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Why Isn’t Therapy Working?

When Psychotherapy Isn’t Helping With Panic Disorder

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Updated November 30, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Psychological interventions are commonly used to in the treatment of panic disorder, panic attacks, and agoraphobia. Even though it is one of the most frequently used treatment options, psychotherapy is not always effective. If you have tried therapy with little to no results, you may be wondering why therapy isn’t working.

There are numerous reasons why psychotherapy may not be helping you work through personal issues and manage your panic disorder. Listed here are some common roadblocks that may explain why therapy isn’t working for you. This list can help you sort out potential obstacles with therapy and take steps toward working through them.

An inability to commit to therapy

Therapy sessions typically run for close to an hour every week or every other week. To get the most out of therapy, you will need to dedicate time and effort both in and out of therapy sessions. Your therapist will most likely ask you to complete homework assignments between sessions. You will also be expected to actively participant in the sessions, which will involve exploring your thoughts and feelings and practicing new skills.

Therapy not only requires an investment of your time and money, but it also involves a commitment to working toward self-improvement. Many times you will only get out of therapy what you are willing to put into it. If therapy has been unsuccessful, ask yourself is you have truly devoted the necessary time and effort. If you find that your personal resistance or feeling unmotivated is holding you back, discuss these problems with your therapist.

Issues with your therapist

The first therapist you meet with may not be the right match for you. When seeing a therapist for the first time, ask yourself if you feel that this is someone you are comfortable regularly meeting with and opening up to. You will be working closely with your therapist, revealing personal experiences, expressing deep emotions, and practicing new ways of being. It is important that you feel at ease with your therapist and confident in their abilities to help you.

Finding the right therapist involves considering your own personal preferences and verifying the therapist’s qualifications for working with panic disorder. Tips for choosing a therapist include finding a person who you have good communication with, determining if your therapist is competent in treating anxiety disorders, deciding if the therapist’s gender is important to you, and feeling that your therapist possess empathy and understanding of your condition. You will also want a therapist who has knowledge in therapeutic interventions that have been found to be effective in the treatment of panic disorder, such as cognitive behavioral therapy or panic-focused psychodynamic psychotherapy.

Problems with social support

Family and friends can play an important role in your recovery process. By encouraging your personal growth, your loved ones can be a huge assistance in helping you succeed in your therapeutic efforts. At the same time, some loved ones can actually complicate your therapeutic treatment process.

As a part of therapy, you will develop new skills and strategies to manage your panic disorder symptoms. Some family and friends may unintentionally enable you by not giving you the independence you will need to change and grow. For example, your therapist may suggest you practice desensitization, in which you slowly expose yourself to panic-inducing situations. An overly protective family member may convince you to avoid anxiety-provoking events and settings. Listening to an enabler will only contribute to your continued fears and dependence on others.

Some people in your life may feel intimidated by your personal growth and try to discourage you from making any positive changes. Such people will try any tactic to sabotage your efforts, such as telling you that your therapist is wrong or that you are hurting them by changing yourself. They may even argue with you over your success or distance themselves from you altogether.

It is also possible that you have little social support for panic disorder outside of therapy. Staying motivated to attend therapy can be difficult if you are also dealing with loneliness. If you are able to build a social support network, you may be able to stay encouraged and inspired between therapy sessions.

Co-occurring conditions

There are many medical conditions that often co-occur with panic disorder. Some common co-existing health issues include headaches, irritable bowel syndrome, and acid reflux disease. Additionally, there are many related mental health disorders that are common among people with panic disorder. Some of these conditions include depression, social anxiety disorder, and PTSD.

If co-occurring illnesses remain unrecognized, they can obstruct your progress in therapy. Dealing with panic disorder can be challenging on its own. Therapeutic progress can be even more difficult when you have another condition to cope with. For example, if you are also experiencing symptoms of depression, you may find it difficult to maintain the energy and interest in your personal wellness.

If you suspect that you are experiencing a related condition, make sure that you discuss your concerns with your therapist. If you are diagnosed with an additional illness, your therapeutic treatment plan should reflect managing both conditions.

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