Stress is the thing we're all managing, all the time.

The morning commute. The inbox. The project with the impossible deadline. The argument you're still turning over in your head three days later. The background hum of financial worry that never quite goes quiet. For most people, stress is so constant it's become atmospheric—the water we swim in, the temperature of daily life.

And that's precisely the problem. When stress is constant, we stop noticing how much it's costing us. We adjust, adapt, push through. Until one day we can't—or we end up on a GP's couch with unexplained chest pain, or we find ourselves weeping in a supermarket car park and genuinely don't know why.

Counselling for stress isn't about learning to breathe differently (though breathing helps). It's about understanding what's underneath the stress—and changing it.

TL;DR: Key Takeaways

Chronic low-level stress is often more damaging than acute crisis, precisely because we habituate to it
Therapy for stress explores the sources, patterns, and meanings behind your stress response—not just the symptoms
Humanistic approaches are particularly effective for stress related to values conflicts, identity, and relationship dynamics
The difference between stress and anxiety matters clinically; a good counsellor will help you understand which is driving your experience
You don't have to be in crisis to benefit from therapy—functional but exhausted is reason enough

The Problem with "Just Managing" Stress

Self-help content on stress tends to focus on management strategies: mindfulness, exercise, sleep hygiene, time management apps. These aren't wrong. But they address the downstream consequences of stress without touching the upstream causes.

If your stress is driven by a job that conflicts fundamentally with your values, no amount of breathwork will resolve it. If it comes from a relationship in which you chronically suppress your own needs, a productivity system won't help. If it's rooted in an internalised belief that you're only acceptable when you're achieving—that your value is conditional on performance—then learning to "relax more" misses the point entirely.

This is where counselling works differently.

Rather than providing strategies to cope with stress, therapy asks: what is this stress telling us? What is it about your particular situation, your particular history, your particular way of understanding yourself in the world, that creates this experience? And what would have to change for the stress to genuinely ease rather than just be temporarily managed?

These aren't comfortable questions. But they're the ones that lead somewhere.

What Causes Stress: Beyond the Obvious

We tend to think of stress as situational—too much work, not enough time, difficult circumstances. And situational stress is real. But clinical experience consistently shows that the same situation can create very different levels of stress in different people.

Two colleagues get the same difficult feedback from a manager. One takes it on board, adjusts, and moves on. The other lies awake for weeks, catastrophising about their career. Same event; radically different stress responses.

The difference usually lies in what the event means to each person—shaped by their history, their beliefs about themselves, and their unconscious relationship with approval, failure, and safety.

Common drivers of chronic stress include:

Perfectionism and conditional self-worth. If your sense of value depends on never making mistakes, sustained high performance, or constant achievement, the ordinary imperfections of life generate ongoing threat. Stress isn't a response to the situation—it's the price of the belief.

Boundary difficulties. An inability to say no—rooted often in fears about disappointing people, conflict, or rejection—means taking on more than is sustainable. The stress is real, but the source is relational and characterological rather than simply logistical.

Unresolved grief or loss. Sometimes what presents as stress is actually suppressed grief that hasn't found a healthy outlet. The body keeps producing a state of alert even when there's no immediate threat.

Relationship tension. Unresolved conflict, emotional distance, or persistent communication difficulties with a partner, colleague, or family member creates a background stress that has little to do with workload.

Values misalignment. Working in a role or environment that conflicts with your core values creates a particular kind of low-grade existential discomfort that manifests as stress, flatness, or cynicism.

Expert Perspective: "What we call stress is often the body signalling that something important is out of alignment—that we are being asked to live in a way that doesn't match who we are at some fundamental level. Therapy's job isn't to help people tolerate that misalignment more efficiently. It's to help them identify and address it." — Dr Fiona McNeil, BACP-accredited counsellor and supervisor

How Counselling for Stress Works

The Assessment Phase

In early sessions, a counsellor will want to understand your stress in context. Not just "what's happening" but: how long has this been going on? Is the stress pervasive or linked to specific situations? Has anything happened recently that might have precipitated or intensified it? What have you tried so far? What does the stress feel like in your body, not just your mind?

This phase matters because different sources of stress respond to different therapeutic approaches. Stress that's primarily driven by situational overwhelm might call for different work than stress rooted in long-standing patterns of self-criticism or perfectionism.

Understanding Patterns and History

Most chronic stress has roots. A therapist working humanistically will be interested in where your particular stress response came from—what early experiences or messages shaped your relationship with pressure, performance, and safety.

This isn't about blaming your upbringing or spending years excavating the past. It's about understanding why certain situations feel threatening when they logically shouldn't, and where the internal critic whose voice turns ordinary challenges into catastrophes learned to speak that way.

When you recognise that your stress response is partly learned—that it made sense in an earlier context even if it's disproportionate now—it becomes possible to engage with it differently.

Working with the Present

Alongside historical understanding, good therapy for stress works with what's happening now.

This includes: helping you identify what's genuinely negotiable in your circumstances and what isn't; exploring whether there are decisions or conversations being avoided that the stress is partly masking; and developing a clearer sense of what you actually value and want, rather than what you think you should want.

Sometimes therapy for stress leads to surprising places. A client who came to work on workplace stress discovered, over several months, that the stress was partly protection against examining a relationship that wasn't working. Another found that the relentlessness of their schedule was maintaining a distance from an uncomfortable feeling of emptiness they hadn't known how to face.

Neither of these outcomes was planned or predicted. That's how it tends to work.

Body Awareness

Stress is physical as well as psychological. A skilled counsellor will attend to somatic experience—what happens in your body when the stress peaks, where you hold tension, how your breathing changes, what physical sensations signal that you're approaching your limit.

This isn't mandatory in all counselling approaches, but humanistic and integrative therapists often incorporate body awareness because the body carries information that can be difficult to access cognitively. When someone says "I'm fine" and simultaneously has their shoulders around their ears, both pieces of information matter.

Stress vs. Anxiety: Understanding the Difference

These terms are often used interchangeably, but there's a clinically useful distinction.

Stress is typically triggered by identifiable external pressures—workload, a difficult relationship, financial strain. When the external pressure eases, the stress tends to ease too.

Anxiety often exists in the absence of an obvious external trigger, or is disproportionate to one. It's characterised by persistent worry, physical symptoms (racing heart, difficulty sleeping, muscle tension), and a pervasive sense of threat even when things are objectively okay.

In practice, they frequently co-occur—prolonged stress can generate anxiety, and anxiety makes you more vulnerable to stress. But understanding which is driving your experience helps shape the therapeutic approach.

A counsellor can help you untangle this in your first few sessions, which is often clarifying and reassuring in itself.

Signs That Counselling for Stress Might Help You

You don't need to be in crisis to benefit from therapy. Any of the following warrant consideration:

Stress that hasn't shifted in three months or more, regardless of what you've tried
Physical symptoms without a medical explanation—persistent headaches, digestive problems, fatigue, tension in the neck and shoulders
Sleep disruption that leaves you exhausted and makes everything worse
Increasing use of alcohol, food, or other substances to cope
Withdrawal from things you used to enjoy because everything takes too much effort
Irritability or emotional volatility that's affecting your relationships
A persistent sense of overwhelm even on days when there's objectively less to do
A feeling that you're just getting through the day, rather than actually living it

None of these individually guarantee that therapy is the right response. But together, or over a sustained period, they suggest that the stress has gone beyond what self-management can address.

FAQs: Therapy for Stress

How quickly does therapy for stress work? Some people notice meaningful shifts within four to six sessions—particularly if the stress is linked to a specific, identifiable situation. For more pervasive or long-standing stress, the work tends to take longer, though clients usually notice progress incrementally rather than all at once.

Can therapy make stress worse before it gets better? Sometimes, in the short term. Therapy can surface feelings and awareness that were previously managed by staying busy and pushing through. This temporary intensification is normal and usually settles as the work progresses. A good therapist will talk you through what to expect.

Should I see my GP as well? Yes, if you have physical symptoms that haven't been medically assessed. Some physical symptoms of stress (irregular heartbeat, chest tightness, significant sleep disturbance) warrant a medical check-up alongside therapy. Your GP may also be able to refer you to NHS counselling services, though waiting lists can be long.

What's the difference between counselling for stress and life coaching? Life coaching typically focuses on goal-setting, accountability, and future-oriented problem solving. It doesn't involve therapeutic exploration of psychological patterns or history. Counselling goes deeper—it's relevant when the issue isn't "how do I achieve X" but "why do I keep experiencing Y, and what can I do about it?"

Is online therapy as effective for stress as in-person? For many presentations, yes. Stress-related counselling works well remotely, especially when the work is primarily verbal and reflective. For stress with a significant somatic component, in-person therapy may offer additional benefit.

A Note on Self-Help Alongside Therapy

Therapy works best when it's part of a broader approach to wellbeing. This doesn't mean doing everything at once—that would simply be more stress. But some things genuinely support the therapeutic work:

Regular physical movement: Not as punishment, but as a way of discharging stress hormones and reconnecting with your body
Consistent sleep: Not perfectly, but as a priority when possible
Reducing alcohol: Alcohol worsens anxiety and disrupts sleep, making stress harder to address
Deliberate rest: Not just absence of work, but genuinely restorative activity—whatever that looks like for you

Your therapist won't prescribe these or use them as a metric of success. But if they're absent, worth exploring why.

Annabel is a BACP-registered humanistic counsellor working with stress, anxiety, low mood, relationship issues, and personal growth. She sees clients in Fulham, SW London, and online. Book a free introductory call to talk about what's going on and whether counselling might help.

Counselling for Stress: When Everyday Pressure Needs Professional Support