Anxiety & OCD Therapy · Portland & All of Oregon · Telehealth

Your mind is working
overtime.

You've been managing it — sometimes well, sometimes not. But anxiety has a way of taking up more and more space until it's hard to remember what calm felt like. You don't have to keep outrunning it. Telehealth anxiety and OCD therapy for adults across Portland and all of Oregon.

Book a Free Consultation See what I work with ↓

Licensed in Oregon OCD & ERP Trained PMH-C Certified 15+ years experience Accepting new clients

CBT EMDR ERP for OCD Mindfulness-Based Psychoeducation

Types of anxiety I work with

Anxiety takes many forms.
All of them are treatable.

Anxiety is not one thing. Whether you're dealing with pervasive daily worry, sudden panic, specific fears, intrusive thoughts, or the bone-deep exhaustion of chronic stress — effective, targeted treatment exists. It's built around your particular experience, not a generic protocol.

🌊

Generalized Anxiety Disorder

If worry is your default state — about health, work, relationships, money, the future — and it's been that way as long as you can remember, this is likely GAD. The worries feel productive, even necessary. They're not. You don't have to live at this level of constant tension.

⚡

Panic Disorder

Panic attacks are terrifying — heart pounding, chest tight, the certainty that something is seriously wrong. What often makes them worse is the fear of the next one. Panic disorder is a cycle we can interrupt. With the right tools, you can stop dreading your own nervous system.

🌀

Phobias & Specific Fears

A specific fear — driving, flying, medical procedures, crowded spaces — can quietly reshape your entire life as you build your world around avoiding it. Exposure-based therapy and EMDR are highly effective for phobias, often with faster results than people expect.

🔥

Burnout & Chronic Stress

Burnout isn't weakness — it's what happens when a nervous system has been in overdrive for too long. The exhaustion that doesn't lift with rest. The numbness. The loss of meaning. Therapy helps you understand what your system is doing and build a path back to feeling like yourself.

🤱

Perinatal Anxiety

Anxiety during pregnancy or the postpartum period is extremely common — and often dismissed. Constant worry about the baby, fear of something going wrong, intrusive thoughts, inability to relax. This is one of my core specialties, and it's very treatable with the right approach.

😰

Social Anxiety & Perfectionism

The fear of being judged, of saying the wrong thing, of not being enough — showing up as avoidance, overpreparation, or just quietly shrinking. When anxiety is wrapped up in your sense of worth, untangling it takes more than breathing exercises. CBT and EMDR both go to the root.

A note on Portland & Oregon

Portland's culture carries its own particular relationship with anxiety. The pressure to be productive, mindful, and low-key about it all at the same time can make anxiety feel like a personal failing — something to quietly manage rather than actually address. Tech workers, healthcare providers, educators, parents, and creatives all carry invisible loads.

Telehealth means no commute to an appointment after an already overwhelming day. You can take a session from your car, your lunch break, or your couch — with the same quality of care you'd get in an office. Serving Portland, Beaverton, Hillsboro, Eugene, Oregon City, and all of Oregon.

OCD ERP Trained · PMH-C

Specialty area

Perinatal OCD, and OCD in all its forms.

OCD is one of the most misunderstood and underdiagnosed conditions in mental health — particularly during pregnancy and the postpartum period, when it often looks very different from what most people picture when they hear "OCD."

Perinatal OCD typically doesn't involve counting, checking, or organizing. It looks like this: intrusive, unwanted thoughts about harm coming to the baby — thoughts so disturbing and so at odds with who you are that you become terrified of your own mind. These thoughts feel shameful and impossible to admit. Because they don't fit the stereotype, they often get misdiagnosed as postpartum depression, or missed entirely.

Here's what matters: having these thoughts does not mean you would ever act on them. The distress they cause is part of what makes this OCD. People with perinatal OCD are not dangerous. They are suffering. And they deserve a therapist who knows the difference.

I also work with OCD outside the perinatal period — harm OCD, checking, contamination, scrupulosity, and other presentations. OCD requires a specific clinical approach, and I treat it as the specialty it is.

The gold-standard treatment

ERP — Exposure and Response Prevention — is the most evidence-based treatment for OCD and the approach recommended by the International OCD Foundation. Unlike general anxiety therapy, OCD requires a specific method: gradually engaging with what triggers the anxiety while resisting compulsive responses. It's challenging. And it works.

What perinatal OCD can look like

Intrusive thoughts about harming the baby
Fear of being left alone with the baby
Compulsive checking (breathing, temperature, latching)
Reassurance-seeking that never brings lasting relief
Avoiding objects like knives, stairs, or bath water
Intrusive thoughts about illness or contamination

PMH-C certified

As a Certified Perinatal Mental Health Specialist (PMH-C), I have specific training in how OCD presents during pregnancy and postpartum — and how to treat it without inadvertently making the anxiety worse. This is a space where generalist OCD knowledge isn't enough.

Treatment approach

How we actually work on anxiety together.

There's no single protocol that fits every anxious person. My approach draws on several evidence-based methods, combined based on what your particular anxiety responds to — and what your nervous system actually needs.

CBT Cognitive Behavioral Therapy

Most anxiety involves patterns of thinking that feed the fear — catastrophizing, overestimating threat, underestimating your own ability to cope. CBT gives you practical tools to identify and interrupt these patterns. It's structured, skill-building, and gives you something to take with you long after therapy ends.

EMDR Eye Movement Desensitization & Reprocessing

When anxiety is rooted in past experiences — even ones that don't feel obviously "traumatic" — EMDR helps the nervous system complete what it got stuck on. Particularly useful when CBT alone hasn't reached the root of the anxiety, or when the body's response to anxiety is as difficult as the thoughts themselves.

ERP Exposure & Response Prevention

The gold-standard treatment for OCD. ERP involves gradually engaging with what triggers the anxiety while resisting the compulsion to neutralize the discomfort. It teaches your nervous system that the feared outcome doesn't require a compulsive response — and that you can tolerate uncertainty. Challenging. Effective.

MBI Mindfulness-Based Therapy

Mindfulness isn't about eliminating anxious thoughts — it's about changing your relationship to them. When you stop fighting anxiety and learn to observe it instead, it loses some of its power. Mindfulness-based approaches help you carry anxiety differently, find moments of calm, and build a felt sense of safety in your own body.

What becomes possible

"What if anxiety was something you managed — instead of something that managed you?"

This is what life looks like after anxiety therapy.

Your thoughts stop running the show

You still have anxious thoughts — but they don't automatically become your reality. You notice them, name them, and choose how to respond. That gap between thought and reaction is where your life opens back up.

Calm becomes available again

Not a permanent state — anxiety isn't eliminated. But you have tools to return to calm when you need them. Breathing exercises that actually work. A nervous system that knows it can settle.

Your world stops getting smaller

You stop avoiding the things that triggered anxiety. The highway. The social situation. The doctor's appointment you've been putting off. One by one, the world you'd cordoned off starts coming back.

You recover from burnout

Not just rest — actual restoration. You start to feel interested in things again. Energy returns. The numbness lifts. You reconnect with what matters and build a more sustainable relationship with your own limits.

OCD loses its grip

The intrusive thoughts still come — but they stop commanding your behavior. You learn to let them pass without the compulsion to neutralize them. The relief they used to demand starts to become optional.

You trust yourself again

Anxiety erodes self-trust. Recovery rebuilds it — slowly, then noticeably. You stop second-guessing every decision. You start taking up space. You recognize yourself again.

Getting started

Simple steps to begin feeling better.

Free 15-minute phone consultation

We'll talk about what's going on — what type of anxiety you're dealing with, what you've tried before, and what you're hoping to feel like on the other side. No pressure. No commitment.

Your first session

We go deeper — your history, how anxiety shows up in your body and your life, and what we'll work on together. We build a plan around the specific kind of anxiety you're dealing with, not a one-size-fits-all approach.

Ongoing support, building real tools

Most clients meet weekly or biweekly. Sessions are 50 minutes over secure telehealth — from wherever you are in Oregon. Between sessions, you practice what we work on. That's how real change happens.

Want to know more about how I work before reaching out? Read about Geraldine's background, approach, and training →

Oregon scheduling

Morning sessions available: 6am through 2pm

Oregon sessions run 6am through 2pm — including early morning slots for before-work clients and lunch hour appointments.

6–8am

Before work

While the house is still quiet

Lunch

Midday reset

Step away, come back grounded

Oregon insurance

Oregon insurance plans accepted.

I accept several Oregon insurance plans directly — including OHP, so anxiety therapy is accessible regardless of income or employment status. If you're unsure whether your plan is covered, I'm happy to clarify during our consultation call.

OHP / CareOregon Moda Health Pacific Source Trillium Health Health Share of Oregon

Private pay: $170/session · Initial assessment $220 · Sliding scale available upon request.

Out-of-network superbills available for plans not listed.

Common questions

Things people often wonder before reaching out.

How do I know if what I have is anxiety or OCD?

Anxiety and OCD overlap significantly, which is why misdiagnosis is common. A key distinction: OCD involves intrusive, unwanted thoughts followed by compulsions — behaviors or mental acts done to reduce the discomfort. With general anxiety, the worry tends to feel more rational and doesn't follow the same intrusive-thought-then-compulsion cycle. In practice, many people have elements of both, and the treatment approach is adapted accordingly. The consultation call is a good place to start unpacking what's going on for you.

Does EMDR work for anxiety (not just trauma)?

Yes — and significantly so. While EMDR is most known for trauma, it's increasingly used for anxiety, phobias, panic, and OCD. It's particularly effective when anxiety is rooted in specific memories or past experiences that continue to activate the nervous system. If CBT-style approaches haven't fully addressed your anxiety, EMDR often reaches the parts that talk therapy alone doesn't.

I'm burned out, not anxious. Is therapy right for me?

Burnout and anxiety are deeply connected — chronic stress keeps the nervous system in high alert, which depletes the same resources anxiety burns through. Therapy for burnout involves understanding what's driving the depletion, building a different relationship with rest and limits, and treating any underlying anxiety that's keeping you stuck. If you're running on empty and can't figure out how to stop, that's exactly the kind of thing therapy is for.

I'm pregnant or just had a baby. Can you treat perinatal anxiety?

Yes — this is one of my core specialties. As a PMH-C Certified Perinatal Mental Health Specialist, I have advanced training specifically in anxiety during pregnancy and the postpartum period, including perinatal OCD. Many perinatal clients are relieved to work with someone who doesn't need a lot of context — who already knows what this period involves, clinically and humanly.

What insurance do you accept in Oregon?

In Oregon, I accept OHP / CareOregon, Moda Health, Pacific Source, Trillium Health, and Health Share of Oregon. Private pay is $170/session with sliding scale available. Out-of-network superbills are available for plans not on this list — many PPO plans reimburse a portion of out-of-network therapy.

Take the first step

You've been managing anxiety
long enough.

A free 15-minute phone call is all it takes to start. We'll talk about what you're experiencing and whether we're the right fit — no pressure, no commitment.

Book a Free Consultation See all Oregon services

Not ready to book? Have a question first?

geraldine@kuphalMFT.com

Email me anytime — I usually reply within one business day.

Telehealth · Licensed in Oregon · OHP & insurance accepted · Accepting new clients

Your mind is workingovertime.

If you're constantly anxious, overwhelmed, or stuck in your head: you are not alone.

Anxiety takes many forms.All of them are treatable.