CBT for Anxiety

Anxiety disorders are the most common mental health complaints.
If you’re feeling nervous, worried, or on edge, please know that you’re not alone.

It’s important to remember that anxiety is totally normal. Anxiety comes from our fight-flight-or-freeze response, which has evolved over time to keep us safe. In ancient times, humans encountered threats like predators (think mammoths and tigers) and warring tribes. That fight-flight-or-freeze response kept our ancestors safe in those situations by triggering a rush of adrenaline, rapid heart rate, sweating, and other physical symptoms. If humans didn’t have that response, we wouldn’t have survived.

Today, however, many of the threats we encounter are less visible. We worry about things that might go wrong in the future. We fear failure at work or school, disappointing others, the safety of people and animals we love. And yet our bodies still respond with that same fight-flight-or-freeze response. It’s the right response but it’s happening at the wrong time because the threats are in our minds, not out there in the world. Those physical symptoms can’t help us battle those threats.


There are several different anxiety disorders, including generalized anxiety disorder, social anxiety disorder, specific phobias, and panic disorder and agoraphobia.

Anxiety disorders are characterized by symptoms like:

  • uncontrollable worry
  • feeling restless
  • irritability
  • difficulty sleeping
  • stress
  • feeling overwhelmed
  • panic attacks
  • overthinking

We don’t fully know why some people struggle more with anxiety than others. However, research suggests that both genetics and the environment play a role. Some researchers suggest that on average, about 30% of the variance in anxiety can be explained by heritable genetic factors. So while this means that anxiety disorders do tend to run in families, MOST of that variance is due to the environment.  So if you have children of your own, take heart in knowing that the bulk of the factors that explain anxiety are modifiable.

Often early experiences leading to beliefs about uncontrollability and unpredictability, combined with a genetic risk, play a role. You may have had experiences growing up that caused you to believe that the world is inconsistent and that you don’t have control over what happens to you. In response, you may have developed perfectionistic tendencies, a sense of over responsibility, and strategies to try to control your world that just aren’t working any more.
We use primarily Cognitive Behavioral Therapy (CBT) and exposure and response prevention interventions for working with anxiety.

CBT is based on the idea that thoughts (cognitions), behaviors, and emotions all work together. To decrease anxiety, we work with clients on several different strategies to change negative thoughts, including developing a more flexible, realistic mindset, mindfulness skills to slow down and become aware of the impact of negative thoughts, and learning to tolerate uncertainty. We also work with clients to set behavioral goals to gradually face feared situations and decrease avoidance with exposure therapy. This helps our clients to get unstuck and move forward in living a life they love.

It’s important that our work in therapy is collaborative. We know a lot about CBT in general, but you are the expert on your own anxiety. In our initial work, you’ll develop a treatment plan and a shared understanding of your symptoms with your therapist. By combining your knowledge, you and your therapist will take general principles and strategies and start to understand how they apply specifically to you.

CBT for anxiety is an active, skills based treatment. It’s meant to be a time-limited intervention so each of your sessions is productive and focused on helping you develop new skills and strategies for dealing with anxiety. There will be information, in session practice of new coping skills, and homework and worksheets between sessions where you’ll get a chance to put the ideas you talk about with your therapist into action. Our goal is to teach you as much as we can about CBT so you can work toward being your own therapist.