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  • Writer's pictureKristen Genzano, LPC

"Exploring the Depths: Deciding When to Take Your Therapy to the Next Level"



After more than a decade working with clients in long-term therapy, I’ve sat across from clients time and time again who have met the goals they initially entered therapy for, have started to integrate new habits into their daily lives and are unsure about if they should continue therapy; unsure of what the next phase would look like. I tend to use this moment to explore the many possibilities of therapy. 


Throughout our lives it’s common for people to do some work in therapy, take a break, and return to therapy down the road when something difficult arises. For some clients, this ebb and flow is exactly what’s needed. For others, once a point of stability is reached, a shift into “deeper” exploration is what’s called for. As a therapist I find this deepening an exciting moment in the work. 


Despite my excitement and enthusiasm, going deeper in therapy can feel scary and uncertain for many clients. It’s entering into often uncharted territory; a place where we don’t know what we’ll uncover. Although shifting into deep work is a natural progression in treatment it can feel a bit like leaning back in a trust fall.


If you’ve been wondering what going deeper in your therapeutic work might look like, this post is for you. 


The Start of Therapy: Why Most Clients Begin

You’ve reached a tipping point. Whether it’s a distinct stressor such as a recent health diagnosis, the death of a loved one, infertility, relationship stress, increased depressive symptoms, or mounting life struggles from undiagnosed challenges (ADHD, Autism, Anxiety, Body Image, CPTSD) you recognize that you’ve struck a point at which the status quo is no longer working. Something has to change.


This is the most common reason for reaching out to a therapist. Whether it’s the first time or you’ve been in therapy before, a discreet stressor is most often the impetus for engaging. 


The Arc of Treatment: Three Phases

Depending on the type of therapeutic approach, therapy can last anywhere from three months to three decades! For those who enter therapy with a specific concern such as the scenarios described above, the arc of treatment typically moves through three phases and often resembles a downward slope.


During Phase One, symptoms are acute and session frequency is high. You might meet with your therapist anywhere from 1-3 times a week. In the first couple of sessions you work with the therapist to determine a treatment plan. During this time the focus is on understanding why you’re experiencing distress, exploring existing coping tools, and identifying changes you would like to make in order to experience relief.


Once you feel relief from the immediate distress, the therapist may help you build coping skills and expand internal and external resources. This is Phase Two. During this period the focus is on creating sustainable and integrated skills to support you in managing and thriving in your daily life. These skills can range from stress management skills to how to handle difficult emotions


Once you reach a level of stability and consistent use of newly learned skills therapy often shifts to Phase Three: Maintenance. It’s during this phase I most often hear clients state they don’t know what to discuss. The immediate crisis is over and there’s often a general sense of wellbeing. The client is capable of navigating daily challenges however there is often a quiet desire to keep going, to go deeper. This sense can feel like standing on the edge of a cliff, peeking down at a beautiful body of water and not knowing how to get there, how to dive in.


Why Go Deeper?

In 1943 Abraham Maslow developed what’s called the Hierarchy of Needs. In short, this model suggests that as our basic needs (food, shelter, water) are satisfied we have the foundation to build upon and move up the hierarchy toward safety and security, belongingness (positive relationships), and esteem (sense of accomplishment).


As we move through therapy clients often develop the skills and resources (inner and outer) to meet foundational needs on a regular and consistent basis. Once this happens you may feel a sense of relief as well as an increase in ease and joy. Many clients decide this is an appropriate time to end therapy.


For others, however, this is just the beginning. Many clients find that once their foundational needs are met they’re ready to dig deeper into self-understanding, growth and – the top of Maslow’s hierarchy – self-actualization. According to the model, self-actualization is reaching one’s full potential. Self-actualization consists of attributes such as morality, creativity, and spirituality. It’s the experience of personal fulfillment completely aligned with your own values. For many people this sense of deep purpose and meaning is the most important aspect of psychological growth.   


How do I Go Deeper in Therapy?

Many of us – especially those of us who have struggled with basic needs in our lives – are unsure how to access the top of the hierarchy. It can be incredibly helpful to have a trusted therapist by your side to help you move into the space of exploration, creativity, and play. This is one kind of deep work.


Some approaches to depth work include exploring your core values. Connecting with your core values may allow you to identify what your own moral compass looks like and how to take action in your life that aligns with your personal values. 


Another approach to working deeply is exploring Family of Origin themes. This might include reflecting on generational trauma, or working to understand how your family system shaped your relational patterns and psychological aspects such as self-esteem. 


A third, very common way to approach depth work in psychotherapy is by working with the unconscious. Carl Jung worked with the unconscious through dream analysis. Creative therapies such as art therapy and dance movement therapy are other modalities that might support you in going deeper in therapy.


How do I Know I’m Ready for Depth Work?

Doing “deep” work looks different for everyone. As a therapist it’s important that I follow my client’s lead on what depth work is for them. 


If you’re not sure what your personal depth work is, consider exploring that question with your therapist. Your therapist may have noticed some themes in what you’ve explored during your time together. They may be able to highlight some patterns they’ve observed in your relationships or ask open-ended questions that help you get in touch with what going deeper means to you.


Take time to assess your own level of readiness. Sometimes when you hit a lull in therapy it might be time to take a break from the work. Perhaps you’re ready to focus on putting the skills you’ve built into practice or to put more energy into building deep and meaningful relationships outside of the therapy room. Whatever the case is for you, consider what you need and explore that with your therapist. Your therapist should always be available to listen to what you’re experiencing and what your view on your treatment progress is.


Lastly, an important piece of the growth process to remember is that it is not linear. We move in and out of the need for urgent or acute support. It’s also okay to take breaks from therapy. Don’t be afraid to talk to your therapist about taking a break or about reassessing your goals. Maybe it’s time to shift from coping to building a creative practice and your therapist is able to support you in that shift!

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