How Can Therapy Help with Anxiety?
Anxiety is one of the most common reasons why people reach out for therapy and yet, it is often one of the most misunderstood experiences.
Many people come in saying things like:
“I don’t know why I feel this way.”
“Nothing is technically wrong, but I feel on edge all the time.”
“I’ve tried calming myself down, but my body won’t listen.”
If that sounds familiar, you are not alone.
What Is Anxiety?
At its core, anxiety is a protective response. It is your mind and body working together to scan for danger and prepare you to cope. In small doses, anxiety can be helpful. It can motivate us, sharpen our focus, and keep us alert. Rather than being a sign of weakness or “overreacting,” it is a sign that your nervous system has learned to stay on high alert (kind of like if you were fighting a tiger), even when you are not in immediate danger (no actual tiger).
Beyond temporary moments of fear and worry, anxiety is an ongoing state that affects many areas of our life. It also can take the form of panic, social anxiety, phobias and the broader sense of unease known as general anxiety disorder.
An important thing to consider is that when anxiety becomes chronic, intense, or unpredictable, it can start to feel less like protection and more like something that’s getting in the way of how you want to live.
The Impact of Anxiety on Daily Life
Anxiety doesn’t just live in your thoughts. It affects your whole system.
It can show up as:
constant worry or rumination
difficulty relaxing, even during downtime
tension, restlessness, or fatigue
disrupted sleep
irritability or emotional overwhelm
avoidance of situations that feel risky or uncomfortable
trouble concentrating or making decisions
Over time, anxiety can shrink your world and lead you to organize your life around avoiding discomfort rather than moving toward what matters to you.
Common Signs of Anxiety
Anxiety looks different for everyone, but some common signs include:
In the mind
racing or intrusive thoughts across multiple life domains
catastrophic thinking and “what if” spirals
difficulty making decisions due to fear of wrong outcomes;
harsh self-criticism
difficulty tolerating uncertainty
shame about inability to “just relax”
overplanning and over-preparation;
In the body
tight chest or throat
shallow breathing
stomach issues or nausea
headaches or muscle tension
In behavior
over-preparing or perfectionism
people-pleasing
avoidance or withdrawal
seeking constant reassurance
Many people are surprised to learn that anxiety is often less about the situation itself and more about how past experiences, beliefs, and nervous system patterns are interacting in the present.
How Anxiety Can Be Treated in Therapy
There isn’t a single “right” way to treat anxiety. Different approaches work at different levels of experience and this is where integrative therapy becomes especially powerful.
Here are a few treatment approaches:
Psychodynamic Psychotherapy for Anxiety
Psychodynamic therapy helps us understand the deeper emotional and relational roots of anxiety; why it shows up, what it protects against, and how earlier experiences may have shaped a sense of the world as unsafe.
Rather than focusing only on reducing symptoms, this approach invites us to listen to anxiety as meaningful; what is it telling us about ourselves and our lives? Often, it’s not just “overthinking,” but a signal pointing toward unresolved emotional experiences, unmet needs, internal conflicts and even wishes.
For some, chronic worry becomes a way of coping. For example it can be a way to create a sense of control, anticipate what could go wrong, or contain a more diffuse, harder-to-name feeling of unease.
In our work together, we gently explore where these patterns may have taken shape.
What did your early relationships teach you about safety, closeness, or unpredictability?
Did you learn to stay on high alert, manage others’ emotions, or suppress parts of yourself to cope?
Over time, these experiences can form internal templates that continue to influence how you relate to yourself and others.
We may also notice that anxiety emerges when deeper emotions are close to the surface. These could be feelings like vulnerability, anger, or longing. In that sense, anxiety can be understood as a kind of messenger, asking for attention in a way that feels safer or more familiar.
In this work, we explore:
inner tensions (for example, the pull between independence and connection)
protective strategies like overthinking, controlling, or intellectualizing
patterns of attachment and relational safety
the impact of self-criticism and internalized expectations
And importantly, the therapeutic relationship itself becomes part of the healing.
It offers a space where new experiences of safety, trust, and connection can begin to take root to support more lasting, meaningful change.
Cognitive Behavioural Therapy (CBT) for Anxiety
Cognitive Behavioural Therapy (CBT) focuses on the connection between your thoughts, emotions/body sensations and behaviours. It helps us understand how anxiety is maintained and how it can be shifted.
From a CBT perspective, anxiety follows patterns. One of the most common is the struggle with uncertainty.
When not knowing feels uncomfortable or unsafe, the mind tries to close the gap by worrying. This can look like running through scenarios, predicting outcomes, and trying to feel more prepared or in control. But because certainty never fully arrives, the relief is short-lived, and the cycle continues. In this sense, sometimes learning to tolerate ambiguous situations and say I don’t know, can be a step in a good direction.
CBT also looks at the beliefs we hold about worry itself.
For example:
“If I worry, I will be more prepared.”
“Worrying helps prevent bad things from happening.”
Alongside:
“My worry is out of control.”
“I can’t handle this.”
This can leave you feeling both reliant on worry and stuck in it.
Another important piece is how worry can function as a form of avoidance.
Staying in your head, thinking, analyzing, planning, can create distance from deeper emotional or physical experiences. While protective in the short term, this can prevent those experiences from being processed.
Over time, certain patterns tend to emerge:
overestimating how likely or severe something bad will be
underestimating your ability to cope
focusing attention on potential threats
relying on strategies like checking, overplanning, or seeking reassurance
These responses make sense. They are your system trying to keep you safe.
But they can also reinforce anxiety by keeping you from discovering that you can tolerate uncertainty and navigate challenges.
In CBT, we work to delicately shift these patterns. This might include:
identifying causes and triggers for anxiety
looking at what anxiety is getting in the way of
developing discernment to separate actual danger from imaginary threat (ex. is there an actual monster under the bed, or is it a sock?)
recognizing anxious thinking patterns
interrupting worry cycles
challenging cognitive distortions like catastrophic or self-critical thoughts
reducing avoidance and safety behaviours
building confidence and distress tolerance through gradual, supportive exposure
Over time, this work helps to create a different relationship with anxiety, one that feels more manageable, flexible, and grounded.
Internal Family Systems (IFS) for Anxiety
From an IFS perspective, anxiety isn’t something to get rid of. It is something to get curious about. What we call anxiety can be viewed as a part of you that is working hard to anticipate danger and keep you safe.
These parts can be future-oriented and hypervigilant. They might be scanning for cues of what could go wrong and trying to stay one step ahead through “what if” thinking. At their core is a simple belief:
If I can anticipate everything, I can prevent something bad from happening.
Sometimes they ruminate about the past too! This can, for example, lead one down shame-spirals where they might start judging themselves for everything they did sub-optimally. In this state, even the tiniest of mistakes can turn into fuel for self-loathing (looking at you typo!).
Whatever exact part might be surfacing, it can feel exhausting. To make it extra hard (because, why not), these parts don’t step back easily because they are often protecting something more vulnerable underneath. Frequently, they are guarding other anxious parts of you that carry earlier experiences of trauma, fear, helplessness, abandonment, or shame.
You might notice this system showing up in different ways:
a Worrier scanning for threats
a Perfectionist trying to avoid mistakes
a Controller managing uncertainty
an Inner Critic pushing through pressure
parts that numb or distract when it all feels like too much
vulnerable parts holding deeper emotional pain or unmet needs.
The goal in this work isn’t to silence these anxious parts, but to relate to them differently; with curiosity and compassion. It might sound surprising, but we actually want to befriend it and learn from it!
As your core Self (this is IFS lingo for your calm and compassionate essence) becomes more present, these parts no longer have to carry the full burden alone.
Over time, the system can soften. The anxiety doesn’t disappear but it doesn’t have to stay on high alert and dominate everything in your life. This makes space for more ease, flexibility, and a deeper sense of internal safety.
Mindfulness and Nervous System Approaches For Anxiety
This perspective understands anxiety as a state of the nervous system, not just a mental experience.
We could focus on:
helping your body feel safe again
directing attention to the present moment
learning to recognize nervous system states
using breath, movement, sensation, and connection to support regulation
building capacity to ride waves of activation without panic
For many people, this is a relief because it explains why “just thinking differently” often is not enough.
Why an Integrative Approach Works Best for Treating Anxiety
Anxiety isn’t just in your thoughts. It lives in your body, your emotions, your nervous system, and your relationships. That is why there isn’t one single approach that works for everyone.
An integrative approach to therapy allows us to:
meet you exactly where you are
respond to what’s unfolding in real time
weave together insight and practical tools
address both the symptoms and the deeper roots
Often, it’s not just about calming anxiety. It’s about understanding what it’s trying to communicate.
Let’s Explore your Anxiety Together
Therapy for anxiety isn’t about becoming perfectly calm or never feeling nervous again (I wish, haha). It’s about:
understanding yourself more deeply
responding to anxiety with compassion rather than fear
expanding your sense of choice and freedom
feeling more at home in your own skin
If anxiety has been shaping your days, your decisions, or your sense of self, you don’t have to navigate it alone.
Support is possible and with the right approach, anxiety can become something you understand, work with, and move through, rather than something that defines you.
If any of this resonated with you, I would like to invite you to reach out for a free consultation to explore how I might be able to support you as you work through your anxiety.
Resources:
Anderson, F. G., Sweezy, M., & Schwartz, R. C. (2017). Internal family systems skills training manual: Trauma-informed treatment for anxiety, depression, PTSD & substance abuse. PESI Publishing & Media.
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective (15th anniversary ed.). Basic Books.
Borkovec, T. D., Ray, W. J., & Stober, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22(6), 561–576.
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36(2), 215–226.
Leichsenring, F., Salzer, S., Jaeger, U., Kächele, H., Kreische, R., Leweke, F., ... & Leibing, E. (2009). Short-term psychodynamic psychotherapy and cognitive-behavioral therapy in generalized anxiety disorder. American Journal of Psychiatry, 166(8), 875–881.
National Institute for the Clinical Application of Behavioural Medicine, Expert Stategies for Working with Anxiety, Online course.
Schwartz, R. C. (2021). No bad parts: Healing trauma and restoring wholeness with the Internal Family Systems model. Sounds True.
Stahl, B., & Goldstein, E. (2019). A mindfulness-based stress reduction workbook (2nd ed.). New Harbinger Publications.
Wells, A. (2009). Metacognitive therapy for anxiety and depression. Guilford Press.