Stagnation In Therapy: When You Just Feel Stuck

Dr. Dawn Ferrara
Dec 26th, 2022

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You’ve been going to therapy for a while, and you’ve made good progress. You’re proud of how far you’ve come and your skin picking isn’t as intense as it was.  Lately, things seem to be moving more slowly in therapy. Honestly, sometimes you’re feeling kind of stuck. Does this mean your therapy isn’t working anymore? Have you gone as far as you can go? Or is this feeling stuck part of the process?

In a new webinar, Dr. Vladmir Miletic takes a closer look at stagnation in therapy and what you can do to get through this challenging time.

What is Stagnation Exactly?

Stagnation in therapy is a phenomenon that occurs when progress starts to stall. You might find that you’re feeling stuck. You may find that motivation for change is waning. You might even feel like you’ve gone as far as you want to go for now or not ready to take the next step. Stagnation can happen for lots of different reasons too.

When you first began therapy, you’re full of hope and all in. It can feel like you’ve found the last golden ticket. You know it will sometimes be really hard, but you’re committed to doing whatever it takes to heal. As therapy progresses, you’re delving into the deeper, sometimes painful issues but you know it’s part of the process.

Change is hard work. The emotional work you do in therapy is hard, especially when working with issues like skin picking which have an element of emotional avoidance. Dr. Miletic likens the therapy process to peeling back the layers of an onion. Each layer reveals another set of issues, deeper than the last, waiting to be explored. That kind of work can be emotionally draining, and you may reach a point of not wanting to go farther.

As you work in therapy, you’re learning about your emotions, learning new skills, and reducing your skin picking. As the urgency and intensity of your skin picking ease, you may find yourself less inclined to work at the intensity you did before when the emotional pain was more acute.

It’s also possible that you’ve worked really hard and experienced setbacks or relapses. Therapy is not a linear process, and ups and downs are to be expected. However, even knowing that, it can feel like all your hard work has been for nothing or that it’s not working.

Whatever the reason, stagnation happens sometimes. The good news is it doesn’t have to be the end of your therapy. In fact, when managed well, stagnation can actually be the catalyst to your next progress milestone.

Working Through Stagnation

When stagnation arises, the easy thing to do would be to just give in. Stagnation can actually be a great indicator that you need to reassess where you are and revise your plan moving forward. It’s a process that you and your therapist can work through together. Dr. Miletic offers suggestions for working through stagnation and resetting your course so that you can continue to make progress.

Go Back to the Basics

  • Take a look back at where you started and why.
  • What were your intentions? Why did you start therapy in the first place?
  • Where do you want to get to? What are your goals for therapy?
  • Are you using the tools you need to be using? Try some mind-mapping strategies to break down the process and to see if you’re giving your attention to the parts of therapy that are most relevant for you. For example, if you’re working on using competing responses and practicing mindfulness, think about how often you’re using those strategies. You may find that you’re using one more than another or not using them consistently. Dr. Miletic offers a great example of how to map this in the video.
  • Create a timeline of your attempts to change and reduce your skin picking. Can you pinpoint the situation or insight that triggered your stagnation? For example, did you have a particularly bad relapse that resulted in your feeling this way?
  • Write a letter to yourself restating your intentions. Sometimes, you just need to sit down and have some real talk with yourself. Remind yourself why you started and what you intend to accomplish. Also give yourself some grace and compassion. Change is not linear, and the struggle is part of the process. Use kind words in this letter. You’ll be reading it in times when you need that comfort and reassurance that you’re doing fine and can reach your goals.

Talk About It

  • If you’re in therapy, have a conversation with your therapist about how you’re feeling. Chances are your therapist may already have some sense that you’re struggling but they may not know exactly what you’re feeling. It’s ok to be open and honest about what you’re experiencing so that together you can figure out the next steps that are right for you.
  • Join a support group. Sometimes, you can gain a lot of insight and even motivation from the experiences and feedback of others dealing with the same issues. Hearing how someone else overcame their sense of stagnation may give you some new ideas and motivation for facing your own.
  • Find an accountability partner. Having someone that you are accountable to can be highly motivating and help keep you on track, doing the things you need to do. When choosing an accountability partner, look for someone who can be direct with you when you need it but also kind in how they do it. For example, you don’t want someone who will belittle or demean you if you don’t remember to use your fidget and pick at your skin instead.
  • Consider additional interventions such as supplements or medication (if appropriate). A conversation with your healthcare provider can help you to determine if additional interventions might be helpful.
  • Change therapists if you need to. Dr. Miletic cautions that this step should never be the first choice when things get hard, especially if you and your therapist have worked well together until now. However, sometimes, therapy can come to a place where you’ve accomplished what you can in that setting. If that happens, it’s ok to move on to another therapist to continue your work. It is not an action to be taken lightly or a reason to avoid doing the hard emotional work needed to heal.

Consider the Timely Factor

Dr. Miletic uses the idea of the “timely factor” to underscore the importance of dealing with other issues that may be present along with skin picking. Skin picking may be the problem that brought you to therapy, but you may have another issue that needs attention and may even exacerbate your skin picking. The other issue might need attention first. Some skin-picking while you’re addressing the other issue might feel like stagnation, but the process might actually be creating the emotional space for you to do your work. You may be able to find some ways to work on your skin picking indirectly while this is sorted out. A trained therapist can help you to sort it all out. 

When You Feel Like Quitting

When you feel like nothing is working and you’re tempted to quit, Dr. Miletic cautions, don’t make any sudden decisions and offers these tips to help get you through:

  • Set a schedule for yourself, whether, for example, it’s checking in with your therapist, journaling, or your accountability partner.
  • Do regular self-evaluations to keep track of how you’re doing. A journal is a great place to track the skills you’re using, how they’re working, etc.
  • Mind your self-talk. It’s easy to get down on yourself when things get tough. Stagnation can ramp up negative self-talk. The more negative self-talk you engage in, the more you’ll stagnate. Remember, accountability is great, but you need grace and compassion too. Be kind to yourself.
  • Respect your pace. The journey is yours and it takes as long as it takes. Let yourself take the time you need to.

You can work through stagnation, and you can reach your treatment goals.

To see the entire webinar, visit the YouTube channel at

Want to know more? Visit to learn more about skin picking, treatment, and other resources. You can also subscribe to the newsletter and subscribe to the YouTube channel to receive notifications about upcoming webinars.

Dr. Dawn Ferrara


With over 25 years of clinical practice, Dawn brings experience, education and a passion for educating others about mental health issues to her writing. She holds a Master’s Degree in Marriage and Family Counseling, a Doctorate in Psychology and is a Board-Certified Telemental Health Provider. Practicing as a Licensed Professional Counselor and Licensed Marriage and Family Therapist, Dawn worked with teens and adults, specializing in anxiety disorders, work-life issues, and family therapy. Living in Hurricane Alley, she also has a special interest and training in disaster and critical incident response. She now writes full-time, exclusively in the mental health area, and provides consulting services for other mental health professionals. When she’s not working, you’ll find her in the gym or walking her Black Lab, Riley.

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