Anxiety Therapy
Serving clients in Seattle, WA and via telehealth throughout Washington
If you need someone right now, call or text 988 to reach the Suicide & Crisis Lifeline, free, any time. If you are in immediate danger, call 911.
When Anxiety Looks Like Having It Together
A lot of anxious people look, from the outside, like the most dependable person in the room. They’re early. They’ve thought of everything. They answered the email before anyone else did. What nobody sees is the running commentary underneath: the rehearsing, the double-checking, the low hum of bracing for whatever goes wrong next.
Anxiety is an alarm system. Its job is to spot danger and get you moving, and it is very good at that job. Trouble starts when it stays switched on, sounding for unanswered texts and unfamiliar plans as if they were emergencies. Needing that alarm to keep things together doesn’t mean it has to run your life. Seven quick questions can give you a sense of how loud yours has been lately.
How Anxiety Shows Up
People usually notice one side of their anxiety and miss the others. It tends to show up in three places:
In your head
- Worry that jumps from one thing to the next
- Replaying conversations long after they end
- Running through worst cases “just in case”
- Trouble quieting your mind at night
In your body
- Tight chest or shallow breathing
- Stomach trouble with no clear cause
- Jaw, shoulders, or hands that are always tense
- Sudden waves of panic
In what you do
- Putting off calls, emails, or appointments
- Over-preparing, over-checking, over-planning
- Asking for reassurance that never quite lands
- Skipping things you want to do, to avoid the dread
If you’re mostly seeing yourself in the body column, that’s common. Plenty of people spend years seeing doctors about stomach trouble or tension before anyone mentions anxiety.
Sometimes the Alarm Is Right
Much of standard anxiety treatment assumes the fear is out of proportion to the situation. Sometimes it is. But for a lot of the people we work with, the nervous system is reacting to something real, and treating that as a thinking error misses the point.
- For autistic people, loud rooms, surprise changes, and hours of masking really are costly. When the environment is the problem, fixing the environment can help more than talking yourself out of the reaction.
- With ADHD, worry often starts as a workaround. If forgetting things has cost you before, constant checking is a reasonable strategy, just an exhausting one. Better systems for the executive-function side often quiet the worry that grew up to cover for it.
- After trauma, or as an LGBTQ+ person, staying on guard may be something you learned because you needed it. The work is not to call that paranoia. It is helping your body recognize the places and people where it can finally put the guard down.
Sorting out which alarms are accurate and which are miscalibrated is a large part of the work here, and it goes better with a therapist who already understands your context.
How We Work With Anxiety
The goal isn’t to get rid of anxiety. You need that alarm. The goal is for it to go off at the right times, and to settle once it has.
Therapy usually has two sides: understanding what sets your anxiety off, and practicing different responses to it. Depending on what fits, your therapist may use cognitive behavioral therapy (CBT) to catch the what-ifs before they snowball, and exposure work that moves step by step and at a pace you agree to. Acceptance and commitment therapy (ACT) can help you act on what matters even while worry is present. Internal Family Systems (IFS) looks at the parts of you that feel responsible for keeping everyone safe, and body-based approaches help you recognize and calm the physical side of fear.
For neurodivergent clients, we adapt rather than apply the standard playbook. Pushing through sensory distress isn’t the same thing as facing a fear, and your therapist will know the difference.
Reaching Out, at Your Own Pace
If making the first phone call is exactly the kind of thing you’ve been putting off, you don’t need to make one. Our Therapy Inquiry & Intake Form can be filled out whenever you’re ready, or you can write to [email protected]. If you’d rather keep things in writing, just say so.
You can meet by telehealth from anywhere in Washington, or in person at our office in Seattle’s University District. For some people, being in their own space makes it much easier to relax into a session.
We’re in network with most major Washington plans and Apple Health (Medicaid), and have sliding-scale rates for people paying out of pocket. Rates and accepted plans.
A Quick Anxiety Self-Check
Over the last two weeks, how often have you been bothered by the following problems?
This is a screening tool, not a diagnosis. It can help you put words to what you’re experiencing and give you somewhere to start.
Your answers stay on your device. Nothing is sent to us, saved, or recorded — closing this page erases them.
GAD-7 developed by Drs. Robert L. Spitzer, Kurt Kroenke, Janet B.W. Williams, and Bernd Löwe, with an educational grant from Pfizer Inc. No permission required to reproduce or distribute.
Frequently Asked Questions
Stress usually has a clear source and eases when that source does. Anxiety tends to outlast the situation, attach itself to new things once the old ones resolve, or show up with no obvious cause at all. If worry is shaping what you do — what you avoid, how much you prepare, how you sleep — it is worth talking about, whatever you call it.
If you want something more concrete, the seven-question GAD-7 below takes about a minute, and your answers never leave your device.
You Can Start Small
One form or one email is enough. No phone call needed, and no need to have the right words yet.