Why is therapy so exhausting?

At the end of the last therapy session I had, my counsellor asked how I felt. It was a Thursday afternoon and I was about to head back to work, but all I wanted to do was to curl up in bed and go to sleep. "I'm OK," I said. "But honestly, I'm shattered."

Counselling has been enormously helpful for me. It has helped me explore my anxiety, emotions and feelings, and although I've only just scratched the surface, I already know it will have a profoundly positive impact on my life.

After every session, though, I feel exactly the same. I feel like I've run an emotional marathon, drained of energy and like I could sleep for the rest of the day. So why is therapy so exhausting?

Recalling memories can be draining

"Exploring past trauma and personal issues can be very draining, and it is normal for clients to sometimes feel emotionally and mentally drained during therapy," says Meera Mehat, a psychotherapist who runs the clinic Harley Street Consulting.

This can be taxing for several reasons, she explains. "Clients have to recall memories to tell a therapist. These memories are often emotionally charged and can cause distress to the client. It's hard enough to remember them, and articulating them after that can be even more challenging," Mehat says.

"It can be a source of frustration or stress when clients feel unable to express themselves, and therapists will ask questions to better clarify or aid the articulation of these hard experiences," she adds.

"This questioning can feel difficult for clients who are already struggling to manage their emotions. The mental effort to keep composed and find the right words to express themselves is naturally exhausting and can leave patients feeling tired."

Internalising experiences can take its toll

Another explanation is to look at the physical toll of internalising our thoughts and emotions, says psychotherapist Maryam Meddin, the founder and CEO of the London mental health clinic The Soke.

"Stress, sadness, anger, anxiety, trauma - keeping these feelings hidden, perhaps even as a habit rather than through deliberate intention, has an immense impact on our physical health and our bodies," she explains.

"Therapy is a process by which we allow things to be expelled and, hopefully, expunged. With either route there is undoubtedly an after-effect - a 'hangover' if you will - since honesty and openness in the therapy room demand so much energy."

The fight or flight response

There's also a biological reason why we may find therapy so intense and tiring. Difficult memories can carry emotional burdens that can cause distress, which triggers the release of stress hormones like norepinephrine and cortisol. This reaction is known as the 'fight or flight' response and it can be exhausting to spend time in this state of high alert.

Depending on the type of therapy, clients may be encouraged to reach their own solutions or conclusions under the guidance of their therapist, rather than advice prescribed by the therapist externally.

"Reaching this solution can be a hard journey for the client as they have to problem-solve and explore what will work best for them," adds Mehat. "To problem-solve and self-scrutinise even with an experienced professional therapist can be an exhaustive process."

Although therapy can feel temporarily draining, Counselling Directory member Marteka Swaby highlights that feeling exhausted can be a sign that the therapy is having a positive effect.

"Talking about struggles from your past or things that are painful are never easy, but once you get to the root and start to deal with some of the issues, the pain eventually subsides, and you have a healthier outlook to help you tackle future issues," she says.

If you struggle with post-therapy fatigue, there are steps you can take to ease the tiredness.

How to cope with post-therapy fatigue

Schedule your therapy on quieter days

"Try scheduling therapy on days or during times where you'll have some free time to decompress afterwards," says Swaby.

"Consider coping strategies or distraction activities before the sessions so you have planned something you can do after that will lift your mood. For example, go for coffee with a friend, exercise, or watch a movie."

Listen to yourself

Taking time for yourself is often unhelpfully seen as selfish or self-indulgent. But being kind to yourself is hugely important after a challenging therapy session. If you need to - and you can - have a nap or a rest.

"Treat yourself to something - your favourite cake, get your hair or nails done, buy that new game. Whatever makes you feel special. Be a little self-indulgent," Swaby says.

Mehat recommends listening to some feelgood music. "Find something you enjoy listening to that brings feelings of pleasure, invokes good memories or creates a sense of calm," she says. "If you want you can crank it up and focus on the feelings of pleasure and fun or calm and relaxation, depending on the type of music chosen."

Journal your feelings

Not everyone has the opportunity to relax or have a nap after a therapy or counselling session, but taking ten minutes to scribble any lingering thoughts or feelings in a journal can be helpful.

"Write down your thoughts immediately after therapy," Mehat says. "This can help you make connections and see things differently. Putting your feelings on paper can help to disassociate with them and this can make you feel better."

Exercise

Physical activity releases feelgood chemicals called endorphins, which can help to boost your mood and ease mental fatigue. Going for a jog, doing some gentle stretching or going for a quick walk can help to clear your head.

"After the session, take a brisk walk in the fresh air - even five minutes can be enough to invigorate you," says Mehat. "Take the time to notice your surroundings, the noise, the sights, the smells.

"Focus on your pace, keep your head high and focus on the horizon - keep it brisk so the mind is alerted to the function of walking. By keeping your head high or looking at the horizon you will feel better and it will allow your airways to open up and breathe better."

Don't give up

And remember, going through therapy or counselling is not an easy process. It's often difficult to talk about the way we feel or think, as well as past experiences or trauma, but that doesn't mean it isn’t worth doing.

"Don't give up on therapy - if you're finding it tiring, it means you're doing it right," Meddin says. "You're working hard to improve whatever it is you went there for in the first place, so well done and keep at it."

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