what do you do after therapy?

exploring therapy aftercare: how this crucial time can look and can lead to more internal peace

hi!! you’ve found yourself at dialoguing, a newsletter where I bring what I know from my work as a psychotherapist into the rest of my life--parenting, marriage, friendships, identity, habits, the relationship to myself and my body--in the least clinical way possible. as the name suggests, I'm often quite conscious of how we talk. to oneself, to each other, about media.

one thing before we jump in, I show up very much as myself here. myself first, and all my other labels are secondary. if a therapist speaking candidly feels like too much to your system, that is absolutely is OK and this may not be the best particular newsletter for you.

Me, at the end of every session with a client: Before you jump into what’s next, just take a minute if you can…

Pleading with my client, stay.

Just one moment longer with your tenderness, your insights, your body.

Stay.

This is not something my graduate training taught me. In fact, it’s probably something they’d discourage. Be a bit more unknowable. A little cooler.

Nah. Never been. Not gonna start now. Couldn’t if I tried.

You may be thinking, “Lady, it’s hard enough as it is to fit that hour in, how am I gonna do more?” and I have no rebuttal. It is a lot. It is a struggle to even take 50 minutes to let everything else fall away. Your to-do list and responsibilities, capitalism, the news. Waiting for you.

It is, however, only one hour a week.¹ A week is famously 168 hours, which means that therapy hour is 0.6% of your week. I guess we should factor out sleep. Quick math would get us to .89% of your week. So for context, it’s not even 1% of your week.

One hates to invoke imagery of the 1%, but how do we take this kind of 1% into the rest of our lives. How can we bridge the gap?

I want to be clear, I am not talking about taking everything we learn in therapy and immediately begin to apply all the insights.

No, no. This is not about doing. It’s about being with.

Aftercare to me is about that immediate aftermath. It’s about how we walk our tender hearts home.

Even if you spent the session talking about how numb you feel, that can still feel exposing in its own right and may need some tending to after.

When we don’t do this it reminds me of when you tell someone something about you–something important, vital–and they seem to forget it the next time you see them.

It hurts, right?

One could argue—it’s me, I argue—the same thing happens with ourselves when we go inward and then, without adequate warning, snap back into the rest of our lives.

Telehealth has increased the accessibility of therapy to a magnitude I could have never imagined a decade ago,² which is great, but it’s also made it easier to treat therapy like a light switch.

Therapy On.

Therapy Off.

It’s as simple as opening a new tab on our computers to begin the session and then closing it again when the therapy hour is over.

This is a recipe for disorientation.

Like a strenuous workout without a stretch after. Or a yoga session without Savasana. Going from feeling the warm sun on your skin into the harsh sting of the A/C at a grocery store.

Wowza.

I can sometimes see it in my clients eyes before we end, like “Oh my gosh, I’m going back to everything else.”

Instead of a light switch, I’d like to summon the imagery of on and off-ramps, like ones we use to get on a highway or an airplane.

You’re headed somewhere else, but you’re not quite there yet–and that’s good.

We tend to operate well–nay, better–with some buffer time.

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Another element of resistance I see in considering therapy aftercare is guilt around the privilege of being able to go to therapy in the first place.

It’s true, it is a privilege–AND–who in the world do you think you’re helping by not taking the time to integrate what you gleaned from that session? As a card-carrying member of the Martyrs in Recovery program, I’m very familiar with this argument. Unfortunately, it’s not one that holds much water.

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Aftercare is not a forcing. This is not meant to be rigid. It’s meant to be an invitation. An opening. An expansion. It’s for you.

Below are a few ways to construct your own personal off-ramp.

Emotionally

What from the session needs to be noted?

I mean noted literally. I have a little notebook I write in before and after sessions to jot down whatever stands out as the most crucial. This is my aftercare ritual of choice.

me and my lil’ notebook after a session

As I’ve researched this piece, I’ve seen a lot of people indicate a certain level of checking out-ness feeling necessary after a session.

Sometimes numbness is what follows an intense session. As

ailey jolie

talks about dissociating isn’t inherently “bad.” In her recent post, “The Wisdom in Numbness” she says, “From a somatic lens, numbness is not the absence of feeling—it is the presence of protection. Dissociation, detachment, even the inability to locate sensation—these are not deficits. They are adaptive strategies the body developed to endure. They are sophisticated mechanisms, crafted by the nervous system, to ensure survival when survival felt uncertain.”

When I asked the Substackverse what people do after sessions,

Rachel Casey

of

Sober Banter

bravely acknowledged there used to be a desire to drink after sessions. My perusal through Reddit on this topic points to this is a very common occurrence. As a sober person, I’m admittedly biased, but this would be something I’d want to explore with my therapist further. I would wonder if things were going too far, too fast for certain parts of me and/or the ending of the session felt abrupt.

Somatically

How’s the body doing after a session? A stretch, walk, run and/or rest needed?

How are the nourishment levels? Do we need some food and/or water?

What sort of physical sensations and/or touch would feel attuned? None, a massage, a shower,³ a hug, a cuddle with my pet?

It could also be a moment to consider all of our senses. Do I need quiet, music, the sounds of life outside? What kind of lighting? Smells or tastes?

almost always need this view

Socially

I’m personally very careful about this one. I used to disclose exact details of what I gleaned in a session without much thought. I can have compassion for this impulse now. So excited to share the insights. Deep down thinking the ultimate goal of therapy was to hack the system. Find out how to make me more lovable, more understandable and then communicate that to others. That this was all I needed to feel more whole—hard to admit, but true. This nearly indiscriminate sharing rarely resulted in strengthened connection or further understanding. Mostly it ended with a raging vulnerability hangover.

I’ve grown to check in with myself after a session to see what, if anything, needs to be directly shared with someone. I’ve realized the most foundational piece of my well-being is if I understand how I feel, what’s happened to me / around me / within me.

When I’ve had a hefty session and I notice a desire to be around people, what I crave the most is to be around people with this new awareness. I may request some additional tenderness; other times some playfulness or lightness. Other times I feel a lightning bolt of something I’d like to experience with someone. It’s not as much debriefing as it once was, although sometimes that is a part of it. Perhaps it’s the therapeutic equivalent of “show, don’t tell” in writing.

Creatively

Sometimes a session can make space for our artistic parts to come through.

Staci Belcher, MS, RDN LDN

mentioned she sometimes does watercolor or makes a collage (!!) after sessions. Couldn’t love this more. I feel inspired just reading that.

I haven’t done anything like that yet, but when I write down what needs to be noted from a session, it’s frequently accompanied with drawings. Also, the belting out of a song on the drive home from a session is where you’ll find me almost every time. Strong recommend.

**Note: If you truly can’t find the time after a session for this care and you find the transition from a session to the rest of your life disorienting, this is something you could bring up with your therapist. You’re not doing anything wrong to feel that way. I recently came across a passage by Susan McConnell that speaks to the necessity of being thoughtful about how we close a session and why it’s so damn hard to do so,

“Our systems tend to resist change, even positive ones […] The power of simply bringing our awareness at the end of a session cannot be overstated. My tendency of Western privileging of doing over being, easily slides toward borrowing a bit of time from the last quadrant of our session to see if maybe just a little more might be accomplished.”⁴

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In the end, I will sometimes encourage clients to ask themselves what they think they need at the end of the session.

That may sound borderline unhinged.

Won’t I just hear bad advice in response?

Perhaps. Sometimes. Maybe you won’t agree with what you hear back, but could you get curious about it? What is bad about the advice?⁵

I see a lot of rhetoric about how self-involved everyone is which may be creeping up for you as you read this. Don’t worry, it is for me too.

I’m not arguing that isn’t the case. I can’t speak for the entirety of the universe and the internet. But the sort of “self-involvement” I see in therapy with clients seems different. It doesn’t stay stuck in rumination. It’s expansive. It’s effervescent. It’s flowing out of them. It spills out into those around them. It’s cliche but true that the more we understand ourselves, the more we tend to understand others.

When I ask that question of “What do you feel you need after this?” I typically hear not self-sabotage, impulsivity, or indulgence, but clarity and relief.

As I finish this, I come to see that aftercare—to me—is about allowing ourselves to give voice and respect to what we hear inside of ourselves.

It's similar to what I said recently in a piece on wisdom I came to by way of Liz Gilbert,

“This all may sound like self-care™. And maybe the behaviors can be similar, but I’m finding it’s not about the things I do–marking habits off my to-do’s list, going through the motions– it's the awareness of a stirring inside that needs attention; a need/query/bid met.”

Same lesson, different route to it. Whatever, I’m OK with it.

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For more:

• Heather Havrilesky
  ’s recent 'How Can I Love Myself Without Becoming a Selfish Person?' is a must read.

• Therapy Hangovers & Post Therapy Self-Care

• 7 Ways To Take Care of Yourself After an Intense Therapy Session, According to Therapists Themselves

Questions for you:

1. What do you do after a session? What seems to help and what doesn’t?

2. What gets in the way of your ability to take this time? What sorts of fears and/or beliefs play a role in these obstacles?

3. Do you take the last few minutes of a session to wrap up and check in?

• Coming up: Apologies this one was a bit late. I was in a major rut sandwich with this one. Next week is the round-up on June for paid subscribers. Flirting with the idea of a quick therapisty thoughts on The Bear season 4 which just dropped, but will it ruin the show for me? Stay tuned.

• Disclaiming: Therapy can be great. This ain’t therapy. You can find more info and my full disclaimer on my about page here. Abridged version: I’m a therapist, but not your therapist—even if you are a client of mine ~hi, dear one!~ this isn’t a session. I don’t think you could possibly confuse this newsletter with mental health treatment. Alas if that were to happen, let me say definitively, dialoguing is an entertainment and informational newsletter only, not a substitute for mental health treatment. To find a mental health provider, Psychology Today or Zencare can be a place to start. I am an affiliate of Bookshop.org—an organization that supports local independent bookstores. I may earn a small commission if you click through and make a purchase. The thoughts and feelings written here are all my own.

• Come say hi! Any comments, questions, suggestions, please feel free to email me at dialoguingsubstack@gmail.com—or if you’re reading this via email you can hit reply and send me a message. Love hearing from you for any and all reasons!

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ICYMI:

• Oh my gosh, have you heard the news? Phones are bad for us!

• "Let's Talk Therapy" with Leslie Stephens

• Quick therapisty thoughts on The Four Seasons: Spring, Summer, Fall, and Winter

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1. I see you peeps who do extended sessions or more than one session a week.

2. I’d literally never done a telehealth session before COVID, now more than half my caseload is virtual.

3. This one I have heard A LOT from people

4. From Somatic Internal Family Systems Therapy: Awareness, Breath, Resonance, Movement and Touch in Practice by Susan McConnell. Disclosure: I am an affiliate of Bookshop.org—an organization that supports local independent bookstores. I may earn a small commission if you click through and make a purchase. The thoughts and feelings written here are all my own.

5. Furthermore, what makes you think that is what you’d say to yourself? Where does this mistrust stem from?