CBT for generalised anxiety and chronic worry
What is generalised anxiety?
Generalised anxiety is persistent, hard-to-control worry that moves between topics and rarely switches off, often with restlessness, poor sleep, tension and trouble concentrating. At its core is an intolerance of uncertainty. NICE recommends CBT. At The Lyceum, Sanah Younis works in two forms: focused work to interrupt the worry cycle, and, where the worry sits on an older belief, deeper work on the belief underneath. In Chiswick, Ealing and Richmond, or online. Generalised anxiety is a pattern in which uncertainty itself can feel threatening. It is not simply worry about one event. The mind may repeatedly try to predict, prevent or solve what cannot be resolved in advance. The work begins with a formulation, then shifts from the content of worry to the process of worrying. Where appropriate, this can include applied relaxation for autonomic arousal, cognitive restructuring of positive beliefs about worry, worry postponement and behavioural experiments that build tolerance of uncertainty. Focused work is commonly planned over 8 to 20 sessions. Core Beliefs & Schema Restructuring may follow where the ‘not enough’ belief remains relevant. How we measure progress GAD-7 alongside WSAS (Work and Social Adjustment Scale). A baseline anxiety measure is paired with a measure specific to the difficulty being treated, so a general distress score does not stand in for the specific fear. Generalised anxiety wears people out. They come in exhausted from trying to predict and pre-empt every bad thing that could happen, and they are often told they are just stressed or a control freak. What I want them to see is that the worrying is not keeping them safe; it is the problem wearing the costume of the solution. GAD is not fear of one thing. It is the mind treating uncertainty itself as a threat, and trying to think its way out of a feeling. The work is learning to let the uncertainty sit there, unanswered, and discovering nothing collapses.
Frequently asked questions
What is CBT for generalised anxiety?
CBT for generalised anxiety starts by understanding the worry cycle and the role uncertainty, avoidance and safety behaviours may be playing. The focus is agreed through assessment rather than applied as a standard programme.
How long does GAD therapy take?
Focused work is commonly planned over 8 to 20 sessions. If an older belief remains central, further work can continue on an open-ended basis with a formal review every six sessions.
Is high-functioning anxiety a diagnosis?
High-functioning anxiety is not a formal diagnosis. It is a useful description for people who appear to be coping while persistent worry, tension or self-pressure continue underneath.
Can generalised anxiety be treated online?
Online CBT may be discussed alongside face-to-face appointments in Chiswick, Ealing and Richmond. Suitability and current availability are considered individually.
What is high-functioning anxiety?
High-functioning anxiety is not a formal diagnosis. It can describe someone who appears composed and capable while persistent worry, tension, self-pressure or exhaustion continue underneath. Assessment considers the impact of the pattern rather than judging it by outward functioning.
What is the difference between GAD and normal worry?
Normal worry is a temporary, proportionate response to a specific problem; it has a clear endpoint. Generalised Anxiety Disorder (GAD), on the other hand, is an exhausting, free-floating engine of "what if?" that jumps from topic to topic without ever finding resolution. It is often accompanied by physical tension and poor sleep. Once we map your specific pattern, CBT helps you build a tolerance for uncertainty rather than endlessly trying to control the uncontrollable.
Does CBT work for generalised anxiety?
CBT can explore the process of worrying, intolerance of uncertainty and beliefs that make worry feel necessary. Where appropriate, work may include behavioural experiments, worry postponement, applied relaxation or cognitive restructuring, with the focus agreed collaboratively through assessment.
How many sessions will I need for generalised anxiety?
Focused work is commonly planned over 8 to 20 sessions, although the pace and scope are set through assessment. If an older core belief remains important, further work may continue with a formal review every six sessions.
Can anxiety be treated online?
Online CBT may be discussed alongside face-to-face appointments in Chiswick, Ealing and Richmond. An initial conversation can clarify current availability, the practical format and whether online work is suitable for your circumstances.