In this paper, the author describes an evolving and integrative approach to working with anxiety consisting of self-psychological, psychodynamic and developmental understandings. By encouraging an adolescent patient who presented with considerable and limiting anxiety, to “befriend” her anxiety through acceptance rather than try to rid herself of it, this teen was freed from myriad symptoms and enabled to separate from her mother and attend college. Both psychoanalyst and patient learned more about themselves and changed through engaging deeply with one another.