Sometimes it just doesn’t work. Maybe it’s you, maybe it’s them, and at some point, the therapy process has failed both of you. Believe it or not, many of my training programs led the trainees to believe that when therapy failed it was always the patient at fault—their resistance, their lack of motivation, and so on. It's understandable how that misconception could arise, especially if a training program emphasizes certain perspectives, such as psychodynamic or psychoanalytic psychotherapy. However, therapy isn't a one-size-fits-all solution, and there are many factors that can contribute to its success or failure. Sometimes, it's not just about the patient's resistance or lack of motivation; it could also involve mismatched therapist-patient dynamics, ineffective treatment approaches, or external factors affecting the patient's ability to engage in therapy. So many factors at play.

It's crucial for therapists to adopt a more nuanced understanding of therapy outcomes and to recognize that both the therapist and the patient play important roles in the therapeutic process. This includes acknowledging the limitations of certain therapeutic modalities and being open to adapting approaches to better meet the needs of individual patients. Therapy is a collaborative effort, and when it doesn't work, it's an opportunity for both the therapist and the patient to reflect, learn, and potentially try different strategies or interventions.