Understanding Your Anxiety

Anxiety rarely appears from nowhere. Julie came to see me experiencing panic attacks and overwhelming stress at work. She described feeling “constantly on edge” and unable to predict when panic might strike. While her symptoms felt immediate and physical, understanding them required looking beyond the present moment.

Assessment involves exploring your early life experiences, family relationships, and formative years. We examine how you learned to respond to stress, what messages you received about emotions and vulnerability, and which experiences shaped your current patterns. Julie’s assessment revealed that her teenage years at school had been marked by high expectations and little room for mistakes. The anxiety she felt at work echoed those earlier experiences of needing to be perfect to feel safe.

The pattern becomes clearer when we connect past experiences with present difficulties. You might notice that your anxiety intensifies in situations that mirror earlier challenges, even when the current circumstances differ significantly from what you faced before.

My Approach to Working Together

I work from the understanding that anxiety serves a purpose, even when that purpose no longer fits your current life. The beliefs driving your anxiety made sense at some point in your development. Our work involves identifying those beliefs, examining where they originated, and deciding whether they still serve you.

Julie and I spent time creating a formulation together. A formulation is simply a shared understanding of how your difficulties developed and what keeps them going. Rather than using technical language, I explain concepts in straightforward terms that connect to your actual experiences. Julie found this particularly helpful: “I finally understood why I reacted the way I did. It was not just random panic, it connected to real things that had happened.”

I pace the work according to what you can manage. Some weeks we might focus intensively on difficult material. Other weeks we might consolidate progress or address practical concerns. Flexibility matters because anxiety itself fluctuates, and rigid therapeutic structures can add pressure rather than relieving it.

The Therapeutic Process

Working through anxiety involves several interconnected elements. We target specific anxiety-causing beliefs by examining the evidence for and against them. You learn to identify automatic thoughts that trigger anxious responses and question whether those thoughts accurately reflect reality.

We also reflect on experiences throughout your life, noticing patterns and connections you might not have seen before. Julie realised that her belief “I cannot make mistakes without terrible consequences” had developed during school but continued influencing her work life years later. Recognising the belief’s origin helped her evaluate whether it still applied.

Creating new experiences forms a crucial part of the work. You cannot overcome limiting beliefs through discussion alone. Julie gradually took on challenges at work that tested her anxious predictions. Each experience that contradicted her beliefs weakened their hold. “The small steps felt manageable,” she said. “I was not thrown in at the deep end. We built up gradually.”

The relationship we develop provides a foundation for this work. You need to feel understood and safe enough to examine painful experiences. I explain my thinking clearly and check that we remain on the same page. Julie appreciated knowing what we were doing and why: “You never just did something without explaining it. I always knew what we were working on.”

What to Expect

Therapy typically begins with assessment across two to four sessions. We explore your current difficulties, life history, relationships, and the development of your anxiety. This comprehensive understanding informs how we work together and what we focus on.

Following assessment, we develop a formulation collaboratively. You bring expertise about your own life and experiences. I bring professional expertise about how anxiety develops and what helps. The formulation guides our work but remains flexible as we learn more.

Sessions involve talking through experiences, examining patterns, and planning steps forward. You might notice anxiety symptoms between sessions as we address difficult material. We discuss how to manage this and adjust the pace if needed. Julie and I worked together for 16 weeks, though the duration varies depending on individual circumstances and goals.

The work requires active participation from you. Change happens through what you do outside sessions as much as what occurs within them. You experiment with new behaviours, practice different responses, and notice patterns in your daily life.

Progress and Outcomes

Progress looks different for each person. You might experience fewer panic attacks, reduced general anxiety, greater confidence in situations you previously avoided, or better understanding of what triggers your anxiety and how to respond.

Julie made significant progress during our 16 weeks together. Her panic attacks reduced substantially, and she developed tools for managing stress at work. More importantly, she gained insight into her anxiety’s origins and changed the beliefs that had maintained it. “I feel more in control now,” she reflected. “Not because the anxiety disappeared completely, but because I understand it and know what to do with it.”

Outcomes depend partly on what you hope to achieve. Some people want symptom reduction. Others seek deeper understanding of themselves. Many want both. The collaborative nature of the work ensures we pursue goals that matter to you.

Professional Standards and Individual Care

My work with anxiety adheres to British Psychological Society ethical principles. The approach you receive goes beyond mechanical application of techniques. Your therapy is shaped around your specific experiences, beliefs, and circumstances.

While evidence-based principles guide the work, how those principles apply to your situation remains unique. The collaborative relationship ensures the work fits your needs rather than forcing you to fit a predetermined approach.

Effective therapy for anxiety requires trust and genuine connection. Finding a therapist with whom you feel comfortable discussing difficult experiences forms the foundation for successful outcomes. The techniques matter, but the relationship within which they occur matters equally.

If you feel you can work with me or one of my team, get in contact below.
-Garrett

References

Clark, D. M., & Beck, A. T. (2010). Cognitive therapy of anxiety disorders: Science and practice. Guilford Press.

Leahy, R. L., Holland, S. J., & McGinn, L. K. (2012). Treatment plans and interventions for depression and anxiety disorders (2nd ed.). Guilford Press.

National Institute for Health and Care Excellence. (2011). Generalised anxiety disorder and panic disorder in adults: Management (Clinical guideline CG113). https://www.nice.org.uk/guidance/cg113

Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303–315. https://doi.org/10.1037/pst0000193