Lauren Cruickshank LMSW

For high-functioning people, anxiety rarely looks like anxiety. It looks like competence. It looks like being early, over-prepared, and unable to sit still on a Sunday. Underneath is usually a nervous system that learned vigilance was necessary and never got word that it isn't anymore. We work somatically as well as cognitively, because you likely already understand your anxiety intellectually and that hasn't made it stop.

During my graduate training I worked with people facing opiate addiction at Bellevue Hospital, and that work shaped how I hold this. Addiction usually made sense before it stopped working. It is not a character failure. I also work the other side of it: adults who grew up with a parent's drinking or using, who learned to read a room before they could read a book. Whether you are in recovery yourself or still carrying what someone else's use cost you, there is room here.

You are the one everyone calls. You read the room before you walk into it. You know what everyone else needs and go blank when someone asks what you need. That is not a personality. It is a skill you built young, usually in a house where somebody else's mood set the weather. We look at where it came from, what it still protects, and what opens up when being needed is no longer the price of being loved.

Trauma does not live only in the story you tell about it. It lives in a nervous system that learned to brace and never got word it could stop. I trained in Somatic Experiencing because talking about what happened often is not enough on its own. We track what shows up in your body as we go, work in small doses rather than flooding, and build capacity before approaching anything hard. If you have done years of insight-oriented therapy and still feel stuck, this is often why.

How you were related to early becomes the template for how you relate now. If you grew up attuning to a parent instead of being attuned to, it tends to show up later as over-functioning, difficulty asking for anything, or waiting for the other shoe. Attachment-based work makes that template visible and gives you the experience of a relationship that does not run on it. Much of what happens between us in the room is itself part of the work.

DBT gives you something concrete for the moments when insight is not enough: distress tolerance when everything is too loud, emotion regulation when the reaction outsizes the situation, and interpersonal skills for people who are fluent in everyone else's needs and blank on their own. I trained in DBT and draw on it flexibly rather than running a rigid protocol. For most clients it works alongside deeper work, giving you footing while we get underneath it.