When Therapy Doesn’t Work: Why It Happens and What to Do Next
For New Yorkers, therapy can be a powerful resource—but it doesn’t always work the way we hope. Sometimes, despite the best intentions on both sides, the therapy process breaks down. Maybe it’s you. Maybe it’s them. Maybe it’s just not the right fit. But one thing is clear: therapy that doesn’t work leaves both the therapist and the client disappointed.
In many traditional psychotherapy training programs—including those rooted in psychodynamic or psychoanalytic theory—when therapy fails, the burden is often placed squarely on the client: resistance, lack of motivation, poor insight. But in truth, therapy is a two-way street. It’s a complex and relational process. And when it stalls, both therapist and client deserve the space to reflect—not blame.
When Therapy Fails: A More Nuanced Understanding
At Holistic Therapy & Wellness NY, we take a multidimensional view of the therapy process. Healing is not one-size-fits-all. As a licensed psychotherapist and trauma-informed EMDR specialist in Manhattan, I know that therapy outcomes are shaped by many moving parts—clinical skill, relational fit, life circumstances, and the willingness of both participants to engage in the work.
Below are some common reasons why therapy may not succeed:
1. Mismatch Between Therapist and Client
A strong therapeutic alliance is the foundation of good therapy. Sometimes, despite credentials or experience, there’s simply a lack of chemistry, shared language, or attunement. If a client doesn’t feel seen or understood, progress can stall.
2. Unrealistic Expectations
Therapy isn’t a quick fix. In New York City, where productivity is prized, clients may expect rapid transformation. But meaningful change often requires time, vulnerability, and the willingness to sit in discomfort. Therapy works best when there’s a shared commitment to the long game.
3. Resistance, Avoidance, or Ambivalence
Avoiding painful truths is a common defense mechanism. Sometimes, clients are not emotionally ready or able to confront what needs healing. This isn’t a flaw—it's a signal. A skilled therapist will help explore the resistance rather than pathologize it.
4. Inadequate or Mismatched Treatment Approach
Even the most evidence-based methods can fall flat if they’re not attuned to the client’s nervous system, culture, identity, or lived experience. That’s why at Holistic Therapy & Wellness NY, I draw from multiple modalities—EMDR therapy, somatic psychotherapy, mindfulness-based approaches, cognitive behavioral therapy (CBT), and psychodynamic work—to tailor care to the individual.
5. Underlying Conditions That Need Specialized Care
Some mental health challenges—like complex trauma, bipolar disorder, substance use, or personality disorders—may require more structured or integrative support. Without the right tools or referrals, therapy may not reach its full potential.
6. External Life Stressors
Ongoing stressors—such as financial insecurity, medical issues, burnout, or toxic relationships—can create emotional noise that drowns out therapeutic insight. Therapy may become a holding space rather than a place of transformation, through no fault of either party.
7. Limited Access or Lack of Support
Inaccessible scheduling, inconsistent attendance, or lack of social and emotional support outside the therapy room can undermine progress. This is why I offer concierge psychotherapy options for Manhattan clients seeking flexibility, high-touch support, and continuity of care.
8. Therapist Burnout or Lack of Cultural Competency
Let’s be honest: therapists are human, too. We can miss things. Sometimes therapists operate from their own blind spots or biases, or they haven’t received the depth of training needed for a particular issue, identity, or trauma. Cultural humility, ongoing training, and supervision matter deeply.
When Therapy Doesn’t Help—What Now?
If you’ve been in therapy and felt it wasn’t helping—or worse, that it left you feeling misunderstood, blamed, or stuck—you’re not alone. The therapeutic relationship should feel collaborative, curious, and safe. When it doesn’t, that’s valuable information—not failure.
If you’re in Manhattan or seeking a boutique therapy experience with a holistic, integrative focus, I invite you to explore a new approach. Together, we can co-create a path forward that honors the complexity of your emotional world, using methods that are both evidence-based and deeply personalized.
Sometimes, a shift in therapist, modality, or treatment plan is exactly what opens the door to the healing you’ve been seeking.
Ready for a New Kind of Therapy Experience?
At Holistic Therapy & Wellness NY, I work with high-functioning professionals, creatives, couples, and women navigating complex transitions—from trauma and burnout to anxiety, hormonal changes, and relational struggles. My approach is warm, grounded, and tailored for those who want more than surface-level symptom relief.
Schedule a consultation today and discover a therapy process that actually meets you where you are.
About Holistic Psychotherapy & Wellness Manhattan
Kimberly Seelbrede, LCSW is a New York State licensed Psychotherapist, EMDR Practitioner and Couple Therapist with a private practice in New York City, Montana and virtually. As a wellness psychotherapist and holistic consultant, she has receive advanced, extensive training in Trauma Therapy, Psychoanalytic Psychotherapy, Internal Family Systems (IFS), Eye Movement Desensitization Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Somatic Experiencing (SE), and Nutrition & Integrative Medicine For Mental Health. She is passionate about honoring the exquisite interplay of the mind-body connection. Kimberly Seelbrede specializes in anxiety & mood disorders, trauma and women’s mental health. She brings over 20 years of counseling, coaching, and healing experience to her holistic practice and transformational work.
In addition to online therapy for anxiety, depression, trauma and relationship struggles, Holistic Psychotherapy & Wellness offers a wide variety of online services to fit the needs of busy professionals. New Yorkers often lead fast-paced and complex lives, which makes work-life balance and managing career, family and social obligations a challenge. Psychotherapy and wellness practices provide the support to help clients cultivate resources, resilience and enhanced emotional health, as well as uncover conflicts and obstacles that may interfere with having the life they desire.