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Boston Anxiety Counseling & Therapy

Anxiety a Leading Reason for Therapy

Anxiety and related conditions are the leading source of unease and suffering that brings people to therapy. The severity and duration of anxiety can fall on a continuum from mild and quite manageable with or without psychotherapy to extreme to the point of a near total inability to function.

Tendency to Anticipate Danger

Our brains are wired for and have evolved to perceive immediate and serious potential threats. There are evolutionary reasons for the human tendency to anticipate danger and to fear for our survival. Three different parts of our brain create a triune of reactions that have remained part of the human psyche long past the time when humans had clearer threats, such as being harmed by a wild animal. The brain causes us to have rational, emotional and instinctive reactions to danger. As a result, not only threats to our lives can elicit powerful anxiety and fear reaction.

Existential Threats Which Provoke Distress

Humans of the 21st century typically, of course, live lives far removed from those of our distant ancestors but we share nearly the same brain and eons of evolution with survival being the predominant requirement. In our modern world, direct threats to our physical well-being may be diminished, but we still regularly experience setbacks such as perceived sleights, failures, troubled relationship, family conflict, loss of a job, perceived diminished social standing, or lack of meaning and connection in life, as an existential threat which can elicit enormous levels of distress and suffering. As a result, not only threats to our lives can elicit powerful anxiety but also our lives can feel as though we are facing existential threat on a regular basis and this of course is a deeply painful experience. This is in many ways the essence of most anxiety disorders

The Natural Tendency to Escape from Anxiety

As humans who wish not to suffer, it is normal and understandable that we seek to escape these anxiety producing feelings as quickly as possible. The trouble is that we often try to escape in ways which are of limited use, or even which make things worse. Some of the ways in which we seek to escape the painful feelings of anxiety include suppression or denial of painful feelings, diversion and inability to focus, obsession with other activities, such as work or exercise, television or video games, or problem use of drugs, alcohol, gambling or sex.

It is important to understand that the tendency to want to escape from anxiety doesn’t indicate a moral failing or a personal weakness. It is perfectly human to seek to escape by any means necessary from that which we perceive may destroy us. What is needed are new tools and methods to live with our distress, to be able to pursue and experience our lives as meaningful and to be able to find and experience periods of joy and contentment, in spite of the distress of anxiety. As a byproduct of this, we will often find that the anxiety severity and duration can abate and make space for other experiences and feelings which we may find much more satisfying and hopeful. d It is through such processes as psychotherapy and mindfulness based meditation in which the foundation of real change and progress can be begun.

Relationship between Fear and Anxiety

Anxiety disorders include those that share features of excessive fear and anxiety. Fear is the emotional response to real or perceived imminent threat. Anxiety is the anticipation of future threat.

The states of fear and anxiety overlap, but there are differences. Fear often initiates the fight-or- flight response due to thoughts of immediate danger and escape. Anxiety is more of a vigilance in preparation for future danger, initiating cautious or avoidant behaviors that cause muscle tension.

Types of Anxiety

Here are some of the most common forms of anxiety:

Agoraphobia: Fear of being in large or unknown public places, often associated with panic attacks. This phobia may cause a person to fear leaving home. This may be connected to a troubling or traumatic experience, and often in therapy, the reason for this fear may surface and allow the person to develop strategies that allow a more ordinary coming-and-going.

Free Floating or Generalized Anxiety: A chronic sense of doom or excessive worry that affects a person almost daily, lasts for six months or more, is difficult to control and does not seem to be attached to a specific issue or concern. Some symptoms include fatigue, restlessness, irritability and sleep problems.

Obsessive Compulsive Disorder: Recurring, unwanted thoughts or obsessions along with repetitive behaviors or compulsions. These behaviors might include hand washing or repetitive checking on things, for instance, whether the stove is turned off.

Panic Disorder: Unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath or dizziness.

Post Traumatic Stress Disorder: Anxiety that develops after exposure to a terrifying event, such as military combat, a personal assault or a natural disaster.

Social anxiety: Excessive self-consciousness or fear in one or more social situations, such as public speaking, or in more generalized cases, anxiety from being around other people in many types of situations.

Options for Treating Anxiety

The two main treatments for anxiety disorders are psychotherapy and medication, and sometimes a combination of the two.

Psychotherapy, also called talk therapy or psychological counseling, with a qualified professional is an important first step to get an accurate diagnosis and plan a course of treatment.

Cognitive behavioral therapy, or CBT, has been shown to be a highly effective form of psychotherapy for anxiety disorders. CBT focuses on learning specific skills to use in situations that may cause anxiety.

The proper treatment can lessen the severity and duration of anxiety and make space for other experiences and feelings that are more satisfying and hopeful. Often with anxiety, even a little progress can be very meaningful, as it can provide a path to a different and better way to experience our lives.

Research and experience has shown that processes such as psychotherapy and mindfulness-based meditation can be the stepping stones to change and an increased sense of optimism and hopefulness.

New Insights on the Nature of Anxiety

We are only beginning to more deeply understand that what distinguishes our species is our ability to contemplate the future. Martin Seligman, a leading expert on “positive psychology,” said in a New York Times article that, “Looking into the future, consciously and unconsciously, is a central function of our large brain, as psychologists and neuroscientists have discovered, rather belatedly, because for the past century most researchers have assumed that we’re prisoners of the past and the present.”

Seligman said this future orientation creates optimism in some people, while “… those suffering from depression and anxiety have a bleak view of the future, and that in fact seems to be the chief cause of their problems, not their past traumas nor their view of the present.” The human tendency to anticipate, combined with an over-estimating future risks, can cause anxiety.

It is one of the paramount goals of our practice to work assiduously and collaboratively with our clients to help them uncover their inherent strengths and resilience and to enhance and build on them to create meaningful and lasting positive change in their lives. As this work progresses, anxiety can evolve from a defining quality in  one’s life to a more transient and diminished thought construct and feeling leaving space for other more positive, engaging and optimistic thoughts and feelings to take a more central role in one’s life.



Diagnostic and Statistical Manual of Mental Disorders, DSM-5, American Psychiatric Association, Oct. 1, 2016

Price, John S., “Evolutionary Aspects of Anxiety Disorders,” National Institutes of Health, September 2003.

National Institutes of Health, “Major Types of Anxiety Disorders,”

News in Health, “Understanding Anxiety Disorders: When Panic, Fear and Worries Overwhelm,” National Institutes of Health, March 2016

Seligman, Martin and Tierney, John, “We Aren’t Built to Live in the Moment,” New York Times, May 19,2017.

Stark balck and white portrait of anxious woman

Anxiety Increasing Across America

Anxiety about Daily Life Increasing Across America Searching Google for information about America’s most common anxieties may not be the most scientific research. But one opinion writer for The New York Times suggests, at the very least, it’s a snapshot of what’s worrying folks across this diverse country. In an article titled “Fifty States of […]

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Coping with Unemployment Anxiety

Unemployment Linked to Anxiety and Depression Jamie, age 45, is by all measures a talented and hard-working person. He has earned multiple graduate degrees and amassed much professional expertise. Yet Jamie finds himself unemployed, with no immediate job-prospects. He is surprised to find himself in this position in mid-life, and has been experiencing feelings of anxiety […]

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Nancy Hoffman, LICSW

Nancy Hoffman
Nancy Hoffman, LICSW

Therapy Approach

At some point, we all have to deal with the effects of life’s stressors, be they at the loss of a relationship or job; a parent’s or spouse’s illness; the onset of a medical condition; conflict within a relationship; or other sudden and unwelcome changes in life’s routine. Everyone has strengths that are silenced by such stressors and I specialize in helping my clients to deal with those stressors by bringing back those strengths. I see individuals from adolescents to seniors who want to understand and/or change their feelings of anxiety and sadness. Through conversation, support, techniques of relaxation, and, at times, some humor, I help them learn to feel strong again in the face of adversity.

I have assisted a wide variety of clients ranging from parents and siblings of children with challenges; adults who lost parents or are dealing with placing parents in nursing homes, couples, blended families, high school and college students who are having a difficult time with transition, and those going through any kind of loss and anxiety. Much of my work is short term, 6-12 week sessions and critical situations (crisis intervention) which aims to restore clients to full functioning.

In addition to private practice, I have worked in medical and psychiatric hospitals and mental health settings in both clinical and administrative positions and have been an adjunct clinical instructor/field work supervisor at both Boston University and Boston College Schools of Social Work.

I bring 40 years of professional and life experience which my clients find of great help.
I also will make some home visits.

Professional Training

  • Boston University School of Arts and Sciences BA
  • Boston University School of Social Work MSW

Help for Social Anxiety

Social Anxiety Disorder is the third most common psychiatric illness, and depending on the definition one uses- the incidence is believed to be anywhere from 5 to 13 percent of the population in the United States suffer from it in their lifetime. What is Social Anxiety? Social Anxiety manifests in various ways some of which […]

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albert ellis founder of rational emotive therapy

Depressed? Poor Self-Esteem? Anxiety? Rational Emotive Therapy Can Help

If you are suffering from depression, poor self-esteem, or anxiety, Rational Emotive Therapy (RET) can help you learn how to feel good.RET helps you identify the emotional and practical problems in your life, and helps delineate the difference between the two. You will be able to minimize emotional disturbances, obtain self-actualization, and experience an improvement […]

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Anxious student

Anxiety Disorders: How to Identify, How to Help

Characteristics of Anxiety Anxiety in one form or another is the most common issue that brings people to therapy. It ranges in severity from a vague but persistent sense of unease to incapacitating panic attacks and many levels in between. Various forms of psychotherapy can be very effective in addressing the pain of anxiety and helping […]

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Bear Cub Alone but Okay

The bear cub, the one with the splayed foot didn’t know how long she had been walking. But she knew she was lost. The rich sweet smells of Huckleberry and Pine were faint and far on the horizon but diffuse and so hard to locate exactly. The deep green scent of Oak, Spruce, Evergreen and […]

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