Living with allergies isn’t just about avoiding certain foods—it can take a serious emotional and psychological toll. Dr. Francesca Sawer currently works as a paediatric clinical psychologist at Great Ormond Street Hospital, alongside running a private practice supporting young people and families in managing emotional wellbeing and confidence, with a focus on allergies.
Previously leading the psychology team at Evelina Children’s Hospital, she also continues to help families through her social media platform, collaborations with Dr. Helen Allergy, and as a specialist advisor for the Sadie Bristow Foundation. In this blog, we explore her journey and how her Allergy Anxiety Method® helps families navigate life with allergies confidently
Getting to Know You
Can you tell us a bit about your background — what led you into a career in psychology?
I grew up in a very small seaside town in North Yorkshire. It was idyllic, although ashamedly I never really appreciated that as a child, as all I cared about was the fact I had to travel an hour to get to a cinema or any decent shops. Which is ironic, because as an adult I often crave going back to a life where I’m cut off from some of the busyness of life.
I did really well at school, but the type where I had to work hard and put in lots of effort. Looking back, I put a lot of expectations on myself, and I was also a very anxious child and teenager. I remember worrying about everything and constantly feeling like I had the weight of the world on my shoulders. But this wasn’t something people spoke about like they do now, so I didn’t really know any different and because I functioned so well, you would never have been able to tell. I was part of the generation where it was seen as an achievement to never have a day off school and to get 100% in tests, although I look back now and realise this was all likely fuelling my anxiety.
Ultimately though, I don’t think this was a bad thing for me because I found my own effective ways of managing, and it never impacted me or held me back. Perhaps unconsciously it was setting up my future career to support other children and teenagers who were anxious.
Growing up I wanted to be a lawyer. I was good at constructing and winning an argument and I took part in all the school debating competitions. I did work experience with a local solicitor, spent a week in the Crown Court, then went on to do A-Level Law and got a place at university to study it. But there was always this niggling feeling that it wasn’t right. In the courts I’d been more interested in why people had done things, and I think my mum who was actually a careers advisor always knew this wasn’t what I was destined to do, although I would never have listened to her at the time. Instead, she suggested I do some psychometric tests, which concluded that psychology and social sciences were a better fit for me than law.
Long story short: I switched my choices, headed off to Bath to study psychology, and as part of this completed a placement year. At this point I still had no idea I wanted to be a clinical psychologist or even what one was, but I did my placement year with an absolutely amazing clinical psychologist working in the area of eating disorders, and from there onwards I knew this was the career for me.
I went back to complete my final year of my undergraduate, now knowing how competitive it would be to do my chosen career. So I went into full determination mode; back into my obsessive hard-working tendencies, completely focused on getting a first (which was essential at the time for this career). I signed up for voluntary work at school and charities, all giving me more and more insight into the world of psychology. When I graduated, I was fortunate to secure a role as an assistant psychologist, and from there got my place on the Doctorate in Clinical Psychology, which is another three years of study. Since 2016 I’ve been qualified as a clinical psychologist, and I absolutely love my job and wouldn’t want to be anything else.
What does a typical day look like for you?
Let me caveat this by saying a typical day for me is not a typical day for other clinical psychologists and I think that’s the beauty of this role. Every day is completely different, and there are so many different parts to my job.
I usually get up between 5 and 5:30am to do some exercise. Either a run, time on the bike or a strength workout, this sets me up for the day and exercise is absolutely essential for keeping my mental health well.
I work full time for the NHS as well as running a small private practice and providing lots of free content on social media. So if it’s an NHS day, I’ll leave the house around 7:30am and travel into work for 8:30am to prepare for the day.
I’ll usually start with a meeting with my team to plan for the patients we’re seeing. Then I’ll have five to six hours of face-to-face contact, with email reading, clinical notes and my own clinical supervision in between. I’ll travel home and may see a few private clients for therapy online. I do this two days a week, and then I have a work-from-home day which is spent writing the reports for the clients I’ve seen earlier in the week. These are typically 2000-4000 word reports, so I do a lot of writing, alongside other tasks which might include consulting with schools and teachers or speaking with professionals in the NHS who may be supporting a child I’m assessing. In the evening, I will maybe see a few more private clients, write the emails for my mailing list which I send out each week or prepare content for social media, when possible, I’ll also head to the running track with my running club to get some speed training in. My partner and I like to eat dinner together every evening once we’ve finished work, and then watch some TV, although I usually start falling asleep by this point.
The rest of the week is spent at my other job, which is working at a university supporting the training of clinical psychologists on the Doctorate in Clinical Psychology (DClin). That time is spent on managerial tasks like checking expenses, signing off annual leave, and checking in with people who’ve been off sick or on maternity leave to make sure the necessary paperwork is in place and more importantly, that they’re supported and appropriate plans are in place. At other points in the year I do teaching, read application forms, conduct interviews, and every year we have a new intake of trainees and I have to make sure contracts are ready and that the necessary employment checks are done. For trainees finishing the programme, I often meet with them to discuss job options, applications and interviews, and to write references. I manage 30 trainees, and I pride myself on knowing them all really well so I can support them through the full training experience and make sure they can come to me with any challenges or issues; both academic and emotional. The training can be tough, and the NHS can be a difficult place to work at times and I believe it’s so important to have supportive leaders and managers. Ultimately, it’s a huge system and we need to think about how changes filter down, so I see this as my opportunity to do that for the next generation.
What do you enjoy most about your job?
There are so many things I enjoy, but my top three would be:
- The variety of work. Every day is different, no therapy session is the same. I get the opportunity to be really creative in how I connect with children and support people through a range of approaches—not just therapy, but also through courses, social media content, videos and teaching.
- I get to work with inspiring people every day, including other professionals and clients. It is a privilege to witness people’s lives and hear their stories, and for them to trust me to support them during what is often a vulnerable time.
- My job is incredibly rewarding. Seeing the changes people make, how far they come and the difference in their lives is so amazing. Watching clients get to places they never thought they could reach is something that keeps me doing what I do.
Was there a moment that made you want to focus on the psychological impact of living with allergies?
There was no specific training on the psychological impact of allergies during my training, and I have also learnt that this is similar in medical training where you may only get a few lectures on the topic. So, my entry into the allergy field only began once I was qualified.
Before working in allergies, I had a lot of experience in eating disorders and neurodevelopmental conditions such as autism, which can often affect feeding, restricted eating and anxiety. I had also worked with a variety of genetic, metabolic and epileptic conditions which impact diet and eating, as well as in more generic mental health services. I had also helped set up a new service in intensive care for staff and families.
In 2019 I was offered a job working in The Children’s Allergy Service at The Evelina, where the need for psychology had been recognised and was just starting to be integrated into the team. I joined as the psychology lead and absolutely loved it. I had my own ideas about the psychological impact of allergies before starting, but by the end of the first week I realised that was only scratching the surface. The psychological impact was wider ranging than anything I had worked with before. I was shocked that this was going under the radar and it made me incredibly determined to raise awareness and highlight the need for psychological support in this area.
What I also discovered was that the families I worked with often reported big progress in quite short periods of time. Sometimes just having access to information about anxiety and basic strategies helped children manage things like skin prick tests or blood tests that they had avoided for years. That again inspired me to think about other ways I could help more people access this information.
Unfortunately, my role in that service was fixed term and while we were planning to get more funding, Covid hit and changed service delivery for a while. I moved into a different role at another large children’s hospital; however, I have continued working within the field of allergies and I will always remain active in it because I know I can make a difference.
I also quickly realised that supporting people with allergies requires a slightly different therapeutic approach to other conditions and I developed and have continued to refine my own methods based on evidence-based techniques but adjusted to suit some of the nuances and specific challenges that come with allergies. Ultimately this means finding ways to live with uncertainty rather than battling constantly to control everything. Having a background in mental health, child development and neurodiversity also helps me support allergy related challenges more holistically because we need to consider the full picture including life, emotions, relationships and individual development not just the allergy itself.
Understanding the Psychology of Allergies
How important is it to address anxiety or fear linked to allergic reactions?
Living with allergies means you will always have an awareness of the risks and what could happen during a reaction. That awareness is part of what keeps people safe. However, I like to distinguish between what I call allergy alertness and allergy anxiety.
Alertness is being aware of danger but without having your thoughts consumed by it. It is being mindful of what could happen but still living in the present and enjoying life. It is accepting some level of risk, minimising it, holding things in perspective and not letting your thoughts spiral out of control.
Allergy anxiety is much more impactful. It can lead to avoiding situations that are ‘safe enough’, feeling constant worry and overthinking, and living in a state of high alert and threat every day.
I would say that if allergy anxiety is interfering with life, affecting family decisions or preventing things from happening, or if it is clouding daily judgement and thinking, then this is when it is important to address it.
Often people tell me they feel they have to worry, because worrying is what keeps them thinking about the risks and keeps them safe. But this is a myth. Worrying about a future reaction is not what prevents it. You can manage risk and stay safe without relying on worry and anxiety. This is exactly what I help people with, and why I created Allergy Anxiety Method® to be accessible and affordable for anyone who needs support. It is a starting point to show that life with allergies can be managed confidently and not from a place of overwhelm.
Do you see differences in how children, teens, and adults cope with allergies?
I think coping styles are usually shaped by a person’s developmental age, as well as by what they have been exposed to through observing and learning from others.
- With children, the anxiety I often see relates to procedures or specific situations that are new or unfamiliar because they have often not had the experience of navigating these before and are not able to yet generalise the strategies they already know. Many children I work with have lots of worries about uncertainty and about eating food they are unsure of. Sometimes this is because it looks or smells different, or they have learned that certain foods are unsafe. We have to remember that children are not yet able to assess risk or anticipate consequences in the same way adults can. This is developmentally appropriate, so they need support and a clear plan for what to do when they are unsure. That might mean checking something with an adult or working through a situation together so they can build those skills.
- Teenagers are typically developing independence, and if their parents have been managing their allergies well, this can be a time of realisation and increased anxiety. They start to see that parents will not always be there, and that they need to take responsibility themselves. We often see more avoidance behaviours while they figure out how to trust their own judgement and use the skills they have. It is also a time when they are shaping their identity, trying to fit in and managing more complex social dynamics, which can make allergies feel even more difficult to handle.
- When I support adults, it is often either parents of allergic children or adults with allergies themselves. This can include lifelong allergies or newly diagnosed ones. Adults are all coping because they have to, but it is the level of distress they experience that usually leads them to seek help. They have more life experience and problem-solving skills, but allergies are not a temporary challenge to resolve and instead it’s an ongoing uncertainty to live with. However, for adults with more awareness, that can be harder to switch off and anxiety can present as much more intense.
Have you come across any strategies or resources that really seem to help?
I think it’s a bit of a myth that there is one strategy that helps everyone. Strategies need to be tailored to the person and what is driving their specific situation. That’s why, as a clinical psychologist, I always begin by helping a person understand their unique context, triggers, thoughts and behaviours. This helps us decide which strategies are appropriate and when to apply them.
There aren’t many resources specifically focused on the psychological impact of allergies. We can borrow from evidence-based approaches for anxiety, but often those are built around the idea that anxiety is irrational or based on perceived (rather than rational) danger. But with allergies, the danger isn’t irrational, so the strategies need to be adjusted.
Most anxiety treatments talk about exposure to the feared object or situation, but this doesn’t work the same way when it comes to allergens. Exposure is not appropriate, and the goal isn’t to stop avoiding the allergen but to manage living alongside, accepting some risk, but being able to more accurately risk assess from a place of balance rather than fear.
That’s why I have created my own approach called The Allergy Anxiety Method®. It starts by helping people understand their personal cycle of anxiety and introduces the concept of “safe enough”.
“Safe enough” means recognising that some uncertainties are unavoidable, and that trying to eliminate them entirely causes anxiety to spiral. It brings people back to the present moment and helps them stop the constant cycle of what ifs. It acknowledges that risk exists but allows people to focus on confidence, capability and realistic planning rather than fear.
Everyone’s version of “safe enough” will be different, and it changes over time as confidence builds. It’s also context specific—what feels safe enough at home may be different to what feels safe enough when travelling.
My method helps people begin exploring their own position on this, reflect on their beliefs about allergies and separate helpful, protective behaviours from those that are driven by anxiety. It includes a mix of practical strategies to stay in the moment and manage the physical experience of anxiety, allowing people to choose what fits their needs.
Dr. Francesca’s work shows that living with allergies doesn’t have to mean living in constant fear or overwhelm. With the right strategies and support, it’s possible to regain confidence, enjoy daily life, and approach allergy management from a place of empowerment. For anyone struggling with anxiety related to allergies, The Allergy Anxiety Method®. is a highly accessible starting point. You can also sign up for free weekly tips and resources here to get ongoing support and practical guidance straight to your inbox.
Stay tuned for our next blog post, where we’ll explore another key challenge for families living with allergies: managing guilt and how Dr. Francesca’s strategies can help lighten the emotional load for both parents and children.
