How to Make Progress in Therapy When It Feels Like You're Going Backward

Here's the thing about therapy progress-it almost never feels the way you expect.

Why Nine Therapy Sessions Hasn't Fixed You (And What That Actually Means)

You're nine sessions into therapy. You've done the work, shown up consistently, tried the strategies. And for stretches of time, it feels like something is shifting-you're more aware, more present, more connected to what you're feeling.

Then the dip hits.

The emotional numbness returns. Feelings that were accessible yesterday have vanished. Everything feels flat, empty. And the first thought that arrives: I'm going backward. Nothing is actually working. Maybe I'm broken in some fundamental way that can't be fixed.

If you've had this thought, you're not alone. But what if I told you that the reason therapy feels like it's not working has nothing to do with whether you're broken-and everything to do with where the actual work of change happens?

The One Place Therapy Actually Changes You (It's Not the Session)

Here's what most people don't see when they go to therapy:

The session itself isn't where change happens. The fifty minutes in the therapist's office? That's where you learn about the strategy, understand why it matters, map out what you'll do.

But the actual rewiring-the moment your brain builds new pathways, the instant you connect a physical sensation to an emotion for the first time, the second you notice a feeling before it disappears-that happens in the 10,080 minutes between sessions.

Research on therapy homework adherence shows something striking: when scientists track people session by session, they find greater improvements in symptoms during the weeks when people practiced more between sessions. Not after having more sessions. During the weeks with more practice.

The invisible mechanism behind therapeutic change is this: Sessions give you the map. Practice between sessions is the actual journey.

Most people believe the session count is what matters. "I've had nine sessions, I should be better by now." But that's like believing that nine cooking classes should make you a chef-without considering whether you've actually cooked between classes.

The therapy room is where you learn. Your life is where you change.

How Postponing Your Session Became the Smartest Therapy Decision You Made

So here's what happened when you made the decision to postpone your ninth session:

You'd just returned from Germany-your first time traveling there. You'd been away on holiday. You looked at the list of strategies you'd created with your therapist the previous session and realized: you hadn't had adequate time to actually practice them.

You could show up to session nine on schedule. Check the box. Stay on track to finish your ten-session allocation.

Or you could postpone the session to get two more weeks to implement and practice the strategies. To try them in real-world situations. To collect data on what actually works for you.

You chose to postpone.

And your immediate thought was: "I'm procrastinating. I'm being difficult."

But here's the strange part: if between-session practice is the primary driver of change, and sessions are primarily where you learn what to practice... what were you actually choosing when you postponed?

What You Actually Chose When You Postponed (It Wasn't Procrastination)

You were choosing the thing that makes the difference.

Research shows that therapy session frequency matters, but not in the way most people think. Studies find that weekly sessions are associated with better outcomes-when people are actively practicing between sessions. But rushing through sessions without adequate practice time? That's prioritizing completion over effectiveness.

When you decided that coming to a session without having practiced would be "pointless," you were recognizing something fundamental: sessions without implementation are just conversations. Informed conversations, yes. Helpful conversations, absolutely. But transformation requires taking what you learn in that conversation and testing it against reality.

You weren't procrastinating. You were prioritizing effectiveness over arbitrary completion.

You weren't being difficult. You were recognizing that checking a box without doing the actual work would be performative-going through the motions while missing the mechanism of change.

Here's what research on the space between therapy sessions reveals: the transitions between therapy and everyday life are essential but seldom recognized parts of the therapy process. Disturbed transitions have an adverse impact on outcomes. When people don't have adequate time to integrate what they learned, to practice it in multiple contexts, to encounter obstacles and adjust-the therapy is less effective.

You chose integration over efficiency. And that choice was strategically sound.

Your Emotional Dips Have a Clinical Name (And a Treatment Path)

Now let's talk about those emotional dips-the ones that make you feel like you're going backward, like you're fundamentally broken.

Those dips have a clinical name: alexithymia. Difficulty identifying and describing emotions. Moments where emotional awareness seems to vanish completely.

And here's what almost no one mentions when they're nine sessions into therapy and experiencing these dips:

Alexithymia affects approximately 10% of people struggling with mental health symptoms. In therapy populations specifically, that number rises to 25%. One in four people in therapy experiences exactly what you're experiencing.

It's not personal brokenness. It's a recognized pattern with documented treatment approaches.

Systematic reviews of psychological treatments for alexithymia show that multiple approaches can be effective-acceptance and commitment therapy, behavioral activation, schema therapy, compassion-focused therapy. There's even a structured program called TREAT (Training to Reconnect with Emotional Awareness Therapy) that teaches emotional awareness skills in just eight sessions. Participants in randomized controlled trials showed significantly less alexithymia, emotion dysregulation, anxiety, and depression after completing the program.

But-and this is the part that matters-all of these approaches require sustained practice. Not sustained sessions. Sustained practice.

The research explicitly states: treatment effectiveness requires tailoring interventions to individual emotional difficulties and patient subgroups. One-size-fits-all doesn't work. And emotional numbing is identified as "a long-term aspect requiring sustained therapeutic work."

Long-term. Not nine sessions and done. Not linear improvement without dips. Long-term sustained work.

The dips aren't evidence that therapy isn't working. The dips are part of the documented pattern of working on this particular challenge.

How to Actually Measure Whether Therapy Is Working

Let's connect this back to your specific situation.

You've been approaching therapy with an invisible assumption: that the number of sessions completed should correlate with the degree of improvement. Nine sessions = 90% better. That's the mental model most of us carry.

But that model doesn't match the mechanism of change. The mechanism is: learn a strategy → practice it in multiple real-world contexts → notice what works and what doesn't → adjust based on that data → practice the adjusted version → build the skill through repetition.

That process doesn't map to session count. It maps to practice volume and quality.

This is why your previous approaches felt like they weren't working. You were tracking the wrong metric. You were measuring sessions attended rather than strategies practiced.

And this is why the trip to Germany felt different. You said during travel you were "more present"-that everything was new, so you had to pay attention, you couldn't go on autopilot. That wasn't a magical property of Germany. That was novelty creating natural conditions for awareness.

You discovered something crucial: novelty is a catalyst for emotional awareness. When you try new food, navigate new places, encounter new experiences, you can't rely on automatic patterns. You have to be present. And presence creates opportunities to notice what you're feeling.

What becomes possible now:

You can stop measuring progress by session count and start measuring by practice consistency. Three solid weeks of daily two-minute body scans will do more than three additional therapy sessions without practice.

You can stop interpreting dips as failure and start interpreting them as expected fluctuations in a long-term pattern. When a dip happens, it's not evidence you're broken. It's confirmation you're working on exactly what research identifies as a long-term challenge.

You can stop waiting for big moments and start engineering micro-novelties. Different route to work. One new thing from the book series you're reading. Small experiments that create the same awareness conditions as traveling to Germany-without requiring international flights.

The Four Between-Session Practices That Build Emotional Awareness

You have two weeks before your final session. Here's how to approach them:

Practice Strategy #1: The Body-Emotion Connection
Every morning, two-minute body scan. Not to relax. Not to feel better. To practice noticing physical sensations and gradually connecting them to emotional states. Research on reducing alexithymia shows that interventions targeting the ability to identify feelings and bodily sensations are particularly effective.

Practice Strategy #2: Daily Emotion Labeling
Label at least one emotion per day using discrete emotion words. Even if the most accurate label is "neutral" or "uncertain." The practice of labeling-of putting language to internal experience-is one of the core skills taught in structured emotional awareness programs. You're building the skill through repetition.

Practice Strategy #3: Weekly Micro-Novelty
One new thing per week. Doesn't have to be dramatic. Try a food you've never had. Take a different route. Attempt something from your book series. Then journal what you notice about emotional presence during and after.

Studies show that regular daily practice of identifying and describing feelings leads to measurable improvements. Not the occasional practice. Not the "when you remember" practice. The daily practice.

Practice Strategy #4: Compassionate Dip Response
When a dip happens-and it will, because that's part of the documented pattern-you now have evidence-based self-talk: "This is alexithymia. It affects 10-25% of people in therapy. This dip is part of a long-term pattern I'm working on, not evidence that I've failed. The practice is what matters, not perfection."

Your final session will be most valuable if you arrive with two weeks of data: what you tried, what you noticed, where you got stuck, what surprised you. That's the raw material for refining your approach.

How to Choose the Right Long-Term Approach for Your Specific Pattern

You now know that emotional awareness skills can be systematically developed through structured, sustained practice. You know the dips have a name and a treatment pathway. You know that between-session practice is the mechanism of change.

But here's the question this raises:

The research mentions multiple therapeutic approaches that show effectiveness for alexithymia-acceptance and commitment therapy, behavioral activation, schema therapy, compassion-focused therapy, structured emotional awareness training programs. The evidence explicitly states that treatment effectiveness requires tailoring interventions to individual emotional difficulties.

You've discovered through your own experience that novelty supports your emotional awareness. That you respond well to collaborative decision-making. That you value real-world practice over completing sessions on schedule.

Given what you now know about yourself-about how you respond, what supports your awareness, what patterns show up-which evidence-based approach would you want to explore in greater depth for long-term management?

Because you're not broken. You're working on a documented challenge that requires sustained, tailored practice. And the question isn't whether you can develop these skills. Research confirms you can.

The question is: which specific approach fits the way your particular version of this pattern shows up?