Anxiety & Overwhelm
Chronic worry, panic, hypervigilance, high-functioning anxiety that the world never notices but you live with every hour. We learn to work with the nervous system, not against it.
Licensed Clinical Social Worker • Portland, OR
A steady place to begin.
Individual therapy for anxiety, grief, and the quiet weight of life's transitions. In-person in Portland or by secure video, at a pace that respects how you actually move through the world.
Accepting new clients • Sliding scale available
"You don't need to have it figured out before you call. That's what the room is for." — Dr. Miriam Holt, LCSW
About
Therapy that holds complexity.
I am a Licensed Clinical Social Worker with fifteen years of practice, most of them spent sitting with people who felt too complicated for a twelve-session protocol. I trained in attachment theory and somatic approaches, and I draw on both when the moment calls for it.
People come to me when something has shifted — a loss, a relationship ending, a career that no longer fits, or simply a creeping sense that something important has been set aside for too long. We work at the pace your nervous system sets, not the pace an insurance company dictates.
My practice is affirming of all identities. I am particularly experienced with LGBTQ+ clients, first-generation immigrants, and people navigating caregiver grief.
LCSW
MSW — Columbia University
Somatic-Informed
Attachment-Focused
LGBTQ+ Affirming
15 years in practice
How I work.
01
We begin with a real conversation.
Your first session is 75 minutes. Not because I am filling a form, but because I want enough time to understand how you got here — not just the presenting problem, but the history underneath it. We will also talk about whether we are a good match, because fit matters more than credentials.
02
We follow what is alive in the room.
I am trained in structured approaches — including CBT, IFS, and EMDR — but I do not follow a manual. I follow you. Some sessions are about making sense of something cognitive; others are about slowing down and noticing what happens in your body when a memory surfaces.
03
Progress is measured by your life, not a scale.
We check in regularly about what is shifting, what isn't, and what you need more of. I will never hold you to a plan that no longer fits. The measure of good work is that Monday mornings feel different — not a score on a symptom checklist.
Areas of focus.
These are the territories where I have the deepest experience. If yours isn't listed, reach out — there is a good chance we can still work together.
Grief & Loss
Bereavement, ambiguous grief, the slow grief of a relationship ending, or the grief of the life you expected but didn't get. All of it is welcome here.
Life Transitions
Career changes, divorce, relocation, early retirement, becoming a parent, losing a parent — moments when the story you told about yourself needs rewriting.
Identity & Self-Worth
Who are you beneath the roles you fill? Imposter syndrome, people-pleasing, perfectionism, and the quiet erosion of self that happens when you've been taking care of everyone else.
"I came in certain that I was broken. Miriam helped me see that I had just been carrying things that were never mine to carry alone."
"She never made me feel judged. Even the parts of myself I was most ashamed of. Especially those parts."
"I can finally sit with uncertainty without it feeling like an emergency. That alone has changed my life."
"Slow, steady, real. That is the only way I know how to describe it. And it actually worked."
FAQ
Ready to take a first step?
Send a message below. I respond to all enquiries within one business day. The free 20-minute consultation is a no-pressure conversation — it is just a chance to find out if we are a good fit.
- Office
- 2187 NW Thurman St, Suite 4, Portland OR 97210
- Phone
- (503) 555-0142
- Hours
- Mon – Thu 9am – 6pm • Fri 9am – 1pm