A Therapy Session Focused on Reducing Anxiety

Anxiety is the number one reason people come into therapy. Are you trying to manage life with anxiety?  Imagine what your life would be like if you were able to minimize your anxious thoughts?  Imagine what your days will be like with more calmness. You may have thought about working with a therapist but just haven’t taken that step. When we are faced with the unknown we tend to avoid.  I thought it might help if I shared with you what may happen in a therapy session with me as we work together on reducing that anxiety you’ve been living with.   Follow along as if you are in session with me.  Think about the questions. How would you answer them? Take notes. Go ahead and perform the coping exercise I describe.    
 
Now imagine you just walked into my calming office. Take a seat, anywhere you’d like.  

Let’s begin . . .
 
I’d like to get to know a bit more about your goals and history of anxiety. 
 
What would you like to gain out of therapy and particularly this session?

Anxiety feels different for everyone so therapy with me is very personalized for your specific issues.  It’s also important to realize that therapy is a partnership between you and me – the therapist.  I will be here to guide you, gently push you and help you realize that with your participation you can minimize your anxious thoughts. 
 
Have you ever been diagnosed with an anxiety disorder such as Social Anxiety, Obsessive-Compulsive Disorder, Panic Disorder, Post Traumatic Stress Disorder, or any specific phobia?  
 
Let’s get more specific about your goals. If you don’t have a goal in mind you won’t know when you’ve gotten there. What three goals are you looking to gain?  They may be something like, decreasing your number of panic attacks, reduce your anxiety around specific relationship issues, decreasing performance anxiety at work. Share what your three goals are - the more specific, the better.   Write them down. 
 
For each goal I’d like to know how your life would be different when you reach each goal.  For example, “I’ll be able to perform better at work”,  “It’ll be easier to socialize with others”, “I will have more days of the week with no panic attacks”.  Write down how you imagine your life will be different with minimal or no anxiety. 
 
In order to continue to measure your improvement I will most likely have you complete a GAD-7 quick assessment often. It’s an easy 7 question rating scale.  I’d like you to complete it at least once or twice a week.  Completing this easy rating scale will help you track your improvement.  I will provide you access to this assessment. 
 
Let’s put some focus on your symptoms and how they manifest for you.  This is very important.  Here are a few more questions. 
 
How long have you been trying to manage your anxiety?
When does your anxiety affect you the most – at home, when you first wake up, at work, socially?
When did your anxiety begin affecting you?  
What treatments have you had in the past?  What treatments helped and which ones didn’t?
 
It’s important to discuss triggers. What are your triggers that cause anxiety?  For example, chronic stress, health issues, domestic violence, military duties, financial concerns, not feeling safe, etc.  Write down all of your triggers. 
 
How have you been coping with your anxiety, if you have at all? For example, do you have specific ways of distracting yourself from the anxious thoughts?  Behavioral coping skills might be walking away, exercising, taking a nap, focusing on slow breathing, etc. Some cognitive coping skills could be thinking positive thoughts, saying positive affirmations, brainstorming about solutions, thinking through and making a to-do list. Write down some ways you’ve been coping with your anxiety. 
 
You need actionable strategies and skills to overcome your anxiety. 
Having a physical awareness is important. What are your physical / emotional reactions to anxiety?  Headaches, butterflies in your stomach,  hands are shaking, feeling nauseous, your heart feels heavy today or an overwhelming feeling of just not feeling right. 
 
Focusing on your physical symptoms are very important.  Your physical feelings work hand in hand with your thoughts.  That’s the body and mind connection.  We need to regulate our body first to regulate our mind.  Lets focus on your body first so that you can regulate your mind.  We can’t focus on one and ignore the other.
 
I’d like you to work through this exercise so you can enhance your body and mind connection.  You’ll be scanning your body with purpose so that you can regulate your body naturally.  This is called a Somatic experience which focuses on the body.  You can help your body calm down naturally.  And remember you can’t relax your mind if you’re physically having issues such as trembling hands, headaches, pounding heartbeats. 
 
Dr. Peter Levine is the founder of Somatic Experiencing and introduced it in 1997.  He introduced the exercise I’m going to describe below which will work through your physical symptoms.   This exercise gently invites awareness back into the body and can create experiences of safety and calm.
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Go ahead and follow along below. 
 
Somatic Exercise:
 
Get comfortable, sitting or laying down, at first you'll need to read through the instructions but eventually it's beneficial if you close your eyes.

Put one hand on your forehead and one hand on your heart.  Think about a mildly anxious moment and notice how you are physically feeling.  How is your body responding? Just let yourself feel it.  Pay attention to your hand on your forehead. Just be there and focus on your hand on your forehead.  Don’t rush it. Notice any response. 
 
Now focus on your hand on your heart. Don’t do anything, just observe.  Focus on any physical feelings. No need to address anything, just notice any feeling you have. 
 
Now go inside your body by focusing on any area between your hands, notice any sensations on your forehead, face, neck, shoulders, chest. Notice any physical feelings. How do those body parts feel? Do they feel tense, soft, fidgety, or comfort. Just notice it, be curious.  Be with those sensations and wait for the shift. Notice how you are breathing, stay there, notice it.  
 
Now take your hand from your forehead and place it on your belly. Now focus on the sensations in your belly. Is it relaxed, tense, warm, cold, heavy, and/or tingling? No need to do anything, just notice the physical feelings and wait for the shift or change in your body.  
 
Now bring your attention to what’s going on. Notice any sensations that are going on in your entire body - your chest, back, neck, arms, fingers. Wait to notice any shift or change. 
 
Now take both hands and place them on your thighs.  What sensations are you feeling? Gently press. Be observant, no need to do anything. Let your body just happen. Notice how it feels. Your body will regulate itself inside and outside. Notice how you are breathing. 
 
Count to three and slowly open your eyes and take a deep breath and bring your attention back to the room.   Notice any shifts you may be feeling now. What specific parts were regulated? Give yourself 5 minutes to focus on your body. 
 
What body parts were stable and relaxed?
Notice the relaxation in your body now?
If there is some tension, what got in the way?  
Were you able to get out of your mind and focus on your body? 
Do you feel safe in your body and your environment now?    
 
The two key concepts in this exercise are feeling a sense of safety and a sense of present moment in your body. 
 
This beautiful mindfulness exercise only takes 5-10 minutes.  It becomes easier and you will be  better able to focus the more often you do it. This will create a better relationship within yourself and enable a sense of compassion and curiosity. 
 
I encourage you to practice this self-holding exercise at least two times a day in a neutral setting and neutral mood.  Then describe how your mood is each time you complete this.  Utilize a 10-point scale with 0 being neutral and 10 being very anxious. It’s important to check in with yourself.  Practice this coping skill daily. 

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If anxiety is something you’d like to reduce and you’re ready to begin healing, feel free to reach out to me.  Schedule a free 15-minute consultation with me or go ahead and call to set up an appointment.  At the moment I’m scheduling appointments about a month out, unless I get a cancellation.  So don’t put this off. 
 
At the onset of this article I asked that you “Imagine what your life would be like if you were able to minimize your anxious thoughts?  Imagine what your days will be like with more calmness.”  I don’t want you to have to only imagine that any longer. I want you to begin living it.   I’m looking forward to hearing your story.

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I am a licensed Marriage & Family Therapist who can provide services with anyone who resides   in the State of California. I have also been trained in Clinical Hypnotherapy which is beneficial for more specific goals.
Liz Birch, LMFT, CHt ~ 714-584-6047 ~ [email protected]

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​​The information provided through this website is for informational purposes only.
​This information is not intended to and does not create a therapist-client relationship. ​