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Anxiety, panic and obsessive-compulsive disorder

Anxiety makes life smaller, usually very slowly.

First you avoid one thing, then two, and at some point your world has narrowed so far that you can barely say when it happened. Anxiety and obsessive-compulsive disorders are treatable. Even when it has been like this for years.

Recognising it

What it feels like. From the inside.

With a panic attack it comes out of nowhere: racing heart, no air, the feeling that you are about to die or lose control. What stays afterwards is the fear of the next attack, and that often changes life more than the attack itself.

With generalised anxiety it is quieter and more constant. Your mind never stops guarding against things, thinks every scenario through to the end, and even good news is only reassuring for a short while.

Social anxiety is talked about least of all. It is not shyness, but the firm conviction that at any moment you will be exposed as inadequate: in the meeting, on the phone, eating with other people.

OCD

Compulsions, and the silence around them.

Obsessive thoughts are thoughts you do not want, and that come back for exactly that reason. Images of violence, of harm coming to people you love, of something forbidden or shameful. They are not an expression of what you want; they are an expression of what you fear most.

Compulsions are the attempt to set that right again: checking, washing, counting, ordering, seeking reassurance. It helps for a few minutes and makes it bigger over time.

For many people, years pass between the first symptoms and the first conversation about them. Not because they suffer too little, but because they are certain that the content of their thoughts says something about who they are. It does not. And I have heard enough of it to be able to tell you: you will not shock me.

Treatment

Exposure. What it actually means.

Exposure means turning towards the situation or the thought instead of avoiding it, and going without the safety behaviours while you are there: distracting yourself, staying near the exit, bringing someone with you, seeking reassurance. Not because enduring things is a value in itself, but because it is the only way your nervous system can have a new experience: it passes, and it passes by itself.

We do not begin with the hardest thing. Every step is prepared together, you know beforehand what is coming, and you have a say. Nothing happens against your will. A confrontation that catches you off guard would be bad therapy.

For anxiety and obsessive-compulsive disorders, this approach within cognitive behavioural therapy is particularly well studied and has a solid evidence base. “Treatable” is not a comforting word here; it is the accurate description.

How we work

What we do together. Step by step.

  1. Understanding what holds the pattern in place

    We look closely at which thoughts, which avoidance and which reassurance keep the anxiety alive. Only once that is clear do we know exactly where to start.

  2. Building a plan you can stand behind

    Together we put the situations in order, from easy to hard. You set the pace. I make sure we do not come to a standstill.

  3. Practising: first with support, then on your own

    We take the first steps together, in the session or outside it. After that you carry on practising between appointments, because that is where your life happens.

  4. Planning for setbacks

    Anxiety comes back in waves, especially under strain. By the end of therapy you know what to do then, without having to start again from the beginning.

Practicalities

Costs and practical details. Before the first appointment.

Fees and reimbursement
  • Individual therapy, 50 minutes Billed under the German fee schedule for psychotherapists (GOP), at 2.3 times the standard rate. The amount depends on which services the session involves. Self-payers: 167.58 €. 134.06–167.58 €
  • Group, 100 minutes Closed group, 6 to 9 people, 12 weeks. by arrangement
  • Duration For specific fears often 12 to 25 sessions; for obsessive-compulsive disorder as a rule longer. We review how it is going together, regularly. 12–25 sessions

Private health insurance, Beihilfe (the reimbursement scheme for German civil servants) and self-payment. People with statutory insurance can apply for Kostenerstattung under § 13 (3) SGB V. Individual appointments take place at the practice in Frankfurt or by video at the same rates; the first appointment is at the practice. The group runs in person only. Languages: German, English and Farsi.

Common questions

What usually gets in the way. And what there is to say about it.

Exposure sounds impossible to me. Do I have to?
At first it sounds impossible to almost everyone; that is part of it. We begin where you can picture taking one step, and that step is usually smaller than you fear. You will not find yourself in any situation we have not talked through together beforehand, and the decision stays with you at every moment.
My obsessive thoughts are ones I cannot say out loud.
That is the most common reason people wait for years. Almost always it involves content that contradicts everything that matters to the person, and that contradiction is precisely the hallmark of obsessive thoughts, not a sign of dangerousness. You may paraphrase it first, write it down, or say it in your mother tongue. What you tell me stays in this room.
Are anxiety and OCD really treatable?
Yes. For panic disorder, agoraphobia, social anxiety, generalised anxiety disorder and obsessive-compulsive disorder there are cognitive behavioural therapy approaches with a very good evidence base. That does not mean it runs the same way for every person, and I cannot promise you a result. It means you are starting with a realistic prospect of noticeable change.
Do I need medication?
For anxiety and obsessive-compulsive disorders, psychotherapy is a first-line treatment and works without medication too. Where symptoms are severe, medication can be a sensible support; it is prescribed and monitored by a physician. If that comes up, I coordinate with your doctor.
I have panic attacks. Is that dangerous?
A panic attack feels life-threatening and is not. Even so, it is important to have physical causes such as thyroid, heart and circulation checked by a doctor once, so that we know for certain what we are dealing with. After that, the work starts at exactly the point that keeps a panic disorder going: the fear of the fear.
Is the group right for me?
For social anxiety, group treatment is a well-researched cognitive behavioural therapy format: you practise in a real social situation instead of talking about one, in other words precisely what you are afraid of, under conditions made for it. The group is closed, has 6 to 9 participants and runs over 12 weeks, 100 minutes a week. It does not replace individual therapy, it adds to it. Whether and when it fits for you is something we decide together.
A beginning

You do not have to know what to call it.

Tell me roughly what it is about. I will get back to you within two working days. If I am not the right person for you, I will say so and suggest someone better suited. The practice opens on 1 November 2026; you can request appointments for the first weeks from now on.

Request an appointment

In a crisis please do not wait for me: call 112, where you can speak English, or go to the emergency department of the nearest psychiatric hospital. Telefonseelsorge, 0800 111 0 111, counsels in German.