About 5 years ago, I started seeing a therapist weekly to do CBT for my lifelong anxiety. However, my anxiety quickly latched onto the therapy itself. I found myself worrying constantly about what the therapist thought of me and whether I was doing therapy wrong. Going to sessions became a major anxiety-inducing experience, and everything the therapist said felt like criticism. I eventually worked up the courage to talk to the therapist about the issue. She said she understood. We discussed it several times and challenged some of my beliefs about it. But it didn’t help. So, a year later, I discontinued regular therapy. I learned a few useful strategies for anxiety but also came away feeling worse about myself. Last year, after experiencing some stressors in my life – which caused extreme anxiety – I went to see a new therapist. I thought this time would be different. I told the therapist right at the start about my therapy anxiety. Yet now, a year later, I find myself in the same pattern. I feel that my anxiety about the therapeutic process itself, and my relationship with the therapist, is getting in the way of therapy. The therapist is well aware of the issue and we discuss it frequently. She suggests things for me to do – ways to ground myself during sessions, exposure-based approaches to accept the uncertainty – but I’m unable to do them, which makes me feel even more anxious and frustrated. Sessions have now turned into a huge performance anxiety thing for me because I’m so afraid of how they’ll go. My therapist doesn’t *feel* like an ally to me (but I know it’s not her, it’s me). I’m at a loss. Again, I feel worse about myself now than when I started therapy. I do okay in my life despite my anxiety – I have a full time job and a good long-term relationship. I would still like to find ways to reduce the amount of worrying I do … but I can’t seem to be able to overcome my anxiety about therapy to make therapy useful to me. Do I quit and accept that therapy has too many side effects for me to be useful? Are there other ways to overcome my therapy anxiety?
I admire your bravery and resilience in coping with this—as well as your persistence and honesty in working with your therapists. I have two recommendations. The first would be to discuss with your therapist the possibility of using some anti-anxiety medications where a psychiatrist or nurse practitioner could offer evaluation and recommendation. Often the use of medicine can help in breaking the cycle of anxiety while the underlying issue or thought pattern can be understood and treated. Secondly, if a medicine is not what you are interested in, you may want to discuss with your therapist alternative supplements (such as GABA) that may help with anxiety. You may also want to supplement your therapy with journaling if you and your therapist agree that this would be helpful as a journal can help identify the thoughts before and after therapy that may be a clue to defusing them. Finally, meditation may be a great complement to your therapy.
In each of these situations, the relationship you have with your therapist is key to helping resolve the situation. Talking about options and alternatives and agreeing to experiment with them will be a helpful process and you continue to seek answers.
Wishing you patience and peace,
Dr. Dan
