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Why Does Psychotherapy Hurt So Much Emotionally? 🧑‍⚕️

Growth is painful, and that’s just the way life is. In psychotherapy, emotions such as anger, shame, or even repulsion are normal. But why does it have to hurt so much and be so much of a struggle?

Psychotherapy hurts so much emotionally because it forces patients to confront ugly truths about themselves. Often, this will involve revisiting traumatic events. Then, the work involved in fixing those issues requires a lot of discipline and dedication. 

You could be reading this because you’re considering psychotherapy, but you’re not sure about the pain you might have to endure. This article gives you a no-nonsense view of what to expect, warts and all. Read along.

Psychotherapy Brings Up Painful Memories

When you go to therapy, your main goal is to get better regardless of what might come up. That means that when you open up about a present moment in time, there might be painful memories that are connected to this moment that will come up. 

Painful memories are difficult to deal with and can create a lot of physical stress as well. Think about a time when you suffered some sort of trauma. Without reliving it while reading this article, try to think about how that trauma felt and the feelings you have around it. 

If it feels like a wound that is still raw, even after several years, then it is likely that this memory is holding you back in life. Psychotherapy aims to bring up these painful memories and help you deal with them in a controlled and guided manner. The therapist will give you some tools that you can use to heal the feelings surrounding your painful memories. 

Psychotherapy also can be painful when you’re dealing with new trauma or painful experiences. 

If you’re just starting therapy as a means to heal a fresh experience, it’s going to hurt a lot, and it will create quite a bit of stress and anxiety. However, try to remember that psychotherapy is a lot like putting hydrogen peroxide on a fresh wound. It will sting for a bit, but in the end, it will feel a lot better.

What To Expect When You Start Therapy

At the start of therapy, you’re in a specific frame of mind. Apart from the apparent mental condition that made you seek help in the first place, there are particular thought processes that you hold. 

Psychotherapy at its core examines thoughts because they form our beliefs, and it is painful because the first thing the therapist does is poke around trying to identify those beliefs. 

Beliefs are so powerful that they’re responsible for splitting families. Dinners are ruined on the altar of political polarization, and children are disowned for believing in a different religion. Psychotherapy attempts to shed light on your problematic beliefs. 

It’s, therefore, no surprise that a psychotherapist poking around your thoughts can lead to some unpleasant feelings. Of course, our beliefs are being challenged all the time, but we usually have the option of running away. 

In therapy, you have no choice but to have difficult conversations that can be painful. But rather than trying to avoid these conversations, the therapist will gently guide you through them so that they no longer cause you pain.

All this poking around will form the basis of the therapist’s “formulationOpens in a new tab.,” and they’re manifested in three ways.

Core Beliefs

Core beliefsOpens in a new tab. are deeply rooted ideologies about life and have to do with everything you believe about life, including how you interact with the world. 

Core beliefs manifest in three ways: 

  • How you see yourself. 
  • How you see the world. 
  • How you see the future.

Now, consider that core values aren’t built consciously. They’re developed over time through experiences and reinforced ideas. 

For example, someone could hold the core belief that humans are never to be trusted. They could believe it so much that it becomes a part of their identity and the source, or one of the many sources, of their mental issues. 

An individual who subconsciously builds his identity on the idea that humans can’t be trusted will fight to hold that belief. They’re not averse to change, but it’s simply that the view was formed by some experiences that make them faithful to Them.

Dysfunctional Assumptions

Dysfunctional assumptionsOpens in a new tab. are rigid, unrealistic, and generalistic rules held by people. These rules guide their decision-making and how they approach certain aspects of their lives. They aren’t as encompassing as core beliefs because they come from core beliefs. 

Dysfunctional assumptions are commonly manifested in three ways.


These assumptions have to do with how we perceive social dynamics and their effect on us. For example, someone might believe that placing a foot wrong will lead people to reject them. As a result, they bend themselves into pretzels to be perfect all the time. 


Achievement-based dysfunctional assumptions impact people’s ability to see their identity beyond the things they achieve. It not only affects how an individual perceives himself, but it impacts how they judge other people. 

For example, a parent might assume that any child who doesn’t get an A in math is not that intelligent. Or, a person might believe that anyone who’s wealthier than they are is a better human being. 


Control-based dysfunctional assumptions shape how individuals view the power dynamics in a relationship. For instance, someone might believe that asking for help makes them cede control of a relationship. 

Dysfunctional assumptions manifest in many different ways, shaping how people approach life. They’re usually sore spots for many people, and coming to terms that these assumptions aren’t factual or rooted in logic can be daunting and painful. 

Negative Automatic Thoughts

Consider a fresh cup of coffee. You don’t choose to smell the coffee, but rather the aroma wafts to your nose, and your nervous system automatically picks on that. Many of the sensations that we feel are involuntary and automatic. 

Daniel Kahneman gives a detailed explanation on this topic in his book Daniel Kahneman Thinking fast and slow (available on Amazon). 

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But sensations aren’t the only things that happen automatically. Negative thoughtsOpens in a new tab. also invade us without permission. We don’t see them coming, but they sneak up on us and color the way we see things. 

For example, you may feel a wave of sadness wash over you for no reason. 

The problem is we sometimes believe that these things happen. But that’s not true, as they result from the information that we allow to stay in our minds, such as the experiences we exalt above others, the trauma we never dealt with, and so on. 

It can be upsetting to realize that we are responsible for intrusions that we consider to be beyond our control. Hence, the suggestion that we have to take responsibility for our negative thoughts can be a difficult pill to swallow. 

There are plenty of areas where psychotherapy will bring our beliefs about the world to the fore. 

Psychotherapy is rather ruthless in uncovering them because that’s the key to successful therapy. Most of the time, unearthing these things will require the patient to dig into experiences they’d instead not explore. 

It’s like being submerged into a sea of negative thoughts, emotions, and experiences. You’re not allowed to ignore them or gloss over them. You’re required to address them, explore them, and talk about them, which is a great source of pain. 

While a good therapist will ease the burden and try to make you comfortable, you still have to prepare yourself mentally for the pain that accompanies digging into your mind. 

What To Expect During Therapy

We covered some things that the therapist will first attempt to uncover in the previous section. 

That part of the process is painful because it requires confronting personal truths that we’d instead not visit. But that is just the beginning of therapy, or what’s known as the foundation.   

After discovering the individual biases that negatively impact the patient, it’s time to fix them. Therapists will monitor, evaluate, and challenge the patient consistently. Different types of psychotherapy have various techniques, but they all require a degree of self-awareness from the patient. 

The therapist’s formulation will shape the assignments given and will aim to impact how your emotions, thoughts, and behavior interact with one another. Generally speaking, the projects will involve documenting and keeping track of your feelings and ideas throughout the day. 

While the therapist would give guidelines, they wouldn’t be there to help you execute. 

It’s because most experiments that your therapist recommends would involve you being conscious in real-life scenarios. 

When you wake up in the morning, commute to work, interact with others, you’ll document everything. Some people may not have the discipline and courage it takes. Consistently and honestly evaluating themselves might be a foreign practice to a patient, which might cause you pain at first.

Sometimes, the patient will have to let go of instant gratification to follow the therapeutic instruction. For example, it could be gratifying for the patient to react angrily without following the instruction to question the reason for that anger. 

They may consider themselves a failure after remembering that they were supposed to follow the therapist’s instructions. Shame sets in, maybe even anger at themselves, and they feel guilty that they can’t follow therapeutic instructions. They might conclude, “I sabotage everything, including therapy.” 

One example of a therapeutic assignment is a behavioral experiment. 

Behavioral Experiments

Beliefs rarely change as a result of intellectual challenge, but only through engaging emotions and behaving in new ways that produce evidence that confirms new ideas.

A behavioral experiment will target a precise core belief, automatic negative thought, or dysfunctional assumption. The patient and the therapist will design an experiment that involves making predictions. Then, a method for recording the data will be formed as well. 

Examples of behavioral experiments are as follows: 

  • A man holds the dysfunctional assumption that asking for help will make his colleagues perceive him as weak. As a result, he sabotages himself by trying to do everything himself. A behavioral experiment for him could be to ask for help five times a week intentionally. He will execute this experiment and record the reaction of his colleagues. 
  • A woman has the core belief that men don’t care about anything apart from work and football. There are many things she would like to experience with her husband, but because of her core belief, she never even asks. A behavioral experiment will ask her husband if they could maybe go to the park together. She could also include her brothers, father, uncle, and other men in the experiment. 

Behavioral experiments force patients to gather empirical evidence that refutes their view of the world. People may find it difficult because it takes courage to go against what you hold to be true consciously. 

So, why go through all this? What’s to be gained from putting oneself through such intense personal reviews? The thing about psychotherapy is that it’s often done without medication, and it’s a long process that leads to long-standing, deep-rooted, and lifelong benefits.

The Benefits of Psychotherapy

When you go through psychotherapy and complete all of the work, you’ll find that you have more tools to cope with your life and relationships. You’ll have increased self-awareness, and you’ll heal some of those painful memories. 

Let’s discuss some of these benefits in more detail.

Learn Coping Mechanisms and Mental Models

Many people feel powerless in their lives, and they’re constantly overwhelmed by an onslaught of emotions and thoughts. For example, people who suffer from anxiety often can’t control themselves. 

Psychotherapy teaches tailor-made coping mechanisms that help individuals deal with their issues. You’re probably familiar with simple techniques such as counting to ten when angry. Yet, there are many more powerful techniques for coping with day-to-day life. 

One of such techniques is emotional regulation, which teaches people to do the opposite of whatever they’re feeling. 

But if coping mechanisms help people deal with day-to-day living, mental models help people thrive. You can view coping mechanisms as survival and mental models facing life with confidence. 

Mental models are frameworks that can be used to conceptualize the world. Perhaps you’ve wondered what it’s like to be in the mind of a consistently happy or effective individual. The truth is that they practice things like gratitude and positivity. If you practice those things, you’ll probably be pleased too. 

Coping mechanisms and mental models will completely transform the way you live life.

Develop Healthy Relationships

Humans are inherently social, and we derive satisfaction from interacting with other people, often basing our identity on our social lives. For a good reason, too, as our ability to be effective in life is deeply woven into interacting with other humans. 

We are dependent on other people, including the farmers who grow our food, the people at our jobs, or the spouses who make us happy. That’s why it’s difficult for a person who can’t build and maintain healthy relationships.

Psychotherapy helps with relationships by addressing false thoughts and beliefs that negatively impact our interactions. For example, someone might say, “I don’t trust anybody.” 

True to their word, they keep everyone at a distance and cannot accept love. 

Psychotherapy asks, “why don’t you trust anybody?” And then, psychotherapy tries to get to the bottom of that problem. So you come out of treatment able to trust people, receive love, and enjoy the company of other humans. 

Increase Self-Awareness and Responsibility

Everyone has an “ideal person” in their minds, which is an image of who you’d like to be. Unfortunately, many people can only imagine, without understanding, why they aren’t who they want to be. There’s a dissonance between their desires and their actions. 

To be self-aware is to understand yourself and to know why you do the things you do and say the things you say. To know yourself is a source of power because if you’re dissatisfied with your life, you’ll be able to understand why. 

Say, for example, you keep falling short of your goals. A self-aware person knows exactly why that’s the case, and they know that they sometimes give up too quickly and come up with a plan to tackle that. 

That takes it a step further because self-awareness leads to personal responsibility. 

The psychotherapeutic process relies heavily on your ability to look inwards and project your thoughts and emotions. It also teaches you to take responsibility by doing the work to eliminate the ideas and feelings that could be sabotaging your happiness. 


The words “no pain, no gain” is actually in psychotherapy, which is a process that’ll force you to confront the demons within and take accountability. It’ll stretch you in terms of discipline, resilience, and self-awareness. 

Sometimes, you’ll want to quit and say, “I don’t have to do this.”

But that’s all the storm before the calm, and there’s a light at the end of the tunnel. If you do the work diligently and follow the lead of a therapist you trust, psychotherapy would yield positive long-term results. 


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