The Other 167 Hours: What Happens Outside the Therapy Room Matters

Therapy usually happens once a week.

That means we spend one hour a week in the therapy room and 167 hours outside of it. Many people come to counseling because they aren’t satisfied with how they are feeling. They want to feel better, function better, or live differently.

But if we want therapy to create meaningful, lasting change, we have to look beyond the one hour we spend in the therapy room.

If we want to feel better, we first need to understand why we are feeling the way we do. What has happened in my life that may be contributing to how I feel? How am I currently living, and are there aspects of my daily life that may be affecting my mental health? Identifying the underlying factors contributing to our symptoms is an important first step toward meaningful change. We can begin exploring these questions together in the first few sessions and return to them throughout the counseling process.

Once we have a better understanding of what may be contributing to how we feel, the next step is figuring out what we can do about it.

This is where the other 167 hours come in.

We can start by looking at the things that often have the biggest impact on our wellbeing. These aren’t complicated. They are the basic, foundational parts of a healthy life that can be easy to overlook when we are struggling.

Let’s start by talking about a few of them.

Start by Changing the Basics

The first and most important things to address are the simplest. They also offer opportunities for the biggest impact!

Sleep

We don’t operate well when we are underslept. If we aren’t feeling well, one of the first things to consider is whether we are getting enough sleep. Many people underestimate how much sleep they really need, and work schedules and life demands make it hard to prioritize a good night’s rest. However, our brain and body require rest to operate; if we consistently don’t give it what it needs, we shouldn’t be surprised when we don’t feel our best.

Exercise

The mental health benefits of exercise are profound and well-supported by many years of research. Our bodies are made to move! Exercise does not have to be high-impact for us to benefit from it. Adding movement into our days, no matter how small, is a powerful way to support our mental health and change how we feel.

Relationships

Humans are relational beings. Our relationships–or the lack of them–can be a significant contributor to distress. Addressing the sources of support in our lives, outside of therapy, can have a huge impact on our ability to cope with stress, overcome hardship, and build lives that genuinely support our mental health.

Diet

What we eat can directly influence how we feel. Just as our bodies need adequate sleep to support our mood and daily functioning, our bodies need proper food as fuel to run on. We can’t expect to drive on an empty gas tank! Supporting ourselves through eating healthy foods can have a powerful impact on our wellbeing.

When it comes to the other 167 hours of our week, there are many things that influence how we feel. However, sleep, exercise, relationships, and diet are often the lifestyle factors with the greatest impact.

Many people come to therapy wanting to feel different. To feel different we must act differently!

Making changes in the other 167 hours of our week may be simple, but it is often not easy. This is where therapy comes in. Change is hard and often comes with a lot of resistance. Having someone like a therapist, who is trained in behavior change, to help you navigate the discomfort, identify what is getting in the way, and practice small shifts can make all the difference.

The goal of therapy is not simply to feel better for one hour a week. We want to help you build a life that supports you during the other 167.

This does not happen overnight. In fact, lasting change often begins with small, consistent shifts. Maybe that looks like getting to bed a little earlier, taking a walk during your lunch break, eating a real meal, or reaching out to someone you care about. Maybe that looks like simply spending less time doing things that leave you feeling worse and making more room for things that help you feel good.

The work of therapy happens in the therapy room, but it also happens when you walk out the door.

You have 168 hours in a week. Therapy may account for one of them.

What happens in the other 167 hours matters too.

References:

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Jacka, F. N., Pasco, J. A., Mykletun, A., Williams, L. J., Hodge, A. M., O’Reilly, S. L., Nicholson, G. J., Kotowicz, M. A., & Berk, M. (2010). Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry, 167(3), 305–311. https://doi.org/10.1176/appi.ajp.2009.09060881

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Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023

Walker, W. H., II, Walton, J. C., DeVries, A. C., & Nelson, R. J. (2020). Circadian rhythm disruption and mental health. Translational Psychiatry, 10, Article 28. https://doi.org/10.1038/s41398-020-0694-0

Yoo, S.-S., Gujar, N., Hu, P., Jolesz, F. A., & Walker, M. P. (2007). The human emotional brain without sleep: A prefrontal amygdala disconnect. Current Biology, 17(20), R877–R878. https://doi.org/10.1016/j.cub.2007.08.007