Therapists experiencing anxiety is not uncommon. I’ve been there!
I remember the early days of being a therapist. Often, when I would gear up to see clients I would feel so anxious. Really anxious. Like, borderline “I’m going to have a panic attack” anxious.
Having experienced severe panic disorder in high school, I knew all the “right” tools to cope with my anxiety. I took deep breaths, I engaged in activities that helped me relax, and I didn’t avoid the thing that made me anxious. Don’t get me wrong, those coping skills are well and good! I still use them often, as needed.
But, at the time I thought my experience of anxiety as a therapist was all happening because of my history with panic disorder. Now that I’ve been a therapist for a minute, when I look back at that early career anxiety, I see it more as a normal part of learning a new skill. Dare I say, a healthy part of practicing becoming a therapist.
Given that, I think I could have interacted with the anxiety a bit differently to help it stay contained and take up the appropriate amount of space in my body. Rather than it sometimes threatening to take over and overwhelm my system.
Just in case they’re other therapists experiencing anxiety, I thought I’d share some tools in hopes that they might be helpful to you.
If you’d rather watch than read, check out the video version of the article below:
Changing the anxiety narrative
Here’s the first tip, and the primary point I want to make today: when anxiety shows up, get curious.
When you start to feel anxious leading up to a session or the beginning of a work day rather than noting the anxiety and then using the tools to try and engage your parasympathetic nervous system to calm down I invite you to first ask what your narrative is around the anxiety.
Both as a society, and as a profession, we’ve become so prone to wanting to reduce or eliminate anxiety whenever it shows up. We often forget that anxiety is a very appropriate response in certain situations.
What can happen is when the anxiety pops up and we see it like a fire we need to put out. Let’s extinguish that anxiety! We feel like the fact that it’s present is already an issue. We forget a lot of times that our bodies have anxiety as a built-in response in order to help us in the right situations.
I remember experiencing anxiety before a session often in those early days. And the narrative would sound like: “Darn anxiety! It’s back again. I thought I overcame that in high school. What am I going to do if I get anxious in session?! What if my clients can see that I’m anxious? They’re going to think I’m not competent as a therapist. I have to get rid of this anxiety at all costs so it doesn’t cause problems for me.”
So, for me, the anxiety would pop up and all my alarm bells would go off. Now that I have more experience as a therapist, I can look back at how that anxiety showed up in those early days and replace it with a different narrative.
My new anxiety narrative
Now my narrative sounds more like: “There’s that anxiety again. Wow, that sure feels uncomfortable. What brings you here today? Anxiety, are you trying to tell me something? Which part of me is feeling nervous? Okay, I see that I’m implementing a new therapeutic approach with my client today. The perfectionist in me is afraid I’ll mess up. That makes sense.”
When I make this kind of shift in my narrative, rather than trying to get rid of the anxiety, I’m consulting with it. Ironically, whenever I acknowledge that the anxiety might be there for a good reason and that it’s valid, it immediately lifts the intensity of the anxiety to a manageable level.
My primary tip for you is when that anxiety shows up, gently ask yourself what your narrative is around that anxiety.
And, definitely check-in with yourself to see if there’s anything about your narrative around anxiety that’s invalidating the anxiety. Because, funny enough, when we invalidate the anxiety, it makes the anxiety get worse.
Reframing Anxiety
One item that comes up for therapists experiencing anxiety, myself included, is because we assume that we’re not supposed to feel anxious, then when the anxiety pops up we may interpret it as a sign that we’re not prepared.
For example, imagine I’m getting ready for my first session with a new client. As I’m preparing the anxiety pops up. Suppose I tell myself: “Uh, oh! I’m not supposed to be feeling anxious!”
Then, my brain needs to find a new way to see what’s going on and explain why I’m feeling anxious if I’m not supposed to be. I may interpret it as a sign that I’m not ready to see this client. Or, I’m not ready to be a therapist. Then, of course, that narrative is only going to fuel even more anxiety. But, it may not be accurate at all!
Something I wish we talked more about as a culture is how anxiety is a very normal response to doing new things. It is so normal! We should expect to feel anxious.
If you notice that you’re interpreting the anxiety as a sign that you’re not competent, pause. Then, ask yourself: “Am I maybe feeling anxious because this is so new? And I’m also having to perform while I’m learning how to be a therapist.”
Can you reframe your narrative to be a reflection of reality?
Seek trusted support
The next tip if you’re feeling anxious is to discuss your experience with trusted peers, supervisors, or colleagues. Find someone who you can be honest with. Hopefully they can help normalize the experience of anxiety for you. They can also support you in acquiring any tools that you may need.
Have a learner’s mindset
What about if you get hit with anxiety during a session with your client? I’ve definitely been there many times!
For me, there were two primary categories of anxiety that would happen in session. One is the kind that I’ve been talking about so far. I would be concerned that I wouldn’t know how to approach a situation or have the right tools to help my client.
In this scenario, if you are anxious you aren’t going to be competent about something a client brings up, remind yourself that you don’t have to know, in this moment, how to navigate that. If we tell ourselves that we have to be competent at everything all the time then we’re much more prone to make more serious mistakes. We might make a decision in the moment that may not be what our client needs.
No matter how far you are into your career, we’re all still learning! None of us are experts in everything!
There are many ways for you to acknowledge aloud with your client that you will need to check on something and get back to them. I think it’s a lot easier to access that way of responding if we’ve embraced that we can’t know everything. And that it’s in our client’s best interest to always acknowledge when we don’t know something.
I think it’s important to admit that while we’re learning we will make mistakes. What’s more important is to embrace a learner’s mindset. Be open to feedback, open to shifting, and open to learning something new.
Experiencing a trauma reaction in session
The other category of anxiety that I’ve experienced is when a client is bringing up something that brushes against my own experiences. For me, there are certain types of trauma that I’ve experienced in my history. If a client starts to bring that up in their story, my body reacts in a very anxious reaction. My sympathetic nervous system starts telling me to run! Get out of this situation now!
If you are having a trauma response that looks like anxiety then utilize coping tools. Try to practice some deep breathing or do what you need to compartmentalize and take care of yourself in the moment.
After the session, I would strongly urge you to consult with some trusted colleagues. I think that is a good idea pretty much anytime you have a trauma response. Speak with trusted colleagues, supervisors, peers or even your own personal therapist. Ask your trusted people to help you better understand what happened and what to do now going forward.
But even with all that said, it is still totally normal to have a trauma reaction in session.
Especially if you have your own history of trauma. That’s how our bodies work!
Closing thoughts
Hopefully this article helps you reframe that therapists experiencing anxiety is normal, expected, and even healthy.
I hope you feel a little bit more okay wherever you are in your career. Especially if you are in the early career days because that’s when I felt the most anxious.
Along with less anxiety there are many changes between being a new vs. seasoned therapist. You may resonate with my reflections on the many differences I’ve noted in myself between the beginning of my therapy career and now.
If you do experience anxiety I have a video that boils down my advice into one mindset shift that has really helped me to overcome anxiety during sessions with a client.
Until next time, from one therapist to another: I wish you well.
-Marie
Photo by Joice Kelly on Unsplash
Photograph by Gary Butterfield on Unsplash
Photo by name_ gravity on Unsplash
Leave A Reply