Overcoming Anxiety with ISTDP Therapy
- Apr 17
- 3 min read
Updated: Jul 28
Anxiety isn’t random.
It’s part of your internal threat system, the same one that would help you survive if you were in real physical danger.
But unlike a fire alarm that rings when there’s actual smoke, your anxiety system can get triggered by emotional experiences too. Especially if you’ve learned, at some point in your life, that it wasn’t safe to feel certain emotions.
That’s when anxiety becomes less of a warning and more of a blockade. It steps in to protect you, but it also holds you back. And over time, this kind of internal pressure can leave people feeling emotionally drained or even burnt out. I’ve written more on burnout and emotional shutdown here.
A metaphor I often use with clients is the smoke alarm. The alarm itself isn’t the problem, it’s the sign that something deeper is going on. If we just try to shut the alarm off without putting out the fire, it’ll keep coming back.
ISTDP helps you locate and put out the fire, not just silence the alarm.
An Example from an ISTDP Session
Here’s how that might play out in therapy:
Client: My boss is really critical of me. She points out things I’ve done wrong, but always in a way that feels unfair. When she does it, I just go on edge.
Therapist: Do you notice that as you’re telling me this, your anxiety is increasing?
(The therapist notices fidgeting and faster speech, signs of a rising anxiety level.)
Patient: I didn’t notice. I’m just used to pushing through it or pretending it’s not there.
Therapist: That makes sense. But when we ignore anxiety, we miss the chance to understand what’s underneath. Let’s pause and really notice where it is in your body, so we can help you regulate it.
(They do this together, and then return to the topic.)
Therapist: Did you notice the anxiety rose when you started talking about your boss’s criticism?
Client: Yeah… now I see that. It happens a lot in similar situations.
Therapist: So let’s take a look. How do you actually feel towards your boss in those moments?
What we found in this session was that the patient had learned it wasn’t okay to feel or express anger, so her body responded with anxiety instead.
By helping her safely reconnect with those emotions, the anxiety no longer needed to step in and block them. The pressure inside eased, not just in the session, but over time.
What You Can Expect from ISTDP
Many people come to therapy thinking of anxiety as something that “just happens”, a feeling that strikes out of nowhere. But often, anxiety is tied to deeper emotional processes that aren’t yet fully in awareness.
ISTDP helps you start noticing the internal signals that may be fuelling your anxiety, even if you’ve never thought about it this way before.
Rather than simply talking things through or trying to change your thoughts, ISTDP offers a more active and focused way of working. It’s a process that:
Helps you tune into anxiety in your body as it shows up
Guides you to explore what feelings or emotional blocks might be underneath
Supports you in making sense of these patterns safely and at your own pace
Creates meaningful change in how you experience yourself and your relationships
Over time, this kind of focused emotional work helps reduce the need for anxiety to keep sounding the alarm, because the deeper issues are no longer being avoided. If you’re curious about how this differs from more surface-level coping strategies, I explore the difference between managing symptoms and resolving them in this post.
Ready to Go Deeper?
If you’re tired of being stuck in the same anxious loops, even though you “know” what’s going on, this approach might be a good fit for you.
Feel free to get in touch to find out more about how we could work together.
I offer in-person therapy in Nottingham and online sessions across the UK and Europe.
And if you’d like to learn more first, you can download my free guide, it explains how anxiety, emotion, and defences are connected, and what you can do about it.
