IFS Therapy for Anxiety in Massachusetts and Rhode Island

Your mind is always trying to get ahead of something.

Maybe you're lying in bed thinking about tomorrow. You have a difficult conversation coming up, and you're rehearsing what you'll say, what the other person might say, and what you'll say if they say that.

Or you're trying to make a decision: you research, make a list, ask someone what they think. Then you ask someone else. You finally decide—and almost immediately start wondering whether you've made the wrong choice.

You may prepare much more than other people seem to. Before a meeting, a trip, a doctor's appointment, or a difficult conversation, you want to know what to expect. You think through the possibilities. You make sure you've covered everything.

Sometimes this works well.

You're prepared. You remember things other people forget. You anticipate problems before they happen. People may experience you as conscientious, thoughtful, responsible, or simply very good at getting things done.

The trouble is that it's hard to know when you've done enough.

There is always one more thing you could check. One more scenario you haven't considered. One more question you could ask. One more way things could go wrong.

And even when there is nothing more you can actually do, your mind may keep working on the problem.

You might replay a conversation that's already over, or wake up at 3 a.m. thinking about something you can't address until morning. At other times, someone reassures you that everything is fine, and it helps—for a few minutes.

Or maybe your anxiety doesn't involve much conscious worrying at all.

You just feel on edge. Your shoulders are tight. Your stomach is upset. You can't settle. You're irritable with people you love, exhausted but can't sleep. You have trouble concentrating because some part of your attention seems to be constantly scanning for what needs your attention next.

Sometimes you avoid the thing altogether. You put off opening the email, making the phone call, scheduling the appointment, or making the decision—not because you don't care about it, but because engaging with it seems to set the whole machinery in motion.

Anxiety can keep us working very hard to prevent bad things from happening.

Because what if the moment you stop worrying is the moment you miss something important?

What problem is your anxiety trying to solve?

Anxiety often arises when something important feels unresolved—and your system doesn't yet believe it can safely leave it unresolved.

Sometimes the problem is out in the world.

You're waiting for medical test results. Your job is uncertain. Someone you love is struggling. You have to make a decision that will have real consequences, and you don't have all the information you wish you had.

There really are things in life to worry about.

But sometimes the problem is harder to see because the conflict is happening inside you.

Maybe you don't want to do something, but you don't want to disappoint someone either. You want to leave your job, but another part of you is terrified of giving up the security you've worked so hard to build. You want more closeness in a relationship and, at the same time, find yourself wanting to pull away when someone gets too close.

There may be no choice that gives every part of you what it wants.

So your mind keeps working on it.

You reconsider. Imagine another possibility. Try to figure out which feeling is the “real” one. Make a decision, then go back over everything to make sure you haven't missed something. Wait to see whether something changes and makes the answer clearer.

Sometimes anxiety is trying to find a solution that doesn't require you to lose anything, disappoint anyone, take a risk, make the wrong choice, or live with uncertainty.

But sometimes every available choice asks you to give something up or live with something you can't know for sure.

And sometimes the source of anxiety isn't clear at all. You may wake up anxious without knowing why, or notice that your body is braced even when nothing in particular seems to be wrong.

In therapy, we can approach anxiety not simply as a symptom to get rid of, but as something to get curious about.

What problem is your anxiety trying to solve?

The things you do to manage anxiety can make sense—and still keep you caught in it.

When something feels unresolved, it makes sense to try to resolve it.

You think about it. Research it. Prepare. Check one more time. Try to make sure you haven't overlooked anything. Maybe you ask someone what they think. Or maybe asking someone feels like the last thing you want to do, and you work even harder to figure it out yourself.

And often, doing something helps.

You send the email and feel better. You look up the symptom and find a reassuring explanation. You make a plan for what you'll do if the thing you're worried about actually happens. You figure out how to handle something on your own without having to depend on anyone else.

Or perhaps you do reach for reassurance. You ask your partner whether they're upset with you and they say no.

For a while, you feel better.

The problem is that relief can teach your system something too: Good thing we checked.

So the next time uncertainty appears, the urge to check, research, prepare, ask, or think it through can become even stronger.

Avoidance can work the same way.

If making the phone call makes you anxious, putting it off gives you some relief. If you're afraid you'll make the wrong decision, not deciding means you haven't made the wrong one yet. If you're worried about how someone will respond to what you have to say, you can keep editing the text instead of sending it.

It makes sense that you'd keep doing things that have helped you feel better before.

Research, preparation, careful thought, and other people's perspectives can all be genuinely useful. So can relying on your own judgment.

The question isn't whether you should stop doing these things.

It's whether what you're doing is helping you respond to the situation—or helping you postpone the moment when you'll have to live with something you can't completely resolve.

You may have to make the decision without knowing for certain that it's the right one, or send the email without knowing how it will be received.

And sometimes there isn't anything left to do at all.

That's often where anxiety has the hardest time letting go.

What does your anxiety believe would happen if it stopped doing its job?

When anxiety has been working hard to protect you, simply telling yourself to stop worrying usually doesn't get you very far.

Even when one part of you knows you're probably going to be okay, another part may not be convinced.

That part may believe that worrying keeps you prepared. That staying alert keeps you from being caught off guard. That thinking through every possibility is what keeps you from making a mistake you'll regret.

Or it may be protecting you from something more personal.

Maybe asking someone for what you need feels dangerous because they could say no. Maybe relaxing feels irresponsible when there are people depending on you. Maybe not knowing what comes next brings up a feeling of helplessness that you've spent much of your life trying not to feel.

Sometimes the fear isn't even about what will happen.

It's about what you imagine you would feel if it did.

What if I couldn't handle it?

What if I needed help and no one was there?

What if I let myself hope for this and then lost it?

From the outside, it can look as though anxiety is trying to control the future. But often it's also trying to protect you from feelings and experiences that some part of you doesn't trust you to be able to bear.

That gives us somewhere different to begin in therapy.

Instead of asking only, How do I make this anxiety stop?, we can begin to wonder what it's working so hard to prevent.

How can therapy help with anxiety?

If you've been anxious for a long time, you may already have tried a lot of things to make yourself feel better.

Some of those things may genuinely help. I want you to have ways to find some relief when you're overwhelmed.

But we can also try to understand what your anxiety is doing, rather than treating it simply as something we need to make go away.

Using Internal Family Systems (IFS), we can slow things down enough to get curious about the parts of you involved in your anxiety.

There may be a part that runs through every possible outcome. Another that has very strong ideas about what you should do. A part that would rather avoid the whole situation. And perhaps another that is exhausted by all of it.

Rather than deciding which of these parts is right, we can begin to understand what each of them is trying to accomplish.

And sometimes what we find isn't what you thought you were anxious about in the first place.

We may discover that a part of you isn't only afraid of making the wrong decision, but of what you'll think about yourself if you do. Or that the part insisting you handle everything yourself learned a long time ago that depending on other people wasn't a particularly reliable strategy. Or that the part rehearsing tomorrow's conversation is trying to make sure you're never again caught without words when you need them.

Understanding this intellectually can be useful. But understanding isn't the same as having a different experience.

In IFS, we talk about relating to parts from Self—the capacity for curiosity, compassion, clarity, and calm that becomes more available when we're not completely caught up in a part's fears or urgency.

When you can be with an anxious part in this way, something different can happen. Instead of trying to convince it that everything will be okay, trying to get it to calm down, or getting swept up in its urgency, you can become curious about what it's afraid of and what it has been trying to do for you.

For a part that has spent years believing it has to anticipate every problem, keep you from being caught unprepared, or prevent you from making a mistake you can't recover from, being met this way can be a transformative experience.

It doesn't have to disappear. But it may begin to trust that it isn't alone with the problem anymore.

And as that happens, there can be more space inside. More room to think without having to think everything through. To prepare without needing to prepare for every possibility. To make a decision without first eliminating every risk. To feel anxious without assuming the anxiety means you need to do something about it immediately.

Depending on what you're experiencing, we may also draw on Somatic Experiencing or Deep Brain Reorienting (DBR).

With Somatic Experiencing, we can pay closer attention to how anxiety is showing up in your body—the bracing in your shoulders, the impulse to pull away, the restlessness that makes it difficult to sit still, or the sense that you need to do something even when you don't know what. Sometimes noticing these responses more closely can help us understand what your system is preparing for and give it more room to respond differently.

DBR gives us another way in. It focuses on very early responses to threat, before we've had time to make sense of what's happening or even necessarily feel a recognizable emotion. This can be especially useful when anxiety seems to arrive before you can think your way through it: your body reacts, something in you knows there's a problem, and only afterward does your mind begin trying to figure out why.

We don't have to decide in advance which approach we'll use. We can pay attention together to what's happening and work in the way that seems most useful at the time.

What might change if anxiety didn't have to work so hard?

You would still think ahead.

You'd still prepare for things that matter, notice potential problems, and take your responsibilities seriously.

Over time, the goal isn't to become someone who never feels anxious or never worries about what might happen.

It's to have more confidence that whatever happens, you'll have some capacity to meet it.

You might be better able to recognize when you've done enough.

You could make a decision knowing there are things you can't predict. Send the email without reading it six more times. Have the difficult conversation without rehearsing every possible version of it first. Notice yourself worrying about something you can't do anything about tonight—and let yourself go to sleep anyway.

When something genuinely difficult happens, you may still feel anxious. You may be scared, uncertain, disappointed, angry, or overwhelmed.

But those feelings don't have to mean that something has gone terribly wrong or that you need to make them disappear.

You can have conflicting feelings without having to resolve them immediately. You can want something and be afraid of it. You can make a choice that costs you something. You can disappoint someone and still stand by the choice you made.

And when you don't know what will happen next, you may be increasingly able to trust something anxiety has had a hard time believing:

You don't have to anticipate everything that might happen in order to be able to meet what does.

Interested in working together?

If some of what you've read here feels familiar, we can talk about what's bringing you to therapy and whether working together feels like a good fit.