anxiety

Therapy in 2026: Pressure Beneath the Surface

Therapy is often where the private experience of modern life becomes visible. And right now, the patterns are striking.

Nationally, therapists report that the most common concerns bringing clients in are anxiety or stress (34%), followed by depression (15%) and trauma (9%). But underneath those categories are more specific, very current themes - ones that reflect the moment we’re living in.

Four in particular are showing up again and again with some of the professionals that reach out to me: AI anxiety, leadership pressure, identity questions, and relationship strain.

These aren’t separate issues. They’re deeply interconnected.

AI Anxiety: “Where Do I Fit If Everything Changes?”

For many high-functioning adults, AI isn’t just a technological shift - it’s an existential one.

Clients are asking:

  • “Will my role still matter in a year?”

  • “Am I already behind?”

  • “How do I stay relevant when the rules keep changing?”

This isn’t just about job security. It’s about identity. When your sense of value has been tied to your expertise, efficiency, or intellect, the rapid rise of AI can feel destabilizing.

The result is a specific kind of anxiety: future-focused, hard to ground, and often accompanied by urgency—figure it out now or risk falling behind.

Leadership Pressure: The Weight of Responsibility

Leaders are coming into therapy not because they’re failing - but because they’re carrying a lot. This can be at work, at home or at both.

They’re navigating:

  • Ambiguity without clear answers

  • Responsibility for other people’s livelihoods

  • The expectation to stay composed, decisive, and optimistic

All while managing their own uncertainty.

There’s often a quiet question beneath the surface:
“Who supports me when I’m the one everyone relies on?”

Leadership can be isolating. And without space to process, that pressure accumulates - showing up as irritability, decision fatigue, or a constant low-grade stress that never fully turns off.

Identity Questions: “Is This Still Me?”

Another theme emerging in therapy is a reevaluation of identity.

People are asking:

  • “Do I actually want the life I’ve built?”

  • “What matters to me now?”

  • “Who am I outside of my roles?”

These questions often surface during transitions - career shifts, parenthood, burnout, or even success that doesn’t feel the way it was expected to.

What used to feel clear now feels uncertain. And that uncertainty can be disorienting, especially for people who are used to having direction.

Relationship Strain: The Ripple Effect

When internal pressure builds, it rarely stays contained.

Clients are reporting increased strain in relationships:

  • Communication breakdowns

  • Less patience and more reactivity

  • Feeling disconnected despite being physically present

In many cases, it’s not the relationship itself that’s the root issue - it’s the cumulative stress each person is carrying.

Two overwhelmed people trying to stay connected without the tools or space to reset often leads to friction.

Beneath It All: Anxiety, Depression, and Trauma

While these presenting issues feel modern, they often map onto familiar clinical foundations:

  • Anxiety (34%) shows up in AI fears, performance pressure, and uncertainty about the future

  • Depression (15%) can emerge when people feel stuck, unfulfilled, or disconnected from meaning

  • Trauma (9%) - whether acute or chronic - can influence how individuals respond to stress, change, and relationships

The context may be new, but the nervous system is not. It still responds to overload, ambiguity, and perceived threat in very human ways.

A More Useful Frame

It’s easy to interpret these struggles as personal shortcomings:

  • “I should be handling this better.”

  • “Other people aren’t as affected.”

  • “I just need to push through.”

But what if these experiences are actually signals?

Signals that:

  • The pace of change is outstripping our capacity to process

  • The expectations placed on individuals are unsustainably high

  • The structures we rely on for identity and stability are shifting

In that context, anxiety, doubt, and even disconnection make sense.

Where the Work Begins

Therapy, at its best, isn’t just about symptom reduction - it’s about clarity.

Clarity around:

  • What’s actually within your control

  • Which pressures are internal vs. external

  • How your patterns are helping - or limiting - you

And from that clarity, more intentional choices become possible.

Not perfect ones. Not easy ones. But aligned ones.

You’re Not Alone in This

If you’re navigating AI anxiety, leadership pressure, identity questions, or relationship strain - it’s not random. You’re responding to a moment that’s asking a lot of people, all at once.

And while the specifics may vary, the underlying experience is widely shared.

The goal isn’t to eliminate uncertainty or pressure entirely.
It’s to build the capacity to move through it - without losing yourself in the process.

When Therapy Doesn’t Feel Safe: Reclaiming Your Space

Psychological safety is often described as the ability to speak freely without fear of punishment, judgment, or embarrassment. In therapy, that standard matters even more. This is one of the few places in your life that is meant to belong entirely to you - a space where your thoughts, feelings, contradictions, and questions can exist without needing to be edited.

So it’s worth asking: Is there anything you’re holding back in your therapy sessions?

Maybe it’s a belief you’re unsure about. A feeling that feels “too much.” A thought that you worry might be misunderstood, judged, or even subtly discouraged. These moments are important. They are not inconveniences to therapy - they are the work.

If you notice yourself filtering, softening, or reshaping your inner world before you speak, pause there. That’s not failure - that’s information.

Bring it into the room.

A strong therapeutic relationship isn’t built on agreement; it’s built on your therapist’s ability to hold space for experiences and perspectives they may not share. You should not have to align with your therapist’s worldview - religious, political, cultural, or otherwise - to feel accepted or understood. When that alignment becomes an unspoken requirement, the space shifts. Therapy starts to feel less like a place of exploration and more like another environment where you have to adapt yourself to meet someone else’s expectations.

And chances are, you’re already very skilled at that.

Many people who seek therapy are exceptionally attuned to others. You may know how to read the room, anticipate reactions, and shape yourself accordingly. These skills likely helped you navigate relationships, workplaces, and family dynamics. But in therapy, those same instincts can quietly undermine the very thing you came for: the chance to hear yourself clearly.

Because that’s what therapy offers at its best - a place where your internal world can exist out loud. Where you can hear your own thoughts reflected back to you, expanded, challenged, and understood. Where you don’t have to manage someone else’s comfort in order to be fully seen.

You deserve at least one space like that.

If you sense that your therapist needs you to adopt a particular perspective - whether it’s about identity, relationships, values, or the world at large - it’s important to name it. Sometimes this can lead to meaningful repair and a stronger alliance. Other times, it may reveal a mismatch that’s worth honoring. Either way, you are working on a skill that you will apply outside the session.

The goal isn’t to find a therapist who agrees with you on everything. It’s to find one who can stay with you in everything.

Therapy should not be another place where you perform, accommodate, or contort. It should be where you practice being fully, unapologetically honest - even when that honesty is messy, uncertain, or evolving.

Because the work isn’t about becoming more acceptable.

It’s about becoming more you.

When The Cycle of Pain is Not Broken

I recognized her face on the news report and my emotions began to spin. I scrambled to find her name and sure enough it was her. I felt sick to my stomach.

That is how I learned this week some difficult news about a foster care youth I had the privilege to meet about 9 years ago. She was a very troubled young lady. She is apparently a mother now and, tragically, according to the news, her baby has experienced trauma and abandonment and will likely enter the nightmare of the foster care system.

While many of the young people who find support in the foster care system find some inner peace and belonging in this world, it is most true that the cycle of trauma continues and that is my definition of failure.

I hope the young lady and her child get very good care so that the child gets a chance to get the tools of security and love to stop the cycle some day.

Please note that many children experience abuse and/or neglect and never make it into the foster care system. They are still the same children. It is still the same cycle. It leads to trust issues, insecurities, self-injurious/high risk behavior, as well as a lack of healthy boundaries and support systems.

A fascinating read is "Parenting from the Inside Out" by Daniel Siegel. If you are a foster care youth, check out a program called A Home Within that provides free counseling for as long as you need it.

While my goal is always to help my clients heal, it is driven by the desire to break the cycles and give more hope to the next generation.

For all of you out there trying to break your own cycles of pain, keep up the fight. For those of you helping others, keep your eyes on the prize.

There Is No Magic Behind Psychotherapy

At least not the way I do it....

It's scary to think or much less believe that you are in charge in your session. Not the person you think of as the expert. Get this: Every single thing that happens comes from you. Your counselor gets credit for nothing.

If they are good...they have spent years understanding themselves and understanding the human condition. They will have done this through books and conferences and clinical supervision but mostly through real life exposure to the experiences you are having.

And then, they simply don't get in your way. They give you space to be. They give you space to express. They give you the "I hear you. I see you" we all need to connect to our genuine self that is not afraid to explore our greatest fears. They introduce curiosity to you about you.

It is in that space of human connection, without judgement or consequence for trying out different ways to figure out "who am I?", that the non-magic occurs. It brings me chills every time I get to be in a room, or a nature walk, or a video conference with a person determined to keep trying. To change the trajectory of their existence.

Your courage and effort brings the change. There is no magic. Keep it up!