Counselling & Therapy for Anxiety

Anxiety is a word we use to describe feelings of unease, worry and fear. It incorporates both the emotions and the physical sensations we might experience when we are worried or nervous about something. Although we usually find it unpleasant, anxiety is related to the ‘fight or flight’ response – our normal biological reaction to feeling threatened. Like all other animals, human beings have evolved ways to help us protect ourselves from dangerous, life-threatening situations.

When you feel under threat your body releases hormones, such as adrenaline and cortisol, which help physically prepare you to either fight the danger or run away from it. These hormones can:

  • make you feel more alert, so you can act faster
  • make your heart beat faster to carry blood quickly to where it’s needed most.

Then when you feel the danger has passed, your body releases other hormones to help your muscles relax, which may cause you to shake. This ‘fight or flight’ response is something that happens automatically in our bodies and we have no control over it.  In modern society we don’t usually face situations where we need to physically fight or flee from danger, but our biological response to feeling threatened is still the same.

When does anxiety become a mental health problem?

Because anxiety is a normal human experience, it’s sometimes hard to know when it’s becoming a problem for you – but if your feelings of anxiety are very strong, or last for a long time, it can be overwhelming.

The most common anxiety disorders are:

  • Generalised anxiety disorder (GAD)
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Phobias
  • Post-traumatic stress disorder (PTSD)

You might not have, or want, a diagnosis of a particular disorder – but it might still be useful to learn about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.

Generalised anxiety disorder (GAD)

If you have felt anxious for a long time and often feel fearful, but are not anxious about anything specific that is happening in your life, you might be diagnosed with generalised anxiety disorder. Because there are lots of possible symptoms and effects of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from the problems another person experiences, even though you have the same diagnosis.

Panic disorder

If you experience panic attacks that seem completely unpredictable and you can’t identify what triggers them, you might be given a diagnosis of panic disorder.
Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks.

Obsessive compulsive disorder (OCD)

Obsessive-compulsive disorder is a diagnosis you might be given if your anxiety leads you to experience both:

  • Obsessions – unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind

  • Compulsions – repetitive activities that you feel you have to do.

If you experience two or three symptoms then this could be measured as a mild case of SUD, however, if you feel that four or more symptoms apply then it is advised to seek support around these behaviours.


A phobia is an intense fear of something, even when that thing is very unlikely to be dangerous to you. If you have a phobia, your anxiety may be triggered by very specific situations or objects.

Post-traumatic stress disorder (PTSD)

If you develop strong feelings of anxiety after experiencing or witnessing something you found very traumatic, you might be given a diagnosis of PTSD. PTSD can cause flashbacks or nightmares about the traumatic event, which can feel like you’re re-living all the fear and anxiety you experienced during the actual event.

Seeking Anxiety therapy:

As a psychologist, I am trained in diagnosing anxiety disorders and teaching my clients healthier, more effective ways to cope. A form of psychotherapy known as cognitive-behavioral therapy (CBT) is highly effective at treating anxiety disorders. CBT helps patients learn to identify and manage the factors that contribute to their anxiety.

Through the cognitive component of therapy, patients learn to understand how their thoughts contribute to their anxiety symptoms. By learning to change those thought patterns, they can reduce the likelihood and intensity of anxiety symptoms.

With the behavioural component, patients learn techniques to reduce undesired behaviours associated with anxiety disorders. Specifically, patients are encouraged to approach activities and situations that provoke anxiety (such as public speaking or being in an enclosed space) to learn that their feared outcomes (such as losing their train of thought or having a panic attack) are unlikely.

Psychotherapy for Anxiety disorders: What to expect

Psychotherapy is a collaborative process, therefore we would work together to identify specific concerns and develop concrete skills and techniques for coping with anxiety. Patients can expect to practice their new skills outside of sessions to manage anxiety in situations that might
make them uncomfortable.

Panic attacks

A panic attack is an exaggeration of your body’s normal response to fear, stress or excitement. It is the rapid build-up of overwhelming physical sensations, such as:

  • A pounding heartbeat
  • Feeling faint
  • Sweating
  • Nausea (feeling sick)
  • Chest pains
  • Shortness of breath
  • Shaky limbs, or feeling like your legs are turning to jelly
  • Feeling like you’re not connected to your body.

During a panic attack you might feel very afraid that:

  • You are losing control
  • You are going to faint
  • You are having a heart attack
  • You are going to die

When do panic attacks happen?

It’s different for different people. You might have a good understanding about situations or places that are likely to trigger an attack for you, or you might feel that your attacks come without warning and happen at random.

Panic attacks can also come in the night while you’re asleep, and wake you up. This can happen if your brain is very alert (due to anxiety), and interprets small changes in your body as a sign of danger.
Experiencing a panic attack during the night can be particularly frightening, as you may feel confused about what’s happening, and are helpless to do anything to spot it coming.

How long do panic attacks last?

Most panic attacks last for between 5 and 20 minutes. They can come on very quickly, and your symptoms will usually peak within 10 minutes. Sometimes you might experience symptoms of a panic attack, which last for up to an hour. If this happens you are probably experiencing one attack after another, or a high level of anxiety after the initial panic attack.

How often might I have panic attacks?

Again, it’s different for different people. You might have one panic attack and never experience another, or you might have attacks once a month or even several times a week.

How can Anxiety therapy help?

There are many types of therapy that are suitable for addressing anxiety and any underlying issues. As an integrative therapist I would most likely use Cognitive Behavioural Therapy to help a person understand behaviours and ways of thinking that might contribute to the development of an attack. Identifying and changing these patterns can help prevent further attacks and reduce their severity. In some circumstances I may recommend exposure therapy. In this type of therapy, the person in treatment is exposed to the sensations that accompany panic, one at a time, in a controlled environment so that effective ways of coping with those sensations can be learned. Individuals who have developed agoraphobia are encouraged, as part of treatment, to face open spaces and crowds until they begin to feel more comfortable in them.

Coping with a panic attack

In the middle of an attack, focusing on breathing and getting to a safe, private space can help the attack subside. Releasing physical tension and relaxing one’s muscles can help, too. Panic attacks are not dangerous and usually go away on their own, but can pose a danger if the person is driving or engaging in other dangerous activities when the attack hits. It can also be helpful to think realistically, instead of either overestimating the dangers of a panic attack (fainting, dying, experiencing a heart attack) or catastrophizing the dangers (embarrassing oneself in public, not receiving help). To challenge these types of thinking, a person might write out any fears or imagine the worst possible scenario that a panic attack could lead to and then plan a way to cope if it does occur.

Stress management is also vital in combating panic attacks. Many people have panic attacks when they grow so overwhelmed with stress that they simply cannot cope, but talking about stress and getting regular breaks and leisure time can help mitigate the damaging effects of chronic stress. Remembering that a panic attack is not likely to cause one to faint, lose control, “go crazy,” or die may also help some individuals relax and deal with panic attacks more effectively, when they occur.

Private Counselling & Psychotherapy for Anxiety London

To schedule a confidential consultation to discuss how I can help you overcome anxiety, simply call on 0207 205 2868 or complete the online enquiry form.

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