Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square area, Greenwich Village, New York, NY

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Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square area, Greenwich Village, New York, NY

Anxiety

“How much pain they have cost us,
the evils which have never happened.”

~Thomas Jefferson

Anxiety is a normal response to stress

You would expect to feel anxious or nervous before a big interview, an audition, on your wedding day or a first date with someone you’re really interested in, and many other real life situations where anxiety is an understandable, expectable reaction. Anxiety can even be a helpful response – it sharpens you up and makes you focus. You are more alert and on your toes than you might otherwise be. As such, at times it is a useful coping mechanism, and important for survival.

Excessive Anxiety

But when worries and fears become recurrent and pervasive, excessive or out of proportion to the reality of whatever is going on or what would be an expected response to the situation, then it no longer helps you cope. It does the opposite – it gets in the way of coping and surviving. When a kind of free-floating, non-specific anxiety (generalized anxiety disorder) persists with no let-up for months at a time, it becomes a disruption to getting on with everyday life. You never feel free – you’re always beset with worry. Even if some part of you knows the worries aren’t realistic, they feel like they are. Someone is 40 minutes late and you are absolutely sure something terrible has happened. Even when you know there’s often heavy traffic on their route or construction on their subway line or that the person is chronically late, your pattern is to work yourself into a lather of anxiety.

Fear & Panic

There can be feelings of dread or sudden feelings of terror that arise in certain situations or about certain objects or places that develop into panic attacks that repeat unexpectedly. You might have a fear of heights, of flying, crossing bridges, being in confined or open spaces, contamination by germs, or fears of certain insects or animals (phobias).

Social Anxiety or Trauma

Or you may have a kind of social anxiety that prevents you from meeting people, advancing at work, or simply enjoying everyday encounters with people. The kind of anxiety associated with trauma can also remain long after the trauma (PTSD), or resurface after many years of being hidden. Sometimes the association between the trauma and the current spells of anxiety aren’t clear.

A Smaller World

All these anxieties can result in increased withdrawal and isolation from the world. As the fears get bigger and take up more and more room in your thoughts, your world gets smaller and less and less pleasurable. In our sessions we can take a look at how and when your fears began to plague you. We try to separate out what’s real and what’s possibly exaggerated or unrealistic so you can begin to experience new and different responses instead of the hopeless out-of-control feelings you’ve come to expect.

I am not a physician and cannot prescribe medication. And though I prefer to first try working on the issues troubling you in a purely talk-therapy situation, if medication might be indicated, I will refer you for a psychiatric evaluation.

Hope

Often feelings of anxiety have been bottled up in you with nowhere to go. Maybe you expressed your fears and worries to your friends or your family. Maybe it helped for a while but then things went back to the way they were. Or maybe it didn’t help at all. Having somewhere safe to unburden yourself, to talk about all those things you’re afraid someone else will think are ridiculous and “nothing to worry about,” knowing that someone will be respectful and understand how hard it is, that you can’t “just stop worrying.” usually feels hopeful to someone who’s felt trapped by anxiety. Depending on how long it’s been with you, how entrenched and how deeply felt it is, some relief can be almost immediate or it might take quite some time to diminish. But there is help for anxiety for those willing to address it.

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