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Anxiety Therapy in Central London (W1W) & Online

For people who appear to be coping, but feel constantly tense, driven, or unable to switch off

Many people I see for anxiety are functioning well on the outside. They work, perform, meet expectations, yet internally feel on edge, overcontrolled, or mentally exhausted. Anxiety may show up as overthinking, constant pressure to “get things right”, difficulty resting, or physical tension that never fully settles.

I offer anxiety therapy in Central London (W1 / W1W) and online, working with adults whose anxiety is maintained by internal pressure, emotional inhibition, and threat-based habits, not just worry.

My work integrates evidence-based approaches including ISTDP, CBT, and psychodynamic therapy, with a strong focus on how anxiety is maintained in the present, and how it can change.

When anxiety isn’t just worry

Anxiety is often described as “excessive worry”, but for many people it looks different:

  • Constant mental effort, monitoring, or self-criticism
  • Feeling driven, pressured, or unable to slow down
  • Tension in the body, jaw, chest, stomach, or shoulders
  • Avoidance of rest, emotions, or certain situations
  • Difficulty knowing what you actually feel, beyond “stressed” or “anxious”
  • Strong responsibility for others, fear of disappointing, or fear of losing control

In these cases, anxiety isn’t random. It is often doing a job, regulating emotions that feel unsafe or unfamiliar.

The anxiety cycle (how it keeps going)

Across different presentations, anxiety tends to follow a familiar pattern:

  • Pressure, uncertainty, or emotional triggers arise
  • The mind interprets threat (“I can’t let this go wrong”)
  • The body activates (tension, adrenaline, restlessness)
  • You respond by:
    • overthinking or analysing
    • controlling feelings or behaviour
    • avoiding rest, conflict, or vulnerability
    • pushing yourself harder
  • Anxiety drops briefly
  • The nervous system learns control = safety
  • Anxiety returns stronger and more automatic

Over time, anxiety becomes the default way of managing internal experience.

How ISTDP understands anxiety

From an ISTDP perspective, anxiety is not the core problem, it is a signal.

Anxiety rises when emotions that matter (such as anger, sadness, closeness, or assertiveness) are activated but not yet tolerable or safe to experience. The nervous system shifts into anxiety as a protective response.

Different people experience anxiety differently:

  • muscle tension
  • gastrointestinal symptoms
  • chest tightness or breath restriction
  • mental overactivity or detachment

ISTDP therapy focuses on:

  • identifying what feelings trigger anxiety
  • understanding how anxiety is managed in the body
  • gradually increasing emotional capacity so anxiety no longer needs to take over

Rather than teaching you to manage anxiety forever, the aim is to reduce the need for anxiety altogether.

How therapy helps with anxiety

Therapy is active, collaborative, and focused on change in daily life. We work to:

  • Identify your specific anxiety pattern (not a generic model)
  • Understand what emotions or pressures anxiety is regulating
  • Reduce reliance on overthinking, control, or avoidance
  • Build the capacity to feel without flooding or shutting down
  • Develop new responses that reduce anxiety at its source

This approach is particularly helpful for high-functioning adults, professionals, and people who feel stuck despite insight or previous therapy.

What sessions usually look like

Early sessions

  • Clarifying how anxiety operates for you
  • Mapping emotional and bodily patterns
  • Understanding what anxiety is protecting you from

Ongoing work

  • Working directly with anxiety in session
  • Increasing tolerance for feelings that have been avoided
  • Reducing internal pressure and self-attack
  • Translating emotional change into real-world behaviour

Sessions are usually weekly initially and adapted over time.

Related ways I work

Depending on your presentation, therapy may integrate:

  • ISTDP, when anxiety is linked to emotional inhibition, overcontrol, or relationship patterns
  • CBT, for avoidance, fear of sensations, and behavioural loops
  • Psychodynamic therapy, for longer-standing patterns and relational themes

You may also find these pages helpful:

Frequently asked questions

Is anxiety always caused by stress?
Not always. Anxiety can be triggered by stress, but it is often maintained by how emotions and pressure are managed internally.

What if I’ve tried CBT or therapy before?
Many people come after previous therapy that helped them understand anxiety but didn’t reduce it. We work differently, focusing on what anxiety is regulating.

Do you offer therapy in Central London?
Yes. I work in person in W1W and online.

Do you work with insurance?
I work with several major insurers. Please see Fees & Insurance for details.

Next steps
If this description fits your experience, therapy can help you change the pattern, not just manage symptoms.