Anxiety

Anxiety is one of the most common reasons people seek psychotherapy. Anxiety often signals the emergence of uncomfortable feelings that are difficult to tolerate “as a feeling” and can lead to impulsivity and acting out behaviors that may be self-sabotaging.

Anxiety may present in many different ways: chronic worry, panic attacks, dissociative states such as numbing, physical tension, irritability, sleeplessness, racing thoughts, somatic complaints such as stomach aches or headaches, or a persistent sense that something is wrong even when one cannot identify the cause.

Adults often describe it as a mind that will not shut off. Adolescents often describe it simply as “too much”—too much pressure, too many expectations. Anxiety can lead to feelings of overwhelm, fogginess, and a tendency to shut down.

The goal of therapy is not to eliminate anxiety entirely. Anxiety is part of the human nervous system that serves an important function to signal and alert us that we need to attend to something. Therapeutic work helps manage/reduce its intensity, change its distorted impact over one’s decisions, and better understand its triggers. This helps develop the capacity to reflect on a more reliable/reasonable way of responding to internal and external stressors.

How Therapy Helps

Therapy creates a structured safe space to slow the spiral, observe what is actually happening, and carefully reflect on the feelings and circumstances that trigger anxiety. The goal is to develop more effective ways of managing anxiety. Depending on the person, the work may include:

• distinguishing alarm from reality
• interrupting catastrophic or rigid thinking loops
• retraining the body’s physiological response (breathing, mediating, grounding)
• examining perfectionism, avoidance, and rigid patterns and expectations
• reducing behaviors that unintentionally feed anxiety (checking, reassurance-seeking, withdrawal)
• developing tolerance for discomfort via customized coping strategies instead of organizing life around fear. In life there are inevitable uncomfortable feelings that must be tolerated in order to grow and mature.

For adolescents, this may also include social comparison pressures, academic strain, identity formation issues, technology-mediated pressures to conform, perform and appear “fine”. Adolescents must negotiate the developmental tensions between autonomy and dependency.

Adults may experience relationship issues with self and other, career/work stressors and dilemmas, parenting strain, caregiving burdens, unresolved trauma, or long-standing unproductive patterns formed early in life.

Throughout the life span, psychotherapy offers a safe space for processing loss, grief, anger, and underlying conflicts. Anxiety signals us that something needs to be addressed.

When Anxiety Starts to Interfere

Therapy is worth considering when anxiety begins to shape your choices, limit your activities, interrupt sleep, constrict relationships, or produce physical symptoms without medical explanation.

It is equally appropriate when you appear to be “coping” externally but are doing so at a personal cost: chronic tension, toll on relationships, psychosomatic symptoms, irritability, exhaustion, or collapse after holding it together all day.

You do not have to wait for a crisis to seek help.

Treatment Approach

I draw on psychodynamic and contemporary relational psychoanalytic models, family systems models, including multiple evidence-based frameworks — such as Cognitive Behavioral Therapy (CBT), DBT, exposure-based work when appropriate, and skills-based strategies. Some individuals need tools first. Others require understanding, narrative, and meaning before tools can function.

My use of treatment strategies is always embedded in a layered in-depth understanding of how we have developed our ways of being in the world.

Patients have described my therapeutic approach as always collaborative and adaptive to the individual, to the couple, to the family.

A Deeper Analytic Perspective

While structured skills can reduce symptoms, they do not by themselves explain why anxiety takes the particular shape it takes in you. Contemporary psychodynamic and psychoanalytic thinking looks beneath the surface: how early relational templates, internalized expectations, unconscious conflicts, and the intergenerational transmission of traumas impact a person’s reactions long before the present stressors arrive.

From this perspective, anxiety is not merely a malfunction to be silenced; it is a meaningful signal — often the surface expression of something older, unspoken, or unworked-through. Engaging with in-depth understanding and larger context does more than quiet symptoms: it can revise the inner developmental structures that generate them, which is why analytic work can be so transformative, more reliable and enduring, rather than temporary.

If This Describes You or Your Teen

You do not have to wait until anxiety becomes “severe” to seek help. Early intervention prevents patterns from becoming chronic and reduces the likelihood of escalation into depression, avoidance, or substance-based coping.

Seeking therapy does not imply something is “wrong with you” — on the contrary, it often indicates you actually have the strength to explore and know yourself better, and resist avoidance.

Actually, most people seeking psychotherapy are the “worried well” portion of the population. In the current socio-economic and cultural context, it is actually a privilege to be able to access good quality treatment that facilitates long lasting shifts in “mature emotional development”, as well as symptom reduction.