Anxiety Therapy in New York City
I help high-functioning adults in New York work through anxiety — the worry, dread, and physical tension underneath a life that looks entirely under control.
I’m a Licensed Clinical Social Worker (LCSW) offering private, in-person anxiety therapy on Fifth Avenue in Manhattan, and online across New York, New Jersey, and Connecticut.
Anxiety therapy — scope at a glance
High-functioning adults (18+)
Worry · panic · social anxiety · phobias
Psychodynamic exploration · exposure therapy
New York (in person + online)
Anxiety that reads as drive, until it doesn't.
For high-functioning people, anxiety often hides behind competence — it looks like ambition, thoroughness, or being “on top of things,” until the worry stops letting you rest. Much of my New York practice is people who recognize themselves in patterns like these:
• A mind that won’t stop running through worst-case scenarios
• Physical tension, racing heart, or a sense of dread with no clear cause
• Avoiding situations — social, professional, or otherwise — that used to feel manageable
• Anxiety that’s started to shape decisions, relationships, or how you show up at work
Anxiety doesn't look the same for everyone.
Naming the shape your anxiety takes is often the first useful step. Some of the forms I work with:
Generalized Anxiety (GAD)
Persistent, hard-to-control worry about everyday things — work, health, relationships — that rarely fully quiets down.
Panic Disorder
Sudden, intense episodes of fear with physical symptoms — racing heart, chest tightness, dizziness — and the fear of the next one.
Social Anxiety
A deep fear of judgment or embarrassment in social or professional situations, often masked by outward confidence.
Phobias & Agoraphobia
Intense, specific fear of a place, situation, or object, often managed through quiet avoidance.
Health Anxiety
Persistent worry about illness or physical symptoms that’s hard to reassure away, even with medical input.
Performance & Achievement Anxiety
Anxiety tied tightly to performance, achievement, or being evaluated — common in high-functioning, high-visibility lives.
Understanding it, and facing it.
My work with anxiety combines psychodynamic exploration — understanding where the anxiety actually comes from — with exposure therapy, gradually and safely facing what anxiety has taught you to avoid. Understanding alone rarely resolves anxiety, and exposure without understanding can feel like white-knuckling; together, they tend to move things. And, as always, I’ll say honestly what I’m noticing, so the patterns become visible enough to change.
Who this work is for.
This work is for high-functioning adults whose anxiety has outgrown what willpower or self-help can manage — people who look composed and capable while privately carrying a mind that won’t settle. Much of my practice is visible, high-profile clients who need genuine discretion while they do this work. If that’s where you are, we’ll likely be a good fit.
What patients are saying on Zocdoc
See all reviews on Zocdoc →
Nicole Trister, LCSW
Anxiety therapy in New York — FAQ
How do I know if what I'm feeling is anxiety, or just stress?
Stress tends to rise and fall with a specific trigger and eases once the pressure passes. Anxiety is more persistent — excessive, ongoing worry that lingers even when there’s no clear stressor present. If your mind stays braced long after the moment has passed, that’s often the difference worth paying attention to.
Is it normal to feel anxious even when everything in my life looks fine?
Short answer: yes. In a world of near-constant stimulation and relentless demands — social, professional, personal — it’s hard to imagine what a life entirely without anxiety would even look like. What matters far more than whether you feel anxious is how you relate to that anxiety and how you cope with it. Many people don’t realize anxiety has been quietly running their day-to-day, shaping their choices from behind the scenes. Slowing down is often what allows us to see where our actions are truly coming from.
What does treatment for anxiety actually look like with you?
We begin by understanding the driving force behind your anxiety — its origins, how long it’s been with you, your earliest memory of the symptoms, and what you imagine life might feel like without them. Anxiety is almost always adaptive at first; at some point it served to protect you, until it stopped helping and began to cost you. From there, I draw on several evidence-based approaches. Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention (ERP) are powerful for panic and anxiety, because we often intensify our own anxiety through resistance — these tools use exposure to build genuine coping. I bring in CBT to identify and shift distorted thinking and behavior, and elements of DBT to reduce the emotional intensity that can make anxiety feel unmanageable.
Will I have to take medication?
No — medication is never a prerequisite to working with me. My role is to help you change the way you relate to your thoughts, your behaviors, and your sense of self in the world, which tends to have a cascading effect on your relationships and the way you respond to others. That said, medication is an option, and I collaborate closely with trusted psychiatrists when it’s warranted. Many people hold strong feelings about medication, and therapy can be a space to explore those feelings and determine whether it might be a helpful addition. When used, medication is a tool to support therapeutic change — not a replacement for it. The choice is always yours.
How long does it take to feel better?
I typically see clients weekly for at least six months, and I use validated measures like the GAD-7 and PHQ-9 to track your symptoms and progress as we work. Most people come to me for longer-term, depth-oriented therapy, though some prefer focused, short-term behavioral change — and I’m glad to meet you at your level of need. I do ask for weekly sessions, because meaningful change takes time, and lasting change requires habituation, reflection, and accountability.
I've tried therapy before and it didn't help. Why would this be different?
I can honor your skepticism — it’s relevant, and it belongs in the work. Often when therapy hasn’t led to meaningful change, it’s because there wasn’t the right attunement in the therapeutic relationship, and that’s grist for the mill rather than a dead end. From our first phone call, you’ll notice that I’m forward, discerning, and kind. I’ll challenge you and hold you accountable, drawing on evidence-based methods, an ongoing commitment to continued education, my clinical intuition, and regular psychiatric and peer consultation. I feel genuinely equipped to work with people who have felt stuck in therapy before.
Can therapy help with physical symptoms like a racing heart, tight chest, or trouble sleeping?
Absolutely. Many people experience anxiety primarily through the body, and it’s one of the most common ways it shows up. ACT and DBT skills help both the brain and body habituate — building understanding, acceptance, and tolerance of those physical symptoms so they lose their grip over time.
Do you treat specific anxiety disorders, like panic attacks or social anxiety?
Yes. I work with the full range of anxiety-related disorders, including panic attacks, social anxiety, body dysmorphic disorder, excoriation (skin-picking) disorder, and others.
What if I'm too busy or high-functioning to "look" anxious?
You’re likely moving through the world carrying a level of anxiety that no one around you perceives. As an outpatient provider, that’s exactly who I work with — the person holding it all together so seamlessly that no one would ever guess. If that’s you, you’re precisely the person I want to support.
If the worry has stopped letting you rest, let's talk.
Consultations are held privately and by inquiry.