Growth in Therapy is Not Linear
Back in my previous life as a college professor, I had to teach a course titled “Fundamentals of Quantitative Data Analysis”. This is a fancy way of saying “statistics”. I was teaching statistics. To social science majors. The first day of class, I was usually met with a crowd of faces displaying the kind of dread that is only reserved for people going to traffic court or the dentist. My first act of the semester was to start with a little pep talk about how the pathway to learning statistics is rarely a steady, uphill pattern of knowledge acquisition. Growth in mathematics does not come in predictable increments that chart like half of a perfect Bell Curve. It comes in fits and starts after long periods of nothing making sense, less like the smooth side of a hill and more like the most erratic and unsafe staircase you could ever imagine.
A person starts at a flat plateau with a certain level of understanding, slogging through days and weeks of confusion until there is a moment of clarity, and that plateau morphs into a huge step upward, only to lead to another plateau. This flat period may last a day, and then there is another step upward, this one small and less significant than the first, but it is a sign of progress. And so begins another knowledge plateau, this one lasting a month. It seems pointless. There is no clarity happening. Then, another magic step appears, and a whole new level of understanding opens up. This step may gain you feet instead of inches, but it just leads to another plateau that is there until it meets another step. Maybe this plateau is a few centimeters long and it leads to a step that is barely an inch. The amount of the gain is not what is important. The fact that the gain happened at all is the win.
Ironically, in the past eight years of being a therapist, I have come to realize that growth in therapy is a lot like learning statistics. My clients constantly want to be climbing, steadily acquiring growth on a Bell Curve, only to be met by the reality of a staircase. What is even worse is that, unlike with learning math, we sometimes regress in therapy, tumbling back down that staircase to some random point, left to gather our bearings and recon how far we have fallen, only to start that journey back up again. Sometimes, we can leap back up the staircase with the dexterity of a gymnast. Other times, we get injured upon landing and just have to lie there a while, recovering until we are ready to limp our way back up.
When I encounter clients who spend most of the initial session complaining about why their previous attempts at therapy have not worked, the reason usually relates to the expectation that growth will be linear, brisk, and steady. They see relapse or regression as a sign that the process failed them, not that the process is following patterns that our brains and bodies are hardwired to experience. Change is hard, and it sometimes involves failing, backtracking, or stalling completely. In fact, most models of psychological growth and change specifically include a phase of relapse or regression to reflect how hard real growth can be to both achieve and sustain.
Growth in therapy is not linear, and helping people understand this can be one of the hardest parts of my profession. It can be very difficult to reassure my clients that they are making progress when their partners, friends, family members, and colleagues are eager to point out the ways in which they are falling back into old patterns and habits, sometimes after months of progress in therapy. It is even harder to reassure them when they notice they are falling back into those patterns and habits. I choose to take the fact that they even noticed the regression as the sign of growth. I remind them that having a person they care about point out something uncomfortable to them, without them being reactive or shutting down, is a sign of growth. There has been some progress towards change, which is what matters. And I remind them to take the win and to continue to strive for the next one.
Written by Deanna Diamond, LPC
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