Seattle Trauma Counseling provides somatic therapy for anxiety, panic attacks, and panic disorder, in person in Edmonds and Kirkland, and online across Washington.
Rather than only managing symptoms, our licensed therapists work with the nervous system that produces them, using approaches like the Safe and Sound Protocol, Brainspotting, Internal Family Systems, and mindfulness-based somatic therapy.
Every therapist offers a free consultation.
Some anxiety is healthy, it's the body's alarm system, and in the right dose it keeps you alert and gets things done. The line is crossed when the alarm won't switch off: chronic anxiety that hums beneath everything, what clinicians call generalized anxiety disorder, or GAD, severe anxiety that cancels plans, health anxiety that turns every sensation into a threat, excessive worry that steals sleep. When anxiety starts interfering with your relationships, your work, or your rest, it has stopped being useful, and it deserves treatment, not endurance.
Clinicians usually describe four main types: generalized anxiety, panic disorder, social anxiety, and phobias. They often overlap, and anxiety can also show up in ways people don't expect: tingling, a lump in the throat, dizziness, or a strange sense of unreality. If you are asking at what point anxiety becomes too much, the honest answer is: at the point where it is shaping your decisions. That is enough.
Anxiety rarely travels alone. Many people also carry low mood or depression alongside it, especially where there's a history of trauma, and treating the nervous system underneath tends to help both.
A panic attack is a sudden surge of intense fear or discomfort that peaks within minutes. It typically includes four or more of the following:
A pounding or racing heart
Sweating, trembling, or shaking
Shortness of breath, or a feeling of choking or smothering
Chest pain or discomfort
Nausea or stomach distress
Dizziness, light-headedness, or feeling faint
Chills or waves of heat
Numbness or tingling
Feelings of unreality (derealization) or detachment from yourself (depersonalization)
Fear of losing control, or of dying
A first panic attack often sends people to the emergency room, because it genuinely feels like a heart attack. When attacks recur and the fear of the next one starts shaping your life, that pattern is called panic disorder, and when fear of the next attack starts shrinking the places you'll go, agoraphobia can follow. Both respond well to treatment. If your attacks come with strong feelings of unreality or detachment, that's dissociation, an area we know deeply.
In the moment, the goal is not to stop the attack, fighting it feeds it, but to ride it out while it peaks and passes, which it will. What helps: remind yourself out loud that this is a panic attack, not a heart attack, and that it will pass. Lengthen your exhale, breathe in for four counts, out for six or more, because a longer out-breath is the fastest signal of safety your body accepts.
Ground through your senses: the 5-4-3-2-1 technique (name five things you can see, four you can touch, three you can hear, two you can smell, one you can taste) or the simpler 3-3-3 rule (three things you see, three sounds you hear, then move three parts of your body) pulls attention out of the spiral and back into the room. Cold also helps: cool water on your face or a cold pack on your cheeks triggers a natural reflex that slows the heart. Sit or lean somewhere stable if you feel faint, keep your posture open rather than curled, and let the wave finish.
Afterward, be kind to the comedown: attacks are physically exhausting, and shakiness, embarrassment or tears afterward are normal. Water, gentle movement and an early night help. What matters more than any single attack is the pattern, and the pattern is what therapy treats.
Anxiety is often the alarm of a nervous system that learned, somewhere along the way, that the world isn't safe. Sometimes that learning traces to experiences you'd name as trauma; often it doesn't, and you don't need a trauma history to work with us. Either way, the alarm itself lives in the body: in breath, heart rate, muscle tension, and the vigilance you can feel but not think your way out of. That's why our approach is somatic, based on the nervous-system research of Dr. Stephen Porges and others, we work with the alarm at its source rather than only managing its noise.
This is also why panic can seem to come out of nowhere. Attacks that feel random usually are not: they are a nervous system that has been running near its threshold, from accumulated stress, poor sleep, old unprocessed experiences, or long-suppressed emotion, finally tipping over at a moment that looks calm from the outside. The trigger isn't the moment; it's the load. Treating the load is the work.
We match the approach to your nervous system, never the other way around. The methods we most often draw on for anxiety:
Safe and Sound Protocol (SSP): developed by Dr. Stephen Porges from his polyvagal research, the SSP is a structured listening intervention that helps shift the nervous system out of chronic fight-or-flight, working through the vagus nerve, the body's main calming channel, into a state where calm is possible, often a powerful starting point when anxiety feels physical and constant.
Trauma Release Exercises (TRE) and Mindfulness: TRE uses simple movements to discharge the physical charge that fuels panic, while mindfulness training builds the capacity to notice anxiety without being swept away by it. Many clients find the physical intensity of panic begins to ease as this work takes hold.
Brainspotting and Internal Family Systems (IFS): Brainspotting reaches the places anxiety is held when talking about it isn't enough; IFS, often called parts work, helps you meet the anxious part of you with curiosity instead of a fight, which is frequently when it finally softens.
Acceptance and Commitment Therapy (ACT): ACT builds a different relationship with anxious thoughts, less struggle, more room to live by what matters to you even while the mind is loud.
Anxiety is one of the areas our therapists know best, meet our therapists and we will help you match with the right fit for how your anxiety works.
Anxiety and panic should not feel like a way of life you have to accept. While therapy can't promise happiness, we believe it's realistic to change your inner state from one of constant anxiety to one of genuine calm, to wake up in the morning without the dread already running. That may sound foreign. We believe it because each of us at Seattle Trauma Counseling has experienced it ourselves.
Yes, panic attacks and panic disorder are a core part of our anxiety work. We treat the nervous-system pattern behind the attacks, not just the fear of the next one, using somatic approaches like TRE, the Safe and Sound Protocol, and Brainspotting.
It's a quick grounding technique: name three things you can see, three sounds you can hear, then move three parts of your body. Like the longer 5-4-3-2-1 version, it works by pulling attention out of the anxiety spiral and into your senses, which interrupts the feedback loop between anxious thoughts and body alarm. These techniques help you through the moment; therapy works on why the moments keep coming.
If you feel faint, sit or lean somewhere stable rather than lying flat, staying upright with an open posture tends to help breathing, and grounding through your feet keeps you connected to the room. More important than position: lengthen your exhale, remind yourself it will pass, and let the wave peak rather than fighting it.
They almost never actually do. Attacks that feel random are usually a nervous system that has been running close to its threshold, from accumulated stress, sleep debt, suppressed emotion, or unprocessed experiences, tipping over at a moment that looks calm from the outside. Some attacks even arrive during relaxation, when the body finally drops its guard. Identifying and treating that underlying load is exactly what somatic therapy does.
Several medical conditions can mimic one, including heart rhythm problems, thyroid issues, asthma, low blood sugar and inner-ear disorders. A first attack, or attacks with new or unusual symptoms, warrant a medical check to rule these out, and we encourage it. Once medical causes are excluded, recurrent attacks are highly treatable as an anxiety condition.
The biggest one is avoidance: every time you dodge a feared situation, the relief teaches your brain the danger was real, and the anxiety's territory grows. Other common amplifiers are caffeine, alcohol (calming tonight, rebound anxiety tomorrow), sleep debt, doomscrolling, constant reassurance-seeking, and fighting the anxiety itself. Treatment works partly by reversing these loops, gently and at your pace.
A single attack after a stressful period may never return. But once a pattern forms, attacks recurring, life reorganizing around avoiding them, it rarely resolves untreated, because the fear of the next attack is itself what fuels the cycle. The good news: panic disorder is among the most treatable anxiety conditions, and breaking the cycle is a well-mapped process.
Therapy is an effective treatment for anxiety for many people, and our somatic approaches work directly with the nervous system that drives it. We're therapists, not prescribers, we don't advise for or against medication, and we're glad to coordinate with your doctor either way.
Sometimes, a nervous system shaped by difficult experiences can stay on alert long after the danger has passed, and many people discover their anxiety has roots they hadn't connected. But you don't need a trauma history to have anxiety, or to work with us. We treat anxiety on its own terms.
Therapy that works with the body's side of anxiety, breath, heart rate, tension, and the stuck alarm response, alongside the thoughts. Because anxiety is a whole-nervous-system state, working only at the level of thinking often brings understanding without relief.
You'll most often read that cognitive behavioral therapy (CBT) is the best-researched talk therapy for anxiety, and for many people it helps. Our approach is different: somatic therapy works with the nervous system underneath the anxious thoughts, which is often what makes the difference when understanding your anxiety hasn't been enough to change it. Honestly, the best therapy is the one that fits how your anxiety works, and the free consultation is where we help you figure that out.
“Anxiety attack” isn't a formal diagnosis, people usually mean a building wave of intense anxiety with a clear trigger. A panic attack is more abrupt: it peaks within minutes, often without an obvious cause, and brings strong physical symptoms like a racing heart, breathlessness, or feelings of unreality. Both are treatable, and both respond to the body-based approaches we use.
Most panic attacks peak within about ten minutes and pass within twenty to thirty, though the shaky, drained feeling afterward can linger much longer. If attacks keep recurring, treatment works on the pattern behind them, not just on surviving each one.
It depends on your history and your nervous system, honest answer. Some people feel a real shift within weeks, especially with body-based approaches; longstanding or trauma-linked anxiety takes longer. The free consultation is the place to talk timelines for your situation.
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