Counselling for Anxiety: What You Will Learn & How it Helps

Insomnia.

Racing heart.

Shortness of breath.

Sweating.

Ruminating on social interactions, both before and after they happen.

Saying no to invitations and new experiences.

Any of these sound familiar? Or all of them?

Anxiety is probably the most common issue my individual clients present with, and it’s something I have first-hand experience with myself. These days, I’d say my anxiety generally operates within the ‘range of normal’ — it doesn’t paralyse me or interrupt my day-to-day functioning, but certainly makes itself known if I have to do any public speaking or I'm going through a period of heightened uncertainty.

Anxiety is an issue I really enjoy working with, because there are a number of strategies and approaches that are very effective for managng and reducing it over time. I certainly wish I had learned these techniques in my early 20s when it first became a problem for me, and I love being able to support my clients with making progress with their own anxiety.

My approach to anxiety in counselling is generally two-pronged — first, you will learn methods for recognising and reducing anxiety symptoms quickly, to reduce the frequency of it getting out of hand. Secondly, we will look at the cause of the anxiety, which is often less about what is happening around you and more about what’s happening inside your mind.

Am I saying anxiety all in your head? No! That’s horribly invalidating. Your feelings and experience are real. Anxiety isn’t something you can just decide to get over one day and it disappears.

The good news about it being largely caused by what’s happening in your mind is that it means you can gain control over it. You don’t have to wait for the world or other people to change (the exception being of course unless you are in a dangerous environment or relationship — then, those do need to change, and quickly).

Right up front, however, I want to acknowledge that there are many situations where anxiety is entirely normal and appropriate. Exam time at uni? Waiting on a medical diagnosis for yourself or a loved one? Going to a job interview for a position you really want? As long as the anxiety isn't completely crippling, it's unreasonable to just expect yourself to sail through these periods of time unbothered. I like to discuss with clients whether they would deem the anxiety they are experiencing as expected in proportion to the situation they are facing, or whether it feels like it exceeds that and needs some extra attention.

If the anxiety feels out of proportion, and/or is seriously impacting your ability to function, there are many ways we can try to intervene to make it less distressing.

Anxiety is comprised of three parts — what happens in your mind (your thoughts and emotions), what happens in your body (the hyperventilating, the shaking, etc), and what you do (not talking in social settings, avoiding anxiety-provoking situations, and so on).

Learning to identify your own early warning signs is important. Often, we try and persist in the stressful situation until we can’t anymore — we can’t breathe, we want to cry, we have to rush out. Trying to ignore the anxiety usually doesn’t work, and doesn’t help in the long run. We need to learn to see it coming and lower it.

(If you'd like a structured way to work through this, my workbook covers understanding anxiety, techniques for managing panic attacks and anxiety symptoms in the moment, and more — you can find it here).

Once we have a handle on managing the symptoms, we start to unpack the causes. Taking the framework from Cognitive Behavioural Therapy (CBT), we look at identifying the thoughts that cause the anxious feelings. We also look at the beliefs you have about yourself, others, and the world around you that might mean you interpret situations in a way that increase anxiety. Finally, we consider whether there are actions you take that might make the anxiety better or worse — avoidance of situations that are anxiety-provoking is a common and understandable strategy, but unfortunately tends to make the anxiety stronger or even spread to other topics.

Acceptance and Commitment Therapy (ACT) is another useful approach for anxiety. In contrast to CBT, ACT suggests that you don't need to change the thoughts you have so much as change the way you respond to them when they do pop up.

I use both CBT and ACT techniques with my own clients, working with the individual to find the methods that are most effective for them. It might be that a client prefers one approach over the other, or that different issues that make them anxious respond better to CBT or ACT.

Underpinning the work is always a foundation of self-compassion — experiencing anxiety is uncomfortable and difficult, and many people unintentionally add to this distress by also getting frustrated or upset at themselves for being anxious in the first place. All of this anxiety and self-frustration can become paralysing and hopeless. Self-compassion lowers this distress, which then gives you energy back for working on reducing anxiety.

Along with managing the mind, it's important to also address the body. Improving any sleep issues is always priority one when it comes to being able to handle our emotions better. Reflect on ways you might be taking in too much for your brain and body to process (whether that's caffeine, reading the news, scrolling social media or obsessively listening to self-help podcasts). Look for opportunities to engage in activities that de-stress the body — try to find pockets in each day and week for calming and soothing experiences like warm baths, or bobbing in the ocean, lying on the grass under a tree, or just sitting and breathing quietly for a few minutes.

The important thing to know is that you are not crazy, or weird, or alone. Our brains are designed to pay attention to things that might cause us harm so we can avoid them — and these days it can feel like there are a lot things that could hurt us, whether it’s a virus or not succeeding at work or unkind comments from others. What we aim to do in counselling is turn down the volume on those thoughts and get them back in perspective, so you can build a more comfortable, enjoyable, and fulfilling life.

I’m always so impressed by my clients with anxiety that book in for sessions, as getting in contact with a therapist is a pretty anxiety-provoking thing to do. For more information about what that first session is like, please check out this post.

If you are interested in finding out more or booking an initial session, please get in touch with me here.