea of taking medication and be responsible with it.
  • Never stop taking medication on your own, always consult your doctor.
  • Work closely with your doctor to find the correct treatment for you.
  • Be honest with your doctor!

If you are planning to go for therapy or are looking to change your approach, remember!

  • Therapy is not going to show instant results, you will have to work.
  • Therapy is NOT an easy fix. If you have taken the decision to go for therapy, I applaud you. You have finally decided to confront your issues instead of taking the easy road.
  • Therapy is not going to change your personality but it will optimize you. It will help you introspect and better understand your inner turmoil.
  • Therapy can’t change other people in your life but it will change how you respond to them.
  • Success and failure are subjective. I don’t think therapy ever fails. You learn something new from every person you meet, every therapist you see and every time you fail.

It is a long process but with the right kind of help, you will get better.

Hope this was helpful. How has therapy helped you? Do let us know in the comment section!

Hiraeth – Gayatri Lakhiani Chawla

That summer we left our childhood behind

in the darkling mango orchard,

before we knew it

the julienne carrots and turnips

left to sour and pickle

in the scorching sun,

before we knew it

grasping the stone-fruit in our fists

as if the sky had fallen

the lightening felling our wrists

leaving our chappals in the yard,

the porch lights switched on

awaiting our quiet return

we walked away,

before we knew it.

 

 

Gayatri Lakhiani Chawla is a published poet, freelancer and French teacher from Bombay. Her poems have been published in International anthologies and journals. Her poem Anagram won the 2013 Commendation Prize at The All India Poetry Competition, New Delhi. She was a featured writer for Wordweavers Poetry Contest 2015/16. She is the author of book of poems, Invisible Eye.

The time never returns – V B Sree Harsha

The time never returns,
when there were no cars but carts, when the fight for freedom was on and when people went on trading unawares, that someone was inventing a steam motor somewhere and the orange skies of the setting sun had put an end to the day’s work, because someone like ‘Graham Bell’ and ‘Einstein’ never retired, as they didn’t know when the sun rose and when it retired.

On the other side, conflict of religions had been rising and wars began to get their hands on opium, as industrial revolution rose to the fight for occupancy. Where a person somewhere is dreaming a world of peace, unaware of the revolts in the neighbouring country, where the struggle for freedom is pushed stronger

than it ever had been and the railways came in handy to transport goods, but were burnt and looted to stop foreign trade. And the struggle to gain independence began, and borders of nations were drawn, but someone at someplace at that darkest hour was trying to get food, unaware about a man who was walking past the

deserts in search of trade, sun striking from the edge of his eye, tired and weary, not knowing that nations were fighting for wealth and reign over another, while children somewhere were playing cricket game

with a bat straight as a stick, when a deathly sound was heard from far. As ‘hiroshima’ collapsed, fear and death cries went through the skies and all this happened long ago. The time before I was born and a glimpse I

couldn’t catch… but thinking back into ages puts me into deep thought, running miles from nowhere to an unseen distant. Boundaries blinding my eyes and pinching the deepest point of my heart to narrate it, but whenever I do, something remains untold.

 

 

V B Sree Harsha hails from Visakhapatnam, Andhra Pradesh. He is pursuing computer science engineering from Andhra University, Visakhapatnam. He likes to travel, form new relationships and think for long hours.

Sueña el rey que es rey [Calderón de la Barca] – Ricardo Pau-Llosa

Even the dream of power requires skill

conjured blank like beats and breaths, tidal

and leaf fallen.  It mustn’t stir the will

but augur dusk in rises and lid the total

real of dream as if the life of life

depended on it.  Unchained, the prince

at sudden court unfurled his bleak rife

nature and, waking dungeoned, is convinced

that all fates are rancor’s child, throne

in a pauper’s cup.  And so he rises toward justice

at the pinnacle of the unreal, alone

with perfect choices, content with the fullness

the ungripped fog provides to the host blind

stranger, king of self and world and kind.

 

 

Ricardo Pau-Llosa’s 8th book of poetry will be released next year by Carnegie Mellon U Press, which published his previous five titles. His poems have appeared in Agni, Ambit, American Poetry Review, Antigonish Review, Arion, Atlanta Review, Barrow Street, Beloit Poetry Journal, Bellevue Literary Review, Birmingham Poetry Review, Boston Review, Christianity and Literature, Cimarron Review, Cincinnati Review, Dalhousie Review, december, Ekphrasis, Epoch, The Fiddlehead, Hollins Critic, Hudson Review, Image, Island, Kenyon Review, New England Review, Ploughshares, Plume, PN Review, Poetry, Poetry Salzburg Review, Saranac Review, Southern Review, Southwest Review, Stand, 32 Poems, Vallum, Virginia Quarterly Review, Volt, among other literary magazines and numerous anthologies. He is also an art critic and curator.

Billiards – Kevin Casey

“If you shrank the Earth down to the size
of a billiard ball, it would be smoother.”

–Discover Magazine, 2008

 

 

In the beginning, God racked up the planets,

and–dusting the Cue of His Will with the Blue

Chalk of Chance–the Inscrutable Geometrist

disturbed the quiet surface of the slate’s felt.

 

And from that first break, the spheres still chatter

against each other like polished bones,

career in erratic arcs from a side spin,

thud and shudder when a bank is struck.

 

With an opponent only imagined,

it’s no sport, but just a game, and He’ll run

the table in time, until the last ball slips

beneath the firmament through some pocket,

rumbling to stillness once the final shot is called.

 

 

Kevin Casey is the author of And Waking… (Bottom Dog Press, 2016), and American Lotus (Glass Lyre Press, 2018), winner of the 2017 Kithara Prize. His poems have appeared recently or are forthcoming in Rust+Moth, Valparaiso Poetry Review, Connotation Press, Pretty Owl Poetry, and Ted Kooser’s syndicated column ‘American Life in Poetry.’ For more, visit andwaking.com.

In the slums – Beaton Galafa

I was cut out of a chameleon’s belly

Refusing to fall off a tree and burst

On shanties heating themselves up in the sun

That lay like rats massacred in a cornfield

When they found me freezing.

I lay dead marvelling at the maroon on roofs and dust

The knickers hanging in the winds

A heap of garbage to keep the scent alive

The boy in mud ferrying water home in a gallon,

To learn if I could survive a generation.

As it rained kids thrilled their horrors in drains

As some bent backs with noses kissing water

To quench thirst in the heat that followed the rains

And beat dwellers downstream,

Washing rags and dishes to rid the mud and dirt.

A flick of light before I died again

The sun hit on one bright shanty and bounced back

To shine over a group of men and women in queues

Waiting to vote wisely and maybe rise

As a little boy and sewage wondered. If it really mattered.

 

Beaton Galafa is a Malawian writer of poetry, fiction and nonfiction. His works have appeared in Birds Piled Loosely, Atlas and Alice Literary Magazine, Bhashabandhan Literary Review, The Wagon Magazine, Betrayal, The Seasons and in many other international literary magazines.

Two tablespoons analogy and a pinch of salt – Anirban Dam

 

 

two decades and a handful of years later

you realized that even two people

wanting the exact same thing, when placed

in a same room can feel lonely together.

 

my mother always kept the spices on the top shelf

along with the pickles and the jar of salt

(but never sugar or honey.

she’d always keep them on the bottom shelf)

and due to her tall and slender build, it was

always within her grasp.

 

she’d say that everyone should always

have something sweet within their reach

and that no one should have to struggle for it.

but that is how it is with the most of us —

we struggle to seek the things we

need the most, and by the time we acquire it

we no longer possess the struggle to justify what we need.

 

two people in the same room

are struggling to reach the salt.

 

you watch their fingers flutter for a while

before they finally give up and fall still

like dandelions —

 

swaying,

stationery,

slowly disintegrating beneath a motherless roof.

 

this is how grief appears to the naked eye

when within striking distance.

 

Anirban Dam is a twenty-something parasite who thrives on guilt-free sarcasm and gluten-free poetry. His physical form was last spotted in Bombay.

 

The space between silence – Anirban Dam

 

Never turn your back while exiting a temple,

it brings bad luck. Almost a decade later

these words have resurfaced again

(mothers usually tend to show up unannounced)

 

only this time you are willing to explore

the undertones in that statement.

 

Back then, your understanding of the word back

was constricted. A patch of skin evenly spread

between nape and tailbone, partially visible without a mirror.

 

You didn’t know about organ systems —

the inversely proportional relationship between eyes and feet.

 

How each receding footstep shrinks a landscape

to fit your perspective.

 

The horizon gradually reduced to a hyphen, the skyline

compressed to resemble the cuts on your door key.

 

How fickle is this estrangement,

which grows with each receding footstep, how uncertain

the distance which occupies this ever-increasing space.

 

This is how grief operates.

It tricks you into turning your back

 

and instantly all this blur around you sharpens itself into focus,

every single strand of noise slowly evaporates.

 

All that is left behind is a sound

desperately trying to find its voice.

 

Silence couldn’t possibly be more inarticulate.

 

 

 

Anirban Dam is a twenty-something parasite who thrives on guilt-free sarcasm and gluten-free poetry. His physical form was last spotted in Bombay.

 

One-part poetry – Ajay Jhawar

 

I am a glass of milk mixed with mishri that started melting in the heat of summer and you, you want to drink me every morning. I am one-part routine and you are 12 hours work. I am taste you miss or calcium that sticks to your bones.

I am 6 hours sleep you desperately need after a long day at work. I am dreams, you are real, and for reasons strange you want it otherwise. I am one-part energy and you are 8 am in the morning, ready for another fight.

I am temptation, you are stress that will fall in the trap. I am the justification of sin and you are the sinner, but then I am ugly and you have a reputation. I am one-part confidence, you are patriarchy.

I am a handhold, you are a broken heart locked in a room, where light hasn’t reached and it’s 6 am. I am friendzone, you are lost love, and so might I be. I am one capsule care you need tonight.

I am a much-needed conversation. You are a prisoner of your feelings. I am need and you fear being weak, but then I will burst out and you will smile. I am one-part vulnerability, you are caged voice.

I am moon, you are lonely and it’s 3am. Sleep hasn’t arrived. I am lost pain, you are a wreck tonight. I am a six page long letter that was never posted, you are eyes. I am one-part memory, you are running from your regret, the meeting will continue till sleep arrives.

I am a two-minute read and you are anger. You don’t have milk or water and you can’t go for a walk either. I am rhyme, and you are frustration developed at the wrong time. I am one-part poetry, you are an unsettled mind.

 

Ajay Jhawar, 21, studying to be an engineer, which means trying out everything except engineering, hence writing. A resident of Kolkata, India.