Image representing anxiety counseling service offered by Jenai Wu Steinkeller.

Emerging from Anxiety

Understanding the sources of your anxiety, fear and compulsions may help you to find strategies for moderating the disruptiveness of your emotions.

> Anxiety > Panic Attack > OCD

Anxiety caused by persistent worry, fear and nervousness can deeply stress the body and mind, and can interfere with sleep, health, and normal physiological functioning.

We all experience anxiety. Some may be predisposed to worry and fret, while for others anxiety can take the form of emotional storms. Sometimes anxiety can be so debilitating that it can interfere with personality and a normal social life.

Anxiety is a broad-spectrum disorder. Normal, adaptive anxiety is based in fear; it’s the body’s natural alert mechanism. A little anxiety can be a good thing, but clinical levels of anxiety may be caused by temperament, inadequately resolved experiences of psychosocial trauma, be part of another disorder such as depression or other medical problem, or it could be a side effect of drugs or medications. It can be likened to pain in that it functions to put the mind on alert, and often surfaces together with another psychological event. So while it is worthwhile to treat anxiety as a symptom, it’s more important to uncover its cause.

Anxiety, like many psychological states, has emotional, cognitive and behavioral components. Anxiety disorders range from Obsessive Compulsive Disorders (OCD) to a variety of phobias. Social anxiety—what in the past might have been dubbed shyness—could mean many different things, ranging from ordinary self-consciousness to social aversion and avoidance.

Dr. Wu helps patients with anxiety in her Boston office.  Her approach to working with anxiety is to investigate the sources of your anxiety, to help you learn new skills in managing the symptoms of your distress, and to develop strategies in improving functioning.


Psychodynamic psychotherapy combined with mindfulness therapy helps a patient develop skills to recognize and regulate the disruptiveness of anxiety, and to feel more in control and less helpless. Through this process we may also track the symptom in the context of an individual’s life to understand why a person grows anxious, stressed out, worried, fearful, or outright panicked.

Cognitive Behavioral Therapy for Anxiety

Part of the treatment for anxiety is to “unlearn” the thinking process that underlies it. For example, in phobic reactions there may be an irrational belief that the object of phobia is linked to a danger, which provokes anxiety or even a panic reaction that is often self-perpetuating. A gradual and structured loosening of this noxious conditioning empowers the individual with more control over their feelings.

Medicine for Anxiety

For acute anxiety physicians often prescribe some form of sedative-hypnotic or anxiolytic (tranquilizing) drugs to interrupt the escalation of anxiety. Such drugs can be habit-forming, not to mention dangerous in combination with other drugs and alcohol, but can also be helpful if used the right way.

Anxiety Experience

Anxiety can be particularly powerful and visceral because it activates the core nervous system, sympathetic and parasympathetic, affecting cardiovascular, respiratory, motor and gastrointestinal systems, not to mention what happens in one’s mind!

Physiological Symptoms of Anxiety

Persistent worrying

Gastrointestinal symptoms such as upset stomach, diarrhea, frequent urination or difficulty with urination

Rapid heart beat

Tremors or nervousness, pacing or agitation


Peripheral nervous symptoms such as tingling of fingers or toes

Difficulty falling asleep



Dry mouth

Panic Attack

Panic attacks or panic disorder can be understood as a pattern of uncontrolled escalation of anxiety. It is important to rule out the possibility that these symptoms are caused by other medical conditions, such as a heart attack, endocrine or metabolic problems such as hyperthyroidism, or other drug effects.

Symptoms of panic disorder include

Shortness of breath

Sensation of smothering or inability to breathe

Racing or rapid heartbeat


Dizziness or fainting

Fear of dying, going crazy, or losing control of one’s actions

Upset stomach, nausea

Numbness or tingling sensations


OCD (Obsessive-Compulsive Disorder), a form of intense anxiety, involves recurrent intrusive thoughts, obsessions or compulsions that most likely interfere with normal functioning and routines. Modern research suggests a strong genetic basis to OCD, although genetics is not a sufficient condition to developing symptoms of OCD.

People suffering from OCD often see that their compulsion to do something or avoid something, like compulsive checking, or repetitive behavior like hand-washing, is irrational, but nevertheless have trouble preventing themselves from acting on it. OCD can cause enormous psychic distress, not to mention its interference at work or at home. The symptoms of OCD can respond to psychotropic drugs and behaviorally based therapies. Dr. Wu has also treated patients with OCD in psychodynamic therapy by helping them understand their deeper psychology in ways that diminish the power of the symptoms.

Read more about Ways To Cope With Stress.