For people stuck in constant “what if” thinking and chronic internal pressure
GAD often feels like a mind that won’t stop worrying, planning, anticipating, mentally rehearsing, yet never feeling settled. Many people appear capable and composed but feel internally exhausted.
I offer GAD therapy in Central London (W1 / W1W) and online, working with adults whose anxiety is maintained by worry habits, overcontrol, and avoidance of uncertainty and emotion.
My work integrates ISTDP, CBT and psychodynamic therapy, with a focus on what keeps worry going, and how it changes.
When GAD isn’t just “thinking too much”
You might notice:
- constant worry across multiple areas (work, health, relationships)
- difficulty relaxing even when things are fine
- mental rehearsal and “preparing for every outcome”
- tension, fatigue, insomnia, gut symptoms
- reassurance seeking or needing certainty
- self-criticism for worrying
The worry cycle
- Uncertainty or emotional trigger
- Worry starts (feels like problem-solving)
- Short-term relief/control
- Body stays activated (tension, adrenaline)
- More worry becomes the default → anxiety strengthens
How ISTDP understands GAD
From an ISTDP perspective, worry often functions as an internal coping strategy:
- staying in the head to avoid feeling
- controlling uncertainty to reduce anxiety
We work on increasing emotional capacity so worry no longer needs to do the job of regulating feelings.
How therapy helps
We work to:
- map your worry cycle and reduce “mental checking”
- build tolerance for uncertainty
- reduce overcontrol and perfectionism patterns
- work with the feelings worry is protecting against
- improve sleep and switching-off capacity
What sessions look like
Early sessions:
- identify triggers and worry habits
Ongoing work:
- practise different responses to uncertainty
- work with emotional drivers beneath worry
Related ways I work
- CBT – for worry habits, behavioural experiments, uncertainty tolerance
- ISTDP – for emotional inhibition and anxiety in the body
You may also find these pages helpful:
Frequently asked questions
Is GAD treatable?
Yes, particularly when the maintaining cycle is clear.
Do you offer online sessions?
Yes.
Do you work in W1W?
Yes.
Insurance?
See Fees & Insurance.
Next steps