Anxious about therapy? Me too, and I’m a therapist!
Recently I was meeting a potential new client for the first time. They told me that they felt anxious about meeting with a therapist to consider counseling. In the course of our discussion, I revealed that I often feel anxious too when I begin therapy with a new client! In full disclosure, my anxiety feels manageable, which I know is not the case for everyone; my anxiety neither causes me distress nor gets in the way of my work. However, whether you are a client or a therapist, anxiety can be normal and helpful to reflect upon.
Why do clients feel anxious about therapy?
As a therapist, I attribute my anxiety to how important I view the beginning relationship. I want to make a good connection with someone new, and I have a strong desire to start doing our work together effectively. Each person is unique, and I know I will need to work hard to accurately understand their needs. For myself, these are good goals and my anxiety helps motivate me toward them.
On the client side, there are many additional possible sources of anxiety about therapy. Let’s name some of them:
- Meeting a stranger (the therapist). For most of us, but especially folks who struggle with social anxiety, the situation of meeting a stranger may induce anxiety regardless of whether it is a therapist or someone else. You may feel nervous about whether your therapist will like you, judge you, or have a good impression of you. Please remember that good therapy is all about forming a strong connection and collaborating on your goals; your therapist is truly there to understand and empathize with you, and has received significant training to make this happen. If there is a mismatch, it isn’t your fault; it may just not be a good fit! Which brings us to…
- Worrying about whether the therapist will be a good fit. If you decide to seek counseling, it is important for your therapist to fit what you are looking for. Seeking the right match for pursuing your mental health goals can be anxiety-provoking! The first therapist you meet won’t always be the best fit, and it is fine to honestly communicate your hesitations. Many therapists offer free consultations for exactly this purpose.
- Discussing private, difficult topics. You may worry about being judged or whether information will stay private. Therapy is a strange place in some ways. There probably aren’t many places where you can talk as freely about mental health struggles, sex, relationship complexities, and other topics. As a result, breaching private or ‘taboo’ subjects may feel uncomfortable. Please be assured that therapists inhabit this space every day. We not only are used to discussing these topics non-judgmentally and confidentially, we encourage open, genuine discussion for the sake of your well-being.
- Acknowledging to yourself that you need support. Change is hard, and sometimes the first step of a journey possesses outsized meaning. It may be nerve-wrecking to contact a therapist if such an action marks a commitment to move in a new direction.
- Uncertainty. A lack of information about the future is often a trigger for anxiety. A new therapist and perhaps the process of therapy itself may be uncertain to you at the start. Again, anxiety is an expected reaction to uncertainty! For excessive anxiety, one of the skills you may work on in therapy is better tolerating the uncertainties of life.
- Worry that therapy “won’t work.” Sometimes despite your hard work in therapy, it is possible that an initial course won’t reach your goals. This possibility can make you feel hopeless, but remember that doing therapy is like riding a bike. You often have to try and fall off several times before you learn how to ride. Just like you wouldn’t expect to ride a bike perfectly on your first attempt, shifting mental health patterns takes practice and time.
These sources of anxiety are not exhaustive, but some of the ones I most commonly hear from clients. It may be helpful to notice how each source of anxiety is about something important. In other words, these concerns didn’t arise from nowhere – they reflect valid needs, even if the amount of anxiety can sometimes become excessive.
Signs of anxiety about therapy
In addition to standard physical, thinking, and behavior-based symptoms of anxiety, you may experience signs that are uniquely tied to therapy. Do you avoid thinking about therapy? Do you notice yourself making (inadequate) excuses about your need for more support? Is there an anxious pit in your stomach when you think about therapy? Do you find yourself searching for a therapist but not taking the step of contacting one? An incredible aspect of being human is your capacity to observe yourself; take a good look at what messages your thoughts, emotions, and behaviors are sending to yourself!
Don’t let anxiety deter you from the support you need
The average amount of time people wait to begin therapy is 11 years! That is over a decade of unnecessary struggle. Much of that wait results from problems with the mental health treatment system such as health disparities, therapist availability, and cost. However, your anxiety about therapy is one factor that remains more in your control. Whatever your anxiety level, you can still choose to begin therapy. In other words, you can decide to begin therapy WHILE feeling anxious about it rather than avoiding therapy BECAUSE you feel anxious. Don’t let distressing emotions keep you from living the choices you want!