Often, a client asks me a question that I never get tired of hearing. Usually it happens after things have improved.
The crisis has passed. Sleep is better. Work feels manageable again. Home is calmer. We start the session, and after a few minutes they say something like, “I’m not sure I need to be here anymore.”
Sometimes the question is more direct. “Do I really need therapy?” A version of another question usually follows close behind. “How will I know when I’m done?”
What’s interesting is that almost nobody asks these questions when life is going badly. They ask them when life is going well.
For a long time, I assumed clients were trying to determine whether they had improved enough to stop. The longer I’ve done this work, the less convinced I am that’s what they’re actually asking. I think they’re often trying to figure out whether their struggles are important enough to deserve attention.
The people who ask me these questions are rarely in crisis. They aren’t showing up because they can’t function. More often, they’re the people everyone else depends on. They’re managing teams, running businesses, taking care of children, helping aging parents, coaching soccer teams, answering late-night phone calls, and solving problems all day long. In other words, they’re doing what they’ve always done.
One such conversation comes to mind: a client was explaining why therapy probably wasn’t necessary anymore. Work was going well. His marriage felt stable. There was no major conflict at home. As he talked, he seemed genuinely confused about why he kept showing up.
Then he mentioned a recent family vacation. His kid wanted to show him a sandcastle she had spent the morning building. The weather was beautiful. Yet standing there on the beach, he found himself mentally drafting an email he needed to send. Not because anyone expected him to. Not because there was an emergency. Because his mind never seemed to stop working.
When tension becomes familiar
This is not unusual – I’ve heard versions of that story dozens of times. A lot of successful adults have become so accustomed to carrying tension that they stop recognizing it as tension.
The business owner who wakes up at 3am thinking about payroll eventually stops questioning why he’s awake. The parent who feels guilty whenever they sit down to rest begins to assume that’s what responsible adults are supposed to feel. The executive who checks email during a child’s soccer game starts viewing it as normal rather than noteworthy.
To be clear, none of these examples necessarily indicate a serious problem. That’s part of what makes this difficult. Most of the people I work with are capable of carrying these things indefinitely. They’ve already proven that.
One client spent years ending every Sunday the same way. Around four o’clock in the afternoon, a heaviness would settle in. He would start thinking about Monday’s meetings, the problems waiting for him at work, and everything that could potentially go wrong during the week. By dinner he was distracted. By bedtime he was irritable. By morning he felt exhausted before the week had even started.
He assumed this was normal because it had been happening for so long. When something becomes familiar, we stop evaluating it. We just accommodate it.
Being able to carry the load
This is one of the reasons I find the question, “Do I really need to be here?” so interesting. Underneath it is often another question entirely.
“If I can carry this, does that mean I should?”
Those are very different questions. Most people can carry far more than they should have to carry.
I’ve met individuals who haven’t felt fully relaxed in years. I’ve met spouses who love each other deeply but haven’t had an honest conversation in months because both are exhausted by the end of the day. I’ve met business owners who cannot remember the last meal they ate without checking their phone at least once.
They were functioning. They were succeeding. Many were admired by the people around them. They were also tired in ways they had stopped noticing.
One thing that has surprised me over the years is that the clients who ask whether they need therapy are almost never the clients I’m worried about. The people who concern me most are often convinced everything is fine because they have become experts at enduring things.
The clients asking whether they should still be here have usually started noticing something. Noticing the tension. Noticing the loneliness. Noticing how difficult it has become to enjoy things they worked hard to build. Noticing that life feels heavier than it used to.
How will I know when I’m done?
So do you really need to be here? Honestly, maybe not. Most of the people who ask me that question could stop therapy tomorrow and continue living productive, responsible lives.
What I’ve come to believe, though, is that “Can I keep doing this?” is rarely the most useful question. The more interesting question is whether the way you’ve been carrying your life is actually working for you.
When clients ask me how they’ll know they’re done, that’s usually where the conversation ends up. Not on whether they’re capable of carrying the load, but on whether they still want to carry it in quite the same way. And after hearing that question for years, I suspect that’s what many people are asking long before they ever walk into a therapist’s office.