I am a licensed clinical psychologist with close to 20 years of experience working with adults who are managing a lot on the outside and dealing with significant anxiety on the inside. The people I work with most often are analytically minded and high-achieving. They understand their anxiety well enough to explain it. What they haven’t been able to do isrespond to it differently. That gap between understanding and actual change is where therapy work tends to be most useful.
Most people who come in for anxiety therapy are not falling apart. They are doing what they have always done: pushing through, preparing thoroughly, staying ahead of what could go wrong, keeping everything together. They are good at it. But underneath, there is a constant hum that does not switch off. Their bodies are always tight. Their minds are always scanning. Even walking along the Brooklyn Heights Promenade on a quiet morning, surrounded by nothing threatening, they cannot quite exhale.
What brings someone in is not usually a crisis. It is the recognition that avoidance is making things worse, not better. The situations avoided have quietly multiplied. The overpreparation is taking more time than the task itself. A pattern in relationships or at work keeps showing up regardless of the circumstances. They know the anxious thought is distorted. But knowing has not changed anything. There is a real difference between insight about anxiety and the ability to respond to it differently.
People with high-functioning anxiety tend to look fine from the outside. Here are some signs that working with an anxiety therapist could be useful:
We tend to start by getting curious together. What is the anxiety actually responding to? What are the thoughts that show up in the difficult moments, and what do they assume about the situation? What behaviors have developed around the anxiety, and are they helping or making things stickier? Most people I work with have already asked these questions. The difference in therapy is that we slow them down, look at them carefully, and figure out what is actually true versus what the anxious part is insisting is true.
Anxiety that you manage is not anxiety that has changed. There is a difference.
I am a licensed clinical psychologist with close to 20 years of experience working with adults. Anxiety is one of the areas I work with most often, and it is where I have seen some of the most meaningful, lasting change. The people I work with tend to be analytically minded, which means they often understand their anxiety quite well.
What has been harder is making it actually respond differently. That is where having both a clear framework and a genuinely collaborative working relationship makes the biggest difference.
People tell me the work with me feels both structured and warm. There is a clear direction and a real framework, and there is also room to explore, to be a person in the room, and to work at a pace that is challenging without being overwhelming. I push, but gently. I have a steady belief that anxiety is something that can actually change, and I bring that into every session.
My approach is always shaped by what is actually going on and what someone is ready to work with. These are the primary frameworks I draw from, and most of the time, the work involves more than one.
CBT is the foundation of my anxiety work. Most people I work with are already doing some version of this on their own, trying to talk themselves out of their anxious thoughts. CBT gives that process a clearer structure and better tools. It operates on a straightforward premise: the way you interpret a situation drives how you feel about it, and how you feel drives what you do. For high-functioning anxiety, the interpretations are often subtly distorted in ways that are hard to catch because they feel like accurate assessments. In CBT, we slow them down, examine whether the evidence actually supports the thought, and build more accurate and less anxiety-amplifying ways of seeing the situation.
What this looks like in sessions:
ACT is something I incorporate often for people whose insight has outpaced their ability to change. Many analytically minded people can identify the distorted thought, explain exactly why it is distorted, and still find that the anxiety does not respond. ACT addresses the relationship to the thought rather than its content. It focuses on observing the thought without being controlled by it, clarifying what you actually value, and taking action in the direction of those values, even when anxiety is present.
What this looks like in sessions:
Avoidance feels like the right move in the moment. The problem is that it reinforces your anxiety. Avoidance is one of the most powerful ways anxiety stays in place. Every time a feared situation is avoided, the avoidance provides temporary relief and confirms to your nervous system that the threat was real. ERP involves gradually approaching what has been avoided without performing the compulsive or safety behaviors that make the discomfort go away faster. This way, the brain can learn that the feared outcome is both more unlikely and more manageable than the anxiety insists. For OCD and anxiety organized around avoidance, this tends to be where the most meaningful change happens.
What this looks like in sessions:
A significant part of what keeps anxiety going is the attempt to avoid feeling it. When the anxious sensation feels dangerous, the instinct is to push it away, analyze it at a distance, or keep moving so it cannot catch up. In the work we do, I help people actually get in touch with what anxiety feels like, understand what it is responding to, and learn to exist alongside it without needing it to disappear before action is possible. When that happens, the anxiety tends to become less urgent and less controlling.
What this looks like in sessions:
For many people with high-functioning anxiety, the anxiety is layered with harsh self-criticism. The standard feels impossible to meet, and falling short confirms something they already believed about themselves. Compassion-focused approaches work directly with the critical internal voice, examining where it came from, what it has been protecting, and how to build a more accurate and less punishing relationship with yourself. This tends to reduce the anxiety that self-criticism amplifies.
What this looks like in sessions:
Anxiety rarely stays neatly contained.
It shows up as worry in relationships.
Avoidance at work.
And perfectionism in the way one talks to themselves at night.
Generalized anxiety looks like worry that doesn’t always come with a clear reason.It can attach to work, health, relationships, finances, or things that have not happened yet. The worry cycles and does not resolve, even when the situation does. People describe it as their mind just spinning, as being very loud inside, or as needing to always be doing something to keep it at bay. The anxiety keeps reminding them it is still there. In CBT, we look closely at what the worry is actually responding to, what thought patterns are feeding it, and how to interrupt those patterns before they take over.
Social anxiety is often about the fear of being seen poorly, criticized, or evaluated negatively. For high-functioning people, it often shows up as dread before meetings or presentations, overthinking what was said afterward, holding back in situations where they would otherwise contribute, or avoiding things where the outcome feels uncertain. They can recognize that the fear is out of proportion and still feel it completely. CBT helps identify what the anxious assumptions are, where they come from, and what behavioral experiments might actually test them against reality.
Panic attacks are intense, frightening physical events: racing heart, shortness of breath, dizziness, a sense that something is seriously wrong. The experience itself is not dangerous, but it feels like it is, and that experience becomes the object of fear. People begin to avoid the situations that might trigger panic, which quietly narrows their lives over time. Treatment works directly with the misinterpretation of the physical sensations, the avoidance that follows, and the gradual restoration of approach behavior. The goal is not to prevent panic but to stop being controlled by the fear of it.
Health anxiety involves a persistent fear that something is physically wrong, often despite medical reassurance that it is not. Every new sensation becomes potential evidence. Reassurance provides brief relief and then requires more reassurance. The checking and researching behaviors maintain the cycle rather than resolving it. In sessions, we work on the interpretation patterns that drive the anxiety, the reassurance-seeking behaviors that keep it active, and the gradual ability to tolerate uncertainty about health without the cycle starting again.
OCD often involves intrusive thoughts that feel intense, urgent, and difficult to ignore. They can carry a sense of importance that is hard to shake, even when part of the mind recognizes they may not fully make sense. In response to the anxiety, patterns like checking, avoiding, repeating, or seeking reassurance can take hold. These compulsive responses often bring brief relief, but the cycle tends to continue. Over time, compulsions reinforce and maintain the obsessive thoughts.
OCD can show up in different ways. It may center around contamination, checking, fears of causing harm, or a strong need for things to feel just right.
In exposure and response prevention (ERP), the work involves gradually facing situations that trigger anxiety while beginning to step back from the usual responses. This creates space for the brain to learn that the feared outcome is not as certain as the OCD insists.
Perfectionism often presents as high standards or conscientiousness, but underneath it is a fear-driven system. No one needs to be perfect as much as some people feel they do. Mistakes feel catastrophic. The bar keeps moving, so nothing is ever quite good enough. The self-criticism is relentless, and the anxiety about not meeting the standard is constant. For the high-functioning person, perfectionism often looks like success from the outside and like exhausting pressure from the inside. Therapy examines where the perfectionist system came from, what it has been protecting, and what a more realistic relationship with standards and mistakes could look like.
Avoidance is how anxiety sustains itself.Each time a situation is avoided, the anxiety treats that avoidance as proof that the situation was dangerous, and that getting out of it was the right move. Over time, more and more situations fall into the avoided category, and the life someone is living quietly shrinks. Procrastination is often a form of avoidance. Tasks get put off because they feel uncertain or carry the possibility of being evaluated, and delaying them pushes off the feared outcome. In therapy, we map what has been avoided, understand why, and begin approaching it gradually in ways that are manageable rather than overwhelming.
For many people, the confusing part of anxiety is that understanding it has not changed how it feels or how it shows up.
High-functioning anxiety is not a formal diagnostic category, but it describes something very recognizable. It is anxiety that coexists with outward productivity, achievement, and the appearance of having it together. The person is managing their responsibilities and meeting their obligations, often at a high level. What is happening underneath is a persistent, effortful state of vigilance, worry, and tension that does not match what the situation actually requires. The functioning is real. The anxiety is real. The two coexist, and the functioning often masks how much the anxiety is actually costing.
Anxiety has both mental and physical symptoms. For many people, the physical ones are the first to become obvious. The mental symptoms are often ones that have been present long enough to feel like a personality trait rather than a clinical concern.
For most people, the anxiety feels completely convincing in the moment, even when part of them knows it might not be accurate. Anxiety is sustained by specific thinking patterns that make the threat feel more certain, more catastrophic, and more immediate than it actually is. These patterns operate quickly and automatically, which is why they are so hard to catch in the moment.
Most people struggling with anxiety are not just thinking about it. They are organizing their days around it in ways they may not have fully noticed. What makes anxiety a problem in daily life is often less about the feeling and more about what people do in response to it. The behaviors that provide short-term relief are typically the ones that maintain anxiety long-term.
A lot of people living with anxiety notice that the problem is not just how they feel. It is how much energy goes toward managing it. Anxiety that is managed rather than treated tends to narrow what someone can engage with over time. The impact is often most visible at work, in relationships, in sleep quality, and in the capacity to actually rest.
When people ask why they are this way, the honest answer is usually that there is no single reason. Anxiety does not usually have a single cause. It tends to develop from a combination of factors that interact over time, and understanding what has contributed to it is part of the work.
The decision to seek an anxiety therapist is often made later than would be ideal. There is rarely a single moment when anxiety becomes serious enough. What tends to happen is a gradual accumulation: more avoidance, less flexibility, sleep affected, and relationships affected. The relevant threshold is not a crisis but rather whether anxiety is meaningfully getting in the way of the life you want to be living.
Many people feel some anxiety about starting anxiety therapy, which is understandable and does not need to be resolved before the first session. The first appointment does not require you to have everything organized or to share everything at once. Here is what typically happens:
Most people leave the first session with a clearer picture of what is driving the anxiety and a realistic sense of what the work could involve. You do not need to have it figured out before you come in. That is what we are there to work on.
There is often a real gap between understanding anxiety and being able to respond to it differently. That gap is exactly what therapy addresses.
We start by exploring what’s going on beneath the surface so we can understand what’s driving your challenges.
Together, we connect the dots between your thoughts, emotions and behaviors to discover the meanings you place on distressing events in your life.
You’ll learn and try out new ways of thinking, feeling, and responding that support lasting,
healthy change.
We focus on deepening your growth and helping you carry what you’ve learned into everyday life with confidence and clarity.
An anxiety therapist works with you to understand the specific thoughts, behaviors, and emotional patterns that are sustaining your anxiety. The work is not just about talking through what is worrying you. It is about identifying what is driving the anxiety, how it is showing up in your daily life, and what needs to change for it to actually respond differently. A CBT-based anxiety therapist brings a specific framework for understanding how thoughts, emotions, and behaviors connect, and practical tools for changing the patterns that are keeping anxiety in place.
The most common sign is that managing anxiety has become a significant part of your daily functioning. If the strategies that have worked before are working less well, if avoidance has quietly expanded into more situations, or if anxiety is affecting sleep, work, or relationships in ways that are accumulating, those are meaningful signals. Therapy is generally most useful before anxiety reaches a crisis point, not after.
Therapy for anxiety addresses a range of conditions, each with distinct patterns, even though they share anxiety as a core feature. The approach is tailored to what you are actually dealing with, not applied generically. At New Heights CBT, the primary anxiety conditions treated include generalized anxiety disorder, social anxiety disorder, panic disorderwith and without agoraphobia, health anxiety, OCD, specific phobias, and high-functioning anxiety.
Specific phobias involve intense, disproportionate fear of particular situations or objects. Agoraphobia involves fear and avoidance of situations where escape might be difficult. Selective mutism is an anxiety-based condition where someone cannot speak in certain social situations despite speaking freely elsewhere. Separation anxiety involves excessive worry about separation from attachment figures. These are real and treatable anxiety conditions, and a referral to a specialist may be appropriate depending on the severity and presentation.
Trauma as a primary presenting concern, active substance use, and severe emotional dysregulation requiring a DBT-based program are not specialties at this practice. For those concerns, I am glad to help with a referral to someone whose practice is built around them.
Sessions vary depending on what stage of the work you are in. Early sessions center around understanding the full picture: what the anxiety is responding to, what thoughts are present when it spikes, and what behaviors have developed around it. As the work progresses, sessions become more focused on practicing and refining the skills that actually change the pattern. Homework between sessions is central to how that change consolidates.
Homework is central to how anxiety therapy works. Insight in the session needs to be practiced outside the session for change to consolidate. Homework might be a thought record, a gradual approach to something that has been avoided, or a specific behavioral experiment. It is always decided collaboratively and always tied to your actual goals.
Self-management strategies have real limits. Most people with persistent anxiety have already tried managing it on their own. They have tried thinking their way through it, avoiding what makes it worse, preparing more thoroughly, and pushing through it. These strategies often provide temporary relief without changing the underlying pattern. Therapy provides a structured framework for understanding why the pattern has been so persistent and a set of tools that actually change the response rather than just manage it.
Several well-supported approaches are used in anxiety therapy, and the right combination depends on the specific type of anxiety and what a person responds to. At New Heights CBT, the work draws primarily from CBT, ACT, ERP, mindfulness-based approaches, and compassion-focused techniques. Each addresses a different mechanism by which anxiety sustains itself.
CBT is the most extensively studied approach for anxiety and forms the primary framework for the work at this practice. ACT is incorporated when the issue is not the content of the anxious thought but the relationship to it. ERP is used specifically for OCD and anxiety, organized primarily around avoidance. Mindfulness-based approaches are integrated throughout, particularly for the physical experience of anxiety. The combination depends on what you are actually dealing with.
Therapy for anxiety is appropriate for anyone whose anxiety has been present for more than a brief period, is affecting daily functioning in meaningful ways, and has not responded adequately to self-management. The people I work with best are analytically minded, willing to do real work between sessions, and committed to trying something different even when it is uncomfortable. They want to understand what is happening, and they want to actually change it.
I work with anxiety, depression, self-esteem concerns, OCD, and related life issues in adults. Trauma as a primary presenting concern, active substance use, and severe emotional dysregulation requiring a DBT-based program are not specialties here. For those concerns, I am glad to help find a referral.
Earlier than most people do. Most people who reach out have been managing anxiety on their own for months or years before making the call. Anxiety tends to be more responsive to treatment before the avoidance patterns have become deeply entrenched and before the anxiety has expanded into many areas of life. There is no severity threshold required to seek help. The relevant question is whether anxiety is getting in the way of the life you want to be living.
Many people notice some shift within the first four to eight sessions, particularly in how they relate to the anxious thoughts. Behavioral change, particularly working with avoidance, takes longer and requires consistent practice between sessions. Change is not linear, and there will be harder weeks. What tends to be consistent is a gradual sense of having more tools, more flexibility, and more agency in relation to the anxiety.
CBT-based therapy has strong research support for anxiety, and ACT and ERP are well-supported for specific anxiety presentations. Whether any particular course of therapy is effective depends on the fit between the therapist and client, consistency of attendance, and genuine engagement with the work between sessions. What I can say honestly is that the people who do this work and stay with it tend to see real change, not the absence of all anxiety, but a meaningfully different relationship with it.
Anxiety becomes less controlling even when it does not disappear entirely
Automatic thoughts become visible and examinable rather than just automatic
Situations once avoided become approachable with practice
Sleep, relationships, and daily functioning improve as the anxiety load reduces
The sense of being permanently stuck gives way to a genuine sense of movement
Cure is not quite the right frame. The goal is not to eliminate anxiety, which is a normal part of human experience, but to stop it from controlling our lives. Most people who complete a solid course of CBT-based therapy find that anxiety is significantly reduced, that they have real tools for when it spikes, and that the pattern no longer controls what they do or avoid.
The length depends on what you are working on and how longstanding the pattern is. CBT is often time-limited by design, and many people see meaningful change within 12 to 20 sessions. OCD, panic disorder, and anxiety that have been present for many years tend to take longer. We talk about timeline regularly, and the work ends when you have the tools to manage independently, not when a fixed number of sessions has been reached.
Weekly sessions are standard at the beginning of treatment. Consistency matters especially in the early phase because the skills need to be practiced and refined regularly for change to consolidate. As progress is established, some people shift to biweekly sessions. We discuss frequency as part of ongoing treatment planning and adjust based on what is actually working.
It is not uncommon for anxiety to spike temporarily when beginning to address it directly, particularly when starting to work on avoidance patterns that have been providing relief. Approaching what has been avoided is uncomfortable before it becomes easier. This is expected and manageable, not a sign that something is going wrong. The pace is always collaborative and adjustable, and we have grounding and stabilization tools available when the work gets difficult to stay with.
Previous therapy that did not produce change is worth examining, not taking as evidence that change is not possible. The most common reasons anxiety therapy does not work as intended include a mismatch between the approach and what was needed, insufficient attention to the behavioral side, including avoidance, not enough work between sessions on the specific skills, or a relational fit that was not quite right. It is worth understanding what happened before, rather than assuming the same outcome is inevitable.
Anxiety therapy builds a range of practical coping skills that you can use in your day-to-day life, not just in the therapy room. Some are immediate tools to steady yourself when anxiety is activated. Others help you gradually change how you relate to anxious thoughts, feelings, and patterns over time.
General talking, whether to friends or in self-help reading, can provide perspective and temporary relief. What it typically cannot provide is the structured framework for understanding why the anxiety has been so persistent, the specific behavioral tools for changing avoidance patterns, accountability for practicing the skills between sessions, or the objective stance that can see patterns from outside them. Therapy is structured work toward specific change, not just a supportive space to process.
Physical symptoms are a real and significant part of anxiety, not just a byproduct of worrying too much. Muscle tension, difficulty breathing, racing heart, fatigue, headaches, and digestive issues are all common physical manifestations of anxiety that tend to respond well to anxiety therapy.
Therapy helps by addressing the cognitive patterns that activate the physical response. Through mindfulness, grounding work and gradually approaching uncomfortable sensations rather than avoiding them, the physical sensations of anxiety tend to become more tolerable, less threatening and less intense.If physical symptoms are prominent, it is also worth ensuring a medical evaluation has ruled out other causes.
Anxiety can return, particularly during periods of significant stress or major life change. This is expected, not evidence that the therapy failed. What changes through a solid course of therapy is that you have the tools to recognize what is happening earlier and respond to it more effectively. Most people who complete therapy find that if anxiety returns, it is less intense, more manageable, and they know what to do with it.
Medication can be a useful part of anxiety treatment for some people, and therapy can be effective with or without it. Some people find that medication reduces the intensity of anxiety enough to engage more fully with the therapeutic work, particularly the exposure-based elements.
Others prefer to address anxiety through therapy alone. I am not a prescriber, but I work with people who are also working with psychiatrists and can coordinate care when that is relevant. The decision about medication is one to make with a prescribing clinician who knows your full clinical picture.
Both formats work. CBT, ACT, and ERP are all effective in an online format, and for many people, online therapy is easier to maintain consistently because it removes the commute and fits more naturally around a full schedule. Some people prefer the experience of in-person sessions. Both are available, and we can discuss which is likely to be a better fit during the free consultation.
Yes, in-person sessions are available at my Brooklyn Heights office for clients in the area.
The office is steps from Borough Hall / Court Street Station, served by the 2, 3, 4, 5, N, R, and W trains, approximately a 1 to 3-minute walk. Jay St-MetroTech Station, with A, C, F, and R trains, is about 5 minutes away. Several bus routes, including the B25, B41, B57, and B6,1 stop within one block. For drivers, Icon Parking at 180 Montague Street and LAZ Parking at 92 Livingston Street are nearby. Street parking is available but can be limited during business hours.
Many clients come from Cobble Hill, DUMBO, Park Slope, and Boerum Hill, as well as from other parts of Brooklyn and from Manhattan. If you are close to Borough Hall or within a reasonable commute, in-person sessions are a practical option.
The first step is a free 15-minute phone consultation. We will talk about what you are dealing with, I will answer your questions about how I work, and we can decide together whether working with a depression therapist in Brooklyn is the right fit. Reach me at (718) 569-7339 or via my website.
Intensive outpatient programs and day treatment programs for anxiety are available through some mental health centers for people who need more structured support than weekly individual therapy provides. These programs are not offered at New Heights CBT, which typically provides individual weekly sessions. If the level of anxiety or functional impairment suggests a more intensive level of care might be appropriate, I am glad to discuss that and help identify resources.
Below is current information on fees, insurance, and how to access sessions.
Yes. Online sessions are available for adults anywhere in New York State. CBT, ACT, and ERP all translate fully to an online format, and the clinical work is identical to in-person sessions. Many people find online therapy easier to maintain consistently, particularly when managing a demanding schedule.
Finding a good fit matters more than most people expect. The approach, the relationship, and the pace all need to work for you. A free 15-minute consultation is how that gets assessed. It is not a sales call. It is a real conversation about what you are dealing with, how I work, and whether the two are a genuine match. Individual counseling for anxiety in Brooklyn is most effective when the fit between therapist and client is solid from the start.
For a lot of people, yes. Brooklyn Heights, like much of New York City, is an environment that genuinely runs at a higher baseline than most places. The cost of living, the competitive professional environment, the density, the pace, and the expectation to be productive and visible at all times.
These are real stressors, not background noise. For someone already prone to anxiety, that environment can amplify it significantly. Many people who move to New York find that the pressure accumulates in ways they did not anticipate.
Evidence-based anxiety treatment means approaches that have been studied and shown to produce meaningful change in controlled research. CBT and exposure therapy are the most extensively studied treatments for anxiety, with decades of research behind them. At New Heights CBT, the work draws on these structured treatment approaches as the foundation, with ACT, mindfulness-based techniques, and compassion-focused work integrated where they fit the individual.
Some people benefit from working with both a therapist and a psychiatrist who can prescribe and monitor anti-anxiety medications. I am not a prescriber, but I regularly work alongside psychiatrists and can coordinate care when that is part of someone’s treatment.
In some cases, particularly when anxiety is affecting family relationships, family therapy may also be a useful component of a broader mental health treatment plan. The decision about medication is one for a prescribing clinician. What I can say is that therapy tends to build skills that hold after medication is discontinued, and many people address anxiety through therapy alone.
Getting started with anxiety treatment in Brooklyn at New Heights CBT begins with a free 15-minute phone consultation. That call is not an intake. It is a conversation about what has been going on, how I work, and whether the fit makes sense. If it does, the initial assessment happens in the first full session. We look at the full picture: what the anxiety is responding to, when it started, what has been tried before, and what you are hoping changes. From there, we decide together where to begin.
New Heights CBT offers flexible anxiety therapy in Brooklyn through both in-person and online formats. Online sessions are available to adults across New York State and follow the same structure as in-person work.
For people managing full schedules, the online format removes the commute and makes it easier to maintain consistency, which matters a great deal in mental health treatment for anxiety. Many people find that flexibility in how they access sessions helps them regain control over their schedule and makes it easier to stay consistent with their work.
In-person sessions are available in Brooklyn Heights for people who prefer that format.
Anxiety therapy builds coping strategies that are both immediate and structural. Relaxation techniques help manage the physical activation of anxiety in the moment. Structural coping skills change how anxiety is understood and responded to over time. The goal is not to become someone who never feels anxious. It is to have a real toolkit for when anxiety shows up, so it does not have to run everything.
Healing from anxiety is not a straight line, and it does not look like the absence of anxiety. What it tends to look like is a gradually expanding range. Things that were avoided start to become approachable.
The anxious thought shows up and gets noticed earlier, before it has fully taken over. There are still hard days, but there is also a growing sense of having tools rather than just willpower. People who are struggling with anxiety often describe the shift not as the anxiety disappearing but as it matters less, having less control over what they do.
A free 15-minute consultation is the first step. We will talk about what has been going on, I will share how I work, and together we will figure out whether this is the right fit. No pressure. No commitment. Just an honest conversation about whether working together makes sense.
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