Anxiety
Anxiety can take different forms, depending on what you fear, how you respond to uncertainty and the ways in which anxiety affects your life. You may recognise yourself in one or more of the following descriptions.
Panic disorder
If you experience recurrent, unexpected panic attacks, persistent concern about having further attacks and find yourself changing how you live to prevent them, you may be experiencing panic disorder.
A panic attack involves a sudden surge of intense fear or discomfort, often reaching its peak within minutes. You may experience a racing or pounding heart, chest tightness, rapid breathing, shortness of breath, a feeling of choking, nausea, dizziness or feeling faint, sweating, trembling, tingling or numbness, or flushes and chills. You may also feel detached from yourself or your surroundings, as though things are unreal. These experiences can be frightening, sometimes leading you to fear that you are losing control, going crazy or dying.
It is common to worry that these symptoms signal a heart attack or another serious medical problem. You may respond by seeking immediate reassurance or help, or by making longer-term changes to protect yourself, such as avoiding exercise, being alone or places where you fear another attack might occur. You may become increasingly alert to bodily sensations, interpreting them as warning signs that another attack is imminent. In this way, the fear of panic itself can become a source of anxiety.
Although panic attacks can feel alarming, they are not usually physically dangerous in themselves. However, because their symptoms can overlap with those of medical conditions, new or concerning symptoms should be assessed appropriately by a healthcare professional.
Health anxiety
If worries about your health have become a persistent source of distress, you may be experiencing health anxiety. You might fear that you have a serious illness despite being reassured by a healthcare professional, or worry repeatedly about the possibility of becoming seriously ill in the future.
You may find yourself seeking reassurance from your GP, undergoing repeated investigations or researching symptoms online. Alternatively, you might avoid medical appointments, physical exertion or other situations that trigger concerns about your health. You may become increasingly alert to bodily sensations and changes, finding it difficult to feel reassured for long before another concern arises.
Although these responses are understandable attempts to manage uncertainty and feel safe, they can inadvertently keep health worries going. Repeated checking and reassurance may provide temporary relief, while making it harder to develop confidence in your ability to tolerate uncertainty and respond differently when health-related fears arise.
Social anxiety
If you feel intensely anxious in social situations because you fear being judged, embarrassed, humiliated or evaluated negatively by others, you may be experiencing social anxiety.
You might worry about appearing weak, saying the wrong thing or making a poor impression. Physical symptoms can include blushing, sweating, trembling, a racing heart, nausea or a shaky voice. You may find it difficult to make eye contact, speak up or contribute to conversations.
Social anxiety can also affect how you feel before and after an event. You might spend considerable time anticipating what could go wrong, monitoring how you come across or replaying conversations afterwards, focusing on things you think you did badly.
Avoiding situations you fear, such as speaking in meetings, eating in front of others, making telephone calls or starting conversations, may bring short-term relief. Over time, however, avoidance can make these situations feel increasingly difficult and restrict your opportunities at work, in relationships and in your social life.
Generalised anxiety disorder (GAD)
If you find yourself worrying persistently about a range of everyday concerns, such as work, finances, relationships or health, you may be experiencing generalised anxiety disorder (GAD).
You might describe yourself as a worrier, with an almost constant sense of anxiety that shifts from one concern to another. You may find it difficult to stop worrying, even when you recognise that it is unlikely to help. Your mind may repeatedly anticipate what could go wrong, run through possible outcomes or try to prepare you for the worst.
Worrying can become time-consuming and exhausting, making it difficult to concentrate, relax, sleep or be present in everyday life. You may feel that you need to think through every possibility to prevent something going wrong or to ensure that you are prepared. Yet, despite the time and effort devoted to worrying, a lasting sense of certainty or reassurance can remain elusive.
Specific phobia
A specific phobia involves an intense, persistent fear of a particular object or situation that is out of proportion to the actual level of danger. Common examples include needles, spiders, dogs, snakes, flying or dental treatment.
When faced with the feared object or situation, you may experience intense anxiety and an overwhelming urge to escape. You might go to considerable lengths to avoid it altogether, even when you recognise that the level of fear is greater than the actual risk.
Avoidance can bring immediate relief, but it may also reinforce the fear and make it harder to approach the situation in the future. Over time, a phobia can interfere with everyday activities, limit your choices or prevent you from doing things that matter to you.
What can I expect from a CBT approach?
Cognitive Behavioural Therapy (CBT) is an evidence-based psychological treatment for anxiety disorders. It helps you understand how your thoughts, emotions, bodily sensations and behaviours interact, and how certain patterns of responding can maintain anxiety over time.
In therapy, we work together to identify what triggers your anxiety, how you interpret these experiences and what you do in response. We explore how avoidance, checking, reassurance-seeking and other safety-seeking behaviours may offer temporary relief while reinforcing the sense that a situation, sensation or uncertainty is something you cannot manage.
Depending on your difficulties, CBT may involve gradually approaching situations you fear, learning to tolerate uncomfortable sensations or uncertainty, and reducing reliance on behaviours that keep anxiety going. The approach is tailored to your particular difficulties and proceeds at a pace that allows you to develop understanding and confidence.
The aim is not to eliminate anxiety altogether. Anxiety is a normal human emotion, and attempting to avoid it entirely can itself become restrictive. Instead, CBT helps you develop a different relationship with anxiety, so that you can respond more flexibly to uncertainty and discomfort and engage more fully in the parts of life that matter to you.
Could a compassion-focused approach help me?
Compassion Focused Therapy (CFT) may be particularly helpful if your anxiety is accompanied by persistent self-criticism, perfectionism, shame or a deep sense of not being good enough.
You might judge yourself harshly for feeling anxious, criticise yourself for struggling with situations that seem manageable to others, or feel ashamed of your fears and the ways you respond to them. You may understand intellectually that your anxiety is difficult to control, yet still find yourself blaming yourself for experiencing it.
CFT helps you develop a more compassionate way of relating to yourself when you feel anxious or threatened. This involves understanding how your emotional responses have developed, recognising the origins and effects of self-critical thinking, and learning to respond to distress with greater warmth, courage and understanding.
Through approaches that may include breathing practices, imagery and developing a compassionate inner voice, you can begin to cultivate a greater sense of emotional safeness and build your capacity to tolerate difficult feelings without adding further layers of self-judgement.
Rather than asking you simply to think positively or force yourself to feel calm, CFT aims to help you respond to anxiety with greater understanding and less self-criticism. It can complement CBT and other evidence-based approaches, particularly when shame and harsh self-judgement are important parts of your difficulties.
Take the next step
Taking the first step towards therapy can feel daunting. Speaking to a few therapists can help you find someone you feel comfortable working with.
You are welcome to get in touch to arrange a brief telephone consultation, giving us an opportunity to explore whether I might be the right therapist for you.