Managing Video Anxiety During Tele-therapy

From https://mhanational.org/

Video calls can be intimidating (and energy-draining) for a lot of people, especially those who have anxiety. In COVID-19 times, a lot of interaction is happening over video and sometimes there’s no way around it – you just have to show up for classes, meetings, or appointments. If you’re in therapy, sessions may seem more burdensome than usual right now; if you don’t have a therapist but want one, having to start with virtual therapy might be scaring you off. It’s a catch-22 – therapy can help reduce your anxiety, but it might also cause some anxiety, at least early on.

Video anxiety is normal.

A survey in the UK found that 73% of respondents said they experienced Zoom or video call anxiety in 2020. If you already deal with anxiety, you probably tend to overthink and anticipate everything that could go wrong in any given situation. With the uncertainty of video calls on top of that, it can become completely overwhelming.

For some people, anxiety over video calls is related to technology logistics, like potential glitches or using unfamiliar platforms. For others, it’s more about social anxiety or feeling awkward. Most of human communication is nonverbal – things like facial expressions, body language, and hand gestures play a big role in understanding the message someone is trying to get across. While they provide more nonverbal context than phone conversations, video calls take away a lot of that, so it’s easy to not feel as connected to your therapist as you would with in-person sessions. This can also make conversation feel more forced – you might find yourself hesitating before speaking because you can’t tell if your therapist is done talking, or maybe they let silence linger a bit longer than usual for the same reason.

If video calls are too anxiety-inducing to cope with right now, you can start with phone sessions or even live chatting through a platform like BetterHelp or Talkspace. This way, you can warm up to your new therapist, and hopefully you’ll feel more comfortable with video after you establish a connection. Even if you start off with audio or typing, aim to start video-chatting eventually – evidence suggests that video sessions are just as effective as in-person sessions.[i] It might help if you know what to expect with teletherapy, and can even be great exposure therapy since your therapist can help you with video anxiety in real time.

Video calls can be exhausting.

It’s not just in your head – Zoom/video fatigue is real. Video calls require more focus than in-person conversations because you are trying to process nonverbal cues through a screen. Paying close attention to these takes up a lot of energy, and your energy levels are probably already lower than usual because of pandemic-related stress.

Think about your other video obligations when you’re scheduling therapy. Do you have lighter screen time days? Aim to have your sessions then, and definitely avoid scheduling therapy on days when you’re on other video calls, virtual classes, or online presentations for hours. It won’t just be draining – you’ll probably also be less inclined to really open up during your session if you’re burnt out from other calls. Make sure to give yourself time before and after therapy to not be on screen, too. Try to plan your schedule just like you would if you had to travel to and from an in-person session.

The more you do it, the more comfortable you’ll get – but here are some tips to make it a little easier in the meantime:

Tell your therapist that video calls make you anxious. Be honest with your therapist about how you’re feeling about teletherapy. You won’t be the first person they’ve heard this from, and you can work on it together. If you haven’t started therapy yet, talking about this anxiety is a great starting point for your first session.

Have a plan in case of technology issues. Tech glitches can feel awkward, but they happen to everyone. Make a back-up plan with your therapist – like if one of you disconnects, they will call you on your cell phone. Knowing what to do (grab your phone and wait for their call) if something goes wrong can alleviate that worry.

Get cozy. Don’t treat virtual therapy like a class or meeting. Think about what therapy offices look like – they are usually welcoming and relaxing. During in-person therapy, you’re usually sitting in a comfy chair or couch, so don’t force yourself to stay at your desk. The most successful therapy happens when you feel safe and at ease.

Give yourself a pep talk. It’s normal to get increasingly anxious as it gets closer to your appointment time. If this happens, talk to yourself – tell yourself that you’re not in any danger, it will be okay, and you’ll feel a bit better once the call starts. It won’t eliminate your anxiety but acknowledging how you feel can make it less overwhelming.

Avoid looking at yourself on screen. Many people don’t like the way they look on video, and even if it doesn’t bother you, it can be distracting. See if there is an option to hide yourself or cover that part of your screen with a sticky note. Not seeing yourself can even make your video call feel less like you’re talking to a screen.

Keep your hands busy. Just sitting and talking with someone can feel awkward. Fidgeting with something is a great way to release nervous energy and prevent yourself from feeling like you need to “perform.” Try playing with Play-Doh, coloring, stretching a rubber band, or doodling on some scrap paper – just make sure it doesn’t distract you from the conversation.

Find more resources. You can start by taking a mental health screen – based on your results, you’ll be connected to articles, DIY tools, and support communities that can help you manage your anxiety. If you want to talk to someone other than your therapist (or before you find a therapist), reach out to a warmline – they are staffed by people who understand mental health problems and are there to listen and give support. 

[i] Greenbaum, Z. (2020). How well is telepsychology working? Monitor on Psychology, 51(5), 46. https://www.apa.org/monitor/2020/07/cover-telepsychology