What Do I Do If My Therapy Makes Me Anxious?

The thought of engaging in therapy sessions might make you feel apprehensive, like a thousand butterflies are fluttering around inside your stomach. It’s normal to feel anxiety about the therapeutic process, especially if you are starting therapy for the first time. Seeking 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. Even if it might be scary at first, taking the first step to address your mental health can bring a host of benefits. There are several strategies you can use to address your anxieties about therapy, starting with a better understanding of the root causes of your feelings. 

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 showing a therapist your most vulnerable parts. If you are feeling anxious about talking to a therapist, it could be related to one of the following concerns:

• Wondering what to expect
• Feeling shame about your body or 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
• That you will be wasting your therapist’s time
• Fear of revisiting deeply painful moments, revealing embarrassing issues, or discussing behaviors or actions like substance use* that you are not proud of
• That your therapist will judge you, think less of you, think there is something “wrong” with you, or label you as “crazy” or “sick”
• That your therapist will recommend a therapeutic treatment that you are not comfortable with
• That your therapist will expect you to make changes you either are not willing to make or don’t feel ready to implement in your life
• That therapy will ultimately make you feel worse than you already do

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

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 make you feel more comfortable in the therapy space.

“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, 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:

• 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

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 also 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 potentially good fit, consider asking for a first session so you can get a better sense of whether you want to move forward.

From here, you can ask to see them once a week, once every other week, or once a month. If you choose to see your therapist once a month, consider requesting additional resources you can rely on at home if emotions come up that you need help coping with. 

Communicate with your therapist

Communication might seem like a given in therapy. Still, it’s important to communicate with your therapist, not just about your thoughts, feelings, and behaviors but also about the therapeutic process itself. You may also want to ask your therapist questions about your proposed treatment options 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 negative feelings that arise during your conversations with your therapist. This may include anxiety around therapy. An effective therapist will be open to accepting feedback and to potentially modifying their care to best 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 it is not your therapist’s job to judge you. Instead, it is their job to help you, and they can only do that if you are fully honest with them. 

Because of the nature of the therapeutic relationship, it’s unlikely that you will have to interact with your therapist outside of your sessions. You can think of it as a discreet relationship in a safe space where you can discuss personal details without fear of repercussions. 

If you continue to feel uncomfortable in therapy sessions, don’t worry – 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 understand that negative thoughts, behaviors, and relationship patterns take time to address. These concerns may even recur over time, long after a client may have believed they were “fixed” or “cured”. Mental health conditions can be complex, and healing may not be 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. They understand that it takes time to move away from unhealthy behavior patterns. 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. 

Online therapy to reduce anxiety

If you feel nervous or overwhelmed at the thought of engaging in therapy, 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 and qualified 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. 

Research has shown that online therapy outcomes are comparable to those associated with traditional in-person therapy. One study found that online delivery of cognitive behavioral therapy (CBT) may even be more effective when delivered online than when delivered in an in-person setting. Online therapy could be a meaningful way to seek mental health support without increasing your anxiety about therapy.