When working with clients, I sometimes tell them that things may get worse before they gets significantly better.

Often, the reason I will say that is because usually there are many powerful emotions and sensations trapped within the psyche.  A way to understand the phenomena is as so.  Consider a child who in some way is being abused, let’s say the child is being physically abused.  When the abuse occurs there are powerful emotions and thoughts which go along with the physical assault.  Because these feelings and thoughts are overwhelming a child might initially dissociate from the assault.  It is a way for the child to survive without breaching psyche to the point of madness/insanity.  For a child it is an appropriate and useful coping strategy given the circumstances.

However, dissociation can quickly turn to repression – we push painful incidents into our unconscious.  Sometimes we can clearly remember the events, but the feelings and thoughts associated with the event are so far pushed into the unconscious that effectively we have numbed out the pain.  It is a bit like treating the pain of a broken arm, without dealing with the break in the bone.  The reason we do not deal with the break itself is because as a child we simply do not have the skills nor resources to do so.

As adults whenever we approach the problematic event or series of events we begin to experience some of the original overwhelming feelings and thoughts that are buried within.   Often the reason why people enter therapy is because unconscious feelings, thoughts and sensations are beginning to surface.  At some level they feel unable to cope with what is occurring because of the overwhelming and powerful emotions/thoughts/sensations experienced at the time.

The other side of the coin is that they are ready to begin to deal with what is occurring in experience.  Unconsciously, it is a way of letting ourselves know that it is safe enough to do the required work.  Sometimes the ‘required work’ is done in spurts – a stop start type of scenario is not uncommon.  The required work is the reprocessing of the original trauma/event/events.  Often this is mistaken as having to recall the memory, but in practice, it is the emotional/psychological components which need to be reprocessed.

A way to think about this is that when someone is in danger the psyche is orientated towards survival.  It adopts a let’s get us through it as best as we can approach.  Later in life as we gather skills and psychological resources we become more prepared to deal with the repressed material.  In a fashion it becomes safer to deal with the original incidents and reprocess them.

This is exactly what occurs in the therapeutic environment.  As the therapist/healer builds trust with the client, the client unconsciously feels safer.  At this time, powerful emotions, disturbing dreams, violent imagery, and uncomfortable physical sensations may surface just to mention a few phenomenon.  From the client’s perspective, they can begin to question their original decision to undergo psychotherapy because in some ways they feel worse than when they first began.  It is no easy thing for clients to deal with the overwhelming nature of repressed traumatic material.   From the therapists perspective, that feelings, sensations, disturbing dreams and imagery is surfacing is a good sign.  It means that the client is starting to get to some of the core difficulties at hand.

It is not unusual for the client to quit therapy at this point.  This is not a sign of failure.  On the contrary, it typically means the client needs some breathing space and finds that what the unconscious is throwing up in their direction is too overwhelming for the time being.   Working with the unconscious is not a precise science and being overwhelmed can rear its head at the most unexpected times and places.

Often clients will return to therapy months or years later be it with the same therapist or a different one.  The break from psychotherapy/healing is in effect a period of gathering additional resources.

The meaning of it may get worse before it gets better at least in the way I often use it is simply because the unconscious is likely to throw up repressed/dissociated material which is experienced as powerful and sometimes overwhelming for the client.