The first experience of real psychological change is rarely relief. It is loss.

One of the most common things I hear from my patients is: “I thought therapy was supposed to make me feel better.” As a therapist, I cannot offer timelines or guarantees. I can only say that sometimes therapy feels worse before it gets better, and that this is not a failure, but a sign that something real is shifting. The task is not shallow reassurance, but the courage to remain in discomfort long enough for expansion to occur.

Why Therapy Feels Worse Before It Gets Better

We have been trained to interpret discomfort as pathology. If something feels worse, something must be wrong.

But when familiar structures begin to shift, identity destabilises. We may no longer recognise ourselves or our role. As mirroring fades, it can feel like a loss of existence, a profound emotional disorientation. Guilt may emerge. Shame may surface. So too may a loneliness that feels far deeper than ordinary solitude. We may feel disloyal to our families or strangely unrecognisable to ourselves. We may even miss the way we used to be. What follows can often be misread as failure, when in fact it may be the beginning of change.

What happens when we strip ourselves of illusions? In many traditional cultures, rites of passage forced such confrontations. Modern psychedelic experiences can sometimes bypass the rational ego that seeks to preserve psychological homeostasis. In depth psychotherapy, the process is slower and more deliberate. Through consistent sessions, questioning, and the gradual loosening of old patterns, we may begin to glimpse a different way of being. This is often the moment when a psychological threshold is crossed. And if we do not retreat immediately — which many people do at such crossroads — resistance surfaces: “I don’t know about this therapy. Why would I want to change? It’s not so bad. Maybe this isn’t for me.” 

Even the most skilled therapist cannot lead someone further than they are willing to go, and for some, that is far enough. They either end or sabotage the treatment in some way. Especially when the culture around encourages immediate relief: “If it doesn’t feel good, leave.” I help many people realistically observe their limits and say, without shame, this is as far as I can go right now. Change is rarely absolute and more often than not it is incremental. I think about this often, not in a negative way, but as a realistic assessment. When we are holding generations of inherited patterns, transformation may not look like demolition, it may look like expansion, a widening of the walls rather than their collapse.

And some of the deepest work I do with people is when they come back after months or years and say, ok, I’m ready to go a bit further now.

The Loss of Ritual Containment

Historically, cultures encoded disorientation into shared rites of passage. In many traditional societies, rites of passage involved separation from the mother, pain, cutting, fasting, or symbolic death. These rituals didn’t eliminate suffering; they acknowledged it as inevitable and gave it meaning. Even within Christianity, Lent functions as a voluntary stripping away of comfort, a collective entry into the symbolic desert. It is a time of fasting, to give up the excesses or comforts that typically soothe us, in order to contemplate and connect with a deeper and more interior part of ourselves.

As I consider the role of modern day psychotherapy in the transformation process, I often see it as replacing, or at least substituting something that we have lost. As shared ritual weakens in contemporary culture, individuals often enter desert states privately, without symbolic scaffolding. This is where I see the use of the psychotherapeutic endeavour. When we begin we are usually hopeful that therapy will help us to change something. Crossing the threshold means looking at the defences we use to avoid the parts of ourselves that may need help. The first experience is not transformation, but barrenness. And psychotherapy is here to contain it, not eliminate it.

The Grail and the Wounded Land

One of the most enduring myths of our age, The Holy Grail, has been examined in many different ways but, following the work of Emma Jung and Marie Louise Von Franz, it can be thought about as representative of a psychological individuation process. Briefly, the myth revolves around a land that has become dead and barren with a wounded king stuck in his tower, unable to make a difference. The myth revolves around the arrival of a knight, who is able to tolerate the wound of the king and ask the right question at the right time. In so doing, the land can be set free from the curse and fertility can return.

”Only he who was purified by fasting and purification could resolve it.”

The message could be, fertility runs through introspection, purification and endurance, not optimisation. It is about engagement with the wound, not sidestepping it. 

Myth vs. Ideology

In a recent professional discussion, I was struck by the discomfort that genuine thinking can provoke. We have created codes intended to keep us safe, yet they can harden into prisons. This points me to the path of ideology. Myth invites us to stay with suffering, “You are in the wilderness. Stay.” Ideology promises explanation and immediate resolution, “ You feel bad because something is wrong. Leave.” Without symbolic containment, suffering becomes political, medicalised, or externalised.

Myth contains suffering. Ideology explains it away.

Myth contains suffering. Ideology explains it away.

Which is not to say that the suffering produced by the systems we inhabit is unreal. But psychological change still requires inner work. One can remain psychologically trapped even on a beach in Thailand. Psychotherapy, at its best, should remain vigilant about its own assumptions and be willing to question them. It is one of the few places where such reflection is still possible.

Yet psychotherapy may also find itself at a crossroads. It can align itself with ideology, offering certainty and safety. Or it can remain closer to myth, which asks something more demanding of us: to stay with suffering long enough for meaning to emerge.

What This Means Clinically

Clinically, this is the moment when we move further into the desert. Defences begin to fall away and the illusions that once sustained us can no longer be maintained. It is a phase in treatment where we may feel we do not know where we are going, yet we also know we cannot go back. Disorientation is common, but there is no path forward except the one we are already on.

Discernment can feel profoundly lonely, especially when we no longer recognise ourselves. Take the angry son who believes he has individuated from his father, yet whose identity remains organised around opposition. Without that opposition, he does not know who he is. When that structure loosens, he often feels worse, not because therapy has failed, but because he must now begin the long work of discovering who he is without the fight. It is precisely at this point that the temptation to sabotage the work and return to the familiar can be strongest.

We do not know how long this phase will last. That uncertainty is part of the pain. There may be weeks of confusion, anger or shame, even feeling that the therapy itself might be to blame. Shame is particularly difficult to bear: the shame of not knowing ourselves, of feeling weak, helpless or confused, states we are highly skilled at defending against. Without containment, it can feel endless.

Yet this is precisely the terrain where real psychological change becomes possible.

The task, then, is not to escape the desert, but to stay in it long enough that something truer can emerge.

Threshold Series

This essay forms part of a four-part series exploring psychological thresholds and transformation.

• Part I: Crossing the Threshold
• Part II: Staying With What Is
• Part III: Why Therapy Feels Worse Before It Gets Better

Sophie Frost is a psychodynamic psychotherapist and founder of The Primrose Practice in Berlin. Her work focuses on depth psychotherapy, identity, and psychological transformation in the modern world. She works with international individuals and couples seeking thoughtful, depth-oriented therapeutic work.