You started therapy to feel better — so why do you feel worse? If your first few sessions have left you more raw, tearful, or tired, it can be alarming enough to make you want to stop. Here is the reassuring truth: a temporary dip is a common, recognised part of the process, especially in trauma work. It does not mean therapy is failing. It often means something real has finally been touched. Let’s unpack why it happens and how to tell a normal dip from a warning sign.
| Key Takeaways • Feeling worse for a while is common and recognised — often called a “therapeutic dip” — particularly when approaching painful or avoided material. • It usually happens because therapy asks you to face feelings and memories you have been holding down. • A normal dip eases with support; distress that keeps escalating, or feeling unsafe, is a reason to speak up promptly. • Tracking progress and telling your therapist how you feel measurably reduces the risk of lasting deterioration (de Jong et al., Clinical Psychology Review, 2021). |
Is It Normal to Feel Worse at First?
Yes, for many people it is. A temporary increase in distress early in therapy is well recognised by clinicians, particularly in trauma-focused and exposure-based work where you begin to approach memories and feelings you have long avoided. It is often described as a “therapeutic dip” or part of the “trauma curve” — an uncomfortable stretch that typically precedes improvement.
This does not describe everyone. Plenty of people feel steady relief from the start. But if you are in the group that feels worse before better, it helps to know this is an understood pattern, not a sign that you are broken or that therapy is wrong for you.
The key word is temporary. A dip is a phase, not a destination. With the right support, most people move through it and end up meaningfully better than when they began.
Why Does Therapy Sometimes Stir Things Up?
Therapy can stir things up because healing often requires approaching what you have been avoiding. Your nervous system may have adapted to survive by pushing feelings down; when therapy gently lifts the lid, those feelings become more noticeable before they ease. That short-term rise in intensity is the system beginning to process, not malfunctioning.
A few reasons the dip happens:
- Approaching avoided material — memories and emotions you kept at bay come closer, and feel louder at first.
- Lowering long-held defences — coping strategies that numbed distress start to soften.
- Naming things for the first time — putting words to pain can make it feel more real before it feels manageable.
- Your baseline shifting — a nervous system used to high alert can find early calm unfamiliar and unsettling.
None of this means you are going backwards. Often it means you have stopped avoiding — which is where change begins.
How Do You Tell a Normal Dip From a Warning Sign?
The distinction that matters is direction and safety: a normal dip is uncomfortable but bounded and eases with support, while a warning sign keeps escalating or leaves you feeling unsafe. Monitoring how you are tracking — and telling your therapist — is exactly what reduces the risk of lasting deterioration (de Jong et al., 2021).
| Normal “dip” vs a reason to speak up now | |
| Usually a normal dip | Speak to your therapist promptly |
| More emotional or tired after sessions, then settling. | Distress that keeps escalating week after week. |
| Old feelings surfacing, but you still feel basically safe. | Feeling unsafe, or having thoughts of self-harm. |
| Hard sessions followed by a sense of relief or insight. | No rationale for the pain and no plan to manage it. |
| You can still function day to day, mostly. | Sleep, work, or relationships sharply deteriorating. |
Guidance informed by progress-monitoring research (de Jong et al., 2021).
If anything in the right-hand column fits — especially thoughts of harming yourself — tell your therapist as soon as possible, or use a crisis line. That is not overreacting; it is exactly what support is for.
What Helps You Get Through the Dip?
The most important thing is to keep your therapist in the loop. Therapy works best as a partnership, and sharing how you feel between and during sessions lets your clinician adjust the pace — which research links to better outcomes and less deterioration (de Jong et al., 2021). You do not have to white-knuckle it alone.
Things that tend to help:
- Name it in session — “I’ve felt worse since we started” lets your therapist slow down or add coping skills.
- Use grounding tools — breathing, movement, and routine steady the nervous system between sessions.
- Protect the basics — sleep, food, and gentle activity give you more capacity for the work.
- Go at a tolerable pace — a good therapist titrates the intensity so it stretches you without overwhelming you.
Remember why the dip exists. You are not being harmed by facing hard things with support; you are doing the part of the work that avoidance never allowed.
When Should You Reassess?
Reassess if the dip does not lift, if it deepens instead of easing, or if you ever feel unsafe. A short, supported dip is one thing; sustained worsening is another, and it warrants an honest conversation about pace, approach, or fit.
| Our clinical view: Feeling worse for a short while, with support and a clear reason, is very different from feeling unsafe. The first is often the work; the second always deserves a prompt conversation. |
| Going through a hard patch in therapy? A temporary dip is easier to navigate with the right clinician beside you. Limbic Flow offers registered clinicians experienced in trauma and paced, supportive therapy, with secure telehealth. |
| If you need help now: This article is general information, not personal medical advice. If you are in crisis or worried about your safety, call Lifeline on 13 11 14, or 000 in an emergency. |
Frequently Asked Questions
Why do I feel worse after starting therapy?
Often because therapy asks you to approach feelings and memories you have been avoiding, which makes them feel louder before they ease. This “therapeutic dip” is a recognised, usually temporary phase, especially in trauma work, and typically precedes improvement with support.
How long does the “feel worse” phase last?
It varies by person and approach, but a dip is meant to be temporary — a phase, not a destination. If it keeps deepening rather than easing over a few weeks, that is a reason to raise it with your therapist and review the pace or approach.
Is feeling worse a sign therapy is failing?
Usually not. A supported, time-limited dip often means real material has finally been reached. Failure looks more like sustained escalation, feeling unsafe, or sharp decline in daily functioning — which are reasons to speak up promptly, not to suffer silently.
What should I do if I feel unsafe during therapy?
Tell your therapist as soon as possible so they can adjust the plan, and use a crisis line if you need immediate support. Feeling unsafe or having thoughts of self-harm is never something to push through alone — it is exactly what support exists for.
The Bottom Line
Feeling worse before you feel better can be a normal, recognised part of therapy — not proof it is failing.
- A temporary “dip” is common, especially when approaching avoided or painful material.
- Normal discomfort eases with support; escalating distress or feeling unsafe is a reason to speak up now.
- Keeping your therapist informed measurably reduces the risk of lasting deterioration.
If you are in a hard patch, you do not have to push through it alone.
About this article
Author: Limbic Flow Clinical Team
Medically reviewed by Sophia Tsai, B.S., MIPH and MA. Last updated: 29 August 2026.
This article is general information only and does not replace personalised advice from a qualified health professional. In an emergency, call 000; for crisis support, call Lifeline on 13 11 14.
Sources
- de Jong K, et al. — Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. Clinical Psychology Review, 2021. https://www.sciencedirect.com/science/article/pii/S0272735821000453
- Phoenix Australia — Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, PTSD and Complex PTSD (context on paced trauma treatment). https://www.phoenixaustralia.org/australian-guidelines-for-ptsd/