Anxiety therapy
for San Francisco.

High-functioning anxiety is anxiety that shows up alongside (and often fuels) achievement, preparation, and perfectionism. From the outside, you look capable and composed. From the inside, the mind is running constant scenarios, replaying conversations, and bracing for what could go wrong. It usually works, until the cost starts outpacing the benefit. Most clients come in when sleep, jaw tension, stomach issues, or reactivity in relationships signal that the nervous system is asking for attention.

Yes. Exposure and Response Prevention (ERP) is the gold standard evidence-based treatment for OCD. Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093), particularly specializes in ERP for anxiety and OCD presentations. The work is structured, collaborative, and paced to what you can tolerate. We don't push you past your window.

Yes. Most evidence-based anxiety treatments (CBT, ACT, ERP, mindfulness) work just as well over secure video as in person. For most San Francisco clients, telehealth also removes the logistical friction (cross-city traffic, finding a 50-minute window) that can make weekly therapy hard to sustain.

Not required. Many clients do great with therapy alone. Others find that medication paired with therapy gets them further, faster. We don't prescribe (that's a psychiatrist's job), and we don't take a position on whether you should take it. We work with whatever you and your prescriber decide, and we can refer to trusted psychiatrists in the area if you want that conversation.

Life stress is something you recover from when the stressor passes. Anxiety that needs therapy is when your nervous system is running hot even in moments when there's no immediate threat, when sleep or focus or body signals (jaw, stomach, heart rate) are affected, or when avoidance is shaping your daily choices. If you can't tell which one you're in, the free consult is a good place to sort it out.

Common situation for our San Francisco clients. The work isn't about pretending the demands aren't real, or convincing yourself to care less about your job. It's about changing your relationship to the demands: what you absorb versus put down, where your nervous system can rest even when the workload can't, which worries are actually about the job versus attaching themselves to the job. Most clients find that reducing the anxiety also makes the work itself more sustainable, not less.