Finding Calm: What to Discuss in Therapy For Anxiety
What is this feeling that I am feeling? Does everyone feel this intensity when thinking about texting a friend or ordering at a restaurant? Could this be anxiety?
In short, yes! Anxiety manifests in countless ways that all impact your ability to function in day to day situations. Sometimes it may feel your world is getting smaller and smaller as actions feel harder and harder to complete. It may feel that things are past the point of no return, but there is hope. Enter therapy for anxiety.
Of course knowing exactly what to say in therapy for your anxiety issues can feel like an unrealistic expectation if you’re starting your healing journey. But the truth is, clearly and comprehensively discussing your struggles with anxiety and their impact on your life during therapy plays a central role in helping you feel better over time.
Sometimes your therapist will help guide your conversations, but other times, they’ll ask you to share what you are thinking and feeling.. This is intended to open up a space to talk about whatever is bubbling up for you during that session. Whether you recently experienced a panic attack or weren’t able to join a fun night out with friends, your therapist will want to hear whatever you feel comfortable sharing about your anxiety.
Understanding Your Anxiety
According to the American Psychological Association (APA), the leading U.S. body dedicated to mental health issues, anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.
In therapy sessions with a licensed therapist, you'll learn that anxiety can manifest differently for every person - from emotional symptoms like intrusive thoughts to physical ones such as fatigue or heart palpitations.
The Manifestation of Anxiety
A crucial step towards starting and making progress in therapy involves understanding how your personal experience with anxiety manifests itself. This knowledge helps both the client and therapist in understanding each other better, especially when just beginning a new therapist-client relationship.
Symptoms vary widely among individuals dealing with this condition. However, relatively common signs of anxiety include restlessness, irritability, difficulty concentrating, sleep issues, muscle tension, sweating, trembling, dizziness, or a rapid heartbeat.
Impact on Physical Health
Mental health professionals often highlight the link between the mind and body when discussing how to manage stress-related illnesses stemming from untreated anxiety. From chronic headaches to irritable bowel syndrome, your physical health can be adversely impacted by chronic anxiety conditions that remain untreated.
If your anxiety is repeatedly manifesting itself through your body, then that’s something very important to discuss with your therapist. Over time, you and your therapist will be able to identify what triggers cause what physical symptoms. Then comes the work of navigating those triggers, which your therapist will also help you with.
Identifying Triggers for Anxiety
Modern society has started to use therapy terms in everyday conversation. What is a trigger related to anxiety? They’re defined as: something that affects your emotional state, often significantly, by causing extreme overwhelm or distress. It’s usually associated with trauma, however, it can be used when talking about things that trigger an immense anxiety response.
Triggers can include specific phrases, sounds, smells, or even a specific location. Are you aware of any specific things that cause your anxiety? Is it even anything specific or do you just always feel anxious? Answering these questions with your therapist can be helpful for understanding your anxiety.
The Impact of Stressful Events
Stressful life circumstances often act as potent catalysts for anxiety. These could include work-related pressures, financial stressors, health concerns, or personal conflicts. Recognizing what might be the source of your anxiety requires looking back and investigating how your anxiety got to where it is today. This can be an especially fruitful conversation with your therapist, as learning about past events is the foundation of talk therapy.
Mental Associations: The Link Between Memories and Anxiety
In some cases, our minds form associations between particular situations and feelings of anxiety based on past experiences. For instance, if you've had an unsettling experience in an elevator before, every subsequent ride might trigger bouts of nervousness. Your therapist will work with you to identify past experiences that might contribute to current levels of anxiety.
Is anxiety impacting your day-to-day life? If you're looking for your first therapist (or are looking for a different therapist), consider Sage & Sunshine Therapy. Laura Jasen, LPCC, LMHC has years of experience with anxiety therapy helping folks just like yourself get a better hold on their anxiety. Contact me or book a free no-commitment, no-pressure consultation call to see if we’re a good fit!
Developing Coping Strategies for Anxiety
The goal of therapy is to help you learn how to effectively manage your anxiety. A licensed therapist helps you identify your specific triggers and develop personalized coping skills to address these issues. Coping skills empower you to feel more confident and secure in your day-to-day life because you’ll feel equipped if anxiety comes knocking.
1. Embrace Relaxation Techniques
The journey towards effective anxiety management often starts with relaxation techniques such as deep breathing exercises or progressive muscle relaxation, which help reduce physical symptoms of anxiety like rapid heart rate, sweaty palms, and shallow breathing.
Mindfulness-based practices also play an essential role in staying present in the moment rather than getting caught up in anxious thoughts. Discuss this with your therapist to learn which relaxation techniques they’d recommend for your specific situation.
2. Utilize Cognitive-Behavioral Therapy (CBT)
Cognitive-Behavioral Therapy (CBT) focuses on changing unhelpful thinking patterns that contribute to anxiety by replacing negative thought processes with more positive ones. This therapy isn’t the best fit for everyone though, so be sure to first consult with your therapist.
Exposure Therapy, a subset of CBT, can also be beneficial if certain situations or objects trigger your anxiety; this method gradually exposes you to these triggers until they no longer cause extreme reactions within safe therapeutic environments. This type of therapy is most commonly used to help people with debilitating phobias or obsessive compulsive disorder (OCD), but can also be helpful for reducing extreme anxiety responses.
If you’re interested in CBT, talk with your therapist to see if it’s a good treatment for your needs.
3. Adopt Lifestyle Changes
A regular exercise routine can significantly impact how someone copes with chronic stressors at work or home due to its endorphin-releasing properties. Yoga is a great way to increase your mind-body connection which is helpful in treating anxiety.
Better eating habits are key when working to improve your overall health - balanced meals provide stable energy levels throughout the day and the nutrients your body needs to function.
Last but not least, establishing consistent sleep habits. Consistent sleep behaviors promote restorative rest which is crucial for emotional regulation during stressful events., Whether your body needs 6 or 10 hours of sleep every night, discuss your sleeping habits with your therapist as a possible tool to help regulate your anxiety
Exploring Unhelpful Thinking Patterns
With your therapist, the exploration of unhelpful thinking patterns is a critical step in understanding and managing anxiety. These cognitive distortions often fuel our anxious thoughts, creating an exaggerated perception of reality that leads to increased stress.
You may find yourself catching these thought spirals more often before they have a chance to cause extreme anxiety. Your therapist can help you identify these negative patterns and provide possible solutions to turn them around.
1. Cognitive Distortions: The Fuel for Anxious Thoughts
Cognitive distortions are the brain's way of convincing us to believe something that isn't true. Pioneered by Psychiatrist Aaron T. Beck, these thought processes include "all-or-nothing" thinking, overgeneralization, and magnification (also known as catastrophizing), among others. All these distorted thoughts share one common trait - they negatively warp interpretation of events or interactions, leading into a cycle filled with more anxiety. If you find your thoughts going in this direction often, definitely make a note and discuss these thought patterns with your therapist.
2. Recognize Your Unique Thought Patterns
To begin tackling your unique set of unhelpful thought patterns, however, you first need to acknowledge their existence when they occur, which might require increased self-awareness, self-reflection, or journaling about your feelings during stressful situations.
If this proves challenging on your own, starting therapy sessions with a mental health professional such as myself at Sage & Sunshine Therapy can be invaluable in recognizing and understanding how distorted thinking affects you personally and on a day-to-day basis. Only by initially recognizing your thought patterns will you be able to work to improve them. Chat with your therapist about tracking your negative thoughts and what treatment steps might be good for you to start with.
Building Self-Compassion and Resilience
Long-term successful anxiety management necessitates the cultivation of self-compassion. This process involves acknowledging your emotions without judgment, recognizing that everyone encounters difficulties in life, and refraining from being overly critical when things don't go as planned.
It might feel easier said than done right now, but working with a therapist and shifting your thought patterns to be kinder and more positive will become easier over time. This is by no means an easy journey, but your mental health is top priority for a healthy life. Be sure to discuss how you currently talk to yourself with your therapist.
Self talk is known as the voice you use when talking to yourself, and has a great impact on how you view the world. Sharing this information with your therapist provides greater insight into the inner workings of your mind and information on your anxiety). Also, don’t disregard this as not important - how you talk to yourself can make a huge difference before, during, and after a bout of extreme anxiety. Give yourself the best chances of success!
The Importance of Resilience for Coping with Anxiety
Beyond cultivating self-compassion lies another vital component - resilience. Having strong resilience allows you to swiftly recover from stressful events, adversities, or even panic attacks. By working to improve your resilience, you can also improve how your mind and body react to high anxiety and stress. Be sure to discuss how increasing both self-compassion and resilience may help improve your anxiety with your therapist.
Improving Relationships with Others Amidst Anxiety
Anxiety, often a silent disruptor, can definitely put a strain on relationships - friendships, colleagues, family, etc. You may have already experienced this and are seeking solutions or ways to repair those relationships. You’re not alone! According to the National Institute of Mental Health, almost a third of adults (that’s 33% or 3 in 10 people) will experience an anxiety disorder at some point during their lives.
Prior research indicates that those experiencing high levels of anxiety are prone to interpret neutral situations negatively, leading to defensive or withdrawn behaviors. If your anxiety is causing issues in your interpersonal relationships, it might be a good time to discuss this with your therapist. They’ll be able to help you navigate these difficult situations. Try not to feel awkward when discussing this topic - your therapist will have heard many people’s difficult stories and they’re there to cultivate a non-judgemental, safe space for you to share.
Formulating a Treatment Plan to Navigate Anxiety
The journey of managing anxiety is not just about recognizing your triggers and honing coping skills. It demands a forward-thinking approach, one that includes devising a treatment plan for sustained long-term progress. Rome wasn’t built in a day - the goal is to improve your anxiety over time, but to do so you’ll need to implement the tools and techniques that your therapist recommends, track your progress, and exercise self compassion.
Treatment plans for improving anxiety look different for everyone. That’s why a cookie-cutter plan won’t cut it and why sharing details of your anxiety with your therapist will help you both develop the best action plan possible, one that’s realistic, manageable, and suited to your specific needs and goals.
What to Talk About When Things Are Going Well
In therapy sessions, it's obviously more common to focus on challenges and difficulties. However, when you start to have periods of feeling well, it can also be important to talk about for your mental health progress. Continuing the dialogue with your therapist may help reinforce the coping skills that have been effective in managing your anxiety during these positive times. It could also be mindfulness practices or regular exercise routines - whatever has contributed positively towards your well-being deserves attention, too.
Your therapist can also provide insights into why certain techniques have worked better for you than others. For instance, if journaling has proven helpful for managing anxious thoughts, they may recommend other reflective exercises like meditation or guided imagery.
Celebrating Successes
Therapy isn't only meant for navigating hardships, but also for celebrating victories along the way. Recognizing accomplishments, however small, builds resilience against future stressful events and fosters self-confidence. Whether you've effectively used deep breathing techniques during panic attacks or achieved building stronger relationships at work, acknowledging and expressing gratitude for them is key to continued success.
What to Talk About When You're at a Loss for Words
Sometimes in therapy, it’s normal to feel like you don’t have anything left to say.. In these moments, refer back to this resource to identify any points of discussion about anxiety that haven’t been covered yet between you and your therapist.
Otherwise, there are a whole host of other topics and questions that you can talk about in therapy. And yes, because everything is related, these points could very well uncover useful insights into your anxiety and therapy journey.
What You Could Talk About:
Recent events
Relationship issues
Any new causes of anxiety
Mood changes
Stressful life events
Childhood memories
Lifestyle patterns
Your strengths
Life goals and values
Places where you feel stuck
Places where you feel overwhelmed
Anything you’re avoided talking about
All of the positive things that’ve happened in the past week
Anything you want to talk about but feels embarrassing
Recent dreams
Things you care about
Daily stressors
A recent memory or experience you can’t let go of
Making Use of Silence in Therapy Sessions
Silence is hard for most adults to tolerate, but it is an incredible resource in therapy. Allow yourself to sit in the silence and see what thoughts, feelings, and ideas surface from the silence. Oftentimes we rush to fill the silence because we are uncomfortable and feel responsible for driving the conversation forward, but in therapy there is much to be learned and explored from periods of silence.
FAQs
1. What to expect in a therapy session for anxiety?
Most commonly, you can anticipate talking about your experiences and emotions related to anxiety. When starting with a new therapist, they’ll help guide you during these beginning stages. It’s important that they share their boundaries, communication preferences, and what to expect at the beginning of your working relationship. When I meet with a new client I ask them to complete the GAD-7, the General Anxiety Disorder Scale which helps to measure the severity of anxiety. I use the GAD-7 scale to guide the treatment plan we complete together as our roadmap to treatment.
2. What shouldn’t I talk about in therapy?
In therapy, the goal is to create a safe and nonjudgmental space where you can discuss your thoughts, feelings, and experiences openly. However, there might be certain topics that you're not ready to delve into, or that could be triggering for you. It's perfectly okay to set boundaries and communicate what you're comfortable discussing. Your therapist will respect your limits and work with you to find productive and healing topics to focus on. Remember, the aim is to promote your well-being, so if a topic feels too overwhelming, it's okay to steer the conversation in a different direction.
3. Do I have to talk about my trauma or deepest darkest secrets?
Opening up about trauma and deeply personal experiences can be challenging, especially if you're not ready to discuss them. While therapy can be a space to address such issues, you're in control of what you choose to share. Your therapist will never force you to talk about something you're not ready for. Therapy is a gradual process, and you can work with your therapist to determine when you're comfortable discussing these topics. Therapy is about helping you heal, grow, and gain tools to cope, and that journey is unique to each individual.
4. What if I feel uncomfortable or awkward talking about certain topics?
Feeling uncomfortable or awkward when discussing certain topics is a common experience in therapy. It's important to remember that therapy is a space for you to work through these discomforts. Your therapist is skilled in creating a supportive environment where you can explore these feelings without judgment. They can help you navigate through difficult conversations at a pace that suits you. Over time, discussing uncomfortable topics can lead to insights and a better understanding of yourself, ultimately aiding in your anxiety management. In general, a lot of progress lies in the uncomfortable.
5. What if I feel like my therapist doesn’t understand or help me?
Building a strong therapeutic relationship is essential for progress. If you ever feel like your therapist doesn't fully understand your concerns or you're not experiencing the progress you had hoped for, it's important to communicate this. Honest feedback can help your therapist adjust their approach or explore new angles to support you better. If you continue to feel a lack of connection, it's also okay to consider seeking a second opinion or exploring a different therapist who might be a better fit for your needs.
6. Is it normal to get emotional during therapy?
Absolutely, it's completely normal to get emotional during therapy. Therapy often involves delving into deep-rooted feelings and experiences, which can trigger multiple emotional responses at the same time. This is a sign that you're engaging with the process and addressing underlying issues. Your therapist is equipped to handle these moments and can guide you through them. Emotional expression is a healthy aspect of therapy and can lead to breakthroughs and personal growth.
Remember, therapy is a collaborative journey tailored to your needs and comfort level. Don't hesitate to voice your concerns, ask questions, or request adjustments to make the most out of your therapeutic experience. Whatever your life circumstance, seeking help for your anxiety demonstrates strength and a commitment to your well-being.
Written by: Laura Jasen, LMHC, LPCC
