Anxiety can feel like a constant alarm.
Some people come to anxiety therapy because their mind won’t stop racing.
Others feel it in their body, in a tight chest or a pounding heart.
Some are anxious because life feels unsafe right now.
Maybe you feel:
- on edge
- restless
- tense
- worried
Anxiety is your mind and body’s alarm for danger.
Anxiety therapy can help you learn what you are responding to.
What is Anxiety Therapy?
Anxiety therapy helps you understand your mind, settle your body and respond to what’s happening in your life now.
It starts from the idea that anxiety is a natural response to danger or insecurity.
Anxiety therapy looks at the stressors and experiences, past and present, behind your reactions.
It also helps with related concerns, like panic, phobias or constant worry.
Online sessions can be a gentler start when leaving home feels hard.
The work is about helping your body feel safe enough to settle.
How Anxiety Therapy Helps
Therapy helps you understand your anxiety instead of silencing it.
It can help whether your anxiety is new or has always been there.
In anxiety therapy you can learn to:
- calm your body when anxiety rises
- face what you’ve been avoiding
- respond to real insecurity
- tell old fears from present danger
Therapy can’t make the world certain, but it can help you feel steadier.
Change often comes as you learn which anxiety is helping you and which is getting in the way.
Anxiety can become a signal that helps you.
What is an Anxiety Therapist?
An anxiety therapist is a registered therapist who helps people understand and work with anxiety.
Anxiety is one of the most common therapy concerns.
Most therapists learn to work with it in their core training, and some go further.
Some train in approaches with strong research for anxiety, like cognitive behavioral or exposure therapy.
Some complete specialized training for panic, phobias or obsessive-compulsive concerns.
Some train in body-based or trauma approaches.
What matters most is that the therapist is a good fit for you, whatever approach they use.
Some Approaches for Anxiety Therapy
Cognitive Behavioral
It helps you notice anxious thoughts and gently face what you’ve been avoiding, step by step.
EMDR
It helps you reprocess painful memories that keep your anxiety switched on, even years later.
Mindfulness
It helps you watch worry thoughts and sensations come and go without getting pulled under.
Somatic
It works with your nervous system directly, so your body can learn how to settle again.
What to Expect in Anxiety Therapy
Anxiety therapy often starts with getting curious.
Your therapist might ask when anxiety started and what was happening in your life then.
Early sessions often explore what sets off your anxiety, what it feels like in your body, and what you do next.
You might learn skills to settle your body when anxiety rises.
Some therapists suggest tracking worry between sessions, or taking small steps toward what you avoid.
You can share what has helped your anxiety before, and what hasn't.
Anxiety therapy can be short-term for specific fears, or longer when anxiety is tied to old experiences.
Anxiety has been named and renamed.
In 45 BCE, the Roman statesman Cicero was grieving the death of his daughter, Tullia.
He retreated to his country house and wrote about the emotions that trouble people. He called a lasting tendency to worry anxietas. He set it apart from angor, the tight, choking feeling in the moment.
Nearly 2,000 years later, New York neurologist George Beard described nervous exhaustion. In 1869 he coined the term neurasthenia and blamed steam power, the telegraph and the speed of modern life.
In women, anxiety was often called hysteria, from the Greek word for womb. The treatment was often rest. In 1887, a doctor diagnosed the writer Charlotte Perkins Gilman with nervous exhaustion and told her to rest and stop writing. She later wrote The Yellow Wallpaper about how the treatment nearly broke her.
In 1895, Sigmund Freud separated anxiety from nervous exhaustion. Anxiety became its own condition.
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As a Harvard student in the 1890s, Walter Cannon used the new X-ray to watch digestion in animals. He noticed that when an animal was frightened, its stomach went still. When it calmed, digestion started again.
In 1915 he described the fight or flight response. Fear floods the body with adrenaline and pulls energy toward survival. Anxiety was the body doing its job.
During World War II, South African army doctor Joseph Wolpe treated soldiers whose fear didn't end when the fighting did. The treatments of the time did little to help them.
After the war, he studied fear in cats. After frightening them in a cage, he fed them in rooms that looked a little more like the cage each time, until they could eat there calmly.
In 1958 he published a book describing systematic desensitization, a way to face fears one small step at a time. It shaped what we now call exposure therapy, and it helped many people with phobias and panic.
In the early 1960s, psychiatrist Donald Klein noticed that a drug called imipramine stopped panic attacks but seemed to do little for everyday worry.
In 1963, Valium arrived. It was marketed heavily to women, and anxiety was framed as a woman's problem to be calmed. It became the most prescribed drug in America, and by 1978 Americans were taking over two billion doses a year. In 1979, the U.S. Senate held hearings on dependence and how hard it was to stop.
In 1980, psychiatry's diagnostic manual used findings like Klein's to split anxiety into separate disorders. Panic disorder and generalized anxiety disorder became different diagnoses.
But anxiety is often treated as the problem, not the signal.
Anxiety is often treated as a problem inside the person, to be calmed, retrained or medicated. Treatment often works on the fear while overlooking real danger in their home or community.
For people facing unsafe housing, food insecurity, discrimination or violence, anxiety is often accurate, and necessary.
And for people whose alarm was set by trauma, facing fears can feel like danger happening again.
Trauma-sensitive anxiety therapy works inside those gaps. It names fear as valid and calls out real danger. It helps you tell old alarms from new ones. And it lets your body lead when it’s time to face what you fear.
Trauma-sensitive therapy views your responses as protection.
Trauma-Sensitive Anxiety Therapy
What if the danger is real?
Under threat, your body can stay on alert, scanning and bracing.
Trauma-sensitive therapists understand anxiety can signal current or past danger.
5 phrases you might hear in Trauma-Sensitive Anxiety Therapy:
- It makes sense your body reacted that way.
- Is this happening now, or is it from before?
- We don’t have to face that today.
- What does your body need right now?
- Notice your feet on the floor.
Trauma-sensitive anxiety therapy invites you to trust your alarm.
Principles of Trauma-Sensitive Anxiety Therapy
Fear is valid
Even if anxiety comes from old danger, your fear is still valid. Your mind and body remember, and the feeling is real in the moment.
Danger can be real
Anxiety can be a response to real insecurity, like housing, money or safety. Danger is named, not explained away.
Your body is talking
A racing heart and tight chest are real, even when tests come back clear. Your body is telling you something important.
Facing fear together
Some therapy asks you to face what you fear. You get to choose what to face and when, and you can always slow down or stop.
Questions You Can Ask an Anxiety Therapist
A consultation is a good time to ask questions. Trust how you feel after the conversation as much as the answers themselves.
How do you understand anxiety?
Will we talk about what’s happening in my life?
Do you use exposure therapy?
How do you work with anxiety in the body?
What if I panic in a session?
How do you feel about medication?
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