The message you rewrote eleven times
It is a two-sentence reply to a colleague. You have adjusted the punctuation, removed an exclamation mark, put it back, read it aloud, and it is still sitting in the box unsent.
Specialties
Therapy for Anxiety Disorders in Santa Monica, CA
Anxiety is a persuasive negotiator. It promises that one more check, one more rehearsal, one more search will finally deliver certainty. It even pays out — briefly — which is exactly how it teaches you to come back. Therapy is less about arguing with it and more about noticing how much of your life it has quietly been allowed to schedule.
What It Is Actually Like
When the pattern is costing more than anyone can see
You may have constant low-grade worry, panic symptoms, social fear, health anxiety, perfectionism, or a mind that keeps producing contingency plans hours after planning stopped being useful. From outside this reads as being prepared. From inside it is a second job with no end of shift and no pay.
It also shows up as irritability, procrastination, indecision, reassurance-seeking, overwork, thin sleep, and skipping things that actually matter to you. Most of my anxious clients can explain in detail why the feared outcome is unlikely. Their body remains entirely unpersuaded. Knowing the statistics has never once talked a nervous system down.
There is a particular version common in high performers where the anxiety is credited with the success. You believe the dread is what makes you thorough, so you protect it. Then it expands, as it does, and now it is also handling your weekends.
You Might Recognize This
Not a symptom list. A Tuesday.
The event you attended twice
Once in advance, all week, in your head, rehearsing conversations that never happened. Then once in person, where it was fine, and you spent most of it monitoring how you were coming across.
The symptom you looked up
You checked. It said something reassuring. That lasted a little under an hour, and then you checked a different source, because certainty is the one thing the internet cannot actually sell you.
The decision waiting on unanimous approval
You have asked four people. Three agree. You are looking for the fourth, not because you need the information, but because you need somebody else to hold the risk with you.
What People Bring Me
What usually gets named on the first call
Nobody arrives with a tidy summary. These are the versions I hear most often, and what the work is pointed at once we start.
Common challenges
- A mind that treats every unread message as evidence
- Rehearsing conversations that have not happened yet
- Physical symptoms that convince you something is wrong
- Decisions delayed until the risk of deciding feels smaller
- Reassurance that works for an hour and then wears off
- Avoidance that looks like good planning from the outside
What we aim the work at
- Taking your world back from what you have started avoiding
- Tolerating uncertainty rather than resolving it each time
- Dropping the checking and reassurance that keep it fed
- Letting the physical wave crest without intervening
- Making decisions at a normal cost
- Sleeping without a rehearsal running
Direction, not a promise. Nobody can guarantee where therapy lands, and I will not pretend otherwise.
The Work
What the first month looks like, and the sixth
01
First we identify your specific loop: trigger, prediction, body response, safety behavior, short-term relief, long-term cost. Naming it takes most of the mystery out and shows us exactly where change is available. Different anxieties need different experiments — panic, social anxiety, and health anxiety are not one thing, and general reassurance is useless for all three.
02
Then, gradually and with your agreement, we reduce the behaviors that keep the fear untested: checking, avoiding, over-preparing, and outsourcing certainty to other people. This is exposure-informed work and it is planned, paced, and never a surprise. I will ask you to do things between sessions — send the message without the eleventh edit, sit with the physical sensation for ten minutes without leaving, make one decision with three people's input instead of five. Small, specific, and agreed in advance.
03
We build regulation skills alongside that, for the moments when the body is loud: orienting to the present, slowing your action down, tolerating a physical surge without treating it as evidence. These support engagement. They are not there to make every uncomfortable sensation disappear before you are permitted to proceed, which is just avoidance with better branding.
04
The deeper work asks why a mistake feels catastrophic, whose disappointment you are actually anticipating, what the worrying is keeping you from feeling, and when control became inseparable from safety. This matters especially when anxiety improves in one domain and promptly relocates to another, which it will do if we only ever treat the surface.
05
We track progress in ordinary terms: whether the message goes without eleven edits, whether you attend without a week of rehearsal, whether you can decide without a consensus. Observable directions, not promised outcomes.
Modalities
Skills and understanding belong together
I integrate DBT, CBT, and psychodynamic or relational work according to the person and the problem—not because every hour needs every acronym.
CBT and exposure-informed practice
CBT gives a clear structure for testing anxious predictions and changing the behaviors that maintain fear. Exposure work is collaborative and graded — we agree on the step, discuss the rationale, and look at what you learned. The point is credible learning, not positive thinking.
DBT for distress and uncertainty
DBT-informed mindfulness and distress tolerance help you notice anxiety without immediately obeying it. Emotion-regulation work also handles the unromantic inputs — sleep, stress load, vulnerability factors — that decide how loud the alarm is before anything even happens.
Psychodynamic work for the need under the control
Psychodynamic and relational work explores the history and meaning of vigilance, achievement, reassurance, and avoidance, and helps explain why one particular uncertainty carries so much more weight than the rest.
Specifically, for this
- Exposure planned collaboratively and paced to be genuinely doable
- Response prevention for checking, reassurance, and mental review
- CBT for overestimated threat and underestimated coping
- Interoceptive work when the body is the frightening part
- Psychodynamic work on what the worry is standing in for
- DBT skills for the nights it spikes past what skills alone can hold
Closely Related
Where this work often widens
Perfectionism, which is usually the real referral
A large proportion of the anxiety I treat arrives dressed as high standards. The distinguishing feature is not the quality of the work; it is what happens afterward. If completing something well produces relief rather than satisfaction, and the relief lasts under a day, that is not standards. That is a threat-avoidance system with a good résumé.
The work here is uncomfortable in a specific way, because it involves deliberately doing some things to a lower standard and finding out what actually happens. Sending the adequate version. Leaving the slide unpolished. Most people find this considerably harder than exposure to their stated fears, which tells you where the real load-bearing wall is.
Plainly
What I am honest with you about
Where progress is slow, what therapy will not fix, and what the work asks of you.
- Exposure-informed work feels worse before it feels better, and there is no way around that. Anxiety goes up when you stop doing the thing that has been bringing it down. We plan for that, we go at an agreed pace, and I will not spring anything on you — but I am not going to pretend the middle is pleasant.
- Anxiety also tends to relocate. Treat the checking and it may show up as rumination; treat the rumination and it may appear as a physical preoccupation. This is why we do not stop at the surface, and why the work takes longer than a symptom-focused protocol implies.
- Therapy will not deliver certainty, which is the thing anxiety actually wants. The realistic target is a life where uncertainty no longer has to be resolved before you are allowed to speak, rest, decide, or move.
- Sustained improvement almost always depends on what happens between sessions. Insight in my office is pleasant and largely inert; the learning happens when you do the agreed thing on a Wednesday without me there.
In My Practice
How this shows up for the people I see
Questions
Common questions about anxiety disorders therapy
Will you make me face my worst fear immediately?
No. Exposure-informed work is planned collaboratively and graded. We discuss the rationale, agree the step, and review what you learned. Surprise is not a treatment method.
Can therapy help panic attacks?
Therapy addresses the fear of bodily sensations, the avoidance that follows, catastrophic interpretations, and regulation. Timelines vary, and medical evaluation may be appropriate where symptoms are new or unexplained.
What if anxiety is part of my success?
We do not need to remove your care, ambition, or preparation. We do need to see where the anxiety adds useful attention and where it is only adding suffering, rigidity, and avoidance.
Do you treat anxiety by telehealth?
Yes, for clients physically located in California when telehealth is clinically appropriate. In-person sessions are available in Santa Monica.
A Place To Begin
The aim is not a life without uncertainty. It is a life where uncertainty no longer has to be solved before you can speak, rest, decide, connect, or move forward.
- · Individual therapy, 50 minutes, $300
- · Telehealth anywhere in California, or in person in Santa Monica
- · Free consultation call before anything is scheduled
- · Private pay with superbills for out-of-network reimbursement