What to Do Between Sessions When Anxiety Creeps In.

Aug 9

If you struggle with anxiety, in any form, then you probably know that it doesn’t wait for the most convenient time to show up. Often, it can be strongest outside of your sessions, and outside of your therapist’s business hours, which can be overwhelming. The work you & your therapist do in session together will naturally support these moments over time, giving you more tools to cope, reducing the intensity of anxiety, and increasing your capacity for overwhelm. But therapy happens between sessions, too—and small moments of awareness can become opportunities to practice new ways of relating to anxiety.

Double exposure photo of someone who is experiencing anxiety.

Anxiety Doesn’t Wait for Your Therapy Appointment

Your next therapy appointment might be days away, but anxiety doesn't always respect your calendar. Life happens between therapy sessions, and it’s incredibly normal (and, even expected) that anxiety & adjacent symptoms would arise. Having difficult moments doesn’t mean therapy isn’t working, and it can be a valuable opportunity to practice the skills you & your therapist have been building. The goal of therapy isn’t necessarily to get rid of anxiety, but to build a different relationship to it. Different tools work for different people, and therapy is a place for you to find & hone the tools that work best for you.

First, Pause and Notice What’s Happening

The goal is to create space between the anxious feeling and the automatic reaction. We often refer to this as a ‘gap’. Notice how you feel - “I’m feeling anxious right now”, and identify where it shows up physically (somatically) in your body. Begin to notice your thoughts - how does your mind react to anxiety? What stories does it create? Try to notice thoughts without immediately treating them as facts. As you practice this internal awareness, can you determine what you need in this moment? Is there something your body or mind are needing right now? There many be many answers to that last question, and we sometimes need multiple things to reduce the anxiety, so let this part be an experiment. Try one thing, see what happens, and then try another. This is a way for you to become more internally aware, and for you to practice listening to what you are needing in the moment. Remember: we are trying to foster mindfulness and curiosity, rather than judgment.

Come Back to Your Body

Your nervous system is impacted by your body, your mind, and your emotions. When experiencing anxiety, introducing some grounding practices can be helpful to down-regulate the nervous system, and reach a greater sense of calm.

Some tools to consider:

Feel your feet against the floor.
Take a slower breath, emphasizing a longer exhale.
Look around and name a few things you can see/hear/feel.
Place a hand on your chest or abdomen.
Stretch, walk, shake out tension, or move gently.
Drink cold water, splash cold water on your face, or wash your hands with cold water - the temperature change helps with anxiety by triggering a physical reflex that slows your heart rate, shifts your nervous system away from fight-or-flight mode, and floods your brain with feel-good chemicals like endorphins.

The purpose isn't to force your anxiety to disappear. It's to help your nervous system recognize that you are here, now.

Separate the Feeling From the Story

Anxiety often brings a chorus of catastrophic stories—quick, vivid "what if" scenarios that escalate small worries into looming disasters. These stories aren’t predictions; they are patterns the mind learned to use in an effort to prepare for danger. They feel urgent and convincing, but they distort probability, ignore evidence, and magnify worst-case outcomes.

Noticing these narratives is the first step toward changing them. Mindfulness lets you observe the story without automatically believing or acting on it. Labeling thoughts as “a worry story” reduces their power. Grounding, paced breathing, and asking pragmatic questions (“What is actually happening? What would I do if this happened?”) interrupt the spiral. Over time, trauma-informed, skill-based work helps you replace catastrophic storytelling with clearer, calmer appraisal—so you can respond to difficulty rather than be driven by imagined disasters.

Ask yourself, “What do I know right now?” and begin to orient toward the facts. This isn’t in the interest of arguing with your mind/body, but to help you orient toward what is true, real, and factual in this moment.

Next, ask yourself, “What am I assuming?” We often are making assumptions (filling in blanks) when we feel anxious. Sometimes, we need to acknowledge all of the ‘blanks’ our anxiety is filling in through the stories we create in order to address them.

Again, we aren’t trying to argue with our internal experience or the parts of us that create these stories. Instead, we’re trying to understand where they are coming from and help orient our system to the present moment.

Ask: “What Do I Need Right Now?”

Rather than immediately trying to solve or get rid of your anxiety, pause and gently explore what your system may be needing in this moment. Possible needs can include rest, human connection, gentle movement, nourishment (food or water), reassurance, a clear boundary, time away from stimulation, a simple concrete next step, or compassion toward yourself. The intention here is cultivating self-awareness and attunement rather than rushing into self-correction.

Do One Small, Grounding Act

Always begin with the feedback you get from the last step - when we ask our system what we need and it tells us, it helps to listen & act on it! If a specific need isn’t clear, or if you’ve tried that and you still feel anxious, choose one manageable action to practice, rather than creating an elaborate self-care routine.

Examples:

Take a shower.
Go outside for five minutes.
Make tea.
Eat something nourishing.
Put the phone down.
Text someone you trust.
Take a short walk.
Return to a familiar routine.
Do something absorbing and enjoyable.

Small actions can help interrupt the anxiety spiral without turning anxiety management into another task to accomplish perfectly.

Write It Down for Your Next Session

While anxiety often doesn’t show up just in time for a session, you can absolutely bring your experience between sessions into your work with your therapist.

We suggest keeping a simple note:

When anxiety showed up:
What was happening?

What I noticed:
Thoughts, emotions, body sensations.

What I did:
What helped? What didn't?

What I want to explore:
What question or pattern do I want to bring to therapy?

This helps transform an anxious moment into useful information for therapy. You & your therapist can work through these prompts together to identify what worked, what didn’t, and continue to hone your treatment based on your experience and real data.

You Don't Have to Do It Perfectly

The space between therapy sessions isn't a test of whether you've learned enough. It's where you get to practice noticing, responding, and learning about yourself in real life.

If anxiety keeps showing up between sessions, that's worth bringing into therapy. A therapist can help you understand what's underneath the anxiety and develop tools that fit your nervous system, your circumstances, and your life.

Interested in exploring this further with one of our therapists? Click the links below to learn more or get connect with our team.

Meet Nora!

Nora is accepting clients & has specialized training in anxiety therapy. She offers mindfulness-based, trauma-informed approaches to help clients reduce worry, manage panic, and rebuild confidence. Nora integrates evidence-based techniques with compassionate, relational care.

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