Anxiety is the most common reason people walk through my door. After 13 years as a CBT therapist, I've worked with hundreds of people who've been living with it, some for months, others for decades. What strikes me every time is how much people put up with before asking for help.
How anxiety actually shows up
You already know the obvious stuff. The racing heart. The tight chest. The feeling that something terrible is about to happen even when you can't say what.
But anxiety is sneaky. It disguises itself. Maybe you've become the person who always cancels plans. Maybe you check things three or four times before leaving the house. Maybe you lie awake at 2am running through every possible thing that could go wrong tomorrow. Maybe you avoid motorways, or lifts, or phone calls, or conflict.
Maybe you've stopped noticing it because it's been there so long it feels like part of who you are.
It isn't. Anxiety is a pattern. Patterns can be changed.
How CBT works for anxiety
CBT is the gold standard treatment for anxiety disorders. That's not marketing. It's what the research says. NICE recommends it as a first-line treatment for generalised anxiety, social anxiety, panic disorder and health anxiety.
Here's the basic picture. When you're anxious, three things interact: what you think, how your body responds, and what you do about it. Anxious thoughts trigger physical symptoms. Physical symptoms feel like evidence that the thoughts are true. So you avoid whatever triggered the whole thing. And avoidance, the thing that feels like it's keeping you safe, is exactly what keeps anxiety alive.
In CBT, we work on all three areas. We identify the specific thoughts driving your anxiety and test whether they're accurate. We address the physical symptoms with practical techniques. And we gradually reduce avoidance so your brain learns that the feared situation isn't actually dangerous.
Types of anxiety I treat
Anxiety isn't one thing. It shows up in different ways for different people:
- Generalised Anxiety Disorder (GAD) is persistent, excessive worry about multiple areas of life. Work, health, family, finances. The worry feels uncontrollable and it's there most days.
- Social anxiety is an intense fear of being judged, embarrassed, or humiliated in social situations. It goes far beyond shyness.
- Health anxiety is a preoccupation with the idea that you're seriously ill, or that you will be. Checking symptoms online makes it worse, not better.
- Panic disorder involves recurrent panic attacks and a persistent fear of having more. People often end up in A&E convinced they're having a heart attack.
Each type responds well to CBT, but the approach varies. I don't use a one-size-fits-all protocol. The techniques I use for health anxiety are different from those I use for social anxiety. That specificity matters.
What the first session looks like
You'll probably be anxious about coming. That's fine. I'd be surprised if you weren't.
The first session is an assessment. I'll ask you about your anxiety: when it started, what triggers it, how it affects your daily life, what you've tried before. You'll do most of the talking. I'll ask questions to fill in the gaps.
By the end of that first session, I'll explain what I think is going on and how I'd suggest we tackle it. I'll give you a rough idea of how many sessions we'll need. And you can decide whether you want to go ahead. No pressure.
How many sessions does it take?
For most anxiety disorders, 8 to 16 sessions is typical. Some people need fewer. If you've been living with severe anxiety for years and it's deeply entrenched, it might take a bit longer.
I review progress regularly. If we're not making headway by session 6 or 7, I'll say so and we'll adjust the approach. I'm not interested in keeping you in therapy for the sake of it.
A real example
I worked with someone in their 30s who hadn't driven on a motorway in four years. The anxiety had spread. First it was motorways. Then dual carriageways. Then any road they didn't know well. Their world had got smaller and smaller.
We started by mapping out the pattern: the catastrophic thoughts, the physical sensations, the avoidance. We worked through the thought distortions. Then we built a gradual exposure plan. Nothing dramatic. Small steps, each one building on the last.
Twelve sessions later, they drove to Manchester on the M56. Not comfortably. Not without any anxiety at all. But they did it. And then they did it again the following week. That's what progress actually looks like. Not the absence of anxiety, but the ability to do what matters despite it.
Pricing and next steps
Sessions are £60 for 50 to 60 minutes. I offer concessions for military veterans, serving personnel, and blue light workers.
If anxiety has been running the show, it's time to do something about it. You can book a free 15-minute phone consultation or call me on 07469 870 295. That first conversation is just a chat about what's going on and whether I can help.
You can also read more about my general CBT approach or explore how I work with related issues like depression, OCD, and PTSD.
