Trueform Therapy

Author: Dorottya Nagy

  • Why Trying to Calm Down Can Keep You Anxious

    Anxiety is not a personal failing, a mindset problem, or a sign that you “can’t relax”. It’s your body’s threat system doing its job. Sometimes the visit is brief and useful. Sometimes anxiety arrives, puts its feet up on the coffee table, and refuses to leave.

    Most advice about anxiety is about getting rid of it: breathe, relax, think positive, calm down. Some of that advice genuinely helps. But there’s something about anxiety that much of this advice misses, and I think it explains why so many people try everything and still feel stuck.

    Sometimes, the harder we try to make anxiety go away, the longer it stays.

    What Anxiety Is Trying to Do

    Anxiety prepares you for danger. It makes you more alert, tenses your muscles, speeds up your heart and your thinking. That’s very helpful if you’re stepping out in front of an oncoming car. It’s much less helpful when you’re lying awake at 2am replaying a conversation from 2017.

    It shows up in the body as much as the mind: restlessness, tight shoulders or jaw, a churning stomach, a racing heart, shallow breathing. It shows up as irritability, as trouble concentrating, and as a kind of tiredness that surprises people. Anxiety is exhausting.

    For some people, it settles into more persistent patterns, such as generalised anxiety, panic attacks, social anxiety or phobias. These have different names and look different from the outside, but they share a common thread: a threat system that has become very good at spotting danger, and much less good at standing down.

    The Trouble With Getting Rid of It

    Here’s the part that often surprises people.

    When anxiety rises, it’s natural to do something to make it stop. We leave the situation. We avoid the next one. We check, reassure ourselves, distract, or reach for a technique to calm down. In the moment, it works. The anxiety drops, and we feel relief.

    But that relief teaches the threat system something. It learns: that was dangerous, and we only got through it because we escaped. Next time, the alarm goes off a little sooner.

    Psychologists call these strategies “safety behaviours”, and there’s good evidence that they play a part in keeping anxiety going. Even helpful tools, like breathing exercises, can work this way if we use them as an emergency exit: something we must do to get rid of the feeling, rather than a way of steadying ourselves while we stay.

    I want to be careful here, because the picture isn’t simple. A 2016 review by Shannon Blakey and Jonathan Abramowitz found that the evidence on safety behaviours during therapy is mixed. Used thoughtfully, some may help people approach things they would otherwise avoid altogether. So it isn’t that coping tools are bad. It’s that how and why we use them matters.

    The question to ask isn’t just “does this calm me down?” It’s “does this help me stay with my life, or help me escape from it?”

    Tools That Help, and How to Use Them

    With that in mind, there are things that genuinely help. Think of them less as ways to make anxiety vanish, and more as ways to bring your nervous system back within reach, so you can carry on.

    Start with the body. An anxious body struggles to listen to logic, so this is often the place to begin.

    Movement is one of the best-supported things you can do. You don’t need a fitness overhaul. Walking counts. Stretching counts. A large body of research has found that physical activity reduces anxiety, often noticeably.

    Sleep matters more than most people realise. A 2019 study by Matthew Walker’s team at the University of California, Berkeley found that a single sleepless night raised anxiety levels by up to 30 percent in healthy adults. It was a small study, but it fits with what many people notice. So aim for consistency rather than perfection, and be kind to yourself after a bad night. A poor night’s sleep is data, not a judgement. It tells you something about your capacity the next day.

    Regular meals help too. Long gaps without eating can bring on shakiness, a racing heart and irritability, which feel a lot like anxiety and can make it worse.

    Slow your breathing, especially the out-breath. Try breathing in for a count of four and out for six. If counting annoys you, just make each breath out a little longer than the breath in. That’s enough. In a 2023 study at Stanford, people who spent five minutes a day on “cyclic sighing”, a breathing pattern that emphasises long, slow out-breaths, saw greater improvements in mood than people who practised mindfulness meditation. The study was small and mostly involved young, healthy students, so it’s an encouraging sign rather than the final word.

    Tense, then release. Clench a group of muscles for a few seconds, then let go. Work your way around the body. This is less about forcing yourself to relax, and more about reminding your body what not tense feels like.

    Be curious about your thoughts, not convinced by them. Anxiety is excellent at presenting opinions as facts. Instead of “this will go badly”, try “I’m having the thought that this will go badly”. That small step back creates a little distance. You can also ask yourself gently: what’s the evidence? What else might happen? You’re not arguing with your brain. You’re just widening the view.

    Shrink the task. Anxiety loves vague, enormous goals. Break things into small, even boring, steps. Progress beats motivation every time.

    Moving Towards, Not Away

    Perhaps the most powerful thing you can do with anxiety is the least comfortable: gradually moving towards the things it tells you to avoid.

    This is the idea behind exposure, one of the best-researched approaches to anxiety. You approach what frightens you in small, manageable steps, and allow the anxiety to be there without trying to escape it. Over time, the threat system learns something new: I felt anxious, I stayed, and I was OK. That learning is what helps anxiety soften, not the absence of the feeling.

    Other approaches arrive at a similar place from different directions. Acceptance-based therapies encourage making room for anxiety rather than fighting it. And the existential psychologist Rollo May argued that some anxiety is simply part of living a full life: a sign that we’re facing something that matters to us, or stepping into the unknown.

    None of this means forcing yourself into overwhelming situations. It means small steps, at a pace that feels challenging but bearable, ideally with support.

    You Don’t Have to Do It Alone

    Anxiety tends to isolate us, and connection interrupts that.

    Talking to someone you trust can help, even if they don’t offer solutions. Being heard often takes some of the intensity out of anxiety on its own. Peer support groups can help too: there’s something steadying about hearing “me too”.

    Therapy isn’t a last resort, either. Cognitive behavioural therapy has particularly strong evidence for anxiety, and other approaches can help as well, especially when anxiety is tangled up with older patterns, with loss, or with questions about how you want to live. At Trueform Therapy, I offer one-to-one sessions in person in Cardiff and online across the UK and EU, and we can draw on whichever approaches suit you best.

    When It’s Worth Seeing Your GP

    If your anxiety is new, has changed suddenly, or comes with strong physical symptoms such as chest pain, palpitations or breathlessness, it’s worth seeing your GP. Some physical conditions, such as thyroid problems, as well as some medications and lots of caffeine, can cause symptoms that feel like anxiety. It’s always worth ruling those out.

    One Slower Breath

    Anxiety doesn’t disappear because you tried hard enough to make it go. It tends to soften when your nervous system learns, again and again, that it’s safe enough, supported enough, and not alone. Progress is often uneven. That’s normal.

    If anxiety is running the show, getting help isn’t weakness or failure. It’s a sensible response to a system under strain.

    And if today all you managed was reading this and taking one slower breath, that still counts.

    If You Want to Explore These Ideas Further

    If you’re interested in anxiety as part of being human rather than only a problem to fix, Rollo May’s The Meaning of Anxiety (1950) is a classic. It’s philosophical, but deeply humane.

    For a practical introduction to making room for anxiety rather than fighting it, Russ Harris’s The Happiness Trap is a clear, accessible guide to acceptance and commitment therapy.

    If you’d like a structured self-help approach, Helen Kennerley’s Overcoming Anxiety is a well-regarded CBT-based guide from the UK’s Overcoming series.

    And if you’d like to look at the research directly:

    Blakey and Abramowitz’s review of safety behaviours in anxiety (2016): RTI International

    How one sleepless night affects anxiety: ZME Science summary

    The Stanford study on breathing practices and mood: Simply Psychology summary

  • Can Counselling Really Help? An Honest Answer

    “Can counselling really help?”

    It’s one of the most common questions people bring to a first session, sometimes before they’ve even sat down. Often it comes with other questions underneath it. What if I don’t know what to say? What if talking to a stranger makes things worse? What if I’m not the kind of person it works for?

    I understand those doubts, because I had them too. I’ve been a client myself, and I was sceptical about whether talking to someone could really make a difference.

    So I want to give an honest answer to that question. Not a sales pitch, and not a list of reassurances, but what the research and my own experience actually say.

    The Short Answer

    For most people, yes. Counselling helps.

    The research on this is large and fairly consistent. For depression, talking therapy and antidepressant medication have broadly similar effects in the short term. A 2013 review led by Pim Cuijpers, who has spent much of his career comparing treatments for depression, also found that people were less likely to drop out of therapy than out of medication. And people who had CBT were less likely to relapse afterwards than people who stopped taking medication. The changes people make in therapy seem to last after it ends.

    There’s also UK research that matters particularly for counsellors. In the PRaCTICED trial, published in The Lancet Psychiatry in 2021, researchers in Sheffield compared person-centred counselling with CBT for 510 people with moderate to severe depression in the NHS. At six months, counselling was found to be no less effective than CBT. At twelve months, CBT had a small edge. It’s a reminder that different approaches can work, and that the full picture is rarely as simple as one therapy being “the best”.

    That said, “most people” isn’t “everyone”, and I’ll come back to that.

    What Actually Makes It Work

    If you ask people what makes therapy work, they often guess it’s the technique: the right method, the right exercises. Technique matters. But one of the most consistent findings in therapy research points somewhere else.

    An international task force led by Christoph Flückiger at the University of Zurich looked at almost 400 studies of the relationship between client and therapist, sometimes called the therapeutic alliance. Across different approaches, problems and countries, the quality of that relationship predicted how well therapy went. In other words, feeling understood, trusting the person you’re working with, and agreeing on what you’re working towards are not just pleasant extras. They’re part of what makes change possible.

    There’s another finding I find important, and it comes from the research behind the approach I trained in. Mick Cooper, who helped develop pluralistic counselling, worked with colleagues on a review of 51 studies involving around 16,000 clients. They found that when people received the kind of therapy they preferred, they did a little better, and they were almost half as likely to drop out early.

    That means your preferences matter. If you know you want practical tools, or space to talk without being steered, or to understand where your patterns come from, that’s useful information, not something to keep to yourself. A good counsellor will want to know.

    The Part People Don’t Talk About

    Here’s something that rarely appears on therapy websites: counselling doesn’t help everyone. In clinical trials, an estimated 5 to 10 percent of adults end therapy feeling worse than when they started. In routine care, the figures for people who don’t improve are higher still.

    What’s striking is how poorly therapists notice this. In one well-known study, therapists were told how often clients in their clinic usually got worse, and then asked to predict which of their own clients would. Out of 550 clients, they predicted just three.

    I’m not sharing this to put anyone off. I’m sharing it because it changes something important: if counselling isn’t helping, it’s not a sign that you’re failing at it. It might be the wrong approach, the wrong timing, or simply the wrong fit. The most useful thing you can do is say so. Any good counsellor should welcome that conversation. And if it still doesn’t feel right, it’s completely acceptable to try someone else.

    What Counselling Isn’t

    A few ideas tend to put people off before they start.

    It isn’t only for people in crisis. Many people come to counselling not because everything has fallen apart, but because something feels stuck, or heavy, or not quite right. You don’t have to wait until things feel unbearable.

    It isn’t a quick fix, but it isn’t endless either. Change usually takes time, and it isn’t always a straight line. Sometimes things feel harder before they feel easier. But it also shouldn’t feel like years of going round in circles. It’s reasonable to talk with your counsellor, from time to time, about how things are going.

    Your counsellor won’t tell you what to do. The decisions about your life stay yours. That doesn’t mean sitting in silence, though. Depending on what you want, a counsellor might offer ideas, share something useful about how the mind works, or suggest something to try. The point is that it’s collaborative, and you’re in charge of the direction.

    My Own Experience as a Client

    When I first went to counselling, I felt overwhelmed and unsure how to make sense of my own emotions. I didn’t expect much.

    Slowly, I began to understand the patterns underneath the anxiety and self-doubt I’d been carrying. My counsellor introduced things like mindfulness and journaling, which helped me step back and see my feelings more clearly. The changes were small at first: feeling calmer in situations that used to set me off, being able to say what I needed, reconnecting with friends and family in a healthier way.

    It wasn’t always easy. But by the end, I felt more in control of my life, and kinder towards myself than I’d been before. Those changes didn’t disappear when the sessions ended, either. I still draw on them today.

    What the First Sessions Are Like

    The first session or two are mostly about getting to know each other. Your counsellor will ask what’s brought you, a little about your life and history, and what you’d like to be different. You don’t have to tell your whole story at once, or know exactly what you want to work on. It’s fine to say “I’m not sure”, and to start there.

    It’s also a chance for you to decide whether this feels like someone you can work with. You’re allowed to ask questions too: how they work, what they’ve trained in, what happens if something isn’t working.

    Your counsellor will also explain confidentiality. What you share stays private, with a small number of exceptions, such as when there’s a serious risk of harm to you or someone else. A good counsellor will be clear about exactly where those limits are, so there are no surprises.

    Starting Where You Are

    Deciding to try counselling can take a long time. If you’ve been wondering whether it could help, that wondering is worth paying attention to.

    At Trueform Therapy, I offer one-to-one sessions in person in Cardiff and online across the UK and EU. My training is integrative and pluralistic, which means we’ll shape the work around what helps you, rather than fitting you into a single approach. If you’d like to find out whether we’d be a good fit, you’re welcome to get in touch for an initial conversation.

    You don’t need to have the right words. You can start exactly where you are.

    If You Want to Explore These Ideas Further

    If you’re curious about what research says about how therapy works, Mick Cooper’s Essential Research Findings in Counselling and Psychotherapy is the clearest summary I know of. It’s written for practitioners, but it’s readable and honest about what we do and don’t know.

    For a view from inside the therapy room, Irvin Yalom’s The Gift of Therapy (2002) is a short, warm collection of reflections from one of the most respected therapists of his generation.

    And if you’d like to know what therapy feels like from both chairs, Lori Gottlieb’s Maybe You Should Talk to Someone (2019) follows a therapist who goes to see a therapist herself. It’s funny, moving and surprisingly honest.

    And if you’d like to look at the research directly: