Why Does Therapy Make Me Anxious? (and what to do about it)

You’ve been thinking about finally starting therapy, but the thought of being that perceived by another person makes you cringe so hard you can feel it in your intestines. Or maybe you’re already going to therapy, but your shoulders are scrunched all the way to your ears until the session is over. I’m a licensed clinical psychologist, I’ve worked as a therapist for over 12 years, and I’ve even been to therapy myself. Please hear me when I say:

This is completely normal. 

Of COURSE the thought of sharing your deepest, darkest, most painful parts of your life with a complete stranger is nerve wracking. It can be terrifying. It takes incredible courage to be vulnerable with another person like this. You’re strong for even considering doing it, let alone making it through that waiting room. Therapy isn’t supposed to be easy.

Going to therapy is like going to the gym. You get out of it what you put into it, consistency counts, and when you first start, you might be so sore you’re hobbling around like a horror movie creature (vulnerability hangover, anyone?). Real growth and change takes time, commitment, and discomfort. And, like going to the gym, it can also be fun! You can learn about yourself, laugh, and hopefully feel better about yourself over time. 

 So if you’re feeling a little (or a lot) nervous about starting this journey (or your next session), good! That means you’re paying attention. Now, on to what to do about it.

If You’re Completely New To Therapy:

1. Will my therapist judge me? WELCOME! We (therapists) are just happy you’re here. We are not here to judge you, and are honored to get to know you and your world. 

2. What if I don’t like my therapist? Know that it is normal to “shop around” for therapists and find someone you really click with. A lot of therapists offer free consultation calls so you can get a sense of that before committing (book a free call with Dr. Sutton here) 

3. What if I don’t think I can open up to someone? Know that YOU are in charge. You call the shots when it comes to your healthcare. You never have to do or talk about something you don’t want to. Good therapy meets you where you are and goes at your pace. 

4. What am I allowed to talk about in therapy? You might be nervous about what is “okay” to talk about in therapy. It’s your therapy, and there are very few things that most of us would consider TMI. If you’re ever unsure, you can always ask your therapist. (Side note, if the question is if we want to see a picture of someone, the answer is yes.)

5. How can I prepare for my first therapy session? Treat yourself! Plan to give yourself a time buffer after your first session and do a little something nice/fun. A post therapy bagel always hits.

6. What should I do if I’m nervous about starting therapy? Consider telling your prospective therapist what you’re nervous about, and feel free to ask them questions about it. You can think of that first intro call or intake session as you interviewing them for the position, rather than the other way around. 

If You’re Already In Therapy

1. What does it mean that I get anxious about therapy? Get curious about the anxiety. Are there certain topics or sessions where you’re more uncomfortable? There may be some gold nuggets of insight here to explore with your therapist. 

2. What should I do to feel less anxious about therapy? Address points of friction. Do you hate sitting in the waiting room? Maybe ask your therapist if you can switch to virtual. Not a morning person? Schedule your sessions for later. This is kind of like sleeping in your gym clothes for the early morning workout. You’re already doing the hard work of therapy, so make it as easy as possible on yourself to be there.

3. Is it a bad sign if I feel more anxious once I’m in therapy? Talk to your therapist about it. Depending on the type of work you’re doing, an increase in anxiety may actually be a GOOD sign because it means you’re avoiding uncomfortable emotions less. It is often a normal part of the process. 

4. Does being anxious in therapy mean I’m not good at therapy? Be kind to yourself. You are doing such a hard thing! Anxiety during therapy is NORMAL, and usually means you’re Getting Somewhere. Future you is going to thank you for the work you’re putting in now.

TLDR: Anxiety about therapy is normal, because therapy is hard. It takes bravery to work on yourself and to open up to another person. You are always in charge of your mental healthcare, and I empower you to advocate for your needs, ask questions, and be an active participant in the process of your therapy. You got this.

Ashley Sutton, Psy.D., is a licensed clinical psychologist specializing in working with burnout, anxiety, and self-esteem. She serves clients in New York, Pennsylvania, and 42 additional states with evening and weekend virtual availability.