What is one evidence-based technique you've found most effective in your practice for treating anxiety that others might not commonly use? What specific situation or type of anxiety does it work best for?

One lesser-known but evidence-informed strategy used in practice involves color-based self-monitoring tools, such as microdots or mood bracelets, to help clients track the intensity and context of their anxiety in real time. I use either microdots or mood bracelets to have clients monitor situations and circumstances that contribute to their anxiety, especially when they struggle to identify specific triggers or patterns on their own. Clients assign numbers to the colors (for example, 1–10) and then note the color/number pairing whenever they notice anxiety, which externalizes the experience and makes it more observable and concrete. Over time, this helps them recognize how anxiety shows up in their body (e.g., tension, heart rate, stomach discomfort) alongside the color/number data so they can see consistent patterns. Once those somatic and situational patterns are clearer, we collaboratively develop coping strategies tailored to the levels associated with particular colors or numbers, such as specific grounding skills at “yellow 4–5” and more intensive strategies at “red 8–9.” This approach is especially useful for clients with generalized, “floating” anxiety or alexithymia, where traditional trigger identification and standard self-monitoring forms often fall flat because they cannot easily label internal states or discrete precipitating events.

One evidence-based but often underutilized technique I've found especially effective for treating anxiety is interoceptive exposure. While many people are familiar with exposure for external fears, interoceptive exposure focuses on safely recreating physical sensations associated with anxiety, such as increased heart rate, shortness of breath or dizziness, in a controlled setting. I've used this approach successfully with clients who experience panic disorder and health-related anxiety. That is particularly those who fear bodily sensations and interpret them as dangerous. By intentionally and repeatedly experiencing these sensations, clients learn that the sensations are uncomfortable but not harmful. These include exercises like paced breathing, spinning in a chair or light aerobic activity. What makes this technique effective is that it directly targets the fear of the symptoms themselves which often drives panic. Over time, clients develop increased tolerance and confidence in their body's responses. This reduces avoidance behaviors and helps break the cycle of anxiety. It leads to fewer panic episodes and improved overall functioning.

I use a structured writing exercise: we list the specific anxieties, define the desired outcome, and create a brief action plan. It works best for anxiety tied to concrete upcoming tasks or decisions, because turning worry into clear steps reduces overthinking and builds momentum.

Countering psychological reactance by giving patients agency has been most effective for me: I offer a menu of three anxiety strategies and let them choose. This reduces resistance and helps the chosen skill take hold. It works best when anxiety is paired with a strong "don't tell me what to do" response, especially with teenagers in acute distress.

It's wonderful that people are starting to understand that an overstimulated nervous system is a big part of anxiety. Emotional triggers move us into a 'fight or flight' mode and that causes a feedback loop of fear that we experience as anxiety, so we need to learn to relax our nervous system. But the problem is that most people only try to handle this in a reactionary way. They wait until their anxiety gets triggered and then they try to calm themselves with coping mechanisms like breathing exercises or grounding techniques. That's never going to be good enough, because you never get the opportunity to lower your baseline level of stress, and you're not really able to apply the skills and tools you need when you need them. Imagine you watched a video on self-defense, but you never practiced those skills in a safe space. Do you think you'd actually be able to recall and make use of what you learned in that video when a robber grabs you by the collar and shouts at you? Of course not. In moments of danger, logic goes out the door, fear kicks in, and only things that have been deeply embedded as reflexes are available to you. That's why it's important to practice relaxing your nervous system proactively... not only reactively. Start with this... Draw a dot on the back of your hand every day for a week and - throughout the day - every single time that you see that dot, go through the following checklist: - Breathing: No need to practice breathing exercises. Just check your breathing and make sure you're breathing in a calm way, down into your belly (diaphragmatic breathing), without accidentally creating stress and tension in your body via forceful breath. - Muscle tension: Do a body scan and release tension in any muscles that you notice are tight. There will almost always be some tension in your body somewhere, until you master this. - Posture: Make sure you're in a calm and confident position. Nothing crossed or hunched over. - Heart rate: Simply pay attention to your heart rate. Become aware of the state of your nervous system. If you do that consistently, you will ingrain this checklist into your mind. You'll be able to recognize more easily when you are triggered and will more readily be able to calm your nervous system when you need to. Plus, you will be lowering your baseline level of stress, making you less susceptible to being triggered in the first place.

As an EMDR therapist, I often use the flash forward protocol for anxiety. Flash forward focuses on anticipation anxiety in the form of feared "what if" outcomes in various situations. By targeting an imagined worst case scenario with bilateral stimulation (BLS) the fear can be desensitized and the negative belief can shift. This effect often begins to generalize and reduce anxiety in other situations. It works best for recurrent anticipation anxiety about upcoming challenges client's face.

People often overlook imaginal exposure. Visualizing getting through an anxiety provoking situation makes it much easier to face in real life. This is because our brain treats visualization similar to real life experiences. This works well for situational anxiety (for example: fear of driving or fear of medical procedures).

The most effective, evidence-based technique in my practice is a three-session clinical hypnosis protocol that uses direct communication with the subconscious to identify and rationally manage emotional triggers. It works best for trigger-driven workplace anxiety, especially recurring stress in high-pressure environments or before important tasks.

Finding (and sticking to) ways to separate your larger to-do lists from your actionable to-do lists — the things that need to happen today. Analog of digital, it doesn't matter, but working directly from your full list is a recipe for remaining overwhelmed.

Interoceptive Exposure (IE) is an evidence-based technique I regularly use to help patients suffering from panic disorder or agoraphobia. Despite its effectiveness in decreasing the ""fear of fear,"" it has not yet seen widespread usage in general clinical practice. While a majority of exposure therapies focus on external triggers—such as crowds or heights—IE works by purposefully inducing benign but fear-provoking physical sensations that the individual associates with the onset of panic. For example, a clinician might use controlled hyperventilation to create lightheadedness or spinning in a chair to produce dizziness. By allowing the patient to repeatedly experience these physiological sensations without the associated catastrophic event (the panic attack itself), they begin to retrain the brain to differentiate a physical stimulus from an emotional fear response. IE is particularly effective at decreasing anxiety sensitivity. For individuals with panic disorder and agoraphobia, high anxiety sensitivity causes them to become hyper-aware of their body's physiological responses. When this level of awareness becomes overwhelming, it often triggers a full-blown panic attack. Through IE, patients can gradually transition from a state of reactive fear to one of physiological habituation. They learn that a racing heart is simply a cardiovascular response, not a medical emergency. Ultimately, this diminishes the power and control that internal somatic experiences previously held over their lives.

What I have observed while working closely with founders under constant pressure is that intolerance of uncertainty training is one of the most effective yet underused approaches for anxiety, especially in high responsibility roles. I am not a clinician, but after years as a financial consultant sitting in rooms where anxiety quietly shapes decisions, patterns become obvious. I remember a founder who looked confident externally but froze internally whenever outcomes were not predictable, which in startups is almost always. This technique works by helping people stop trying to eliminate uncertainty and instead practice functioning while uncertainty is present. In real terms, that meant encouraging the founder to make smaller reversible decisions faster rather than waiting for perfect information. Over time, the anxiety reduced not because the risk disappeared, but because their nervous system learned that uncertainty did not automatically lead to failure. I have seen this work best for performance driven anxiety, decision paralysis, and anticipatory stress, especially among leaders and operators. It is less about calming down and more about retraining response patterns. One of our team members once noted that anxiety dropped only after the founder stopped trying to feel ready and focused on acting responsibly instead. What makes this approach powerful is that it is grounded in cognitive behavioral research, yet rarely framed this way outside clinical settings. In the context of spectup, we indirectly apply it during investor readiness work. Fundraising is full of unknowns, and founders who learn to tolerate ambiguity perform better in pitches and negotiations. The key insight is that anxiety often feeds on avoidance, not danger. When people repeatedly face uncertainty in controlled ways, confidence grows naturally. From my experience, this technique is especially effective for people who are highly capable but mentally over controlling. It does not remove pressure, but it restores agency, which is often what anxiety takes away first.

One technique that worked better than expected was training people to tolerate the physical sensation of anxiety instead of trying to eliminate it. One session stands out. The person wasn't afraid of thoughts, they were afraid of the body rush, heart rate, heat, tight chest, and it felt odd at first to lean into that instead of calming it down. We used brief interoceptive exposure like controlled breath holds or light exertion, then sat with the sensation until it passed. That small practice mattered. Panic lost its authority once the body proved it could ride the wave. It worked best for panic style anxiety and health anxiety where fear locks onto physical cues. The shift came from learning safety through experience, not reassurance. Anxiety softened when the body learned it wasn't in danger, abit slowly but lastingly.

One technique I discovered that helped with my anxiety, which I do not see discussed as often outside of therapeutic circles, is something called interoceptive exposure. Instead of avoiding anxiety-provoking situations, I learned to bring on anxiety through breath holds and light movement and sit with the anxiety until it passes. This technique allowed me to better cope with anticipatory anxiety. This technique allowed me to better cope with anticipatory anxiety, which occurs before events like meetings, big decisions, and other high-stakes situations. Cognitive Behavioral Therapy (CBT) proposes that fear is an experience that is lessened through exposure and repetition. The self-induced anxiety episodes became less frequent because my brain learned to no longer associate the anxiety symptoms with being unsafe. The big epiphany was that anxiety is not something that should be removed. The main thing that changed was when I realized that what I needed to do was to recalibrate my anxiety. I had the most success when I was no longer fighting the anxiety, observing it instead, and I was able to neutralize the emotional response associated with the anxiety.

One technique that has worked really well in real life practice is helping people slow down their body first instead of trying to fix their thoughts right away. Many people think anxiety starts in the mind but most of the time it starts in the body. A very effective method is slow breathing with longer exhales. It sounds simple but it is backed by strong research. When someone breathes in for four seconds and breathes out for six seconds the body starts to calm itself. The heart rate drops and the nervous system gets a clear signal that there is no danger right now. This works best for people who feel sudden anxiety like panic feelings chest tightness fast heartbeat or fear that comes out of nowhere. It is especially helpful when anxiety shows up in social settings or before important moments. Once the body feels safer the mind becomes much easier to manage and clearer thinking follows naturally.