At a glance
Liking your therapist and getting somewhere are two separate measurements, and only one of them is easy to take. Fit is made of trust, agreement about what you are working on, and room to say the thing you keep going around. This article helps you tell a session that has gone flat from a session that has arrived at something difficult.
Clinical insights from 22 years in psychotherapy
I am Mark Colclough, MA, psychotherapist in Copenhagen. Qualified at the Psychosynthesis Education Trust and the University of East London. 22 years of full-time, face-to-face clinical practice.
- People who change therapist often arrive with the same material intact, described more fluently each time.
- The session someone slightly dreads is frequently the one doing the most work.
- A stall that begins just after a particular subject came up is usually about that subject.
- People working across a time difference tend to book the hour at the end of a long day, and then wonder why they have nothing left to bring to it.
Clinical notes: My observations are anonymised and compounded from my session notes since 2004.
Is it the therapist, or is it me?
A therapist who is not reaching you and a therapist who has just reached what you came to avoid produce the same symptom, and that symptom is flatness. Both give you the small reluctance on the way to the session. Both leave you with the sense afterwards that you performed the hour rather than used it.
What separates them is not the discomfort. It is what sits around the discomfort. Where the work has reached something that matters, there is usually one specific thing you can point at: a subject you steered away from, a sentence you rewrote in your head before saying it, a question you answered for the easier version of yourself. Where the work has stalled, that specificity is missing. The hour is pleasant, the hour ends, and nothing in it has a sharp edge.
The distinction is worth making before you decide anything, because the two situations call for opposite responses. One asks you to stay and say more. The other asks you to stop and look elsewhere. Getting them the wrong way round costs months.
What a working alliance is made of
Fit has less to do with personality than with whether you and your therapist are working on the same thing, in a way you both understand. People arrive expecting to judge warmth, and warmth is easy to supply. The harder question is whether the hour is built around what is actually keeping you awake.
A 2024 review gathered the instruments used to measure the working relationship and sorted roughly 1,000 of their items. The same themes came back: trust, agreement on goals and methods, active participation by both people, and attention to what the client needs.1 Its authors were blunt about how loosely the idea is defined across the field, which is worth knowing before you treat any single checklist as the answer.
- You can say what you came to say, including the part that makes you sound worse.
- You and your therapist would describe the problem in roughly the same words.
- There is a method in the room, and you could roughly explain what it is for. Mine is set out on my page about online psychotherapy.
- Something outside the hour has shifted, even slightly, in how you react rather than in what you know about yourself.
Three of those four can be in place while the fourth is missing for a long time, and the fourth is the one that decides whether you are getting anywhere.
Liking your therapist is not the same as moving
Comfort is a good sign at the start and a question worth asking once the work has settled. Some people stay for years with a therapist they are fond of while nothing in their life changes, because the hour has quietly become a place where they are received rather than moved.
Being understood is a real relief, and relief is worth something. It is not the same as movement, and from inside a warm room the two can resemble each other for a long time. The test I would offer is not a test of anyone’s motive, because you cannot read your own motive from the inside any more reliably than you can read your therapist’s. It is simpler than that. Over the last two months, has anything you actually do differently happened outside the session?
When distance is doing some of the work
Working on a screen removes some of the friction that makes a session land, and that is a practical problem rather than a verdict on the therapy. A room has a walk to it, a door, and a few minutes afterwards in which nothing is asked of you.
Online, people often take the hour between other obligations and return to the same desk the moment it ends. The material has nowhere to settle. Before you conclude that the fit is wrong, change the conditions: a different time of day, 15 minutes with nothing in them afterwards, a room where you are not listening for someone else in the flat. If two or three sessions under better conditions still feel flat, the conditions were not what was wrong.
Saying it out loud, and when to leave
The most useful thing you can do with the doubt is put it into the session rather than settle it alone on the way home. It feels like an accusation. In practice it is information, and a competent therapist has been waiting for it.
- Say what you have noticed rather than what you have concluded: the hour feels flat, instead of this is not working.
- Name the week it changed, if you can find one.
- Say the thing you have been editing before you say it.
- Ask what the two of you are working on, and see whether the answers match.
If the response is defensiveness, or a long explanation of the method that never touches what you said, you have your answer and you did not have to guess at it. If the response is interest, you have just done the most productive thing available to you this month.
Leaving does not undo what you have done. You arrive somewhere new with a clearer sense of what you want and of what does not work for you, which usually makes the early sessions quicker. If you would like to test the fit with me, I work in English with people wherever they are living, through online therapy in English.
Questions people ask
How many sessions before I can tell?
Long enough for the first-session nerves to pass and for you to have brought one thing you did not want to bring. If that has happened and you still feel unmet, the information is reliable.
Is it rude to tell my therapist it is not working?
No, and it is usually the most useful thing you can bring. A therapist who cannot hear it has answered your question for you.
Does changing therapist mean starting again?
No. You arrive with a clearer sense of what you want and of what does not work for you. That tends to make the early sessions quicker rather than slower.
Does working online make a stall more likely?
Not in itself, though it makes the conditions easier to get wrong. Change the time, the room and what follows the hour before you change the therapist.
What if I like the sessions but dread them slightly?
Mild dread alongside liking is often a sign that the work has reached something rather than lost its way. Take it into the room before you treat it as a reason to stop.
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Sources
How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.
