Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is an evidence-based therapy which is considered a “top-down” approach to treating mood and anxiety disorders. “Top-down” is one way our brains process information, focusing on the rational and logical prefrontal cortex. CBT focuses on the thoughts and behaviors that show up alongside feelings of anxiety in your life. By adjusting automatic thoughts and core beliefs, anxiety tends to decrease.

Other “top-down” approaches include trauma-focused CBT (TF-CBT), the skills-based therapy known as Dialectical Behavior Therapy (DBT), exposure therapies for anxiety and OCD, and solution-focused therapies.

Body Focused Therapy

There are limitations to “top-down” approaches to anxiety. Anxiety involves your body’s autonomic nervous system, the automatic “alarm system” that responds to subconscious threats, based on past experiences. So adjusting conscious beliefs and thoughts does not always result in complete healing.

Many “bottom-up” therapies have become popular due to their effectiveness. These types of therapy focus on the experience of emotions, particularly anxiety, in the body, and work “up” from there to help decrease emotional intensity. Eye-Movement Desensitization and Reprocessing (EMDR) is one such therapy that can aid in trauma recovery, but is not applicable in all circumstances.

Several of our therapists incorporate Internal Family Systems (IFS), a therapy that works by accessing implicit memory through emotion and bodily experience. This powerful approach allows the client to heal internally by resolving wounds and meeting underlying needs that were unmet in the past.

Additional bottom-up approaches include play and art therapies, and incorporating movement such as dance and stretching practices into your self-care rhythms outside of session.

Nervous System Awareness

Awareness of your nervous system states and how they operate can be paramount in taming the anxiety in your life. The autonomic nervous system (ANS) is your body’s fight or flight, or alarm system. The ANS may be injured or impacted by past experiences, relationships, and medical conditions or imbalances (see below “Holistic Treatment of Anxiety”), sending it into an over-active or easily triggered state.

Our therapists are trained to help you understand when and why your body’s alarm system is over-firing. We’ll help you identify triggers and teach grounding skills that help every body improve emotional regulation. Polyvagal theory, developed and popularized by Dr. Steven Porges and Dr. Deb Dana, informs our work in this area.

Holistic Treatment of Anxiety

Many physiological factors can affect anxiety; imbalances in the body often “show up” as anxious feelings.

Many of our therapists support you in awareness of these factors, such as

• blood sugar / protein intake

• caffeine intake

• hydration

• vitamins and supplement levels (Vitamin D3, Magnesium, B-6 and B-12)

• thyroid function

• MTHFR gene mutation (inhibits use of B-12, among other issues)

• gut imbalance (disrupts the brain-gut axis)

We will encourage you to talk to your medical provider about checking and addressing these factors.