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Expectation vs What Therapy is Really Like – Illustrated

Even if you’ve never been to therapy or studied psychology, you’ve probably heard of “breakthroughs” in therapy. It’s a word that Hollywood loves – but doesn’t really exist in real life.

In media depictions of psychotherapy – where therapy is often used as a gimmick to advance a plot rather than a realistic representation – a breakthrough is shown as a big “ah-ha!” moment of realization that, once experienced, forever changes a person’s life moving forward.

Lindsay Braman's visual illustration of how hat we expect from therapy often doesn't match the reality of therapy.

Real change happens a bit at a time, however. (For most people starting therapy, according to some research, it takes around 6 months after beginning therapy to experience change). There may be a few significant “lightbulb moments,” but more often – therapy looks like lots of little “oh’s” of small realizations, that are each  markers of tiny shifts in thinking that add up big time over months and years.

Therapy: expectation versus reality. Buy the print on a mug!

And it’s not just realizations that change us – It’s what we do with them.

Our beliefs inform how we move in the world, so when our beliefs shift – even just a little – it takes some time for that to trickle down into our behavior, and even more time for our significant relationships to adapt around that change.

Therapy is all about the long game: improvements in the short term are possible and reasonable to hope for, but a good attitude to bring to therapy is to focus on the long-term goal. Think of it as a compass: changing your trajectory by just a degree or two can, over time and distance, take you to a completely different destination.

Lindsay Braman's visual illustration of how hat we expect from therapy often doesn't match the reality of therapy.
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Image description for screen readers: The main image in this post depicts the expectation and reality of therapy, as shown through graphs.

The first graph is titled “What we think therapy is like.” It is labeled “symptoms” on the y-axis and “time” on the x-axis. The graph shows a line very high on the y-axis slowly declining across the x-axis until it hits a point labeled “giant breakthrough.” After this point, the line drops drastically, showing the the breakthrough reduces symptoms automatically. 

The second graph is titled “What therapy is like.” It is labeled “symptoms” on the y-axis and “time” on the x-axis. The graph shows a line starting high on the y-axis that slowly declines across the x-axis with a peak halfway across that is labeled “crisis.” Along the line on the graph are little points labeled “small insights.” This shows that therapy is made up of small insights over a long period of time that gradually reduce symptoms.

All therapy is not the same, and all trajectories in therapy are different. Different therapists work at different paces, and some clients need a lot more time to begin experiencing the small breakthroughs that lead to big change- every therapist/client combination will work on a different timeline, but some research suggests that most individuals who see a therapist through once a week therapy will start seeing results within six months.

This art attempts to illustrate a very simplified version of this. Your graph of your expectations for therapy and your graph of your reality (should you try therapy), probably won’t look much like this set of graphs at all- and that’s okay. Everybody’s different and gets to create their own timeline of treatment and recovery. And just like in the graph on the right-hand side of the image, most people will probably never experience full remission of all of their mental health symptoms. Instead, there because us the tools to manage her symptoms in a way that they no longer cause us extreme distress or interrupt our lives or get in the way of our goals.

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