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What Do Therapists Do When They Have Anxiety?

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What Happens when the Doctor Gets Sick?

“Despite being a therapist that specializes in anxiety, I have certainly experienced my anxiety from time to time and am no superhuman,” Ashley L. Annestedt, a cognitive behavioral therapist and social worker who works with clients across the country, told HuffPost.

Face it, mental health professionals aren’t immune, their anxiety can also get out of control and become a more significant problem for them.

But whether the anxiety is occasional or more chronic, qualifying it as a true disorder, psychologists know that, unless they can dial it back, they will be far less effective in helping their patients.

“The ability for the practitioner to perform well and provide services to a patient or client requires that that individual is managing his/her mental wellbeing,” says Todd Farchione, Ph.D., research associate professor at the Boston University Center for Anxiety & Related Disorders.

So what do mental health professionals do to extricate themselves from panic mode? Below are some effective and clinically-tested suggestions.

12 Helpful Insights, Strategies and Tactics

1. Awareness and Acceptance

Sometimes the best thing you can do to quell your anxiety is to acknowledge and embrace that it’s happening in the first place, said Kevin Gilliland, a clinical psychologist and author of “Struggle Well Live Well: 60 Ways to Navigate Life’s Good, Bad, and In-Between.”

“Once I came to terms with the fact that I had an active mind — one that sometimes disrupted my sleep and time with my family — I’ve done a much better job of managing it,” Gilliland said.

“Anxiety is a signal telling you something is lurking that you’re afraid of,” says Franklin Schneier, MD, co-director of the Anxiety Disorders Clinic at the New York State Psychiatric Institute. To diminish it, “I try to pin down the fear to something as specific as possible,” he says.

“For example, I’m anxious about an upcoming work meeting because I may be asked to present information on a project, and the project is not going as planned, so people may think I’m incompetent.”

Getting down to that level of nitty-gritty detail allows you to put your anxiety in perspective, says Dr. Schneier. In that same example, for instance, he could tell himself, “My longstanding colleagues are not likely to judge me incompetent based on this one particular project, which is not fully under my control.”

2. Deep Breathing

Deep breathing is the gold standard quick fix for anxiety for a reason. “One of my favorite things to do, because you can do it anywhere and at any time, is breathing,” Gilliland said.

“I am absolutely fascinated by the biology and history of breathing or meditation. It is a great way to change an anxious moment or decrease the anxiety to where it’s manageable. And when you are trying to solve a really difficult situation for a client, you need to be able to think clearly, and that won’t happen if you panic. It’s awesome.”

The reason that it’s a commonly recommended anxiety-buster is that it works. “When I’m feeling unusually strong anxiety, or if I’m having trouble falling asleep due to worries, I’ll do a simple exercise of meditating on my breathing,” Dr. Schneier says.

“You don’t need any kind of meditation experience to benefit from the soothing practice. Just sit quietly and focus on your inhales and exhales rather than your racing thoughts. If your mind does start to wander, gently remind yourself to bring your focus back to your breathing.”

3. Find a Mantra

“In addition to concentrating on your breathing, it might also be helpful to repeat a few calming mantras to yourself,” explained Jennifer Musselman, a psychotherapist in Los Angeles.

“When I have anxiety, I connect to my breath … I combine it with mantras: You are going to be OK. One step at a time. You are going to be OK no matter what,’” she said. “I can better contain and challenge my thoughts this way while soothing my emotions.”

4. Self-Care

“Depending on what the anxiety is about, I like to take a walk and listen to Deepak Chopra on Spotify or set the mood at home with relaxing music and a lavender scent while soaking in a hot bubble bath,” Musselman said.

There are no rights and wrongs when it comes to self-care. It is different for everyone, so what works for you may not work for someone else. What’s important is to engage in an activity or build a routine that truly relaxes you, refreshes you, or gives you the sense that you are more in control of what’s bothering you.

5. Challenge Negativity

Jodi Aman, a counselor and author of “You 1, Anxiety 0,” said she labels an anxious thought when it pops up and then counters it with some empowering self-talk.

“For example, if anxiety says, ‘Something bad will happen if you do that,’ instead of worrying what can happen and going down that rabbit hole, I say [to myself], ‘That’s anxiety chatter.’ It pulls me out of the chaos and back into the safety of the present.”

6. Write Down Your Feelings

Research has shown that writing can be extremely cathartic. Habib Sadeghi, a spiritual psychologist and author of “The Clarity Cleanse,” uses journaling to alleviate anxiety.

“I write down everything that’s disturbing my peace, paying attention to how those things are making me feel and my fears about potential outcomes that might be negative,” Sadeghi said.

“Then, I go to bed, and I awake with a healthy sense of distance between me and the situation with the increased mental space to think through my feelings without them controlling me,” he said. “I can assess the situation without losing myself in it or becoming it.”

Sadeghi said that creating space between yourself and what’s bothering you even for a small period helps you examine the situation with more clarity.

“Without that ability, all we’re doing is feeling with no thinking, unconsciously reacting and usually making the situation worse,” he said. “To be able to think through your feelings is what combines the head and the heart on the way to finding a solution.”

7. Focus on the Moment

At times it is necessary to be fully cognizant of the present to refocus your thoughts. “Instead of using my energy and effort to decrease or get rid of my anxiety, I choose to realign with what I value most in that moment,” Annestedt said.

“Perhaps I am in the middle of playing with my kids, but I have an anxious thought about an impending work project that’s interrupting me. In that moment, I can choose to put all of my attention into problem-solving that thought or I can pull my focus back to playing Legos. I always strive to choose the latter.”

8. Sleep Interventions

Everyone knows that between social media and incessantly checking your email, your phone stresses you out. What’s more, constant connection can also fuel anxiety, especially when you’re about to go to sleep.

“I find I get anxious at bedtime (I’ve had sleep issues since I was a child), so I turn off my phone an hour before I want to go to sleep,” says Larry D. Rosen, Ph.D., professor emeritus in the psychology department at California State University, Dominguez Hills and author of The Distracted Mind: Ancient Brains in a High-Tech World. “I’ll read a book, preferably on paper, so I’m not getting the blue light from screens that turn off melatonin and release awakening cortisol.”

If racing thoughts still keep him awake, Rosen has another trick: He sings himself back to sleep. “If I wake up at night and my brain starts going places that make me anxious, I hum in my head a snippet from a familiar song over and over,” he says. “Usually, my song snippet is ‘Hotel California.’ That works most of the time.”

 9. Don’t Ignore Healthy Habits

Becoming lax regarding healthy habits, like exercise and nutritious eating, can also trigger anxiety, says Steven D. Tsao, Ph.D., co-founder of the Center for Anxiety & Behavior Therapy in Bryn Mawr, Pennsylvania. When he’s anxious, Tsao examines his lifestyle to find the cause.

“Have I been sleeping well? Have I been eating well? How physically active have I been?” To this point, Farchione says that if he doesn’t stick to his usual Jiu-Jitsu schedule of three to four classes a week, he’s “considerably more anxious on a daily basis and less confident in myself,” he says.

10. Confront your Imagination

It’s quite easy to spiral into anxiety when we think that someone is upset with us, even if we don’t have any evidence that it is so. “For instance, say I have a book chapter I’m writing and I’m behind on it. I might think [the editors] are upset with me and they’ll never ask me to write a chapter again,” Farchione says.

What can he do at that moment? Imagine the opposite of that anxiety-riddled emotional reaction. “If I really think it through, do I know that those people are upset? If they were, would they have followed up with me? I teach my patients to think about things in a different manner, to consider the alternatives, as a way to manage their own anxiety.”

11. Develop a Default Coping Strategy

As much as we’d all like to live anxiety-free, it just doesn’t work that way. “Anxiety is a fluid state that ebbs and flows for all humans,” Tsao says. “My job is not to eradicate [anxiety], it’s to find a helpful way to tolerate it without inadvertently fueling it.”

The objective is to learn to cope with anxiety rather than exacerbating those anxious thoughts and feelings. Tsao suggests some simple tactics, like establishing clear work boundaries (e.g., only checking your work email a couple of times on weekends), taking a refreshing walk in the middle of the day, or sharing your thoughts with a loved one.

Dr. Schneier recommends, “I try to think about what I can do now about the situation at hand.” Regarding the example above of the anxiety-provoking work presentation, he suggests a coping strategy of either “preparing an explanation of what is going wrong, or plan to use the meeting to gather ideas about solutions.”

12. Therapy is Always an Option

There is no reason to believe that therapists are superhuman. So, when their usual anti-anxiety tactics aren’t helping enough, they also seek professional help. Farchione says he counts mental-health practitioners amongst his clients. “I see that as a good thing,” he says. “These people are willing to come in and receive care that will help them be more effective.”

To Thine Own Self be True

It is essential to remember not to put the care of others before yourself. It just isn’t sustainable. You need your physical and emotional health for all the important work you do. Everyone needs support, places to vent, and the opportunity to process their emotions. We all need help, including the helpers and our “strong friends.”

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