Can Therapy Make it Worse? I Had a Hard Time Speaking to My Therapist

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Reader’s Question

I’m debating whether or not I should seek help in therapy for my anxiety and Obsessive-Compulsive Disorder, which have worsened recently.¬†Although I would really like to do so, there are a couple of issues that are holding me back. I saw a psychologist a while ago and, strangely enough, my worst anxiety occurred during those sessions. I’m not sure what to make of that. It could be good to work through my stress exactly during the times its worst. But could seeking help for anxiety from therapy when therapy itself nearly gives me panic attacks be more detrimental than helpful?

I’m also wondering how psychologists view patients that are reluctant to speak much? Even though I liked my psychologist, I was always so incredibly nervous, I had a hard time talking. Would therapists in general think that I don’t want to be there and feel annoyed? How would they handle such a situation?

Psychologist’s Reply

Excellent question. Some therapists do feel disarmed by patients who have difficulty speaking. It can be because it is simply difficult for them to tolerate the silence (which is an indication that they need consultation themselves), or because we are so well trained in verbal communication, we forget to use the other 15 ways we communicate. For example, when a therapist is working with a child, it is rare to have a sit-down talk about the kid’s problems. Instead, we play. We draw, we sing and dance, we play board games and sand trays, and therapy becomes something that happens while we are playing. We tend to forget this when we work with adults. Therefore, it is important for you to select your therapist carefully. It is also important for you to explore other means of communication so that you make the best use of your valuable time.

Now, your primary question is, can therapy make matters worse. It can certainly feel worse, especially during the process of analyzing those things that cause you the greatest anxiety and analyzing them in the moment they occur. That can feel terrible and can test your mettle and resolution to do the work. I think we all need to be clear about what therapy is good for. Therapy does not make you feel better. Therapy makes you better at feeling. People, in general, have eclipsed emotional lives because they can’t tolerate painful emotions. We shy away from them, deny them, minimize them, etc. We only confront our pain when we absolutely must. As a result, we also eclipse our ability to experience great joy and fulfillment. One can’t tolerate extreme joy when you must always remain on guard for the next, coming onslaught of pain.

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To help you with your anxiety, you do have options that could be done in concert with therapy. For example, psychiatry may help you in the short term by bringing your anxiety down within tolerable limits. While this is a good option, be forewarned that finding the right medication for you can be a long, difficult process. Another option is to engage in classroom activities that will give you some of the basic skills and vocabulary you need to succeed socially. Assertive communication is one of my favorites. There are many others that may be a better fit for your specific needs. If you find a classroom environment too stressful, then I encourage you to speak — or write — to the teacher in advance. Tell him that you’re very nervous and you would appreciate it if he would not call on you unless you raised your hand. That way, you can concentrate on what’s being said rather than always worrying if he’s going to call you next. Finally, explore your other means of communicating. If you draw or paint, bring your work to therapy with you. If you dream, make sure to bring them to your sessions. If you like a particular book or movie, talk about that. All of these are wonderful ways of connecting with another person, whether that person is a therapist or friend.

Good luck on this undertaking. It is no less than a hero’s journey — one that only you can undertake for yourself.

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