Is it normal to feel anxious about going to therapy?

It is very normal, and incredibly common, to feel anxious about going to, or during, your therapy appointment. This can be the case whether you are about to begin counselling for the first time, are starting over with a new therapist, or have been working with a counsellor for a while.

Some people feel anxiety in physical ways. This could be ‘butterflies’ or churning in your stomach, feeling lightheaded or shaky, or that your heart rate is higher than normal. These symptoms of anxiety, and feelings of uncertainty and discomfort are very rational and reasonable responses to the situation you find yourself in: speaking to someone you don’t know that well, about personal things and feelings that you may not have shared with anyone else before. That’s not something that we do all that often or easily as part of our day-to-day lives!

Anxiety acts like an alarm to warn us of what might be considered ‘dangerous’. For example, you may have been ridiculed or shamed as a child for sharing your feelings, and now as an adult, the idea of opening up might make you feel anxious in case that happens again.

The safe space of therapy offers the opportunity to have a new, ‘reparative’ experience of being heard and accepted when you express yourself. What was once perceived as a threat (sharing your feelings) can now be experienced as part of healthy and meaningful relationships in your life.

When we think of anxiety as holding a helpful message for us, rather than something that is ‘wrong’ with us, we can use it to grow, rather than have it hold us back.

Below are four common reasons why people feel anxious about attending therapy, and how therapy can help.

1. ‘Will my counsellor judge me?’

One of the common causes of anxiety relating to counselling is the fear that your counsellor will judge you and what you share, or not be able to understand your experiences. This can add a lot of pressure onto yourself at a time when you may already be struggling.

Perhaps you have previously experienced being judged or ridiculed by others when you have shared your thoughts and feelings? It could be that your anxiety is trying to warn and protect you from experiencing that again in your therapy session.

However, a good and ethical counsellor or psychotherapist will not judge you or what you share. The counselling space is a non-judgemental place where all parts of you, and all feelings, are welcomed. It is also a confidential and respectful space. The focus of the session is on the client, and their feelings; not what the counsellor thinks is right or wrong. This is why you will often hear a therapist say that ‘counselling does not offer advice’: it’s not our place or our intention to tell clients what they ‘should or shouldn’t do’. It is simply a place to ‘be’.

2. Anxiety about stepping into the unknown

Anxiety is a very reasonable response to uncertainty. Even though counselling sessions have clear boundaries such as a time and place, the content of the session normally isn’t ‘planned’, and doesn’t follow a script. In a sense, you and your therapist are stepping into the ‘unknown’. This can feel really scary, especially if you’re used to living your life in a way that enables you to control as much as possible. While a sense of control might help us to feel less anxious in the short term, it can become exhausting, limiting and unrealistic trying to live in a world where we feel we must always be in control of what happens to us.

Your therapist is trained to work in a way that ‘holds’ the space so that it is emotionally contained and safe. As before, the therapeutic relationship is a non-judgemental space, focused on you, where all feelings are welcome to be explored. The therapist also takes responsibility for managing the time, allowing you to explore whatever you are going through without worrying about how much time is left on the clock. This way, you and your therapist can explore and navigate uncertainty together safely, allowing you room to grow.

3. Anxiety about becoming upset

This is a very common feeling when attending counselling, and highlights the importance of working at your own pace in therapy. The reality of therapy is that you and your therapist will spend some time talking through difficult, upsetting or painful experiences from your past or present. It may well be a very new and unfamiliar experience for you. This is all part of the process of personal growth and healing, but can feel overwhelming and scary if you have never spoken about these feelings or experiences before, or aren’t used to having your feelings heard.

A good therapist will follow your lead and check-in with you as you navigate difficult or upsetting feelings, and will not make you talk about anything that you are not comfortable or ready to share. They will empathise with what you are feeling, rather than judging it or trying to change it. Your therapist will act as an anchor to support you through your upsetting feeling, and help ground you as you come out the other side.

4. Feeling uncomfortable during silence

So many of us are uncomfortable with silence! We spend so much of our lives filling silences with our phones, scrolling on social media, or making small-talk at an awkward pause in conversation. Why are we so uncomfortable with silence? Often, we find comfort in filling the silence and avoiding being alone with our complex thoughts and feelings.

Anxiety is a common response to silences when they show up in the counselling room: ‘Should I be saying something? What am I supposed to do?’. It can be useful to allow the silence just to exist, and observe the feelings that arise where we would normally rush to fill the space.

Perhaps you feel that you need to say something - do you feel that you need to be funny? Interesting? Productive? Once we recognise that it is normal and OK to feel uncomfortable with silence, it takes the pressure off to fill the space, and we can gently explore what comes up.

Moving forward with anxiety

Although it can be challenging, a large part of learning to work with anxiety lies in accepting the way we feel, rather than trying to change it straight away. You might find a short meditation or journaling useful ways of accessing and reflecting on your feelings. It’s OK to feel anxious.

Sometimes, simply sharing the way you feel can help.

If you feel comfortable and ready, you might want to share your anxious feelings with your therapist - even if your anxiety relates to coming to the sessions. A good therapist won’t judge you or be offended that you are feeling anxious about therapy.

Maybe you and your therapist can work together to ease your anxiety: perhaps having a window open to allow fresh air into the room, or you can even discuss getting up and walking around if you find that helps. Perhaps you and your therapist are able to link your current anxiety to other areas of your life where apprehension or fear of judgement have shown up. In this way, rather than holding you back, your anxious feelings can point you in the direction of healing and growth.