written by Nerine Strachan 

In our world people often think that therapy is about feeling less anxious, less sad and less overwhelmed.. That is important. When someone is really struggling it is crucial to help them feel some relief.

From a psychodynamic perspective, feeling better and getting better are two very different things.

Sometimes feeling better can actually be a detour from getting better.

The Comfort of Symptom Relief

A lot of people start therapy because they want their symptoms to go away. They do not want to feel panicked or have trouble sleeping or feel emotionally reactive. They do not want to feel empty. It makes sense to want these feelings to stop.

Usually these symptoms get better early in therapy. When someone is really listened to and understood and taken seriously, their trauma symptoms can get a lot better. They start to make sense of their patterns. They can put words to their feelings. Their nervous system starts to regulate.

This can feel like an achievement and it is.

But psychodynamic therapy asks a question: what are these symptoms trying to tell us?

Symptoms as Meaningful, Not Pathological

From a psychodynamic perspective symptoms are not just random things that happen. They are responses to what has happened in our lives. Often shaped by our early relationships and the ways we learned to cope.

For example, anxiety might be a way of being on guard in a world that felt unpredictable. Emotional withdrawal might be a way of protecting ourselves from getting hurt. Perfectionism might be a way of trying to belong.

When therapy just focuses on making symptoms go away we might be silencing something that is trying to tell us something.. We might not understand why it was trying to tell us something in the first place.

When “Feeling Better” Becomes a Defence

There is a moment in therapy when it seems like things are getting better. The symptoms are gone, the sessions feel lighter. It seems like everything is working.. Sometimes this “feeling better” is actually a way of avoiding something deeper.

It is not something we do on purpose. It is a way of turning away from the things that might be harder to face. Like grief or anger that we never allowed ourselves to feel. Like the patterns of relating to others that we never really looked at.

Psychodynamic therapy pays attention to these moments. Not to take away the relief. To understand what we might be avoiding.

Getting Better Often Feels Worse First

Getting better, in a deeper sense, often involves:

• Feeling feelings that were once too dangerous to feel
• Mourning losses that were never grieved
• Noticing how old relational patterns replay in the present
• Sitting with uncertainty instead of urgently resolving it
• Becoming aware of parts of the self that were disowned to survive

This process can temporarily increase discomfort. People sometimes say:

“I felt better before I started talking about this.”

That doesn’t mean therapy is failing. Often, it means something real is happening.

The Role of the Therapeutic Relationship

In therapy, change does not just come from understanding things. It comes from the relationship between the therapist and the client.

How we relate to our therapist is a reflection of how we relate to others. It shows us our expectations, our fears and our patterns.

These patterns are not changed by talking about them but by experiencing them in the safety of the therapeutic relationship.

This is a kind of change and it is not always easy to see.. It is a lasting one.

From Symptom Reduction to Structural Change

Feeling better is about relief. Getting better is about change. It is about developing the capacity to tolerate our emotions to stay present in moments to see our patterns without being controlled by them.

Symptoms might still come up but they are no longer in charge.

A Different Measure of Progress

Psychodynamic therapy invites a quieter, deeper measure of progress. Not just “Do I feel better?” but:

• Do I understand myself with more compassion?
• Can I notice what’s happening inside me before I act?
• Am I living more truthfully, even when it’s uncomfortable?
• Do my relationships feel more real, not just more manageable?

Sometimes the most meaningful change is not immediate happiness, but a growing sense of internal coherence — a feeling of being more fully oneself.

And that kind of getting better tends to last.