Understanding and Treating Anxiety

Anxiety can be a deeply personal and exhausting experience. For some, it’s a constant hum of worry in the background; for others, it arrives in overwhelming waves that seem to come from nowhere. While anxiety is a natural human response to stress or uncertainty, it can become problematic when it’s persistent, intense, or interfering with daily life.

At Smart Therapy™, based in Waterloo and offering virtual sessions across Ontario, I provide insight-driven depth therapy to help you address anxiety in a way that is both comprehensive and personalized.

 

Common Types of Anxiety I Treat

While anxiety is often used as an umbrella term, it can take many specific forms. Understanding these differences can help in identifying the most effective treatment approach.

Generalized Anxiety Disorder (GAD)

Generalized anxiety involves ongoing, excessive worry about a range of everyday matters. You might find yourself anticipating the worst-case scenario, feeling restless, tense, or on edge most of the time. This type of anxiety can be draining because it doesn’t always have a clear trigger: it’s as if your body and mind are always braced for something to go wrong.

Panic Attacks and Panic Disorder

Panic attacks are sudden surges of intense fear or discomfort, often accompanied by symptoms like heart palpitations, shortness of breath, dizziness, or a sense of impending doom. Panic disorder involves recurring panic attacks and persistent worry about having another one, which can lead to avoidance of certain places or activities.

Social Anxiety

Social anxiety is more than shyness; it’s an intense fear of judgment, embarrassment, or humiliation in social or performance situations. This can lead to avoiding social events, struggling with public speaking, or feeling unable to fully engage with others, even in one on one situations or in small groups.

Anxious Attachment Style

Rooted in early relational experiences, anxious attachment involves a deep fear of abandonment or rejection. This can create a cycle of needing reassurance in relationships, overanalyzing interactions, or feeling very aware of perceived changes in others’ moods or availability.

Adjustment Anxiety

Adjustment anxiety can emerge during times of transition: starting a new job, moving, entering or ending a relationship, or experiencing a significant life change. While some stress is expected during transitions, adjustment anxiety can make it difficult to adapt, leaving you feeling overwhelmed or stuck.

Health Anxiety

Health anxiety, sometimes referred to as illness anxiety disorder (IAD), involves persistent worries about having or developing a serious illness. Even with medical reassurance, the anxiety can remain, leading to repeated checking of symptoms, excessive research, or avoiding medical settings altogether.

Separation Anxiety

Separation anxiety is not just for children; adults can also experience significant distress when separated from loved ones or even pets. This may involve fear that something will happen to them or to you during the separation, or an overwhelming need to maintain constant contact.

Performance Anxiety

Often associated with public speaking, performance anxiety can arise in any situation where you feel "on display," such as: giving a presentation, taking a test, competing in sports, or even during intimate moments. The fear of not meeting expectations can create physical symptoms like sweating, shaking, or a racing heart.

Perfectionism-Related Anxiety

Perfectionism can fuel anxiety by creating unrealistic standards and an intense fear of making mistakes. It often leads to procrastination, burnout, or a cycle of self-criticism, and can impact work, relationships, and personal well-being.

Postpartum Anxiety

While postpartum depression is well-known, postpartum anxiety is also common. It can involve excessive worry about your baby’s health and safety, intrusive thoughts, or feeling constantly "on alert." This anxiety can make it difficult to rest, bond, or trust your instincts as a parent.

 

Supporting Highly Sensitive People (HSPs)

Though not strictly connected to anxiety itself, Highly Sensitive Persons (HSP's) can have their own unique challenges when experiencing anxiety. Highly Sensitive People process sensory and emotional information more deeply than others. While this can be a gift (bringing empathy, creativity, and insight), it can also lead to feeling easily overwhelmed, anxious, or emotionally drained. Therapy can help HSPs develop strategies to navigate a stimulating world while embracing the strengths of sensitivity.

 

Treating Obsessive-Compulsive Disorder (OCD)

OCD is often deeply intertwined with anxiety due to the way the brain processes and responds to intrusive thoughts and uncertainty. OCD can take many forms, and a few of the OCD presentations in which I work with clients are:

• Pure O OCD – Characterized by intrusive thoughts and mental compulsions that are often invisible to others.

• Relationship OCD (ROCD) – Ongoing doubts or fears about your relationship or your feelings toward your partner.

• Religious OCD (Scrupulosity) – Obsessions around morality, sin, or offending a higher power.

While the themes may differ, the underlying pattern is similar: intrusive thoughts trigger anxiety, leading to mental or behavioral rituals aimed at reducing distress. In therapy, we explore these patterns with compassion while working toward more freedom and self-trust.

 

My Integrative Approach to Anxiety Treatment

Anxiety affects both mind and body, which is why I integrate a range of evidence-based therapies that address your unique needs.

Insight-Driven Talk Therapies

• Schema Therapy – Identifies and works with long-standing patterns (or "schemas") rooted in childhood experiences, helping you shift unhelpful beliefs and develop healthier coping strategies.

• Psychodynamic Psychotherapy – Explores unconscious patterns, relational dynamics, and past experiences that shape your current feelings and behaviors.

• Emotion-Focused Therapy (EFT) – Helps you work directly with your emotions as a source of healing and change, increasing your ability to process and respond to feelings in healthy ways.

Mind-Body Therapies

• Clinical Counselling Hypnotherapy – Uses guided relaxation and focused attention to access deeper levels of awareness, reduce anxiety, and create new, more empowering associations.

• Brainspotting Therapy – Accesses the brain-body connection to process and release stored trauma or distress, supporting nervous system regulation and emotional healing.

By blending these approaches, therapy can address both the immediate symptoms of anxiety and the deeper roots that keep it in place.

 

What to Expect in Therapy

Our work together begins with understanding your unique experience of anxiety: its triggers, patterns, and impact on your life. From there, we collaborate on a tailored plan that may involve exploring past experiences, developing emotional regulation skills, addressing underlying schemas, and creating lasting shifts. Optionally, we can also utilize mind-body therapies to calm your nervous system.

This process is not about "getting rid" of anxiety overnight, it’s about changing your relationship with it. Over time, you may notice more clarity, confidence, and resilience, and less of the overwhelming grip that anxiety once had on your life.

 

Moving Toward Lasting Change

Anxiety can make you feel like you’re stuck in a loop: always bracing for the next worry, panic, or intrusive thought. But with the right support, it is possible to break free from this cycle.

Whether your anxiety is rooted in specific fears, life changes, or longstanding patterns, therapy offers a space to slow down, reflect, and take meaningful steps toward the life you want to live. Together, we can uncover not just how to manage anxiety, but how to understand it; and, ultimately, how to transform it into insight, growth, and greater self-compassion.

 

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Meet Rebecca Steele, Registered Social Worker, Psychotherapist (MA, MSW, RSW, CCC) Rebecca is a Waterloo-based trauma therapist offering virtual counselling across Ontario. With over a decade of experience, she helps adults navigate trauma, anxiety, OCD (including “Pure O” presentations), and life transitions. Her insight-driven depth therapy approach supports self-understanding, emotional healing, and lasting change. Book an appointment or learn more about her online therapy services.

Ready to begin? You can book an appointment here or learn more about Rebecca’s online therapy services across Ontario here.

Located outside Ontario? You can explore Rebecca’s coaching and consulting offerings here.