How to Know If Therapy Is Working: What to Look for at Six Months
Most people assess whether therapy is working by how they feel. If they feel better, it’s working. If they don’t, it isn’t. This episode argues that feelings are one data stream — and not always the most informative one at the six-month mark.
This week, Dr. Gil offers a clinical framework for assessing whether sustained healing work has actually moved the pattern. Not a checklist of symptoms. A set of observable questions you can ask about your own life that give you more stable evidence than how you feel on a given day.
The Organizing Question
How to know if therapy is working isn’t answered by mood or anxiety level alone. The better question is: what is my life doing differently? If the work is changing the pattern, eventually the change has to become visible somewhere outside the work itself.
Five Things to Look For
Decision production has decreased. The marker isn’t speed. It’s the amount of internal preparation required to make an appropriate decision in the domains the pattern was organizing. The person who used to spend days deliberating a simple no notices they said no on Tuesday and it was done.
Recovery time has shortened. After a difficult interaction or a stress activation, how long does it take to return to your functional baseline? Sometimes this changes before the person experiences themselves as less anxious — which is why it’s worth tracking separately.
The pattern is visible before it becomes behavior. Awareness is evidence that something has become more visible. It becomes evidence of functional movement when that visibility changes what happens next. The progression worth tracking: invisible — visible — interruptible — changeable — spontaneous.
Change has appeared that wasn’t specifically targeted. Strategy transfer is when you remembered to apply what you learned. Capacity transfer is when you responded differently without remembering to use the technique. When change appears in the capacity transfer category, something more general has shifted.
The change is surviving contact with real life. This is the marker that matters most. Progress is not only change where you practiced change. Progress is change that transfers. The therapy room is where change gets practiced. Ordinary life is where you find out whether it transferred.
What If Nothing Has Changed?
Insufficient progress at six months isn’t a verdict on your effort. Before drawing any conclusions, four questions worth asking: Is the target clear? Is there any movement, even small movement? Is the work reaching the level where the pattern is being maintained? Is something else limiting the capacity to benefit?
And sometimes the honest answer is that the intervention simply isn’t effective enough for this particular person or presentation. Good assessment has to leave room for that conclusion too.
Who This Episode Is For
This episode is for anyone who has been doing genuine work — therapy, somatic practice, self-inquiry — and wants an honest way to assess whether it’s producing observable change. Not reassurance. Not a recitation of how healing is nonlinear. A clinical way of looking at your own life and asking the question that matters: what has actually changed?
Take the healing archetype quiz to identify which layer your work currently needs to reach: https://askdrgil.com/archetype-quiz
Rewrite the Signal opens September 12: https://askdrgil.com/rewrite-the-signal
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