Anxiety is a bitch

My first therapy session

I had no idea how bad it had gotten until my first therapy session.

I felt eager and frustrated as I walked to my therapist’s office, just a few blocks from my own. My stress levels had been off the charts for weeks and it was affecting performance at work. I had a company to run–ironically, a therapy startup. Anxiety and self-doubt had eaten away at my confidence. My to do list grew longer as the speed of my work ground to a halt. I was making slow decisions and, quite frankly, bad ones. I no longer excelled at the things I used to do well; I was still cringing from a pitch that I’d botched earlier that morning.

My anxiety was so frustrating.

I exchanged hellos with the security guard as I walked into the building, went to the elevator, exited on the 7th floor, and gently opened the door to the waiting room. There were two other people inside. A man in his twenties with curly hair sat in a chair, scrolling through his phone. A woman about my age sat across from him, reading a magazine. I poured myself hot water in a paper cup and sat there staring at my drink, avoiding making eye contact.

I felt butterflies in my stomach. I was anxious (hah!) about having enough time in session to tell my therapist everything. I was so desperate to feel better. I also wondered, would my therapist and I hit it off? What if she was weird and creepy even though she seemed normal in her picture? I didn’t want to have to go to another therapist.

The door opened and Angie welcomed me in.

Diagnosis

I liked Angie immediately and loved her within 10 minutes when she said these words:

“Anxiety is a bitch.”

I’m from New Jersey, right outside of New York City, where direct, no-bullshit talk is a question of character. It’s something that I miss dearly about the East Coast.

In the first twenty or so minutes of our session, we went through my family history, where and how I’d lived and worked since college, and major events in my life. I explained the ups and downs I’d had since starting Kip. We talked about my closest relationships, including one that I’d just ended with my (ex) boyfriend of two years. We talked about what was bothering me, the stressors in my life, and how I thought I’d been handling it (answer: not very well).

I also described the physical symptoms: tightness in my chest, clenched teeth, and trouble concentrating. I told her that I had lots of goals for therapy, but that my main goal was to get my confidence back. It felt good to tell someone all of these things that had been bothering me. My chest still felt really tight–the anxiety was still there–but it loosened a bit as we talked.

Angie made me feel heard but she also challenged me by digging deeper than I expected. Curiosity is one of the most important skills of a great therapist. When I said something about how I was feeling or what I was thinking, Angie would ask me why. If she didn’t learn enough from my answer, she’d prod me with another question or the same question asked a different way. She made me explain myself, which when you’re talking about feelings, is hard to do!

Angie didn’t think that my main problem was confidence. She suspected that I was dealing with an overwhelming amount of stress and anxiety from work and that if we fixed the anxiety, my confidence would naturally come back. She asked me,

“On a scale of zero to 10, zero you’re on a beach and 10 you’re stressed to the point of total collapse, where is your anxiety?”

And very casually, I said,

“Nine.”

I said this with no worry or surprise, as if being stressed out almost to the point of total collapse was completely normal. And–it is normal! For startup founders who aren’t managing their stress very well.

All of a sudden, Angie’s demeanor changed. She physically sat up straighter and said,

“I know you want to work on your confidence but the first thing we need to do is lower your anxiety.”

And then she got down to business.

First, she explained anxiety to me very clearly, scientifically, and in words that I could understand. She described anxiety as extra energy in my body that I needed to release. She actually got up and shook her hands and legs to emphasize the point. “There are only two scientifically proven ways to reduce anxiety,” she said, “pills or daily exercise. I want you to do one or both.” I chose daily exercise.

Then ensued a healthy debate over how I was going to create this new exercise habit in my life. Angie suggested ClassPass, which her other clients loved. I told her I was done trying and failing to go to a gym; I’d just cancelled a gym membership the week before. Instead, I asked if I could walk to work. However, she said that I needed to do cardio and get my heart-rate pumping, every day, if I wanted exercise to help. Finally, we landed on biking to work. I loved biking and had meant to start biking to work again anyway.

We started creating a care plan on my Kip app for me to follow between sessions. This may surprise you, but a lot of work in therapy happens between sessions. Your therapist is your guide; in session they’ll teach you skills, give you tools, and help you understand what’s going on in your mind. To get better, though, you need to practice what you learn in therapy every single day.

We added my daily exercise goal to Kip. Then Angie asked whether I drank coffee. I did. Sometimes my morning cup of coffee left me jittery, but I didn’t think I’d be able to wake up without it. She wanted me to cut coffee out completely but we compromised by letting me drink half a cup a day. Also, I promised to try drinking tea instead. We added caffeine tracking as well as a way to track my daily anxiety and daily mood.

Finally, she asked me to do something called a thought record. It’s a structured way of writing down automatic thoughts that I would have throughout the week. Any time I noticed an anxious or unhelpful thought, I was supposed to write the thought down, what was happening when I had it, and what emotions it made me feel. Then, I was supposed to examine the evidence for and against the thought. For example, if my thought was, “I’m failing at this” I’d have to stop and examine whether that statement was really true.

She also gave me a handout about panic attacks. She didn’t think I was having panic attacks, but thought it would be helpful to read since I’d felt panicky a few times in the past week.

Accountability

As the session ended, Angie told me that she wanted me to come in once a week until we reduced my anxiety. She emphasized, again, how important it was to exercise every day. I had many more things that I wanted to talk about, so we decided to meet again that same week and then switch to a weekly schedule. We booked a session for that Friday.

I left the office feeling amazing relief. I’d felt so off my game in those last few weeks, but Angie didn’t make that feel weird. She connected to me as a person. She could tell that I was a functioning and capable human being, and she reminded me that I was doing okay, but that I’d been unable to manage the amount of stress that I had been dealing with everyday. It wasn’t just stress from running the startup, but also the stress and pressure that I was putting on myself to succeed. And she was going to help me learn to manage it better.

But, ugh, I was going to have to bike to work everyday.

This is part of a series that chronicles what it’s like to go to therapy, session by session. Come back next week to see how I’m doing! Follow me or subscribe to the Kip Blog for updates.

Previous posts:
Why I decided to go to therapy

CC: Made by Made, Irene Hoffman, Danil Polshin, Ami at nounproject.com