When reflection feels endless, the walls can close in

Have you ever noticed how we sometimes accept things in therapy that we would never tolerate anywhere else in life? If your mechanic couldn’t fix your car after years, you’d fire them. If your doctor prescribed treatment after treatment for high blood pressure and nothing changed, you’d seek another opinion. If your roof kept leaking after multiple “repairs,” you’d call in a new contractor. If your personal trainer worked with you for years and you still couldn’t run a block, you’d find a new trainer.

And yet, in therapy, many people sit in the same chair week after week, sometimes year after year, faithfully paying while the original problem never shifts. What we wouldn’t accept from any other professional, we often accept in therapy.

How long have you been working on the same issue in therapy? Has anything shifted in a measurable way?

Why Do We Lower the Bar for Therapy?

It’s not hard to see why. Therapy provides a place to talk, vent, and be heard. That can be deeply comforting. People leave sessions feeling lighter, like they’ve processed something important. And for a time, that sense of relief can feel like progress.

But comfort isn’t the same as change. If you’re still facing the same challenges years later — if the anxiety hasn’t eased, the relationship patterns haven’t shifted, or the depression remains just as heavy — therapy may have become less a path forward and more a waiting room.

Sometimes people even wear therapy like a badge of honor: “I can’t make this decision without talking to my therapist first.” But when therapy turns into a substitute decision-maker, it can erode your own agency instead of building resilience.

The truth is, talking has value. Naming feelings can link experience to action. But when talking doesn’t eventually lead to doing, therapy risks becoming lopsided. Even with the best of intentions, sessions can drift into patterns that feel supportive in the room but leave nothing changed outside of it.

Do your therapy sessions leave you with steps to try — or just a sense of temporary relief?

What Physical Therapy Gets Right (That Mental Therapy Often Misses)

This is where another kind of therapy offers a useful comparison. Think about physical therapy. I know this firsthand. After destroying both knees, having surgery on both hands, and needing a hip replacement, I’ve spent a lot of time in physical therapy. And here’s the thing: it isn’t mysterious.

You don’t walk into physical therapy and spend an hour talking about how you feel about crutches. You don’t sit in a circle with the machines and discuss your relationship with exercise. You work. You stretch, you lift, you bend, you push against resistance. It’s uncomfortable. Sometimes it hurts. And when you leave, you have homework: exercises you’re supposed to do every day.

Every one of those exercises is already out there. You get them in a booklet after surgery. You can download them from the hospital website. For my hip, there was even an app with a step-by-step program. None of it is a secret.

So why go to physical therapy? Because the value isn’t in information — it’s in accountability. The therapist makes sure that, at least for an hour or two each week, you’re doing the work you might avoid on your own. And even then, if you don’t do your homework, progress stalls.

Now, mental health is far more complex than a broken bone. Trauma, abuse, and deep emotional wounds don’t heal on a neat timeline. Talking is part of that process. But the principle still applies: if therapy becomes only talk with no movement, it risks keeping people stuck instead of helping them grow.

What would “doing the work” look like for you, outside of the therapy room?

Knowledge Isn’t the Problem — Action IsWall of books — knowledge isn’t scarce — the challenge is turning it into change

This is the real issue: knowledge isn’t what people lack. We live in an age of endless resources. There are thousands of books, courses, podcasts, and programs outlining strategies for depression, trauma, addiction, and relationship struggles. It’s all out there.

What’s missing isn’t information. What’s missing is support for turning information into practice.

That’s what physical therapists provide. That’s what personal trainers provide. That’s what coaches provide. And that’s what therapy should provide, too. Not advice — because advice is just someone else’s plan — but accountability for the work you’ve chosen to do.

Because without that kind of accountability, mental health therapy risks becoming good conversation without practice — and without practice, progress can stall.

If you already know what would help, what’s stopping you from putting it into action?

When Advice Crosses the Line

This connects to another trap: advice.

If therapy starts to feel like it’s just about following instructions — “Do this. Go to AA. Break up with him. You’re not serious unless you follow my recommendation.” — that’s a red flag. Real progress comes when you feel empowered to make choices that fit your life, not when you’re simply carrying out someone else’s agenda.

Good therapy is about helping the client discover their own way forward. Guidance and information have a place, but they should open doors — not close them. There are many paths to sobriety, for example. If a therapist insists there’s only one, they’re narrowing options instead of broadening them. And when that happens, therapy can stall instead of support growth.

The problem isn’t that therapy should hand out advice. The real problem is when therapy lacks action to back up the talking.

When has advice in therapy felt empowering — and when has it felt limiting?

Three Years Later and Still Stuck? Time to ReassessWithout progress, it’s easy to keep circling the same steps

Here’s a hard truth: if you’ve been in therapy for three or four years and it feels like you’re still circling the same issue, it’s worth reassessing. Is this approach actually working for me? Am I making real progress, or am I just talking in circles?

In almost any other part of life, you’d expect to see results. You wouldn’t keep paying a mechanic if your car never got fixed. You wouldn’t stay with a piano teacher if, after years, you could only play “Chopsticks.” You wouldn’t keep taking French lessons if all you could say was “bonjour.”

Yet in therapy, people hesitate. It can feel ungrateful to leave. It can feel scary to start over. It can even feel like failure to admit an approach isn’t helping. But staying in therapy that isn’t moving you forward doesn’t protect you from failure — it only delays progress.

If you imagine your life three years from now, would you be okay with still working on the exact same issue?

The Question Every Client Should Ask

So how do you know if your therapy is actually helping? Here’s a simple test: ask your therapist for a copy of your treatment plan.

Every patient is supposed to have one — insurance requires it. But many clients never see it, or don’t realize they can ask. A treatment plan doesn’t have to be complicated or intimidating. At its core, it’s just a roadmap: what you’re working on, how progress will be measured, and what comes next.

Without one, therapy can feel like driving without a map — plenty of motion, but no clear direction. If you’ve never seen your plan, ask. A good therapist will welcome that conversation. Reviewing it together isn’t just paperwork; it’s part of your progress.

Do you know what your treatment plan says about your goals and progress?

The Cost of Standing StillTime doesn’t pause while we wait to feel ready

Here’s the most sobering piece: you don’t get the time back.

Every week spent spinning in place — talking but not moving forward — is gone forever. These aren’t just dollars spent; they’re hours of your life. If therapy doesn’t lead to meaningful change, what you’re really buying is the illusion of progress. And that illusion costs the one thing you can’t replace: time.

When you’re 90 and looking back, do you want to say you spent decades “working on it,” or that you actually did the hard things, took the risks, and built a life that felt alive?

If your future self could talk to you now, what would they urge you to do differently?

What Therapy Could Be

The good news is that therapy doesn’t have to be this way. At its best, therapy is powerful. It can spark motivation, sustain momentum, and help you face difficult truths. It can give you a safe place to talk and the support to turn those conversations into meaningful action.

That’s how I approach coaching. Some of my clients work with me for years, but never on the same issue we started with. There’s always growth, always forward movement, always new challenges. If a client paid me thousands of dollars and made no progress, I’d consider that a failure on my part.

Therapy should be no different.

What would “forward movement” look like for you right now?

Don’t Mistake Talking for ChangingAt some point, every journey asks you to choose a direction

Here’s my challenge:

If you’re in therapy, ask yourself honestly: am I moving forward, or am I just talking?

If you’re not doing the hard work outside of sessions, why not? That’s where the real progress happens.

And if your therapist can’t show you a clear plan, maybe it’s time to reconsider whether this therapist — or this approach — is the right fit.

Therapy should never be a waiting room. It should be a path forward.

So what do you want from therapy? Sometimes people truly want comfort — a safe place to talk, be heard, and feel supported. That’s a valid choice. But if what you want is change, comfort alone won’t get you there. That’s where clarity, accountability, and action have to come in.

The key is being honest with yourself. Ask: What do I actually want from this process? Am I getting it? Therapy isn’t one-size-fits-all — and your answers will shape whether you stay stuck or move forward.

Want to learn more? Check out these resources:

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