How do you understand anxiety? What is it doing for the person?
Anxiety is often what you feel when a different feeling is trying to come up and you’re pushing it down. The feeling might be anger, grief, or closeness. Anxiety is the alarm, and the avoidance is what sets it off.
In ISTDP, Intensive Short-Term Dynamic Psychotherapy, we look at what the anxiety is covering. It shows up in the body: tight chest, racing heart, a knot in the stomach. That’s real, and we work with it directly. We don’t just manage the symptom, we look at what it’s protecting you from feeling.
Why does ISTDP pay so much attention to feelings?
The approach focuses on feelings you may have learned to avoid, and the ways that avoidance shapes your life.
Can feelings you don’t express show up in the body, as tension or headaches?
If they come to me and they say, “Well, I have headaches, and the doctor tells me it’s a blood vessel in my brain,” I would tell them, “Well, that’s an organic issue. I can’t treat that in psychotherapy.” But if they say, “I get headaches, but they found no biological cause,” I would tell them, “I might be able to help you with that in therapy, because that could be a psychosomatic issue, based on the fact that you’re not properly experiencing your feelings.”
When you don’t properly experience your feelings, that will lead to tightness and tension, and possibly headaches. As we explore your emotional life, my hope is that as the feelings get expressed, your tendency to get headaches will reduce. And I also might say: as we work in therapy, we might see the headaches coming up in real time, so let me know when you feel the headache coming along.
What does a session actually feel like for someone who comes in anxious?
It’s active, and it’s honest. I’ll ask what you’re feeling right now, in the room, and I’ll notice where it shows up in your body. Tension, a breath you hold, a laugh that covers something. We stay with it rather than talk around it.
That can feel uncomfortable, and I go at a pace you can manage. Often, for the first time, you can feel what the anxiety was about. The first session is up to two hours, so there’s room to find your footing, and by the end you’ll know if this is for you.
Do you work with panic attacks as well as everyday anxiety?
Yes. Panic attacks and everyday anxiety, the constant low hum of worry, both come from the same place: a feeling that’s being pushed away. The body does the alarming, and the mind adds the fear.
If you’ve had a panic attack and you’re worried it’s physical, see your doctor first. That’s sensible. If it’s been checked and the attacks keep coming, therapy can help us look at what’s behind them.
What do people often try first for anxiety that doesn’t help?
People try to think their way out of it. They reassure themselves, they make lists, they avoid what sets it off, or they distract themselves. That’s understandable, and sometimes it helps a bit for a while.
But if the anxiety is covering a feeling, thinking about it more doesn’t reach it. It’s the "I know why I’m anxious and I still am" problem. Others have years of talk therapy and are still stuck. This approach is designed for that: it’s direct and active, and it goes to the feeling rather than around it.
Do I need a diagnosis of anxiety to start therapy with you?
No. You don’t need a diagnosis, and I’m not going to put a label on you. If anxiety is getting in the way of your life, that’s enough of a reason to call.
Start with the free 20-minute Zoom introduction. You tell me what’s going on, I tell you whether I think I can help, and if I can’t, I’ll refer you to someone else.
What would you want someone who has lived with anxiety for years to know?
That it isn’t a character flaw, and it isn’t who you are. It’s a pattern, and patterns have a reason. Years of anxiety usually mean years of avoiding something. That’s not weakness, it’s what you learned to do to cope.
I can’t promise it will lift, and I won’t pretend it’s quick or easy. But I’d want you to know there’s a way in that doesn’t take years: up to 26 sessions, about six months, with an end in sight. If you’re willing to work hard, that’s worth a 20-minute call.
What does progress look like in the first months?
First you start to notice what you’re feeling, and where. The anxiety stops being a fog and becomes something specific. Then, over the sessions, the alarm gets quieter because there’s less to push down.
Some people notice the body relaxing: fewer headaches, less tension, easier breathing. I can’t guarantee any of that. We meet weekly, up to 26 sessions, and early on we’ll have a clear picture of whether this is working. If it isn’t, I’ll tell you, and we’ll talk about what comes next.