Working with clients with anxiety requires multiple approaches

I was trained in the humanistic integrative style of counselling, which has brought much to my work and to the clients that I work with. Yet, given the work that I do focusing on a range of anxiety conditions, I am struck by how this modality of work has its constraints when clients require coaching, more structured guidance and psycho-educational work in conditions such as OCD, agoraphobia and social anxieties. This wider approach reaps better results for clients that I work with and also ensures that they can get better matches to the outcomes that they want when they come to therapy. 

A mixture of exploring the experiences of clients, their world views, their identities and how they shaped their lives, critical voices around them and their sense of 'what safety means' is just a start in the therapeutic journey of my work with them. This is followed by practical measures of techniques which can be used to help reduce their anxiety and ensure ways that they can 'go through' particularly difficult events such as panic attacks.

Within these journeys of work, facilitating them to look at how their bodies work, past traumatic events, people-to-people connections and attachment issues, to name a few, requires a much more flexible and broader engagement process with clients in sessions.

No one really teaches you how to be a therapist and each individual has their unique style.

I know that for me, therapists who sat back and let me speak for 50 minutes did not move me on in my personal journey to overcoming the anxiety that had affected me in my early adulthood. In fact, it made things more confusing.

It was only when I worked with therapists who took on a much more guided and focused approach, providing information on how the body works, mechanisms by which I could manage the anxiety and pro-active support in 'going through it' and maintaining repeated exposure, did I loosen the hold of anxiety, and which finally dropped off.

Additionally, I believe that we as therapists need to change the language around anxiety and the way that we convey it to clients. Anxiety and panic attacks feel threatening to clients who suffer from a spectrum of anxiety conditions. Well, that is precisely what evolution did - it gave us humans a system that served as an early warning to us of impending danger.

Anxiety is, therefore, not some alien creature that needs to be built up as a 'David and Goliath' battle through the language used in counselling sessions. It is a means by which our bodies seek to protect us; it is a part of us, trying to look after us albeit in a hyper-sensitised way.

Such softening of language makes a difference. It reduces the view of sufferers who have developed a more brittle perception of anxiety, as though it is life-threatening and much of this is the brain's basic ancient neural pathways reading anxiety as an impending threat and mis-attuning it in the modern world.

If nothing else, let's try and soften the language. At the very least, we can serve clients best if we choose not to 'feed the beast', which is a perception that many clients with anxiety have, of their condition.