As a psychologist in New York City who has conducted thousands of sessions helping clients manage their anxiety, I have come to understand that there is one key to managing your worries. This key unlocks your ability to gain a sense of control over anxious moods and thought patterns. What I’m proposing also helps with an intense fear of something specific, such as a work presentation, medical test results or childbirth.
Just to clarify, when I use the term “anxiety,” I am referring to persistent worry and severe concern in response to an event that may or may not happen, the very uncomfortable anticipation of negative things to come. Anxiety involves a response to something in the future that is less likely to happen. Sometimes we feel anxious without any conscious awareness of what we’re anxious about.
We can all relate to the looping repeat of uncomfortable thoughts that accompany anxiety. Anxious moods steal our ability to focus on work, relax, bond with loved ones and get sound sleep.
My success with helping clients who are grappling with anxiety has depended on establishing the proper starting point for gaining a sense of mental control. In essence, the stage must be set before the band can start playing a relaxing tune.
Managing Anxiety Starts Here
The key to managing anxiety is gaining a sense of hardiness, or faith in your ability to cope with the unknown. Having this faith allows you to know that you’ll be ok no matter what happens. Hardiness is not easy to achieve, but the presence of just a drop of faith goes a long way.
How do you build up your hardiness? It starts with telling yourself 50 times a day, “No matter what happens, I will be ok.” If fear of a specific event is overwhelming you, try gently picturing yourself in the feared scenario and then tell yourself this message 50 times as you look around experience the sights and sounds of this event.
See yourself as making it through the event if you can picture what you fear. Say to yourself, “I made it.”
If this kind of imaginary exposure feels like it’s too much for you, that’s ok! Just feed yourself the reassuring message without imagery.
Faith in your ability to cope can come from a variety of sources. There’s faith in your mind, which refers to a sense of being able to control your thoughts and a sense that you’ll be ok if you lose control of your mind. The chaos doesn’t last. It’s time limited.
You actually do have at least partial control over some things that make you anxious. For example, if you’re getting a procedure done in the hospital, can you decide which doctor will perform the procedure, or the music you listen to, or who will be with you when you’re recovering? Focus on the choices you actually CAN make. The ability to choose some of the minutia of the feared scenario really helps.
The other side of building hardiness is to accept that there are some things you can’t control, which necessitates even a mild commitment to letting go and trusting in yourself, even if you know you will suffer for a period of time. This is where faith comes in. Faith in doctors, faith in God, faith in your efforts to take care of yourself, faith in people to make good decisions and do what’s best for you.
Building Faith in Your Mind
Your ability to control stress and anxiety ultimately depends on how much you believe your mental health can absorb a difficult event.
Sometimes faith in your ability to cope has to do with recognizing what your body can do for you without conscious effort. You were built to cope and return to a comfortable baseline of body functioning. Your body always resets to achieve as close to a sense of balance and equilibrium as possible. For example, if your heart rate soars in anticipation of a catastrophe, you need to remind yourself of your body’s ability to return to a comfortable state. Mental suffering generally comes in waves or cycles, as opposed to a permanent, unrelenting negative experience.
A sense of hardiness is also connected to your immune system. If you tell yourself that you can handle something, your body can have a stronger immune response. Of course, this is not true in ALL scenarios, but feeling hardy certainly gives you a physical boost of strength. Feeling like you can’t handle something is likely to elevate your cortisol levels, which weakens your body’s healing response.
Tips for Managing Anxiety and Building Hardiness
Below are a few hardy suggestions for learning to manage your anxiety.
- Start by sharing your experience of anxiety more authentically with a trusted person in your life. Remind yourself that you have this person to lean on if needed.
- Make sure you go at least one step outside of your comfort zone. It’s ok to be a bit uncomfortable if your behavior is in the spirit of striving toward something.
- Spend time identifying what’s important to you. What are the values you live by? What kind of person are you striving to be for the world? Judge your behavior based on these commitments. Knowing your values and who you are striving to be serve as a guide for difficult choices and personal boundaries.
- Take time to evaluate your personal boundaries with others. Who makes you do things you don’t want to do? Who makes you feel badly about yourself? Consider reading the book Set Boundaries, Find Peace to get a wonderful introduction to setting healthier boundaries.
- Evaluate your expectations for how an anxiety-inducing situation is supposed to go. Do you need to spend time learning to be less perfectionistic? Do you expect too much of yourself or other people? Setting reasonable expectations promotes feeling less shocked by negative outcomes.
- Pay attention to how you use your phone to self soothe. Are you over-reliant on your phone or should you commit to bringing uncomfortable thoughts under control without a screen?
Please feel free to reach out and ask a question or if any of this information feels like something you want to work on in therapy.
Good luck to you and your hardiness!
-Dr. KushnickLearn More
1. What does a psychologist do for anxiety?
A psychologist is trained in providing a variety of methods to alleviate your anxiety. As a Manhattan psychologist who works with ambitious New Yorkers, I offer a multi-pronged approach to alleviating anxiousness. I help clients identify triggers, discover thought patterns that exacerbate anxiety, focus on here-and-now techniques to manage flareups and ultimately gain a toolbox of available techniques to apply to difficult moments. In my experience, the fast-paced life of New Yorkers leads them to have to constantly juggle multiple stressors at once, so anxiety is almost an inevitable part of the NY experience, but there is a tipping point beyond which the anxiety can take over your life. This is where therapy can be immensely helpful.
2. How do psychologists test for anxiety?
A psychologist typically assesses through detailed questioning about your current symptoms and history, including any traumatic life events that may have played a role in your anxiety. Some psychologists offer questionnaires and other formal assessment tools to better understand the nature of your anxiety.
As your psychologist I am better able to help you if I understand many of the details related to the present and the past, but I don’t dwell in the past. I am much more focused on the here and now. The beginning of therapy involves me asking you lots of questions, and then the nature of the conversation shifts into a more collaborative conversation.
3. What type of psychologist should I see for anxiety?
A clinical psychologist is well trained to offer you tools to manage your anxiety. Some clinical psychologists are trained in multiple methods of treatment, such as cognitive behavioral therapy (CBT) or psychoanalysis. Clinical psychologists receive a doctorate in psychology and train in a variety of contexts, including hospitals, clinics and schools. Counseling psychologists represent another option, but they are less common in New York City. Please note that other mental health professionals, such as clinical social workers and mental health counselors can be just as (if not more) effective as a clinical psychologist, but Doctors of Psychology generally receive more formal training on the path to their doctoral degree. Other mental health professionals typically subject themselves to other forms of training after they receive their degree. Please note that there are many exceptions to the comments I made in this paragraph.
I am a clinical psychologist who has trained in just about every type of clinical setting. New York City has offered me so many opportunities to train with such a variety of people from diverse backgrounds and professions. Please do not hesitate to reach out with any questions. I love to talk shop!
4. Can a psychologist help with anxiety?
A psychologist can help with anxiety, but there are a lot of factors involved in determining the extent to which therapy will help. I have found that the following factors play a role in determine success with anxiety treatment for New Yorkers:
a. Timing – Success in therapy is connected to how ready you are and open to subjecting yourself to the therapeutic process. Some clients are in a place in their lives where therapy truly fits in with their life situation. Other clients are initially resistant and fearful, but slowly evolve into a state of readiness to change.
b. The presence of a Medical Condition – Sometimes medical issues slow down progress in talk therapy. Medication might be needed, but that should be determined by a psychiatrist.
c. Your investment in valuing your mental health – In my experience as a New York City psychologist, my clients who allocate a good amount of time to caring for their mental health, even outside of therapy, tend to fare much better than clients who barely make time for therapy and other wellness activities. I respect the extremely busy schedule of ambitious New Yorkers, but to truly manage your anxiety more effectively, you need to allocate time and energy.
5. Is it better to see a therapist or a psychologist?
It really depends on the amount of training of the mental health professional. Many therapists who are not clinical psychologists have undergone more training than psychologists. Look into the breath of experience and areas of expertise of the therapist to determine what works for you. Psychologists are considered one type of therapist.
6. How do I choose a psychologist for anxiety?
In the age of the pandemic, it is even harder to find a therapist because so many people are seeking mental health care. Start with the listing sites on the web, including psychologytoday.com and good therapy.org. Cross reference your findings with the list of in-network psychologists listed on your insurance company’s website. It is a frustrating process for many people to find a therapist. Plan to reach out to 10-20 therapists to find one who is available.
Google each therapist to see if they have a website and more information about their expertise and areas of interest.
If you are able to go out of network to find a therapist in New York City, you can probably find a psychologist who has tons of expertise in exactly the issues that you want to focus on. I purposely created my therapy practice website to give potential clients a lot of information about my approach to therapy and my thoughts about many topics in mental health so that people can get a sense of what I am like even before meeting me. See here for a list of articles I’ve written and expert input I’ve offered.
7. What are 3 coping skills or strategies for anxiety?
a. One coping skill for managing anxiety is to identify your triggers. When you are very aware of the exact stressor, you can work with a clinical psychologist to develop tools to take action.
b. Another coping skill is to become very aware of bodily sensations associated with anxious states. How does anxiety show up in your body? It’s different in everyone. When you have a keen understand of your physical symptoms, you’re less likely to be surprised by the way your body responds in the future. The goal is to be able to say, “Oh, my heart is racing not because I’m having a catastrophic medical issue, but because my anxiety has been triggered.
c. Distraction is king. Redirecting your attention away from your anxiety may also work to reduce symptoms.
(Disclaimer: These strategies are for informational purposes only. Please consult a medical or mental health help if you are experiencing significant anxiety.)
8. How do you calm down/ reduce anxiety?
Anxiety is reduced by developing tools to make you feel more prepared for future episodes of anxiety. It all comes down to what you tell yourself, so self-talk is crucial.
9. What triggers anxiety?
Many things can trigger anxiety, including specific environments, painful thoughts, or in some cases, medical issues.
10. Is anxiety a form of mental illness?
It’s tricky to define what constitutes mental illness. Anxiety is a mental health condition. The word “illness” is less clear to define. The DSMV-TR generally defines mental illness as emotional distress that significantly interferes with one or many aspects of your life, including social, occupational, relationship or school functioning.
11. What is anxiety?
Think of anxiety as the anticipation that a catastrophe is going to occur. Anxiety is the interpretation of an impending threat of some variety. Your mind and body react to the conscious or unconscious message that you won’t be able to handle the threat.
(As seen on Huff Post)
If you’re considering a career as a psychologist AND you plan to practice in New York City, you’re in luck.
Serving the mental health needs of New Yorkers as a psychologist in private practice is more than just great…it’s the most rewarding career path available. Of course, I’m just a tiny bit biased, but I stand by my assertion and you’ll learn why I feel so strongly about it.
Keep in mind that I’m generally referring to what it’s like to be a New York City psychologist in private practice as opposed to working in a hospital, school or clinic setting. You can also have a rewarding career as a psychologist outside of the private practice setting, but running your own show takes the experience a hundred levels higher. And even if you want to be in private practice, you almost always have to train and work in other settings before you can practice independently
All I will say to qualify my bold statement is that a career as a psychologist can only be so profoundly amazing if the following are true:
- You can handle the uncertainty of lacking a regular, predictable paycheck.
- You don’t worship money.
- You have exceptional listening skills, you tend to root for the underdog, you have the humility to take responsibility for your actions in interpersonal conflict and you don’t unravel when you hear about extreme mental suffering.
Yes, this is a gross oversimplification of what makes a solid psychologist, but it will have to do for now.
The Life of the NYC Psychologist
- First and foremost, you get to meet the most intelligent, dynamic and talented group of people in the world. Can you imagine how enjoyable it would be to spend your day enhancing the lives of the movers and shakers of the world? It’s wildly exciting to help younger generations who have the drive, talent, creativity and mental ability to change the world. A typical day may involve working with an ambitious student, then a programmer, then a talented finance or professional, then an entertainer, then a C-suite executive. It’s amazing! I learn as much from my patients as they do from me.
- You learn how to mix art with science to enhance the lives of people who are the world’s best artists and scientists. The best therapy is one that mixes objectively proven techniques with artful, interpersonal maneuvers. Psychologists, especially skilled ones, take mental health care to the next level by offering much than what a book or manual can teach. They mix art into their approach, which adds an intangible element that promotes personal transformation.
- You feel like you’re making a difference in the world on a daily basis. Since New York attracts such a unique type of individual, it can feel like you’re having a profound effect on society by improving the lives of people who make things happen for the world. As your skillset grows, so will your ability to create significant changes for your patients, which in turn, will make them more effective in their influence on the world.
- You become an expert in New York City culture without trying. Imagine being constantly taught about the subtleties of city life, the latest trends, memes, metaphors, fashion, art and everything that makes NYC so unique. It gives you the sense that you have your finger on the pulse of the Center of the Universe, the world’s largest think tank. Clients will incorporate their vast array of cultural opportunities into their therapy. For example, you will get to talk with clients about Hamilton after they see the show, or an art installation, gala or tech convention.
- Investing in self-improvement becomes a thunderclap of wellness that spreads across the city. If you read about an interesting concept, you’re suddenly equipped with a powerful metaphor to use with certain clients. Take on the task of reading a self-help book or attending a seminar and your clients will indirectly benefit from what you personally reap.
- You make your own hours which gives you a invigorating sense of freedom.While everyone else is counting vacation days, imprisoned within a cube city and reporting to a boss, you get to do whatever you feel like. Even with a full roster of patients, there’s still tons of time to play in the city. This can be problematic if you’re undisciplined or you crave the structure offered by a regular paycheck. To be honest, I would give up the predictability of a regular paycheck in a heartbeat for the freedom to walk outside on a two-hour break between sessions to sit in a wonderful coffee shop and write a blog post, take an hour-long stroll and soak in the city’s spirit and beauty, schmooze with New Yorkers or casually browse through a magic shop or a used book store.
- You’re exposed to the most diverse group of people and ideas on the planet. In a single day, you might work with people from six different countries, or help someone manage the stress of the inner city right after assisting someone with managing the stress of running a large company. You get to talk with people with high aspirations, people from backgrounds unlike your own who care about the world and want to make it a better place.
Find out exactly what a clinical psychologist does. Here are some commonly asked questions regarding the role of a clinical psychologist in New York City.
What is the role of a clinical psychologist?
A clinical psychologist works with people to improve their social, emotional, mental and behavioral problems. First, a clinical psychologist conducts an assessment of the problem to arrive at a diagnosis via interviews, observation and sometimes psychological testing. Next, they create a treatment plan with the client and help them to identify goals that the client wants to work on. Then, the clinical psychologist carries out psychological treatment to help the client achieve the goals. Progress is monitored over the course of treatment.
I have been conducting psychotherapy in New York City for over 20 years. One benefit of being a clinical psychologist, as opposed to other types of therapists in NYC, is that my clinical doctoral training in assessment and diagnosis tends to be more extensive than what is offered in most other mental health degree programs.
Some clinical psychologists do research, teach or consult for organizations/businesses to solve systemic and individual issues.
Is the job of a clinical psychologist in New York City different than that in other places?
The role of clinical psychologists in New York City is generally the same as that in other parts of the country. However, there are a few subtle but important differences when compared to clinical psychologists in New York State or other places.
First, in NYC clinical psychologists tend to be more trained in working with people from diverse backgrounds. The amazing diversity of NYC’s population necessitates that New York City clinical psychologists have an added sensitivity to people with alternative lifestyles and varied backgrounds.
Second, the fast-paced speed of everyday life, the noise, the lack of space and the general pressure to achieve success makes New York City a challenging place to live. As a Manhattan clinical psychologist, I am frequently helping people manage their career achievement needs and the stress generated from wanting to “make it big” here in New York. As a result, I have the honor of working with some incredibly ambitious people who are changing the world.
Third, it is my belief that a New York City clinical psychologist also helps people cope with the lack of a sense of community in the city. Other parts of the country have more of a community feel. The absence of community creates the potential for feeling a sense of emptiness, isolation and loneliness, especially when you are new to NYC. A clinical psychologist in New York City who has been in practice for a long time must know how to help patients cope with this kind of challenge.
Please note that other kinds of NYC psychotherapists with lots of clinical experience also learn to help people manage the unique combination of isolation and pressure found in New York City.
What is the Difference Between a Therapist and a Psychologist?
A therapist is a generic term for any mental health clinician who meets face-to-face (or online) with patients to alleviate their emotional suffering. Be careful though. There are also many types of therapists that are not associated with mental health, such as a physical therapist, speech therapist and occupational therapist.
A psychologist is a type of therapist, one with the most rigorous training out of all the types of mental health therapists. Psychologists tend to have more years of clinical training and more hours of supervision and clinical experience even before they graduate from their program.
How long does it take to become a clinical psychologist?
In order to become a clinical psychologist, you need to complete your Bachelor’s Degree first. Some clinical psychologist also complete a two-year Master’s Program in Counseling or a related mental health field before their clinical psychology doctoral program. However, clinical psychology doctoral program students are awarded a Master’s Degree after two years and them they continue on for their doctorate.
Overall, a doctorate in clinical psychology can take between 4-7 years, sometimes even longer. There are three years of graduate classes during which doctoral students are completing supervised clinical training (aka externships) in various mental health settings, such as a hospital, clinic or school counseling center. Once the coursework is complete, the doctoral student has to complete a one-year internship in an accredited mental health setting. After the internship the doctorate is awarded. Then the new psychologist must complete about 2000 hours of post-graduate training before receiving a license in a particular state. Please note that the information provided here varies greatly across states in the US. Please see here for more on the topic.
What is the difference between a psychologist and a clinical psychologist?
A psychologist is a general term for a professional who went to a doctoral program in psychology. A clinical psychologist is an expert in the human mind that attended an accredited doctoral program in clinical psychology. Clinical psychologists also work directly with human subjects. In other words, clinical psychologists work with clients. Other non-clinical psychologists may draw from the same knowledge based but they do not necessarily work directly with clients.
There are other types of psychologists, including industrial psychologists, social psychologists, forensic psychologists and sports psychologists.
Do you need a doctorate to be a clinical psychologist?
Yes, you need a doctoral degree to be a clinical psychologist. You can get a Doctor of Psychology (PsyD) degree or a Doctor of Philosophy in Psychology (PhD) degree in order to be a psychologist.
In some mental health settings, I have seen people loosely use the word “psychologist” to refer to the mental health clinician on staff regardless of their degree, but the true definition of the role implies earning a doctorate in psychology.
What is a PsyD ?
A PsyD or Psy.D. represents a “doctor of psychology,” which is a practitioner’s degree in clinical, counseling or school psychology). In contrast to a PhD, the training you receive at a PsyD program tends to involve more clinical training and more hours of supervised face-to-face interaction with patients. There are probably exceptions. Phd programs in clinical psychology tend to have more of a research focus. While a lot more PhDs are hired for teaching roles, PsyDs are hired as well in universities.
In my PsyD program I received extensive training in clinical psychology, conducted hundreds of hours of supervised psychotherapy AND I wrote a PhD-level dissertation. It was not my original intention to create such a mammoth dissertation, and you generally do not have to write a huge dissertation in a PsyD program. It can be a more contained project.
Is a clinical psychologist a doctor?
Yes, a clinical psychologist is considered a doctor of psychology (not to be confused with an MD, or medical doctor.
What is the difference between a clinical psychologist, a clinical social worker, a mental health counselor and a marriage and family therapist?
A clinical social worker (LCSW) helps people to cope with emotional, behavioral and mental issues, but the training does not include as much emphasis on assessment and diagnosis as compared to a clinical psychology doctoral program. Many LCSWs take their education a step further by attending extensive training programs in specific areas following the completion of their clinical hours for licensure. Social workers receive impressive training in understanding and navigating through various systems that interact with the individual. See here for more on this degree.
A mental health counselor is a Master’s Degree in Mental Health Counseling. See here for more on this degree.
A marriage and family therapist (LMFT) is a specialized degree that focuses primarily on marital and family counseling. There is also training in individual therapy. See here for more on this degree.
What is the difference between clinical psychologists and psychiatrists in New York State?
A clinical psychologist is a PhD or PsyD helps alleviate emotional suffering via various forms of talk therapy.
A psychiatrist is a Medical Doctor (M.D.) who went on to specialize in psychiatry. Psychiatrists tend to work with people who are grappling with more serious forms of emotional suffering, but not always. Some psychiatrists also conduct psychotherapy. They tend to lean toward medication as the solution for emotional problems.
Clinical psychologists in New York State are not permitted to prescribe medication. Nor do they do not receive any formal training in prescribing medication.
Thank you for taking the time to read this. Please feel free to reach out to me with any questions about the field of clinical psychology or to get started in therapy.Learn More