When Catherine started therapy five years ago, opening up about everything that’s happened to her made her feel like she was on a bad bender. Going over “all the trauma you’ve experienced in life and seeing it in a healthier way is really like going over everything you ‘did the night before’ and seeing it through sober eyes,” the 35-year-old office manager tells me. For the first two years, the hour-long sessions never felt long enough. After each one, she’d replay the session over and over again in her head, leaving her “completely drained.”
Catherine was experiencing what’s called a “therapy hangover,” or the “mental, emotional or physical exhaustion following a psychologically demanding psychotherapy session,” clinical psychologist Carla Manly explains. Kind of like when an old computer buffers in response to too much data coming in, individuals go through a “recalibration process” wherein they’re consciously and unconsciously “integrating and processing the therapy session,” says Manly.
Though the concept of a therapy hangover has been casually used among clinicians for a long time, Manly credits therapist Bryan Nixon with popularizing the term in a 2016 blog post. In it, Nixon describes a therapy hangover as “that time-frame after a really meaningful session, typically lasting 1-4 hours in which you may have a slight bit of tunnel vision, your legs and body may feel a bit heavy, your thoughts will be a bit hazy.” (Manly notes some severe therapy hangovers can last up to several days.)
Nixon goes on to say that this feeling “is a good indicator of the beginning of transformation.” Really, it’s the only hangover that means you’re actually doing a good job, but that doesn’t make it feel any better when it’s happening. In fact, Nixon notes he can always tell when new clients are having them because they’ll say things like, “I don’t know if this is helping. I think I am actually feeling a little bit worse.”
“Psychotherapists have long been aware that many clients experience a post-therapy period where they feel out of sorts, exhausted and unsure of their therapy progress,” Manly says. (Again, given what’s often asked of clients in therapy — like digging up deeply painful and buried parts of their past — it’s not entirely surprising that this would make some people feel a little beat up.)
But since therapy hangovers are generally a positive, not every mental-health professional is a fan of the label. “I don’t love the term therapy hangover because it often has a negative connotation around something that’s a normal part of the growth and healing that happens within and outside of therapy sessions,” therapist Heidi McBain says.
For instance, the only way to prevent a mid-30s hangover is by not drinking, but if the same avoidance is applied to therapy, it’s going to be hard for anyone to improve. Instead, it might be better to handle your therapy hangovers the same way you would treat a college hangover — i.e., plan around them. But instead of not taking 8 a.m. classes, “have a buffer between therapy sessions and other commitments when possible.”
Nixon also recommends dealing with therapy hangovers head-on by remembering the three R’s: rest, reflect and reorient. Specifically, he suggests setting aside a minimum of 20 minutes to rest following a tough therapy session before taking a few minutes to look back on what you learned and do some sort of grounding exercise like deep breathing, or a light physical activity.
In addition to rest and quiet time, Manly advises journaling and spending some time outside. ”After demanding sessions, I consistently remind my clients to create personal downtime to rest, relax and walk in nature,” she says. But not every therapist is going to bring up the subject, so it’s important to let them know if you’re struggling.
To that end, Catherine never asked her therapist about her therapy hangovers, mostly because she didn’t know if they were normal or not. Intuitively, though, she knew not to avoid them either. “I’d start planning for the therapy hangover and clear my schedule after therapy and alert my husband that I’d like to be left alone that night,” she recalls.
While Catherine hasn’t stopped showing up to appointments, her personal progress has made her hangovers small enough that she barely notices them anymore. “As the literal acceptance and work toward healing took place, those reeling thoughts lessened,” she says.
And even that wasn’t the case, it’s the kind of hangover she’d now embrace.