What to Expect in Therapy for Anxiety
You know you need help for your anxiety.
The overwhelm, the panic attacks, constantly feeling on edge, feeling paralyzed and not being able to do anything.
You just can't keep going on like this.
You decided you are ready for therapy.
Now what?
How to Find an Anxiety Therapist
First you'll need to find a therapist that meets your needs. It's important to note, not all therapists are going to be a good fit for you. That's okay. Each therapist brings with them their own "flavor" of therapy. The is influenced by their education, experiences (both professional and personal), their on-going training, and their specialties. On top of this, they will have their own personality- some therapists may bring in more humor, some my share more personal stories, some may be more "feeling-type," others more action-based, etc. What is most important is for you, the client, to feel some sort of connection with them. It's okay to feel nervous and take some time to feel completely comfortable, however you need to feel that the therapist understands you, that you feel heard, and that the way they conduct therapy "feels" right for you.
How to Find the Right Therapist
First, do some research. Most therapists are going to have a website that shares more about them and their services. You can find therapists by a google search, through online therapist directories like Psychology Today and Therapy Den, or through your insurance provider. Also, with online therapy, you can see any therapist that is licensed in the state you are physically in. For example, you may live in Northern California and you can see a therapist in Southern California. This really allows the pool of available therapist to be really open in order to find one that is a good fit.
When you look at the therapist's website- check in with yourself on how you feel. Do you connect with it visually? Do you connect with the writing on the website? Is that therapist "speaking" to you in a way that makes sense, that feels like they understand how you are feeling? Read about the services they offer. Do those fit with what you are looking for? If your answer is yes to these questions, then take that next step and reach out.
Take Advantage of the Free Therapy Consultation
Any good therapist is going to offer a free consultation. They do this because they want to make sure it's the right fit too. It does no one (client or therapist) any good when it's the wrong fit. Not everyone is going to work well together and that's okay. It doesn't mean it's a "bad" therapist, just that it wasn't a good fit.
In that consultation you should get a good sense of how they are in their therapy sessions. Do you feel comfortable talking to them? It's okay to feel some nerves, but by the end of that call you should get a sense of if they can help you and if you can feel comfortable with them. It can be helpful to write out any questions ahead of time about therapy, their experience, and background that you want to ask.
It's also important to find out their fees, their recommendations for the frequency of sessions, how long therapy may be needed, and their availability for sessions. Then what are the next steps if you do decide to schedule a session with them.
Should I try a therapy app?
Apps for therapy are definitely hot right now. While they are popular, they may not be a good fit for everyone. Many times these apps will limit how therapy is able to be conducted (by session type, length, frequency). Also, the ability to pick your own therapist is pretty limited and it can be really hard to find a therapist that you really connect with. While these apps may seem cheaper, in the long run they may not be. The more time it takes for you to find the right therapist and if there are limits on how much therapy you receive, it may take a lot longer before you actually feel better.
Research shows that the most important aspect for improvement in therapy is the relationship between the therapist and client. Unfortunately these therapy apps tend to minimize this part. While they have screenings to help connect you with a therapist, many times it just ends up depending on what therapists in their app are available to take on a new client.
Picking a therapist is a very important step in getting help. Attending sessions with a therapist that you don't connect with, that you have difficulties feeling comfortable with, and that doesn't seem to either understand you or be able to help you can really set you back and be very costly. It takes time to build up that relationship with your therapist and can be quite frustrating to have to "start over" with a new therapist.
A therapist that you really connect with and that is able to help you is one that you can continue to come back to at different points in your life when needed which can really save you from a lot of struggle.
The First Therapy Session
It's okay to feel nervous for that first therapy session. In fact, you may feel some level of anxiety/nerves/butterflies before each of your sessions. That's okay!
The first session is going to be mostly information gathering. Likely you were sent over the therapist's practice policies and some information about therapy, or you will be filling that out at the first session. Your therapist should go over these and answer any questions you have. They will then inquire about what lead you to therapy and potential therapy goals.
The therapist may also ask some background questions. They'll want to know your current living situation, are you in a relationship, do you have children, do you work, etc. They may also gather some more historical information- such as some family dynamics growing up, any big events that occurred, and how things that happened earlier in your life may have impacted you today.
It will take time for your therapist to get to know you and get a good understand of what is happening and your symptoms. This is an on-going process and you are not going to be able to "get it all out" that first session. The first session is the start, therapy is a process and it will take time.
After the first session you may find your head buzzing with lots of thoughts, replaying the session, thinking of things you left out, etc. You may also feel emotionally drained. You may feel hopeful and you may also feel the heaviness of it all. It's a lot to start to process through your thoughts and feelings. It can be helpful to plan a little downtime after you session where you can go for a walk, have some time to sit and relax, journal, drink some tea, take a shower, etc.
Therapy for Anxiety
When working with anxiety, I like to get a good understanding of my client's symptoms. I want to know:
How does anxiety show up for them?
What are some physical symptoms?
Are there particular triggers for their anxiety?
How long have they been experiencing anxiety?
Do they have panic attacks?
What have they done to try to help their anxiety? What has worked, what hasn't?
Have they experienced anxiety in the past? Any family members with anxiety?
Have they experienced any trauma or upsetting situations that have impacted them?
What are their relationships like?
Anxiety is really difficult to experience. It's very physical and mental and is not something that can just be "turned off." It's important to me for my clients to find some ways to bring in some relief. To do this, I work with my clients to identify some coping strategies they can start to put in action immediately. I also look at their sleep, how they are eating, and if they are engaging in any exercise, as these areas can make a big impact on anxiety as well.
We also have a pretty good understanding of how the anxiety process shows up in the brain and therefore how to help with anxiety. During my sessions I take time to go over a lot of this information. I find that when we can understand the mechanisms of anxiety on an intellectual level, it actually helps us better be able to help ourselves.
When working with anxiety, it's important to understand that we cannot get "rid" of anxiety completely. Anxiety serves a purpose- it's there to help us in dangerous and threatening situations. There are going to be situations in life that are going to cause anxiety. The point is not to get rid of the anxiety, but to help one cope with the anxiety so that it doesn't take over their life.
Another important aspect, is that sometimes you will feel more anxiety as your work through it. Many times the ways we try to cope with anxiety, like avoidance, actually increase our anxiety in the long-run. In therapy, you'll be addressing these things and likely having to "face" what is causing you anxiety. This is part of the process. As you are able to process and get through situations, you'll be essentially "rewiring" your brain to help decrease your overall level of anxiety.
As you sort through and process through your anxiety, you may find that other things start to come up for you. As you get better at managing your anxiety, you may find that now you are struggling with your relationship, or you really don't like that job and want to get a new one. This is all par for the course. Many times as we start to address one area of our life, we start to make connections in other areas that aren't aligned up or working. Your therapist can help you with all this.
How Long do I Need Therapy?
Many clients want to know how long they will need therapy. There is not an exact answer for this, as it will depend on the severity of their symptoms and their goals. A person experiencing a high level of anxiety symptoms with a more complicated personal history of trauma is likely going to need to be in therapy longer than someone who is seeking out therapy due to stress from their job.
Length of time can also be dependent on what is going on in a person's life. They may be making progress in their anxiety symptoms and then they experience a death, ending of a relationship, a job loss, (or hey, a pandemic) and then need support on this.
A person may also attend therapy for a very specific reason and then once that gets resolved, feels ready to stop. I also have clients that attend therapy, then take a break for a bit and return later when other things come up in their life.
Some of my clients find that therapy is so beneficial that they stay attending long after the original reasons that brought them to therapy are resolved. They use their sessions to continue to process through what is coming up for them, to help them set and reach personal goals for themselves, to help them build healthy relationships, etc.
The length of time in therapy and how frequent your sessions are will ultimately depend on how you are feeling, the severity of your symptoms, your goals, and what is going on in your life.
Why Should I go to Therapy for Anxiety?
Anxiety is really difficult to experience and unfortunately it rarely just "goes away" on its own. Anxiety also will creep in all areas of our life- including our relationships, work, our parenting role, etc. Many times the ways we try to "help" our anxiety, actually can make it worse in the long run. That's why, getting treatment for anxiety is so important.
Our brain is amazing in that it is "malleable" and can constantly take in new information and learn from it. We don't have to stay stuck in our situation. Having someone with the expertise and skills to help you sort through everything that is coming up and can give you the guidance and support to make changes is invaluable.
I like to look at life as an ongoing opportunity to learn about oneself and grow. Many of my therapy clients feel the same way and will use therapy as a tool to support themselves throughout their life.
If you live in California and are interested in starting therapy with me, please reach out!
Disclaimer: This is not a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are in California and looking for a professional therapist feel free to use the contact me to request an appointment or search Psychology Today for local therapists in your area.
