Specialism
Therapy for generalised anxiety disorder (GAD)
CBT for worry that never runs out of subjects — online across the UK, in English or Spanish.
Does this sound familiar?
The worry moves. You settle one thing and it lands on the next — work, money, health, your children, the email you sent this morning, something you said in 2019. There is always a subject available, and each one feels genuinely urgent while you are in it.
Your body has been braced for so long that you have stopped noticing: tight shoulders, a clenched jaw, tiredness that sleep does not fix, a stomach that reacts before you consciously know anything is wrong. Sleep is often the worst part — the lights go out and the mind starts its shift.
You may also have noticed that the worrying feels almost useful, as though thinking it through is what keeps the bad thing away. That belief is one of the most important things we will look at together.
The people around you may not see any of it. Worriers are often the reliable ones — the person who has already thought of the thing nobody else considered, who books early, who checks. That competence is real, and it is also part of what keeps the worry in business, because every time nothing goes wrong the worry takes the credit.
How I treat generalised anxiety
CBT is the treatment NICE recommends for generalised anxiety disorder, and it is what I use. The work is not about arguing with each individual worry — there are too many of them, and a new one arrives as soon as you settle the last. We go after the process instead.
That means looking honestly at what worry does for you: the belief that it prepares you, the belief that it is uncontrollable, and the checking, planning, reassurance and avoidance that keep the whole loop fuelled. We then test those beliefs directly, with experiments you run in your own week rather than arguments we have in the room.
Alongside that we build the practical side — worry postponement, tolerating unanswered questions, and coming back into your body when it has been braced all day. Most people notice the first shifts within a few weeks, once the loop becomes visible.
Sleep gets its own attention, because it is usually where GAD does the most damage and the first place people want relief. We work on what your mind is doing at eleven at night rather than on sleep hygiene leaflets you have already read, and on the daytime habits — the caffeine, the checking, the compressed evenings — that leave the worrying nowhere to go but bedtime.
What to expect
We start with a thorough assessment across one or two sessions and agree clear, concrete goals — usually about sleep, concentration and getting your evenings back. A typical course runs 8–16 weekly sessions of 50 minutes, and you will have something practical to try from the first week.
Between sessions you will be gathering information rather than doing homework for its own sake: what actually happened when you postponed the worry, what the outcome was when you did not check. Those records are what make the change stick, and they take minutes rather than hours.
Sessions are online across the UK and worldwide, or in person at Sanctuary Therapy Centre in Prestwich or Hebden Bridge. We review together as we go, and stop when you have what you came for — I am not interested in keeping people in therapy longer than the work needs.
Common questions
Do I need a diagnosis of GAD before I start? No. You do not need a diagnosis, a GP referral, or the right words — describing what your days and nights look like is enough.
Is worrying not just my personality? Worry can certainly be a long-standing habit, and habits are learned rather than fixed. Plenty of people who have worried since childhood find it loosens considerably with the right work.
What if my worries are about real problems? They usually are. CBT does not tell you your concerns are imaginary; it separates the problems you can act on from the what-ifs you cannot, and changes what you do with each.
Does online therapy work as well for anxiety? Yes — research shows online CBT matches in-person outcomes for anxiety disorders, and doing it from your own home makes it easier for many people to start.
How is this different from the anxiety therapy page? The anxiety page is the overview of how anxiety works and how CBT treats it. This one is about the specific pattern of generalised anxiety — free-floating worry that moves from subject to subject — which is treated slightly differently from panic, phobia or social anxiety.
Will I have to stop worrying altogether? No, and that would not be a realistic target. Some worry is useful: it is what makes you check the booking, plan for the meeting, notice the thing that needs fixing. What we are after is the difference between worry that produces an action and worry that only produces more worry. By the end most people still worry sometimes, and describe the change as the worry having an off switch again — it finishes, it stays in proportion, and it stops following them to bed.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.