What To Do When You Have A Breakthrough In Therapy

Experts share their advice on the steps you should take after you have a big realization or an "aha" moment during therapy.
Therapy comes with major realizations that can change your world. Here's what to do when that happens.
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Therapy comes with major realizations that can change your world. Here's what to do when that happens.

For most people, therapy is a time that’s dedicated to whatever the patient wants, whether that’s venting about a loved one, talking about a stressor at work or diving deep into monumental events in your childhood.

Oftentimes, what comes from these deep conversations are uncomfortable truths about yourself — how your behavior contributes to a problem in your life, your thought process regarding certain situations, the way you treat loved ones and more. These moments can feel like “aha moments” or breakthroughs, according to Taisha Caldwell-Harvey, a licensed psychologist and the founder and CEO of The Black Girl Doctor, an online therapy and wellness platform.

And while these realizations may be pretty scary, they are also a really important growth opportunity. According to Karen Oliver, a clinical associate professor of psychiatry and human behavior at Brown University, a breakthrough moment is “not the last step in therapy, it’s actually a very important beginning to middle step.” It can lay the groundwork for your therapy sessions and establish a goal for you to work toward with your therapist.

So, whether you have been faced with a piece of reality that is hard to swallow or you are hoping for a big moment in the future, here’s what to know about those big, life-changing realizations in therapy:

Not every moment in therapy is an aha moment.

According to Caldwell-Harvey, a breakthrough is different from simply learning a new fact or hearing something fascinating from your therapist. Instead, the aha moment requires “a significant shift in your worldview and the way that you see life for you to be able to sit with it.”

This realization shakes up your world enough that you see your experience, your decisions and yourself pretty differently, and if you try to go through life without any change, you’re going to be really uncomfortable, she added.

For example, your therapist may help you discover that while you always assumed you were just an angry person, you are actually terrified and use anger as a shield, Caldwell-Harvey noted. Or, you may think you’re a people pleaser but are really deeply afraid of losing those around you if you don’t agree to their wants. These breakthrough moments vary greatly and will look very different from person to person.

And since these truths can be hard to sit with, it’s not unusual to feel distraught after the fact, which can make coming to terms with this realization even harder.

To understand this part of yourself, you should sit with this new realization.

According to Caldwell-Harvey, when a breakthrough happens, it takes time — days, weeks or even longer — to come to terms with it.

To fully process this breakthrough, Tai recommends that you “intentionally sit with it and work through it mentally.” You can try journaling about the breakthrough or try to pair your thoughts with exercise, whether physical or mental (like walking, jogging, meditating or praying). This kind of thinking and behavior “can help things resonate with you,” she said.

Here are some prompts Caldwell-Harvey recommends when practicing intentional thinking:

  • Name the realization.
  • Address where this belief came from.
  • Ask yourself how long you have been operating under this faulty assumption.
  • Question how this assumption has impacted your life.
  • Think about how things could be different if you had been operating under this new truth.
  • Determine how you want to be different moving forward now that you have access to this information.

It’s important to know that there are no right or wrong answers to these questions, Caldwell-Harvey added.

It can be helpful to tell your loved ones about this big moment in therapy for additional support and even for accountability reasons.
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It can be helpful to tell your loved ones about this big moment in therapy for additional support and even for accountability reasons.

Once you know how you want to approach life differently with this new knowledge, take a beat before responding to situations so you don’t revert to old ways.

When feeling a strong emotion, a few minutes of deep breathing can help you center yourself and respond in a way that you’ll make your future self proud, Oliver said. Not only can this help you bring awareness to how you’re feeling, but it can help you commit to any new personal goals that emerged from your “aha moment.”

According to Oliver, five minutes of deep breathing “gives you a choice point, it gives you a moment to say, ‘OK, I’m feeling anxious. Normally that’s what I do, but do I want to try something else right now?’”

You can use those five minutes to make sure your behavior aligns with any new goals you have. “It gives you a moment to not be impulsive and not carry on that same path but actually look for the other way,” Oliver added.

It can be helpful to talk to loved ones about this big moment, too.

Talking to people you trust can be a useful way to come to terms with this realization, Caldwell-Harvey said.

“That feedback from people in your life makes it more real [and] it also holds you more accountable because you’ve said it out loud,” she said.

In other words, you may be less likely to revert to old ways or old thought patterns if you know a loved one is aware of your struggle and your intent to act differently. And if they know you’re trying to change, they also may even be more understanding when you try out new behaviors or routines.

It’s also important to continue to talk to a therapist.

One thing you don’t want to do after coming to a realization is quitting therapy, Oliver said.

“In order to make any change [you] need to own that it’s going to take some work, it’s going to take some responsibility,” Oliver said. “It’s really important to stay in therapy and allow the therapist to help you continue practicing this in a safe environment.”

She added that no one is going to completely change their behavior and thought process after a big therapy session; committing to personal change is a process some days will be hard and some days will be easy.

If you haven’t experienced a big moment in therapy, you can talk to your therapist about it.

It takes time and vulnerability to come to these new truths, and while you shouldn’t expect to have one of these huge moments every therapy session, Caldwell-Harvey said you can expect to experience an aha moment throughout your time in therapy.

If you’ve been in therapy for a little while and haven’t come to one of these realizations (and want to), Caldwell-Harvey said you can tell your therapist you’d like to focus on coming to a breakthrough in a certain area of your life.

“It can trigger some really deep conversation and can steer the therapy process in a different direction that can help you get there,” she said.

Be nice to yourself if you’re having a hard time sticking to your goal.

“That [breakthrough] realization is the beginning. It’s the first step, but nothing’s going to change without work,” Oliver said, and “usually these patterns that we have are so entrenched.”

For many, Oliver noted, these maladaptive thoughts and behaviors began in childhood and determine your entire world. That’s not an easy thing to change with the flip of a switch.

“People are creatures of habit,” which can make changes to the way you think and act really, really hard, Oliver said. If you find yourself struggling to always follow this new path, “be kind to yourself and forgive yourself for that.”

Also, keep in mind that you’re more likely to revert to old coping mechanisms the more and more distressed you feel, she noted, so it could be doubly important to give yourself time to make a decision or react in times of distress.

“Managing mental health is a lifelong process. But every day is going to bring a different challenge — there’s going to be highs and lows and the goal is to develop skills to manage as best you can and forgive yourself for the moments you slip up,” Oliver noted.

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