Anxiety Therapy in Northern Virginia

For People who Look Fine and Feel Anything But

Anxiety has a way of just taking over. Your mind racing at 2 a.m. The tension that hijacks you: shoulders hunched, jaw clenched, legs that need to run, stomach churning. A body braced for impact. And in your head, the conversation from earlier in the day on loop, that email you didn't review closely enough before you hit send, the thing your friend said. Was that a dig? Even on the best days, there's a low hum, like that lawnmower down the block, saying something is about to go wrong. Or already has.

From the outside, you're doing just fine. Maybe even better. Work is going well, you're putting in social appearances, and your friends know they can lean on you. But underneath? Most people would be surprised to learn how much it takes for you to get through the day, and how noisy your mind is, all the time. And if things actually go quiet for a few moments, the self-criticism starts. What's wrong with me? Why can't I just hold it together like everyone else?

This is what high-functioning anxiety looks like. And it's so hard to put down because it's the thing you think is driving your success (the over-preparing, the perfectionism, the incessant checking to make sure you haven't disappointed anyone). What started as protection has become the problem.

What Anxiety Looks Like in the People I See

Most people I see for anxiety therapy aren’t having “nervous breakdowns.” They're exhausted. They're running on fumes from rehearsing worst-case scenarios, scanning faces for disapproval, apologizing for things that need no apology. Anxiety symptoms show up in both the body and mind:

• Muscle tension, headaches, nausea or stomach distress

• A racing heart and restlessness, or the opposite: feeling frozen in place

• Overthinking that only leads back to where it started

• Perfectionism and a harsh inner critic

• Avoiding what feels risky, then judging yourself for not acting

• Constant reassurance-seeking, or self-medicating to take the edge off

If you're reading this list and beating yourself up for how messed up you are, stop. Anxiety is a protective response, and you need it. It's just that yours has been working overtime. It doesn't know how to stop. Yet.

What Your Anxiety Is Protecting You From

"I'm just an anxious person." I hear this a lot from clients. I've even said it to myself in the past. And while some of us do have a genetic predisposition to anxiety, that explanation is incomplete. Worse, it quietly becomes a cover for what's underneath: grief, shame, anger, needs that never got met.

If growing up meant staying alert to other people's moods, or earning your place by being good, capable, and low-maintenance, your nervous system learned that vigilance keeps you safe. It also learned that feeling is dangerous. If you felt righteous indignation or grief in those moments, it could get you into trouble with the people you depended on. Better to shut the whole emotional system down than risk what would happen if you actually felt them.

So anxiety ends up signaling two kinds of danger: the danger you expect from other people, and the danger from your own emotions. Because at one time, feeling them could cost you the connection you needed to survive. Now, the moment anger or grief starts to rise, anxiety is first on the scene, alerting your defense system to shut those deeper-lying emotions down. All of this usually happens before you even know what you’re feeling.

These are grooves that were worn in when you were young. Every time you avoid, over-prepare, check for reassurance, or go hypercritical on yourself, they get worn a little deeper. Your life organizes itself around keeping your inner emotional world quiet.

Those grooves sit below the level of thought, which is why understanding your anxiety often isn't enough to change it. You can know exactly where it comes from and still feel your chest tighten before a meeting. What wears a new groove is new experience: letting the feelings anxiety has been blocking actually come up, in real time, in the room. When you feel the anger or grief you were never allowed to feel, with someone alongside you, and nothing bad happens, your nervous system learns something no amount of insight could teach it.

My Approach to Anxiety Therapy

I take an experiential, relational approach to anxiety treatment. In practice, that means we slow down and pay close attention to what you’re feeling and what’s happening in your body underneath the story you’re telling. If your jaw tightens when a certain memory comes up, or you start to laugh while describing something painful, we might slow down right there and get curious about what's happening.

We also notice the ways you protect yourself that end up tripping you up: talking around your feelings, getting busy or going numb, turning on yourself when you're actually angry at someone else, pulling away when someone gets close. I draw from several models and tailor the work to you:

• ISTDP and AEDP. I'm certified in ISTDP (Intensive Short-Term Dynamic Psychotherapy), which offers a precise map for working with anxiety: how it shows up in the body, what it's protecting you from and what it costs you, and how to interrupt the defenses that keep the whole cycle going. My style leans toward AEDP (Accelerated Experiential Dynamic Psychotherapy, an offshoot of ISTDP), which focuses as much on moments of change and healing as on what's stuck.

• EMDR therapy. Eye Movement Desensitization and Reprocessing targets the memories and core beliefs ("I'm not enough," "something bad will happen if I relax") that keep your alarm system set too high.

• IFS-informed work. The worried, controlling, self-critical parts of you are protectors with a job to do. We get to know them. Once you and your protectors trust each other, you can work together instead of being at each other's throats, and your world can start to open back up.

We'll also work on what helps you day to day. Practical ways to settle your nervous system matter, especially early on. They aren't the whole treatment.

Types of Anxiety I Treat

I work with adults dealing with:

• High-functioning anxiety and perfectionism

• Generalized anxiety and chronic worry

• Panic attacks

• Social anxiety

• Performance anxiety, at work or anywhere you feel evaluated

• Trauma-related anxiety

Many of my clients are professionals, parents, and caregivers who look successful on paper and feel stretched thin underneath. Whether you'd call what you're dealing with an anxiety disorder or "how I've always been," the work is the same: understanding what keeps the anxiety going, and changing how life feels to you on a gut level.

Common Questions About Anxiety Counseling

Will this just be coping skills? Coping skills have their place, and we'll use them when they help. Chances are you already have a drawer full of breathing exercises and thought logs. If those were enough, you wouldn't be reading this. Most of our time goes toward understanding the function of your anxiety and its pros and cons, and then, if you decide you want to, wearing new grooves.

I've been in therapy for anxiety before. What would be different? Maybe nothing, if your last therapy was a good fit and you need a tune-up. But if you've spent years talking about your anxiety and it hasn't really budged, experiential work offers a different route.

How long does anxiety therapy take? It depends on what's driving the anxiety and how long it's been running the show. Some people notice a shift fairly early. Patterns that started in childhood usually take longer. We'll talk about what's realistic for you in the consultation.

Anxiety Therapy in Northern Virginia and Online

If you're looking for an anxiety therapist close to home, my office is on Chain Bridge Road in McLean, a few minutes from Tysons and the Beltway. Some people find that coming in person puts a helpful boundary around the work: a set time and place where the anxiety gets your full attention.

I also offer anxiety therapy by telehealth throughout Virginia, Maryland, and D.C., and many of my clients do this work online. Whichever you choose, the approach is the same.

Take the Next Step

Overcoming anxiety rarely means making it disappear. It means anxiety stops making your decisions for you. You get back the room it's been taking up: for your relationships, your work, and the parts of you that have been on hold.

If you're ready to see what's underneath your anxiety, reach out to schedule a free initial consultation. We'll talk about what's going on, and you can get a sense of whether working together feels like a fit.

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