Is feeling worse after therapy normal, how long does post-session tiredness last, and when should you tell your therapist? Understand that heaviness.
As you walk down the stairs after a session your legs feel heavy; when you get home you don't want to talk to anyone, or you fall asleep early that evening. Sometimes there is a sadness or restlessness that stays with you all day. You think, "I went so it would do me good, so why do I feel worse?" Feeling worse after therapy is something many clients experience but usually tell no one about, not even their therapist. Some take it to mean that therapy is not working; others conclude that something is wrong with them. Yet post-session heaviness is often a sign that something is shifting; sometimes it also draws attention to something in therapy that needs adjusting. In this article I look at the causes of the tiredness and heaviness that appear after a session, when it is an expected reaction, when it deserves closer attention, and what you can do to get through this period more easily.
Is Feeling Worse After Therapy Normal?
In most cases, yes. Therapy is a process in which you deliberately make contact with thoughts and feelings that are pushed aside in everyday life. For fifty minutes you may have opened up a memory you had not touched for years, voiced your anger at someone out loud for the first time, or recognised a truth about yourself that is hard to accept. It is not surprising to feel slightly shaken after all that.
You can think of it with a physical comparison. When you work a muscle that has not moved for a long time, you feel sore the next day. That soreness shows not that the muscle has been damaged but that it has been worked. In therapy, too, a mind that has been emotionally "worked" becoming tired after the session is usually a natural part of the process.
That said, not every bad feeling is the same. How long the post-session heaviness lasts, how intense it is and how it affects your life all matter. A tiredness that is short-lived, easing within a few hours or at most a day or two, does not mean the same thing as a slump that lasts for days and disrupts your functioning.
Feeling worse after therapy may be more common in the first sessions. You do not yet know your therapist, you are trying to get used to the room and the process, and on top of that, in the first meetings you have to describe the difficult parts of your life one after another. This accumulated telling can load onto your shoulders in one hour more than you carry in a whole week. As the process moves on and trust develops with the therapist, topics of the same depth are often experienced as less unsettling.
Possible Causes of Post-Session Heaviness
Feeling worse after therapy does not stem from a single cause. To understand what you are going through, you can consider the following possibilities.
A difficult subject has been touched on
If a loss, a traumatic memory, a family matter or a subject you have long avoided was discussed in the session, its effect does not end with the session. The mind continues to process what was said afterwards. Let's say someone who lost loved ones in the 6 February earthquakes describes that night in detail for the first time. Feeling weak, distracted and sad for two days after leaving the session may show that a long-suppressed grief is at last beginning to find its place.
Avoidance has eased
Many people have learned to keep difficult emotions at a distance rather than engage with them: by working intensely, by distracting themselves with their phone, by constantly attending to others. When this avoidance is set aside for a while in therapy, emotions that are normally suppressed rise to the surface. This can feel temporarily worse, but in the long run it helps emotions become less frightening.
The uncertainty that change brings
Sometimes the reason for feeling bad is not a memory but a realisation. Recognising something like "In this relationship, I'm always the one giving" or "I've reached forty trying to win my father's approval" shows that the old order has been shaken but the new one has not yet been built. This in-between period can be confusing and unsettling.
Physical tiredness
Emotional intensity leaves its mark on the body too. After a session you may feel a headache, muscle tension, drowsiness, a sensitive stomach or, conversely, a restless energy. A body that has been held tense for a long time relaxing can also be experienced as tiredness.
A feeling about the therapist
Sometimes post-session heaviness comes not from the topic discussed but from a moment with the therapist. Something the therapist said may have felt hurtful, you may have felt not understood enough, or you may not have been able to say something you wanted to say. Feelings like these are not easily noticed, but they can leave a sense of hurt inside you after the session.
Post-session heaviness often tells you that a door has opened; what matters is knowing that you are not alone as you walk through it.
When Is Feeling Worse After Therapy a Warning Sign?
Post-session heaviness is mostly temporary and meaningful, but some situations may indicate that something in therapy needs readjusting. Watch out for the following signs:
- You feel noticeably worse after every session, for weeks on end, and this does not ease.
- The heaviness lasts for days and makes it harder to go to work, sleep or look after your children.
- After describing traumatic memories in sessions, intense nightmares, flashbacks or a sense of disconnection increase.
- You feel humiliated, judged or blamed after therapy.
- Your need to find relief through alcohol, eating or other harmful means increases after sessions.
Adjusting the pace is especially important when working with traumatic experiences. How quickly and how deeply difficult memories are addressed is decided according to the person's resilience at that time. You can find more information on post-traumatic reactions in the article on post-traumatic stress disorder.
If thoughts of harming yourself or ending your life appear or increase after a session, this is not something to wait until the next session for. In such a moment, call 112 (emergency services) and let your therapist know as soon as possible.
How Can You Make Room for Yourself After a Session?
It is not necessary to eliminate feeling worse after therapy entirely, but it is possible to get through this period more gently. The following suggestions may help:
Leave a buffer of time straight after the session
If possible, put at least half an hour between your session and your next demanding task. Leaving the session and going straight into a work meeting, or collecting the children from school and diving into the dinner rush, gives the mind no chance to process what was discussed. This may not always be possible, but even a fifteen-minute walk, sitting on a bench or listening to music in the car makes a difference.
Look after your body
Drink water, eat something and, if possible, take a gentle walk. Calming the body after emotional intensity helps the mind settle too. If you feel very scattered, simple methods such as grounding techniques can make it easier to return to the present moment.
Postpone big decisions
Avoid making decisions straight after a session such as ending a relationship, resigning from your job or confronting an elder in the family. The realisations that emerge in a session are valuable, but it is healthier to let some time pass and think them through together in therapy before acting on them.
Jot down a short note
Write a few lines about a sentence that stayed with you after the session, an emotion that rose up or a question. This both clears your mind a little and provides a valuable starting point for the next session.
Be kind to yourself
Critical thoughts such as "Why did I get so hung up on something so small?" add to the heaviness. Remind yourself that you have faced something difficult and that it is natural for this to be tiring. Spending a quiet evening, putting on a series you like or going to bed early can be self-care rather than avoidance.
Know what you want from those close to you
Your partner or a family member may ask, "How did it go, what did you talk about?" You do not have to share what was discussed in the session. Saying, "I'm a bit tired today, let's talk later," is perfectly reasonable.
How Do You Tell Your Therapist About Post-Session Feelings?
Sharing what you experience after sessions with your therapist is one of the most valuable parts of the process. Many clients hesitate to mention it; they feel as though they are criticising the therapist or looking "weak". Yet the therapist needs this information.
You might say it at the start of the next session like this:
- "After last session, I felt really heavy for two days."
- "What we talked about regarding my mother kept going round in my head; it was as though something had shifted."
- "Something you said touched a nerve; I didn't quite understand what you meant."
Sharing like this helps the therapist readjust your pace, their approach and the way the session closes. For example, after intense topics the therapist may devote the last minutes of the session to helping you gather yourself a little more, or address a traumatic subject by breaking it into smaller pieces.
Let's say someone cries on the bus after every session but sees no need to tell their therapist. When they finally mention it, the therapist suggests using the last ten minutes of sessions as a space for settling: summarising what was discussed, taking a few breaths, making a small plan for the rest of the week. Within a few weeks the crying on the bus lessens, while the depth of what is discussed does not.
How Are Post-Session Feelings Addressed in Therapy?
Therapists do not simply brush off post-session heaviness with "these things happen"; they use this experience in planning the process. There are a few basic principles they draw on.
The window of tolerance
A concept often used in psychotherapy is the "window of tolerance". This window describes the range in which a person is emotionally aroused but can still think, speak and stay in control. Above the window come panic, anger or overwhelm; below it, numbness, disconnection and a sense of emptiness. An effective therapy session usually approaches the edges of this window but does not spill outside it. If you experience a very intense slump after a session, this may show that the session went outside the window and that the pace needs readjusting.
Adjusting the pace
In cognitive behavioural therapy, work on difficult subjects is generally done gradually. You do not plunge straight into an avoided memory or situation at its most intense; you start with lighter steps. The same principle applies to the depth of topics discussed within a session. Based on your feedback, the therapist may suggest moving more slowly in the next session or including more stabilising work in between.
Strengthening the close of the session
The last minutes of a session can be used to bring you back to everyday life. Summarising what was discussed, noticing tension in your body, doing a short breathing exercise or setting a concrete plan for after the session can all be part of this closing. For some clients, establishing a small post-session "ritual" also helps: having a tea at the same café, walking home by the same route.
Building skills in advance
Acquiring emotion regulation skills before working on intense topics makes post-session heaviness easier to carry. These skills enable you to cope on your own with emotions that rise between sessions and increase your trust in therapy.
Does Feeling Bad Mean Therapy Isn't Working?
This is one of the most natural questions to arise. The effect of therapy does not progress in a straight line. Some periods bring noticeable relief; others are more difficult. Especially during periods when old wounds are being addressed, it is to be expected that you may feel more fragile for a while.
What really matters is the overall direction. You can ask yourself the following questions:
- Does the post-session heaviness pass within a few days?
- Have you started to see change in some areas over time?
- Can you talk about these difficulties with your therapist?
- Do you feel safe and understood in therapy?
If you can answer "yes" to most of these questions, post-session heaviness is very likely part of the process. If, on the other hand, you feel that for months you have only been getting worse, that you see no progress at all and that you cannot discuss this with your therapist, this situation needs to be addressed separately. The article therapy isn't working may guide you on this.
In individual therapy with adults, post-session feelings are among the topics discussed regularly. Sharing these feelings is the most direct way for therapy to be tailored to you.
Frequently Asked Questions
Are headaches and drowsiness after a session normal?
Yes, headaches, muscle tension or heavy drowsiness are common after intense emotional work. These symptoms usually ease within a few hours or after a night's sleep. If they persist or come with other symptoms, it is helpful to consult a doctor.
How long does this heaviness last?
Most of the time it lasts from a few hours to a day or two and eases on its own. If the heaviness lasts longer after each session or disrupts your daily tasks, you need to talk about it with your therapist.
Can I message my therapist after a session?
This depends on your therapist's rules for contact between sessions; most therapists set out this framework from the start. Generally, it is preferred that anything other than arranging appointments is discussed in the next session. In an emergency, call 112 (emergency services) without waiting.
Shouldn't I feel good after every session?
No. Some sessions bring relief, some make you think, and some tire you out. Coming out of every session relieved can sometimes even mean that difficult subjects are being avoided. What matters is whether, over time, you are generally moving in a better direction.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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