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CBT for Anxiety

Nicole Bitter, LMFT

Cognitive Behavioral Therapist

Schedule a complimentary, 15-minute consultation, today!

Successfully Overcoming Anxiety

I offer comprehensive, accelerated and customized treatment plans to address all forms of anxiety. With Exposure Response Prevention (ERP) for certain types of anxieties, we can gain powerful and significant symptom reduction. Using ERP, I customize your treatment plan with creative and innovative exposure methods to tackle OCD, Social Anxiety and Panic. With your hard work and my skills, together, we can tackle any form of anxiety.


Anxiety is a normal reaction to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention. Anxiety disorders differ from normal feelings of nervousness or anxiousness, and involve excessive fear or anxiety.

More often than not though we become anxious for reasons that are not life threatening. This is where anxiety becomes a problem.

People will behave in such a way that will potentially earn a reward, prevent dreaded consequences from happening and/or maintain their safety. For example; when someone is afraid of needles or syringes, upon encountering them they become anxious. To manage their anxiety they may flee, try to avoid places where they may encounter needles (e.g. dentists, doctors, hospitals, etc.) and/or get others to check the environment for needles and syringes and seek reassurance.

This behavior may work in the short term (it may reduce anxiety felt at the time) but it maintains the fear of needles and syringes. Others who worry about their health are more likely to panic if they mistake sensations of anxiety for other physical problems (e.g. the pounding heart and chest pains may be misinterpreted as a sign of impending heart attack).

Sometimes people do not even need to be in the presence of the trigger for their anxiety to escalate, feel anxious – it may be a thought which remains unconscious in their awareness or threat of contact which is enough to activate the anxiety response, carefully avoiding what might increase anxiety while engaging in safe or reassurance seeking behaviors. This maintains the belief that anxiety is dangerous.

The following are common symptoms of anxiety and panic attacks:

  • Pounding heart

  • Sweating

  • Trembling or shaking

  • Shortness of breath

  • Sensation of choking

  • Nausea or abdominal pain

  • Dizziness or light-headedness

  • Feeling unreal or disconnected from oneself

  • Fear of losing control

  • Fear of "going crazy" or dying

  • Numbness

  • Chills or hot flushes

  • Tingling in the fingers and/or toes

  • Physical symptoms that mimic a heart attack and/or chest pain

Panic attacks occur when one is exposed to a "situational cue"– for example being trapped in an enclosed space or exposed to a feared object with no avenue of escape – whereas Panic Disorder appears to the sufferer to have no identifiable trigger, often being described as "coming out of the blue."

The incidence of irritable bowel syndrome is higher among people with anxiety and panic disorders than among that of the general population. Drugs and alcohol may be abused as a means to relieve the effects of anxiety.

Anxiety Treatment

Methods I use in Cognitive Behavioral Therapy will vary according to the type of anxiety and problems you encounter.

The first steps, following a full assessment, are to construct a formulation of the problem unique to the patient. This will then be used to guide the focus of any interventions and methods used.

Possible interventions include Advanced Empathy and motivational techniques, Extensive Cognitive Methods, Graded Exposure, Response Prevention, Habit Reversal Training, Verbal Reattribution, Thought Action Diffusion, Doubt Reduction techniques, challenging of specific thoughts and/or misinterpretations through socratic questioning, behavioral tests and experimentation.

Final stages of therapy include relapse prevention strategies.

Please feel free to contact me today at 408-680-3811 with any questions you have, or click the button below to schedule an initial assessment. I look forward to working with you!
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