How long does it take?

How long it takes for symptom relief varies with the problem. In my experience gross symptoms -- obsessing, phobias, panic, social and sexual anxieties -- clear up rather quickly, within 15 or 20 sessions. If there is no progress in these areas after a good college try, it’s time to consider another therapist or other treatments [behavior therapy, biofeedback, medication].

In any event, I can usually promise patients that within about 15 sessions they will see some change. Probably not a cure, but a clear difference in how they think, feel, and act, or in how things look to them. Some patients see a change sooner, sometimes a big one.

Other kinds of problems need more time. In general, those that are less circumscribed take longer. That is, something which is part of a general pattern of troublesome behavior and feelings in your life probably won’t evaporate as quickly. This should make some intuitive sense. A behavior that is more embedded in your personality, that reflects your overall way of getting through life, will be more difficult to uproot than one that feels like a thorn in your otherwise comfortable side.  

Be aware that it can take a long time just to tell your story, even if you feel highly motivated to do so. Especially if you’ve never really told the whole truth to someone -- and this is more common than we like to admit -- it can be hard to let another person know your secrets. Meanwhile, it may appear to those outside a session that not much is happening. I think that’s unfair to patient and therapist. Someone with this resistance may be honestly trying to talk, but old habits die hard. Many people consciously and in good faith try to tell their therapist what hurts, but the stories come out incomplete, censored, sanitized, confused. (See the beginning of Ron, and you may want to reread this)

Even when the symptoms that bring you into treatment turn out to be the expression of major problems in your life that might take some time to root out, you can still get rapid symptom relief. Therapy is not an all-or-nothing proposition. You don’t even have to resort to medication, nontraditional psychotherapy, or anything else. You should still see clear change within about 15 to 20 sessions. It is sometimes the case, however, that until you root out those larger problems, you won’t get a lasting change. [Ed, Jim]

When to Stop?

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