In a world where a nine-year-old girl accidentally shoots her instructor in the head with an uzi, one human being publicly beheads another and where the “terror” alert in the UK has been raised to severe- I suppose the problem of the anxious therapist is not such an important cultural issue. But the anxious therapist is a kind of conundrum that is a stark commentary upon the times in which we are living.

The psychotherapist is often perceived by the general public as being a professional person who is the pillar of mental health, wisdom and neutrality. A kind of modern-day Socrates. The therapist plays into this persona because it is a luxury (and for some a curse) that their profession affords them. The position they hold comes with a kind of enlightened status, even though most of us know deep down this is rarely ever the case. The therapist is symbolic of a wide-spread misrepresentation that puts into question all of our perceptual abilities. If we perceive the therapist as someone or something they are not, what does that say about the state of our own minds? After all if we really were able to be accurate in our perception of the therapist, we may no longer elect to pay them for their time. And then who would objectively help us through the struggles that haunt our souls?

The anxious therapist is a threat to the entire sanctity and effectiveness of the healing potential of psychotherapy. I am not telling you anything that the anxious therapist does not already know deep within themselves. They represent everything which is false about the claims that they make. At least this is what we may think at first glance, but as we go deeper into the conundrum of the anxious therapist maybe we will find the opposite to be true.

During a session in the anxious therapist’s office, the client and the anxious therapist sit across from each other. The anxious therapist sits in a reclining chair and the client on a couch or in a chair. As the client talks to the anxious therapist about whatever issue they are dealing with, the anxious therapist is struggling to pay attention. To the client, the anxious therapist appears to be deeply listening, but what appears to be true to the client (even though the client may suspect that something is not quite right) is far from the truth.

The truth is that the anxious therapist is trapped in her chair. Her body is doing incredibly strange things to her, which causes her to be fearing that life could slip away from her at any moment. As the client talks, the therapist is stuck in a hypervigilant and panicked negative thought process. She is thinking about ways that she can excuse herself from the room without losing the client and all her credibility. She is using every fiber of her being to remain composed, despite the ominous feeling that within her body their is something terribly wrong and at any second she is going to lose all control. Without moving, the anxious therapist is enduring a kind of arduous inner work out, which causes her palms to sweat, staining her pants with a salty liquid in the areas where she plants her hands. In this very moment, the anxious therapist is working harder than 99% of human beings on earth to not only remain attentive but to also avoid a complete freak out. Even though there is an unlocked door and the anxious therapist is not confined to her chair, the client sitting just across from her causes her to feel painfully stuck.

The phenomena of the anxious therapist is hardly an isolated one. The anxious therapist has been around for as long as the practice of psychotherapy has. Sigmund Freud is the most well-known anxious therapist. He wrote a lot about the various terrors that he struggled with. Freud would often break out into fits of sweating during his psychotherapy sessions, due to the onset of the sudden fear of dying that would come upon him in his sessions. Freud used a plethora of drugs to try to control his anxiety, but besides having his dog besides him during psychotherapy sessions, was not able to find much relief. This resulted in Freud’s life long struggle with depression.

In the field of psychotherapy, a few researchers believe that the phenomena of the anxious therapist is much more wide-spread than is documented. It is only natural that most therapists would not come forward about their struggles with anxiety during sessions with clients. It is embarrassing to admit that during a session with a client the anxious therapist is often struggling with mental health issues much more than her client is. With all the education and training that the anxious therapist has had to go through in order to get to where they are at, publicly admitting their struggle with anxiety threatens to diminish the credibility that keeps them in practice. As a result, most anxious therapists struggle silently through a kind of inner hell from which they see no chance of rescue on the horizon. It is a miserable and unpredictable fate that they have to endure.

But is the anxious therapist really a discredit to the field of psychotherapy? Is the anxious therapist really presenting to his clients as a kind of fraud? Or is the anxious therapist a living example of how a person can struggle through the darkest and most frightening experiences, but still remain calm and composed (for the most part)? After all, in life shit happens and at some point all of us will find ourselves faced with absolute terror. Maybe the anxious therapist is like a shaman because they are silently and energetically imparting the most valuable lesson that a client can learn from psychotherapy: the ability to remain calm and composed in the face of absolute fear.

Personally, as a therapist myself, I believe that the anxious therapist is a kind of hero. In a situation where most people would run to an emergency room or doctor and need to take a Valium or something stronger in order to feel some sense of safety and relief, the anxious therapist silently wrestles with immense fear and physical discomfort while remaining calm enough to continue to engage with her clients without giving much notice (other than the sweat spots on his pants) that something is terribly wrong. This is a skill or ability that even some of the most disciplined meditators struggle to posses.

Most of us are way behind on the current scientific and psychological research into the neurological explanations for anxiety. The scientifically validated explanation for the development of anxiety disorder is that it goes back to the individual’s parents (or primary care-givers) and the psychological and emotional environment that their parents raised them in. It is well documented that a person is not created with a mental illness (mental illness is not genetically pre-determined). Mental illness is created by the environment that the child grows up in (environment begins to have its effect in the fetal stage of development). From a nuerobiological perspective the root of the crippling anxiety that shows up in the anxious therapist’s life can be directly traced back to how she was parented, but knowing this does not make the anxious therapist’s struggle with anxiety during her sessions (and outside his sessions) any easier. All the anxious therapist can do is take full responsibility for her current situation and practice various techniques that can help her navigate her way through the terrifyingly uncomfortable terrain of anxiety. You can not change the roots of a tree, but you can give a tree water, which will hopefully help its leaves to hang on.

It is well documented that Freud’s anxiety often drove him to the edge of isolation and despair. The isolation and despair that he experienced (which he described as a “disappearance of hope”) caused him to often contemplate suicide as a solution. After the potentially life threatening bout of anxiety, which always leaves the anxious therapist thoroughly exhausted, depleted and depressed for days, the anxious therapist finds herself feeling what some could describe as suicidal. The anxious therapist does not necessarily think about ways to kill herself, but feels hopeless up against the anxiety which she knows will soon reappear. Once the anxiety has run its course, the anxious therapist knows that it is only a matter of time before she has to go through it all over again. She knows this because it has been this way for her entire life.

In the end, the most difficult hurdle for the anxious therapist to get beyond, is to accept that no matter how hard they work on themselves, they are not the model of mental health that their clients and profession raises them up to be. The anxious therapist is surviving with a mental illness, that effects their life just as much (if not more) as whatever issues their clients are struggling through. In a profession that demands that the anxious therapist not publicly admit their personal struggles for fear of losing credibility and the luxury of appearing better off than they really are, the fate of the anxious therapist is to feel terribly alone. They live with an inner contradiction that can not be fully expressed in the work they do in the world. If it is expressed, chances are they will lose a lot of the luxuries their profession affords. What pains the anxious therapist most, is that as much as they are able to help their clients to get well, they seem unable to help themselves. Every time the terrifying anxiety returns during a therapy session, they are reminded of just how ill they still are.

For the anxious therapist there is no greater relief in the world than when they look up at the clock and notice that it is time for the session to end. They have made it through the session without freaking or passing out. What a great relief to have not been exposed! But like all temporary rewards, the price to pay for this feeling of great relief is the terrifying and imprisoning feelings that rise back up when the anxious therapist realizes that her next client is sitting in the waiting room. For fifty minutes she must endure all over again the exhausting fight to remain alive.