I have been having anxiety attacks for the past four months. I get terrible chest pain. Then my throat becomes constricted and I hyperventilate. I have been seeing a therapist for a couple of months now. My doctor has evaluated me and said, "The case is closed, there is nothing wrong with you, just a little anxiety." So what is the next step?

E.

I'd tell your therapist exactly what you've told me about the anxiety attacks, and ask him or her what he or she recommends. If you haven't done so already, ask if you can work in therapy specifically on the anxiety attacks. Ask if your therapist has experience on treating anxiety and panic attacks. If he or she doesn't, discuss the possibility of a referral to a therapist who does.

You might also check into Elke Zuercher-White's book An End to Panic for suggestions on ways you can alleviate anxiety attacks. My own clients -- and other people I've known -- have benefitted from practicing relaxation techniques, including deep breathing and cutting down or eliminating caffeine and other stimulants. It also frequently helps to identify whatever thoughts, beliefs or events trigger the anxiety attacks, and address those in therapy.

Some people also find regularly engaging in moderate exercise helpful in alleviating anxiety -- although that's best experimented with on a case-by-case basis, as in some individuals strenuous exercise can trigger an anxiety attack, possibly due to how their bodies interpret the increased heart rate and other physical consequences of vigorous exercise.

Some people find Oriental types of movement practices quite helpful in addressing stress and anxiety. Such practices include yoga, Tai Chi, and Qi Gong. I once met a woman in a yoga workshop who claimed her regular yoga practice cured her anxiety attacks.