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Therapy Panic

I have panic attacks before seeing my therapist.

(this is raw unedited text, computer transcribed directly from the audio, without voice inflection, pauses etc. Sometimes this results in the text implying the opposite of the intended meaning.)

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Here is a question I received from Amanda.

Hi, Dr. Kenner. I just started therapy and two sessions in. I feel like I'm having a panic attack just thinking about my therapist or therapy. I'm feeling worse than before I started. I can't eat physiologically ill since my second session. Not sure if this is good. Thanks, Amanda.

Manda, first, it's not the best situation to be in. It's very common to feel anxious, though going to a therapist. And what you want to do is notice what's going through your mind, when we feel anxious when any of us feel anxious, there are thoughts and at the moment, you may not be able to access them. But if you just gently say to yourself, what's going through my mind, what thoughts what images, what's really eating at me, you might discover that there are questions you have about your therapist.

Now let's assume that your therapist is a woman, it could be either and this would apply to both. You may be just having thoughts such as well, I like her, will she get me? Will she be critical of me like my mom, or my dad? Or my sister? Will she really be able to help me or my just wasting my time? What should I expect? So you may be having very anxiety provoking thoughts and expectations that it will be a negative experience. And you also may have a different area of thoughts. It can be scary to think about the process of therapy. And you might be thinking to yourself, What will I learn about myself? What if I find out that I'm truly unlovable? Or what if what my brother has been calling me all these years a loser is really true. And that's what my therapist tells me? And what if my sister is right? I'm a mean person, or what if I'm a shy person and other people can change, but I can't change even with my therapist help him? Oh my gosh, would have my therapist gives me a scary diagnosis. And what if I tell my therapist, my deepest thoughts? Will she tell anybody else? I don't want that. So when you're approaching therapy, you want to coach yourself before sessions differently so that you can at least deal with the anxiety around therapy, and I've got three tips for you. First, you want to put yourself in the driver's seat. Instead of what would the therapist think of me? You want to say . . .,

Hey, I gotta interrupt this because we've got to pay some bills. 30 seconds. That's it. A very quick break and then Ellen will be back.

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First, you want to put yourself in the driver's seat. Instead of what would the therapist think of me, you want to say, Hey, man, this is like shopping for a dress or shopping for a new car or shopping for even good fruit, I want the good fruit. I don't want the ones the apples that have brown spots on them. So you want to imagine yourself going into therapy and you are in the driver's seat, you're evaluating whether your therapist is a good fit fit for you. Not every therapist is a good fit for every client. And there are some therapists that are better than others. And so you want to ask, Is my therapist warm? Engaging? Do I feel at home with her? Or? And this happens sometimes, does your therapist seem distant and critical? And is it someone that I need to leave you may be getting signals that you need to tend to the anxiety might not just be in quotes all in your head, you know something that's not based in fact, but it could be that the person isn't the right fit for you. So you are choosing an important person to help you. This is you're looking at your own mind. And you don't have to please the therapist and you don't want the view that you're being looked at under a microscope. If you don't like her, you do what you would do if you had a bad hairdresser. You change he addresses or in this case change therapist. So that's the first point. Put yourself in the driver's seat if she's warm and engaging. The stay tuned because you could enjoy the therapy very Watch and gain a tremendous amount from her if she's not. And it's not just a one day thing, it isn't just that she had a bad day, then you might want to consider moving to a different therapist. The second point, if you do like your therapist, give it at least two more sessions, because unfortunately, during the first session or two, we do a lot of paperwork as therapists and it's unfortunate some some of us can get paperwork a little bit in advance, or give people paperwork to take home and bring back. But we need to gather history, we need to know about what medications you're on, what, what's happened in your past. And so there, we also need to set an agenda with you. So there is a lot of more paperwork, and you may not get to the core issues right away. And you may feel like, Oh, this isn't working, you do need you try the third and fourth sessions. The third point I want to give you the third tip is to share your anxiety with your therapist. I've had clients walk into my office for the first time and they tell me, I am so nervous, can you see it, you know, I just feel like I'm going to cry now. Or I feel like I'm going to have a panic attack. I couldn't sleep well, last week thinking about coming here. I'm so anxious. And so guess what I do with the paperwork, I set it aside, I put temporarily you know, I might get their name and address and phone numbers contact information. But I help them work through some of their fears. Because you can't do anything if if the person doesn't feel at home. So you can the therapist can work with you to give you maybe some skills right off the bat in the first or second session to help you deal with the specific anxiety of coming into the therapist that may not take away all your anxieties, but you might be able to see that there's a method to deal with anxiety that I find helpful. So again, I wouldn't give up on therapy, either change therapist or reframe it so that you're in the driver's seat, or share your rings the and I would say definitely and and share your anxieties with a therapist, even if it's a bad therapist, it's good for the therapist to get that feedback. Now that's not putting yourself on the spot you there's no duty to have to do that. That's only if you think that that you want to stay to give her that feedback. And if you're comfortable with that, no, we give you some closure.

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