Anxiety is a normal human emotional reaction to real or perceived threats. Problematic anxiety shows up in emotional, cognitive, physical and behavioral symptoms. It may be a specific phobia, generalized anxiety or a panic disorder. Common symptoms include:

Emotional and cognitive

  • Tunnel vision – there is a narrow focus and an inability to see a broader range of options.
  • Confirmation bias – data is interpreted to confirm a belief.
  • Racing thoughts or slowed thoughts
  • Difficulty concentrating, going blank
  • Feeling discouraged, angry, depressed, having a sense of doom, fearing the next panic attack
  • Repetitive thought loops, rumination, obsessive thinking
  • Blame of self or others, and in the extremely anxious, conspiracy theories
  • Delusional causal associations
  • Rigid thinking, an inability to change one’s point of view

Physical effects

  • Sweating
  • Rapid heartbeat
  • Rapid and shallow breathing
  • Tremors
  • Muscle tension, aches
  • Tingling
  • Dizziness
  • Fatigue


  • Freeze
  • Flee
  • Attack
  • Appease
  • A strong need for togetherness, to want to be around those who think and feel the way we do, less tolerance for individuality and differences
  • Poor impulse control, compulsive behaviors
  • Pain or the perception of pain
  • Sleep problems
  • Avoiding situations or places that have been identified as triggers

My approach to treatment for anxiety is multidimensional. We will first work on gaining a thorough understanding of the anxiety. We will work on creating new pathways to a calm place in the mind and body. I will assign and teach exercises which will help create a physical sensation of calm and work on changing thought patterns that have created and maintained the anxiety.

Some of this work might include:

  • Various deep breathing exercises
  • Mindfulness exercises
  • Progressive muscle relaxation
  • Thought defusing
  • Increasing cognitive flexibility
  • Help with managing relationships and environment
  • Self-soothing
  • Self-care plan

Gaining self-awareness and learning new skills that are repeated and practiced may result in a calmer response, no matter what is going on around you. The goal is not to eliminate anxiety but to increase the ability to tolerate the emotions and the physical experience, to reduce the intensity and frequency of anxiety and to have more options  in how to respond.

If you are experiencing persistent anxiety, I would encourage a telephone call or email to explore how therapy can help.

Additional resources