Anxiety can show up in your thoughts (e.g., memories of events, worries about the future) and bodily sensations (e.g., racing heart, shallow breathing, nausea). These experiences can show up out of the blue, or in response to specific situations (e.g., animals, bridges, crowds). This pain is particularly difficult when it interferes with meaningful activities, like relationships, work/school, or hobbies. We will work together to identify what you are avoiding and use exposure therapy, a form of Cognitive Behavioral Therapy (CBT), to help you overcome your avoidance and develop greater flexibility in how you respond to your anxiety triggers. The incorporation of Acceptance and Commitment Therapy (ACT) helps us to focus on meaningful change in your behaviors, instead of trying to control your thoughts and feelings, which is a futile agenda. My clients say that they particularly enjoy ACT because it focuses on exploring values and moving towards a life of meaning, both when it is easy to do, and when it may involve difficulties (e.g., compromise in relationships, anxiety about pursuing a new job). 

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In order to do this work, we will create an exposure menu together. That menu will include a range of activities to engage in while you practice responding differently to your anxiety cues (e.g., catastrophic thoughts, difficulty breathing). Often, these activities include situations that bring about anxiety (e.g., elevators, highway driving, going to a party), although they may also include choosing to not do/limit a behavior you do in reaction to your anxiety (e.g., number of sites or amount of time spent researching a topic online, saying no to a request). We will practice these activities together in-session, and also make a plan for you to continue with them between sessions to help further your learning. Importantly, all of these exposures will have a purpose for you, with the goal to help you feel more engaged in the life you want to be in. While these sensations and situations may always involve some challenge, we will work together to help you change your relationship to these experiences so that they feel less overwhelming and painful, and you can move fully into the life you want for yourself.

 

For more information, see the Association of Behavioral and Cognitive Therapies and the Association for Contextual Behavioral Science​