Kenya Dickens, LCSW-C, LCSW, LICSW, is a Licensed Clinical Social Worker and Clinic Director at Columbia Mental Health’s Towson clinic. She works with clients who feel stuck or overwhelmed and need a safe space to process trauma, anxiety, depression, and life changes.
Her approach is supportive, collaborative, and practical, using evidence-based tools like CBT, EMDR, and mindfulness to help clients build resilience and move toward healing. In this conversation, Kenya shares how she helps clients understand their own anxiety patterns, when she uses grounding versus mindfulness versus breathwork, and how these skills can help people feel more in control.
Starting with the nervous system
When anxiety spikes, what is the first skill you reach for?
Kenya: When anxiety is high or spiking, the first thing I really focus on is helping the client regulate their nervous system before trying to change their thoughts. Anxiety truly lives in the body first, and because anxiety looks different in everyone, I always start by helping clients notice how their body is experiencing that stress.
Some people feel it in their chest, some feel it in their stomach or their shoulders, and some feel it through restless energy. Once we have identified how anxiety tends to show up for them, then we begin practicing grounding skills, like slow breathing or orienting them to the present moment.
Sometimes it is as simple as noticing their feet on the floor and taking a slow breath in and out, just to start signaling safety to their nervous system. So it really depends on where they are feeling that anxiety, because that helps pinpoint where we begin.
What do you do when someone is holding anxiety in their body?
If someone is holding it in their shoulders and chest, I would actually start with progressive muscle relaxation. That allows them to create tension in different parts of the body and then release it. We may start at the head and move through the body.
One thing I always like to highlight is the tongue. If your tongue is pressed to the roof of your mouth, it should not be there. Lowering it naturally helps you notice that you may be holding stress or anxiety without even realizing it. So just going through the body, creating tension and then releasing it, can help people let go a little bit. Even something as simple as making a fist as tight as you can and then releasing it, and feeling the blood flow in your hand, can really help.
Is noticing where anxiety lives in the body part of mindfulness itself?
Absolutely. If you can pinpoint, okay, it is in my stomach, then that gives us somewhere to begin. You may tighten your stomach and then release it if we are doing progressive muscle relaxation. You may notice you are holding tension in your hand, or your jaw, or your shoulders. That practice of noticing is already part of grounding and mindfulness.
Learning your own anxiety signature
What are some early cues people can watch for when anxiety is building?
Anxiety really does show up differently in everyone, so there is no one universal way that it will look or feel. For some people, it shows up physically. They may notice a tight chest, a racing heart, headaches, stomach pain, or feeling shaky. Those are usually the ones people notice first when they think of anxiety.
But for others, it may be more cognitive. They may have racing thoughts, repetitive thinking, overthinking, or they may constantly anticipate the worst possible outcome. For some people, it is behavioral. They avoid situations, procrastinate, feel really irritable, or have a constant need for reassurance.
I really want to encourage people to begin paying attention to their own personal anxiety signature, because the body usually gives early signs before anxiety fully escalates. When you learn those signals, you can begin to respond earlier and feel more in control of it.
What if someone’s anxiety shows up more as irritability or avoidance?
That still counts. My anxiety shows up as irritation, so that is usually my first cue. Sometimes people do not immediately think of irritability or avoidance as anxiety, but it absolutely can be. That is why it is important to really get honest with yourself about your own patterns.
Mindfulness, grounding, and what they actually mean
How do you define mindfulness for clients?
Mindfulness is really about being aware of your surroundings and honing in on what is happening in the present moment. It can be as simple as sitting in your office and noticing, okay, the wall is this color, I feel heat near my feet, I hear a certain sound, I notice my breathing. You are focusing on your senses and connecting with what is around you, rather than trying to do something with all of it.
That is the part people often struggle with, especially people with anxiety. They notice everything and immediately think, okay, now what do I do with this? But mindfulness is often just taking note.
How is mindfulness different from grounding?
Mindfulness is noticing. Grounding is when we begin to use a strategy to help bring someone back into the present in a more active way. So mindfulness may be noticing the birds chirping, the wind blowing, the warmth on your feet, or the color of the wall. Grounding is when we shift from simply noticing to using an actual technique, like a sensory strategy or a structured grounding exercise.
How do you help people who feel like they always need to do something with what they notice?
I really encourage them to take note of the fact that their mind is racing and wanting to do something, and then give themselves permission to pause. It is okay to take a moment and not do anything with any of it. Our day-to-day lives are so back-to-back that sometimes simply giving yourself permission to pause can be incredibly powerful, especially when you have anxiety.
Mindfulness does not have to mean sitting still
What do you say to clients who struggle with stillness?
Not just for people with ADHD, but also for many people with trauma, stillness can actually increase anxiety. So mindfulness does not always have to mean sitting quietly and being still. It can be active. You can be walking, stretching, holding something textured, washing dishes, or focusing on a repetitive movement. What matters is being intentional about the attention you are paying to the present moment.
You do not have to force stillness. It is okay to fidget while you are being mindful. It is really just about being present in the moment.
Can movement or fidgeting still be part of mindfulness?
Absolutely. I am always playing with something textured myself. For some people, touching their hair, using a keychain, holding a fidget, or using a pop-it can help them stay present. Especially with kids, but really with adults too, people sometimes need that little sensory input in order to ground themselves and pay attention to what is happening right now.
How breathwork helps
Do you practice breathwork with clients?
Yes, absolutely. I teach breathwork in a very practical way, and I always explain why it works physiologically. Slowing your breathing activates your parasympathetic nervous system, which is your body’s natural calming system.
One technique I may teach is 4-6 breathing, where you inhale for four seconds and exhale for six. I also like box breathing. With box breathing, you inhale for four, hold for four, exhale for four, and then hold again for four. It is like tracing the outline of a square. That kind of breathing helps reset the system and signals safety to the body.
For kids, I may not call it box breathing. I may call it cookie breathing or pizza breathing. Smell the pizza, then blow on it so it is not too hot. It is the same skill, just explained in a way that feels developmentally natural.
Does breathwork work for everyone?
Most of the time, when people say it does not work, it is really because we were not using the right coping strategy for the right situation. I may not introduce breathwork right away to someone who is actively processing trauma, because that may be too much too soon for their nervous system. I am always mindful of a person’s window of tolerance.
So it is usually not that the skill never works. It is that it may not have been the right fit for that particular moment. That is why I help clients build a coping toolbox, so they know they have options. Maybe breathing is useful before an interview. Maybe 5-4-3-2-1 is better during the interview. The goal is not one perfect strategy. The goal is to know when to use which tool.
What progress can look like
What changes do you see when clients practice these skills consistently?
After a few weeks of practicing mindfulness and regulation skills in session, I usually see increased awareness and quicker recovery from anxiety. Instead of feeling like anxiety is taking over their whole life, they begin recognizing it sooner and regaining control faster.
A lot of people with anxiety get caught in the anxiety cycle, where they avoid a trigger, feel temporary relief, and then have an even bigger reaction the next time that trigger comes up. So one of the big pieces of this work is helping them stop avoiding everything. Sometimes you have to do it scared anyway.
Through mindfulness and regulation skills, people start building confidence in their ability to handle distressing moments. That can be really empowering.
When anxiety and trauma go hand in hand
How do you approach mindfulness when anxiety is tied to trauma?
When anxiety is connected to trauma, we tend to move much more slowly and carefully. For many trauma survivors, certain mindfulness exercises can actually feel overwhelming at first, because the body is so used to holding stress and staying in that stress response.
In those cases, I start with very gentle grounding exercises. I focus on stabilization and helping the client build a sense of safety in their body before we even begin to process trauma. Trauma-informed mindfulness, EMDR preparation, and body-based grounding can all help clients develop regulation first. Once that foundation is there, the deeper trauma work becomes much more effective, because now they feel safer.
For people who are not sure whether to reach out
What would you say to someone who is anxious about starting therapy?
First, I would want them to know that a clinician’s job is not to pass judgment. Our job is to create a safe space for you in what you bring and how you show up. If you are anxious about starting therapy, even having a consultation can go a long way. It gives you a chance to talk with a potential provider, get to know them a little, and let them get to know you.
Then, when you do come into session, you and your provider can work together as a team to create a plan that helps you feel calmer and more supported. If you are coming in with trauma and you are not ready to talk about it, that is okay. We are going to go at your pace.
A lot of times, people say they could just talk to a family member or a friend, but then they feel frustrated when that person cannot really hold space for them. It is my job to show up for you, and I will be present. You just have to schedule the appointment. Be honest about what you need and what you want from a clinician, because that helps us show up for you in the way you need. At the end of the day, you are the expert in your own experience.
Ready to get started?
If anxiety has been taking up more space in your life, therapy can help you understand your own patterns, build the right coping toolbox, and find strategies that actually fit how your mind and body work. Kenya and the Columbia Mental Health team create a safe, supportive space where you can slow down, feel understood, and begin building skills that last.
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