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Why Therapy Does Not Work

Jérôme is undoubtedly a charismatic and passionate holistic therapist of the new age! At the heart of his work is: Live and embody your essence. He draws on decades of his own personal experiences with shamans, healers, and therapists, as well as years of experience dealing with trauma.

Executive Contributor Jérôme Rey

I would like to inspire you in this article. If you are a therapist, this inspiration may help you to understand why you sometimes get stuck with your clients/patients.

A screaming woman holding a clown mask

You may have already had many therapy sessions with your issues yourself and may have the impression that nothing has really helped you. Nevertheless, your core problem persists and has not changed in essence. In this case, this article may help you to better understand what is unconsciously at work within you.

I would like to point out a certain pattern here, which regularly appears in a similar form in my sessions and those of my colleagues. Of course, there are a number of reasons why therapy doesn't work, but in essence I would venture to say that this only happens if not enough contact has been established in the therapy session. Contact with the mostly repressed issue and between the patient and therapist.

This can manifest itself as follows, for example:

You go to therapy again and again and at the beginning it feels good, you have hope that it will now work to finally get rid of your fears and / or body symptoms. You may even have the impression that you have finally found the right person and the right therapy method. You are willing to work with the therapist and follow their suggestions, you are co-operative and yet you are increasingly wondering whether nothing is really helping you.

It doesn't necessarily feel wrong to work with this person. But you ask yourself what you can really take away after each session and how it will actually help you for your future. You may come to the conclusion that there is something wrong with you, because although the therapy touches you, there is no real change at a deeper level.

Maybe you no longer feel really present and just go along with it hoping that maybe a miracle will happen after all. But if you're honest with yourself, no real change is happening - at least not the change you're longing for. Even though you probably don't even recognise exactly what you're looking for. You may feel a little relief and relaxation, but not really anything more. So do you feel like you're in the wrong place again? Maybe the therapist doesn't really understand you after all. At this point, you certainly feel powerless, resigned and possibly increasingly depressed.

As a therapist, you will encounter a patient who is extremely co-operative and may even be able to describe their problems clearly. He is very familiar with his own history and may even clearly understand the underlying causes, what happened in his early childhood and what compensatory measures he took and what behaviours were learned due to repressed needs.

If you are a hypnotherapist, you will notice that the person follows your suggestions, that there is a good rapport and that the session seems to be going well.

And suddenly, in the middle of the session or at the end, the patient asks the following questions:

I understand and what can I do in the future to feel better?

How can I implement all this in my everyday life? That all sounds very good and what do I do with it now?

Sometimes it turns out that the client seems to forget everything and keeps asking what it is actually about. And asks the same question(s) again and again. Together we may have gained insights that are soon forgotten again. As a therapist, it might even seem that the person is deliberately lying to you. It is then hard to believe that all the insights that felt so good are simply gone! 

It's clear that nobody does this on purpose.

The patient tries everything, but loses hope increasingly. What now?

It is important to understand at this point that a childhood scenario is most likely being repeated here and that the patient has little connection to their emotions and the underlying needs in the here and now. As a therapist, you could ask the patient at this point: "How are you feeling right now? Are you experiencing a situation that seems familiar to you? Have you always had the feeling in your life that people don't understand you? How does that feel for you right now?"

Here could be an answer:

Yes, I know that. It's always the same, there never seems to be a solution. I feel sad and I guess I really am a hopeless case.

Of course, answers like:

Yes, so no, not really, it's always the same. I don't know what the problem is either. I have no idea what else to do.

It may well be that they suddenly feel quite lost here as a therapist and/or anger arises in them.

With a little experience, it is quite obvious what the patient is suppressing here.

There is a hidden rebellion at work, an unspoken protest.

When we understand here that behind almost every problem, behind every fear, there are unfulfilled needs that often signal an unresolved protest. We are usually unaware of this because the cause lies in our earliest bonding experiences, which characterise us throughout our lives.

Children whose core needs are repeatedly not met block their own access to anger, aggression and protest. The emotion of anger, which arises via the sympathetic nervous system, feels threatening to a small child. So it directs its anger inwards. As the child grows older, protest and anger are replaced by resignation and collapse. When anger arises in adulthood, we are cut off from it (dissociated) and only the fears remain in our experience. Patients/clients will then often be able to name their fears, but usually feel absolutely no protest within themselves, which is actually the underlying cause.

Often, grief is felt rather than fear, especially if grief was more readily accepted by the previous environment.

As a therapist, you can ask questions here. Does the grief feel liberating or relieving? In most cases, a "no" or a "well, that's how it goes" will emerge. Then a clearer picture will appear of which repressed needs might be involved.

It could be about the need for freedom and independence. The anger could be a reaction to an environment that had difficulty dealing with the child's autonomy movement. However, it is essential that we test this hypothesis.

When a child is confronted with the threat of a loss of attachment and a failure of its environment, it activates protest in response. Although it will never be a child's first choice to be angry with a caregiver, the original intention behind the protest is to influence the environment so that one's needs are taken care of. Anger is a message to the environment to show that what is happening is not okay, I need you, take care of me!

If the environment then responds positively to the child's needs, such as security, being held in the arms or support in exploring the world and independence, the child calms down immediately and the emotional reaction is completed. However, if the caregivers are not able to respond to the child's needs with fine antennae, the protest has been unsuccessful and the core needs have not been met, which the child experiences as threatening. The protest can escalate into aggression and anger, but more often the child gives up all hope that someone will take care of them. They learn to cut themselves off completely from their core needs and the emotions that express them.

The anger they feel could be too overwhelming for the child, as they still have few ways of coping with such a high level of arousal in the sympathetic nervous system.

So if there is no reaction to the protest, the child finds itself in a dilemma. As children, we are not in a position to feel love and intense anger towards our carers at the same time. And we can't afford to be angry with the person who is supposed to look after us. There would be an enormous threat. This dilemma is usually solved by the child splitting off from the anger. It is better to be the non-lovable child of loving parents than the loving child of unloving parents.

Splitting and identification with the "evil self", which incidentally shows up later as "the shadow" as an adult, initially creates space for hope. The child starts to think that if I get rid of this side that my carers don't seem to like, I will then be completely loved!

The failure of the environment is interpreted as one's own failure and this leads to a shame-based identification as a protective strategy.

This shame-based identification involves splitting off experiences and banishing them from consciousness. Self-shaming is a parasympathetically dominated process. This then gives rise to various behaviours of acting out and acting in.

The acting out then manifests itself as self-criticism, self-shaming, self-hatred, co-dependence. Little by little, we learn to fulfil the needs of our environment.

Acting out can manifest itself in attack, manipulative behaviour and a compulsion to control.

In the examples described above, it is obvious that they are based on the suppression of anger and result in behaviours of withdrawal. Sometimes it can oscillate between the two. What is certain is that the patient will have a negative relationship with anger and will most likely express this.

It may be that the person has already tried a number of things. Many spiritual retreats to finally have a pure heart and only feel love and get rid of this strange basic feeling. If the person often acts out, then they realise that they are often angry and want to finally get rid of this anger. This then works for a while, in transcending experiences and or simply in groups where people sing and meditate together. And that feels so right! Back in everyday life, there are arguments with my partner or just a big feeling of nobody understands me, I feel alone!

In both cases, i.e. whether acting in or acting out, this is a consequence of splitting off to inner healthy aggression!

Healing is about reconnecting with anger and even hate in a healthy way.

Back to the case described at the beginning.

It is based on a protest, which today shows itself in a passive aggressive way. One possibility is to address the frustration you feel because you are back in a therapy session that is not helping. It has been shown to be particularly effective when we can address the anger directly. Of course, it can help if we can realise that we are often angry with our surroundings and can express this. If someone is strongly dissociated, however, they will not feel this anger at all. Interestingly, however, as soon as this anger is expressed, the body will react directly with relaxation.

As a therapist, it can be important here to sensitise the patient to body awareness. However, it can also initially lead to more stress in the body if the defence system is at work and naturally wants to avoid feeling anger at all costs. As a reminder: as a child, this would have meant a risk of relationship breakdown, which is equivalent to a risk to life, i.e. death! As mammals, our bodies have three possible reactions to danger: Fight, flight or freeze. Panic attacks, for example, are a state of freezing. Freezing, immobility is an outwardly calm state, while internally the sympathetic nervous system is working at full speed and at the same time the parasympathetic system is ramped up, which can lead to us hardly being able to move or not being able to move at all. Internally, this feels hopeless, especially if we cannot recognise any real danger on the outside. There is therefore a discrepancy between our inner experience and the external reality, which is a consequence of attachment trauma.

Here it is important as a therapist not to fall for the fact that the person may be very reluctant to deal with the anger. This is because it is often a shadow, a taboo, and a lot of shame and guilt can come up. The ego in turn tries to avoid this.

It can be very useful to slowly introduce the patient to anger.

My inner structure is rather direct, so I ask the patient the question relatively quickly:

What do you think of the therapy? Are you really happy with it?

I have often experienced that there is already great relief when the patient can say: "No, I am not satisfied!

This is an important point. Often people with the above-mentioned repression patterns will not immediately admit that they have difficulties with anger. That is why it is crucial to follow up. It already leads to a change when the person says, I don't like it. Basically, everything relates to the relationship level and the patient's statement should be: You don't suit me!

I feel anger and what you offer me is not enough for me! Maybe even a "I'm fed up!".

That is absolutely right. As a therapist, it is important to be able to accept this 100%. Of course, other factors can also play a role, such as the choice of questions or the type of therapy. Nevertheless, it is of central importance that the patient is finally allowed to direct their anger at a person without it leading to a breakdown in the relationship. This fact is enormously important and should first of all be taken to heart.

The aim here is to create a safe space in which the patient can express their feelings authentically without fear of rejection or consequences.

Depending on how strongly the aggression has been suppressed, it makes particular sense to look at the physical expression.

From a physiological point of view, it has proven useful to first switch from a state of immobility to attack mode. Here, it can make sense to carry out physical exercises (e.g., TRE Trauma Release Exercises), to scream into a pillow, or to hit stacked pillows with a bat. This can lead to the experience that it is okay to feel aggression in the body. A body that is never allowed to feel aggression is at the mercy of other people and we cannot feel mentally strong.

The attitude and statement of the therapist must be here:

Your rage and hate are absolutely welcome here! This attitude is essential, as a therapist you have to be able to be with it, i.e. remain stable. Otherwise it's another re-enactment of childhood. An environment that can't deal with rebellion, anger and hate!

Of course, this requires that you have integrated these feelings yourself and are not just using the role of therapist to avoid having to feel your own emotions and needs, as you are looking after others!

We can therefore encourage the patient to come to peace with the feeling of anger. On the one hand, through the information about why anger and healthy aggression are important for everyone and, on the other hand, through the direct experience of complete acceptance in the here and now, which was not yet stored in the nervous system in this way, i.e. was wired completely differently due to childhood experiences.

It is the new experience that brings about real change!

Gradually, the patient will be able to integrate these forces and will feel less and less resigned and powerless. The process can progress quickly, but it is important to give the integration time and space. The more we can "contain" the emotions, i.e. be complete with them on the levels of body, emotions and mind, the more comprehensive wholeness and healing can be experienced. It is important to respect your own rhythm. It is not about performance, but about mindful acceptance.

Patients are increasingly able to recognise that they can now exist independently of the outside world and that there is no longer any danger in being free and independent while still remaining connected.

Where as children we would have needed an environment that could have responded 100% to our needs, the solution as adults lies above all in recognising our feelings and learning to communicate them.

To summarise, it can be said that the reasons for the possible failure of therapies and the lack of progress is the lack of contact, both with repressed issues and between the therapist and patient. Recurring childhood scenarios also show up in therapy! Successful therapy requires that we learn to recognise and express our feelings again. Healing requires patience and the willingness to integrate emotions on different levels and bring them into contact. It is not about quick solutions, but about an empathetic process of acceptance and integration of feelings.

The important thing is to keep at it, no matter what has happened in the past and how many therapies and methods have not worked. I am 100% convinced that the right solution is waiting for you. Unfortunately, many people give up because they often don't get the right information or may not find the appropriate therapies - this is also part of the process and the current possibilities in society. However, awareness is changing rapidly and more and more people have access to the most important resources.

Essentially, we need to find the courage to come into genuine, honest contact with each other again and thus allow closeness. We are one human family and it is time to stop perceiving each other as competitors and instead support each other. To do this, it is important to recognise what dangers we are still projecting into our environment. As adults today, we have the ability to scrutinise everything and decide for ourselves which relationships we want to remain in.

But we definitely develop the most potential in relationships. When we feel free and connected!


Jérôme Rey, Trauma Therapist, Shamanic Healer, Hypnotherapist

Jérôme is undoubtedly a charismatic and passionate holistic therapist of the new age! At the heart of his work is: Live and embody your essence. He draws on decades of his own personal experiences with shamans, healers, and therapists, as well as years of experience in dealing with trauma. His profound knowledge is based on extensive training in the field of trauma therapy and spirituality. This broad spectrum of personal experience and professional knowledge forms the basis of his professional work and enables him to accompany people on their path of healing and personal growth.


Sources and book recommendations:

  • NARM Practice Book Healing Developmental Trauma by Laurence Heller and Brad J. Kammer

  • Der Vagus Schlüssel zur Traumaheilung by Gopal Norbert Klein



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