In this study we explored helpful and unhelpful processes in psychological therapy for women with a diagnosis of substance use disorder (SUD). Semi-structured interviews were conducted with eight women, seven of whom were white; and analysed using interpretative phenomenological analysis. Three superordinate themes emerged: "What words can't express--finding another language," "Identification with my therapist," and "Getting towards acceptance." Emerging clinical implications are that therapists should consider strategies for helping clients with SUD "de-shame"; and be willing to challenge their resistance and avoidance from an empathic, accepting, and professional standpoint. Creative methods may help clients to identify and express their feelings, while the availability of therapists with their own histories of recovery may support hope and change.