Therapy Makes Me Anxious: Navigating The Therapeutic Process
The thought of engaging in therapy sessions might be anxiety-provoking. It’s normal to feel anxious about therapy sessions and what they may entail, especially if you are seeking therapy for the first time. Reaching out for mental health treatment is sometimes stigmatized as something a person should be ashamed of or embarrassed about. This stigma might exacerbate any existing hesitations for people considering therapy.
Therapy can be helpful for a variety of mental health concerns, and many people who begin a mental health journey overcome pre-therapy nerves with time. Even if it might be scary at first, taking the first step to address your mental health despite having thoughts of “therapy makes me anxious” can bring a host of benefits.
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Common anxieties about seeing a therapist
Walking into the therapy room for your first session can be a nerve-wracking experience. After all, therapy may involve opening up about your personal thoughts and feelings and embracing vulnerability. If you experience anxious feelings about talking to a therapist, particularly prior to your first therapy session or during the initial sessions, the pre-therapy nerves could be related to one of the following concerns:
- Wondering what to expect
- Experiencing shame about your body or appearance, or feeling nervous about being physically seen
- Being uneducated about what therapy entails
- Desiring a connection with a therapist and wondering about what happens if you don’t connect well
- Worrying that you will waste your therapist’s time
- Being afraid of revisiting deeply painful moments or past trauma, revealing concerns you view as embarrassing, or discussing behaviors or actions like substance use that you are not proud of
- Worrying that your therapist will judge you, think less of you, think there is something “wrong” with you, or label you as “crazy” or “sick”
- Feeling concerned that your therapist will recommend a therapeutic treatment that you are not comfortable with
- Worrying that your therapist will expect you to make changes you are not willing or ready to implement in your life
- Fearing that therapy will ultimately lead you to feel worse than you already do
- If you are struggling with substance use, contact the SAMHSA National Helpline at 1-800-662-HELP (4357) to receive support and resources. Support is available 24/7.
All these concerns are valid. Therapy can be an intense process, and there is no way to guarantee that there will not be moments where you feel emotional pain, shame, anxiety, or discomfort. Still, these feelings can be a helpful component of the healing process. There are steps you can take to ensure that your anxiety related to therapy does not prevent you from continuing to progress in your sessions.
Therapy-related anxiety and mental health conditions
While anxiety about attending therapy isn’t always related to a diagnosable disorder, it can sometimes be part of a larger pattern. Anxiety disorders, including generalized anxiety disorder and social anxiety disorder, are typically characterized by excessive, uncontrollable worry, as well as physical symptoms like an increased heart rate and gastrointestinal distress. Therapy is one of the gold-standard treatments for anxiety disorders and can significantly improve symptoms for many people.
How to address therapy-related anxiety with a mental health professional
No matter where your anxiety is coming from, you can still find ways to fully engage in the therapeutic process. Your anxiety could even be a helpful tool to pinpoint areas for possible improvement. Your therapist might have suggestions for addressing your anxiety and be willing to work with you on different techniques to help you feel more comfortable in the therapy space. A good therapist typically fosters a safe and supportive environment where clients can feel comfortable.
Finding the right therapist isn’t just important – it’s everything.
Find your match“Test drive” a therapy session
Before starting therapy, it can be helpful to have a brief conversation so you can ask your potential therapist questions. If you are worried about what to expect from your therapeutic experience or specific therapy modalities, a check-in or “test drive” can help ensure you and your therapist are on the same page. You might consider asking them about the following areas of their professional work to determine whether they’re the right therapist for you:
- Their educational background
- What therapeutic techniques they have specific training in
- How long they have been working as a therapist
- What their work experience entails (i.e., own practice, hospital/clinic work, social services, online therapy providers, etc.)
- How they develop relationships with their clients
- Their therapeutic approach and philosophy toward therapy
- How they developed their own approach to providing therapy
Having an open, honest conversation with a prospective therapist could be a good way to soothe some of your pre-therapy jitters. During the conversation, you can determine whether you and the therapist seem to be compatible. You might want to consider whether this therapist seems aligned with your value system and your goals for therapy. If they seem like a good fit, consider asking for a first session so you can get a better sense of whether you want to move forward.
Communicate with your therapist
Communication might seem like a given in therapy. Still, it can be important to communicate with your therapist, not just about your thoughts, feelings, and behaviors, but also about the therapeutic process itself. You may want to ask your therapist questions about your b and your ongoing treatment plan. This could be the case even if you have been participating in a certain type of treatment for a while.
You may also want to discuss any concerns you have, as well as any negative feelings that arise during your conversations with your therapist. This may include anxiety related to attending therapy. An effective therapist will typically be open to accepting feedback and potentially modifying their care to fit your needs.
Think of therapy as a safe space
It may be impossible to eliminate your fears entirely. You may still have concerns about a therapist potentially judging you or thinking less of you because of what you tell them. However, it can be helpful to understand that therapists are trained to view their clients through a nonjudgmental lens.
Because of the nature of the therapeutic relationship, it’s unlikely that you will interact with your therapist outside of sessions. You can think of the therapeutic alliance as a discreet relationship in a safe space where you can comfortably and openly discuss personal details.
If you continue to feel uncomfortable in therapy sessions, you have other options. For example, it might help to ease into therapy by attending support groups with people who experience similar symptoms to yours.
Understand the therapeutic process
Therapists generally understand that negative thoughts, behaviors, and relationship patterns take time to address. Mental health conditions can be complex, and healing isn’t always a linear process. Some bumps in the road are to be expected. That does not necessarily mean therapy isn’t working.
It's unlikely that a professional therapist will become frustrated with you for not achieving your goals on a certain timeline. Therapists are trained to meet you where you are. It’s important to realize they don’t expect you to make any immediate changes to your life, and you won’t be pushed to talk about parts of your life that you are not yet comfortable discussing. You and your therapist can work together to set the pace of your treatment, including ways to reduce negative coping mechanisms until you have developed positive methods to use in their place.
Coping tools to use before and after sessions
Prior to sessions, using breathing exercises and grounding practices may help you stay calm. Deep breathing for a few minutes or grounding yourself by focusing on each of your five senses may help you overcome anxiety. During sessions, your therapist may provide you with additional coping tools that are tailored to your personal needs and situation. After sessions, you may want to take a few deep breaths or spend time journaling to regulate your emotions after sessions.
Another way to get ready for therapy sessions may be to prepare questions or topics you’d like to discuss ahead of time. You can then refer to these notes during the session to keep the conversation on track and ensure you’re able to talk about any concerns that are on your mind.
When anxiety might signal a poor fit
While anxiety can be expected prior to the first few therapy sessions, it should generally dissipate with time. As you develop a therapeutic alliance with your provider, you should become more comfortable with them, even if you still get a little nervous about discussing challenging topics.
Below are a few signs that your therapist may not be the right fit:
- It seems like they judge you
- It doesn’t seem like they truly hear or understand you
- You regularly feel worse after sessions and haven’t noticed any growth
- It doesn’t seem like you’re moving toward your mental health goals after attending several sessions
Online therapy to reduce anxiety and foster personal growth
If you feel nervous or overwhelmed at the thought of engaging in therapy and beginning your mental health journey, online therapy may be a beneficial option for you. Trying to find a new therapist in a traditional, in-person setting can be a complicated process involving meetings in various office spaces. With an online therapy provider, you can be matched with a licensed therapist from the comfort of your own home.
If you are already feeling stressed about the process of engaging in therapy, it may be even more stressful to think about scheduling, commute times, and other aspects of the in-person therapy process. Online therapy can remove these extra concerns and make it easier to attend regular sessions, promoting personal growth.
Research has shown that online therapy outcomes are comparable to those associated with traditional in-person therapy. For example, a 2020 study reported that online cognitive behavioral therapy (CBT) was an effective treatment for generalized anxiety disorder. Online therapy could be a convenient way to seek mental health support without increasing your anxiety about therapy.
Getting started with BetterHelp is simple:
- Take a short questionnaire. Answer a few quick questions about your goals, preferences, and the type of therapist you’d like to work with.
- Get matched quickly. In most cases, you can be matched with a licensed provider in as little as 48 hours.
- Start therapy on your terms. Schedule sessions by video, phone, or live chat, and join from anywhere you have an internet connection.
Finding the right therapist isn’t just important – it’s everything.
Find your matchTakeaway
Starting therapy can be scary, but it may also be one of the best things you can do for yourself and your overall well-being. If you are feeling anxious about going to therapy, there are several steps you can take to diminish your fears. Online therapy can help you receive qualified care without the additional stress of in-person therapy appointments.
Is it normal for therapy to make you anxious at first?
Many people feel anxious before their first few therapy sessions. While this nervousness can be normal and expected, it often decreases with time.
Why does my first therapy session make me nervous?
Your first therapy session might make you nervous because of the idea of opening up to a stranger about personal topics. You might also be worried that therapy won’t be helpful for you. There are many reasons why people feel nervous before therapy, and it’s often helpful to discuss those concerns with your therapist.
How long does therapy anxiety usually last?
Anxiety about attending therapy usually decreases with time, but there may not be an exact timeline, as everyone is unique. It can be normal to feel a little nervous prior to therapy, but you should develop a sense of comfort with your therapist after a few sessions together.
Can therapy increase anxiety before it helps?
Therapy may increase anxiety before it helps because it often teaches you new coping skills. If you’re used to turning to unhealthy coping mechanisms, replacing them with new skills may initially feel uncomfortable and anxiety-inducing. However, the new skills usually decrease anxiety over time.
For example, if you experience social anxiety, you may habitually avoid certain social situations to prevent anxiety symptoms. When you stop using avoidance as an unhealthy coping mechanism and instead choose to engage in these social situations, using strategies like deep breathing or grounding exercises to calm your nerves, it may be difficult at first. Over time, though, you may find that you no longer experience the same level of anxiety around social situations.
How do I calm my anxiety before a therapy session?
You might calm your anxiety before a therapy session by taking deep breaths or journaling about your feelings. It’s okay to attend a therapy session while feeling anxious, and you can talk to your therapist about what you’re experiencing. They may be able to provide helpful suggestions and words of encouragement.
What if therapy anxiety gets worse over time?
If you find that your therapy-related anxiety symptoms worsen over time, it’s possible that your therapist isn’t the right fit for you. It may be beneficial to consider looking for a new provider who can help you feel more comfortable with the therapeutic process.
How do I know if my therapist is the right fit?
Your therapist is likely the right fit if you feel comfortable with them and have made progress with your mental health goals since beginning to work with them. While a good therapist may challenge you and encourage you to dive into uncomfortable topics, you should still feel heard, respected, and understood.
Is therapy supposed to feel uncomfortable sometimes?
Therapy often feels uncomfortable. Digging into thoughts, emotions, and past experiences can be challenging, but it’s often necessary to move forward.
Should I stop therapy if it makes me anxious?
In general, you should not stop therapy if it makes you anxious. Instead, it may be helpful to speak to your therapist about the anxiety you’re experiencing. If they know what you’re going through, they can help you find effective strategies to manage anxiety symptoms.
Can anxiety disorders make therapy feel harder?
Anxiety disorders can make therapy seem harder for some individuals. Talking and thinking about anxiety-inducing situations and anxiety symptoms, which people usually attempt to suppress or ignore, can be overwhelming at first. However, that doesn’t mean that therapy won’t be effective. There may be an initial challenging period, but with time, the strategies learned in therapy often reduce anxiety symptoms.
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