Practical anxiety therapy for the worry that won't stop spinning.
Written by Gerry McNamara, LMFTLast reviewed May 2026
Online sessions across Oregon. Multi-modal work for analytical adults who can describe their anxiety in clinical detail and still can't think their way out of it.
Request a free 15-min consultation →A practical approach to what's actually going on.
I'm not interested in "just relax." I'm interested in helping you understand why your nervous system thinks the worry is keeping you safe, and what it would take for it to believe you're safe without the worry.
Anxiety isn't a personality flaw. It's a system doing what it was built to do, with old information. Real anxiety work is partly about understanding the patterns and partly about giving your body a different signal than it has been getting.
A lot of the people I see for anxiety are analytical adults with sharp insight into their own minds. They can name what they're feeling, draw a map of the loop, and still find themselves stuck in it at 2am. We work with that, not against it. Insight is real. It's just not the whole game.
Together we look at three things: the patterns (what triggers it, what fuels it, where it shows up in your body), the origins (what your anxiety has been protecting you from, often for a long time), and the tools (concrete practices that move the needle, not just affirmations). The mix depends on what you bring.
Multi-modal, because anxiety isn't one thing.
Tools without understanding doesn't hold. Understanding without tools doesn't move daily life. Anxiety work needs both, paced for what you can actually use.
I draw from cognitive behavioral therapy for the practical pattern-interrupting work, psychodynamic work for understanding where the patterns come from, and trauma-informed pacing because going too fast on anxiety often makes it worse. I match the approach to what you bring, not the other way around.
Before I was a therapist, I was a mechanical engineer at NASA. That's an unusual angle, and it shapes the work. I think in systems. I'm comfortable with how the brain and body actually function as machinery. For clients with science, medical, or technical backgrounds, that translation matters.
I've been practicing for eighteen years. The most important thing I've learned is that anxiety work is collaborative. You bring the data of your own life. I bring tools, frameworks, and the kind of attention that helps you notice what you've been too close to see.
Questions I get asked about anxiety therapy.
Does insurance cover anxiety therapy in Oregon?
Yes, in most cases. I'm in-network with most major Oregon carriers including Regence, PacificSource, Moda, Providence, Aetna, BCBS, Cigna, and UnitedHealthcare. Anxiety is a clinical diagnosis that insurance covers under standard outpatient mental health benefits. I bill insurance directly. If you're out-of-network, I can provide a superbill for partial reimbursement.Is online therapy effective for anxiety?
Research supports telehealth therapy for anxiety as roughly equivalent to in-person work for most presentations. For some clients, the comfort of being home actually makes the work more effective. I see clients online from anywhere in Oregon.How long does anxiety therapy usually take?
It varies. For specific, situational anxiety, some clients feel real movement in 8 to 12 sessions. For anxiety that's woven into how you've been doing things for a long time, the work takes longer, and we'd talk realistically about that early on. I'm not interested in keeping you in therapy forever. The goal is to help you understand yourself well enough that you can keep doing the work without me.Do you prescribe medication?
No. I'm an LMFT, not a prescriber. If medication is part of what you need, I work alongside your prescriber or help you find one. For many people, therapy alone is enough. For others, a combination works better. We figure out which together.What if I've tried anxiety therapy before and it didn't work?
Most of the people I see for anxiety have tried therapy before. Sometimes the modality wasn't a fit. Sometimes the pace was off. Sometimes the work didn't get specific enough about what your anxiety is actually doing for you. We start with what you've already tried and what was missing.
Related work I do across Oregon.
Depression therapy
Anxiety and depression often travel together. The work overlaps in important ways and diverges in others.
Read moreTrauma therapy
Anxiety sometimes has trauma roots. When it does, the work changes shape, and pacing becomes load-bearing.
Read moreMid-life therapy
When anxiety is being driven by the mid-life questions underneath it, the work shifts. Often the two need to be addressed together.
Read more
Ready to talk it through? Let's see if we're a fit.
Send a message, or set up a free 15-minute phone consult. You can reach me by email, call, or text. I'll get back to you within two business days.