Why You Might Not Be Healing in Therapy (And What Needs to Change)
Have You Been in Therapy but Still Feel Stuck?
If you’ve been to therapy—maybe multiple times—but still find yourself repeating the same patterns, you might be wondering if therapy can truly help. You’ve done the work, gained insight, and yet, your behaviors, emotions, relationships, and even your body still carry the weight of past experiences. Maybe you still feel stuck in cycles of shame, chronic anxiety, hypervigilance, or self-doubt. Maybe no matter how much you talk about your struggles, real change never seems to happen. If this resonates, you’re not alone—and the issue may not be you, but the approach your therapy has taken.
Healing is possible, but it requires an approach that works with all parts of you—not just your thoughts, but your behaviors, emotions, nervous system, and deeper sense of self. Traditional talk therapy often focuses on insight and cognitive reframing, which, while helpful, is not enough for those dealing with years of dysfunctional patterns.
If you feel like therapy hasn’t helped you heal, it may be because your therapy experience hasn’t addressed the full picture of what you need to recover.
Why Traditional Talk Therapy May Not Be Enough
Many therapy models focus primarily on discussing emotions, analyzing thought patterns, or uncovering the origins of pain. While these approaches have value, healing demands more than just intellectual understanding. Insight alone does not lead to transformation.
Patterns of distress are stored in the body, nervous system, and deep emotional memory. They show up in your automatic responses, your relationships, and even your ability to feel safe in your own skin. True healing requires a multidimensional approach that integrates all aspects of your experience.
A Multi-Dimensional Approach to Healing
If you’ve been stuck in therapy, it might be because it only addressed one or two of these dimensions rather than the whole picture. Here are six key dimensions that need attention for deep recovery:
Relational – Healing happens in safe relationships. Therapy should offer a space where you can experience security, attunement, and healthy connection—especially if your past relationships have been marked by neglect or harm.
Behavioral – It’s not enough to talk about change; you need to practice new behaviors. This might mean learning how to set boundaries, responding differently to triggers, or engaging in self-compassion instead of self-criticism.
Cognitive (Thoughts & Beliefs) – Instead of just challenging negative thoughts, healing requires defusion from them (an ACT approach). This means noticing thoughts for what they are—just thoughts—not absolute truths. You learn to observe your inner critic with curiosity rather than letting it dictate your identity or choices.
Emotional – Painful experiences often leave emotions stuck or overwhelming. Therapy should provide a safe space to explore and process emotions without avoidance or over-identification. Learning to sit with discomfort, rather than suppressing it, leads to greater resilience.
Somatic (Body & Nervous System) – Many people don’t realize that healing means working with the body. Nervous system regulation, grounding techniques, breathwork, and movement can all help restore a sense of safety.
Spiritual & Existential – For many, healing includes reconnecting with meaning, purpose, and something larger than oneself—whether that’s through nature, creativity, community, or personal beliefs.
What If You Don’t Identify as Having Trauma?
Some people may not resonate with the term "trauma," yet they still struggle with dysfunctional patterns or feel the need for therapy during challenging times. Regardless of whether you see your experiences as traumatic, a multidimensional approach is still necessary for meaningful change. If you find yourself stuck in unhelpful patterns or lacking the tools to navigate difficult situations, it’s likely that past experiences—whether you perceived them as trauma or not—have shaped how you interact with yourself and the world.
If you want to learn skills you can use for the rest of your life and start operating in the world in a more values-based way, you need an approach that goes beyond just talking about your struggles. Therapy should help you engage in deep, lasting change that touches all aspects of your well-being.
Case Study: How Multidimensional Therapy Supports Healing
Meet Sarah. She’s been in therapy for years but still struggles with deep shame, hypervigilance, and emotional numbness. She understands her past intellectually, but her patterns remain unchanged—staying in toxic relationships, overworking to avoid feelings, and battling constant self-criticism.
When Sarah starts therapy with a therapist who integrates a multidimensional approach, the process looks different:
Relational Work: Her therapist builds trust and models safe, attuned connection, allowing Sarah to experience security in a relationship.
Behavioral Shifts: Instead of just talking about her triggers, Sarah practices values-based actions—like setting a small boundary or allowing herself to rest without guilt.
Cognitive Defusion & Self-as-Context: Rather than trying to replace negative thoughts, Sarah learns to observe them with curiosity. She notices when self-judgment arises but no longer lets it control her.
Emotional Processing: Instead of suppressing emotions, Sarah practices allowing and accepting them without being overwhelmed.
Somatic Healing: She learns grounding techniques that help her feel safer in her body and reduce her chronic hypervigilance.
Spiritual Exploration: As Sarah heals, she reconnects with creativity, community, and a sense of meaning beyond her past experiences.
After several months, Sarah notices real change. She no longer fights to control every thought or feeling—she allows them to come and go without letting them dictate her actions. Her body feels more at ease, her relationships are healthier, and she starts choosing behaviors that align with the life she wants to live.
How ACT Supports a Multidimensional Healing Approach
Healing isn’t just about what happens in therapy—it’s about what you take from it into your daily life. Therapies like Acceptance and Commitment Therapy (ACT) work across all six dimensions of healing:
Relational: ACT helps you develop a compassionate relationship with yourself, which improves your ability to form healthy external relationships.
Behavioral: ACT encourages taking committed action based on your values, helping you change unhelpful behaviors.
Cognitive: Rather than trying to replace negative thoughts, ACT teaches defusion—the ability to notice thoughts without being controlled by them.
Emotional: ACT fosters acceptance of all emotions, reducing avoidance and increasing emotional resilience.
Somatic: Mindfulness techniques in ACT help regulate the nervous system, promoting a sense of safety and presence.
Spiritual: ACT emphasizes values, meaning, and living with purpose, supporting deeper existential healing.
When therapy includes these principles, it becomes a space where real transformation happens—not just intellectual insight, but deep, embodied change.
Conclusion: You Deserve Therapy That Actually Helps You Heal
If you’ve been in therapy but still feel stuck, it’s not because you’re “failing” at healing. It may be that therapy hasn’t fully addressed all the dimensions of your experience. True healing requires a multidimensional approach—one that integrates thoughts, emotions, behaviors, the nervous system, relationships, and meaning.
You deserve therapy that actually helps you heal. If you’re considering therapy again, take this knowledge with you. Ask questions, advocate for yourself, and seek a therapist who truly understands what it takes to create lasting change. Your healing is possible.
Note: If you find yourself avoiding the work, feeling overly dependent on your therapist, or something feels off in your relationship, check out my article Not Getting Much Out of Therapy? How to Tell If It’s Time to Stay, Switch, or Stop. This piece discusses the barriers to therapy success and how to overcome them: Not Getting Much Out of Therapy? How to Tell If It’s Time to Stay, Switch, or Stop
Exploring how these themes resonate in your own life? Therapy can be a place to unpack, find clarity, and move forward in a way that feels true to you. If you’re interested in seeing how we might work together, please review my specializations in the “About You” menu at the top of the page. I work with women in Seattle and across Washington State.
