Gaslighting has become a widely recognized term, but ironically, its overuse sometimes obscures its true meaning. People use “gaslighting” to describe disagreements, minor lies, and even simple misunderstandings. But real gaslighting is not simply dishonesty—it’s a strategic, ongoing process of emotional manipulation designed to distort your perception of reality, undermine your autonomy, and keep you dependent.

From a clinical perspective, gaslighting is a form of psychological abuse. It often occurs in toxic relationships, including romantic partnerships, families, workplaces, and even friendships. And while it can be overt and cruel, the most damaging forms are often subtle—because subtle gaslighting is harder to prove, harder to name, and harder to escape.

This article is written for those who suspect they may be experiencing gaslighting and want to understand how it operates—and, crucially, how to document it. Whether you’re beginning to question your own memories or are preparing to leave an emotionally abusive situation, documentation is a powerful tool to reclaim your truth and protect your mental health.

What Gaslighting Actually Is—and Isn’t

Gaslighting is not just lying. Lying is a discrete act: someone tells a falsehood to protect themselves or avoid consequences. Gaslighting is more systemic. It involves repeated tactics that lead the target to question their memory, perception, emotions, or even sanity. It’s not just about denying facts—it’s about shifting the ground under your feet so often that you no longer know what to believe.

Gaslighting is particularly damaging because it induces cognitive dissonance—the psychological discomfort that occurs when two beliefs conflict. Over time, the victim is conditioned to resolve that dissonance by adopting the gaslighter’s version of reality rather than trusting their own.

Red-Flag Behaviors That Signal Subtle Gaslighting

While gaslighting can include extreme behaviors like telling blatant lies or insisting you’re mentally unstable, most of it lives in the grey zone. Below are red flags that indicate psychological manipulation may be at play:

• Rewriting History: They insist something didn’t happen—even when you have proof—or claim you’re remembering it wrong.
• Withholding or Stonewalling: They refuse to engage when you bring up concerns and make you feel like you’re the problem for trying to discuss anything at all.
• Minimizing and Dismissing: They respond to your distress with “You’re overreacting,” “You’re being dramatic,” or “It’s not a big deal.”
• Shifting Blame: They always manage to make it your fault, even when their behavior is clearly harmful.
• Using ‘Logic’ to Undermine Emotion: They frame their dismissiveness as rationality and portray your emotional responses as irrational or unintelligent.
• Public Kindness, Private Cruelty: They behave differently in public than in private, making you question your own experience.
• Making You Doubt Neutral Observers: They suggest that friends, therapists, or colleagues are biased against them—or against you.
• Using Your Words Against You: Anything you share vulnerably can be later used to discredit or shame you.
  

Psychological Impact of Gaslighting

Gaslighting leads to more than momentary confusion—it can result in long-term psychological harm. Clinically, many survivors present with symptoms of:

• Chronic self-doubt and indecisiveness
• Generalized anxiety or panic attack
• Symptoms of complex PTSD\
• Depersonalization (feeling outside one’s body)
• Ruminative thought patterns
• Dysfunctional attachment behaviors
  

The most insidious effect is internalized gaslighting: believing the gaslighter’s narrative so completely that the survivor begins self-policing their emotions and invalidating their own instincts.

Why Documentation Is So Crucial

The goal of gaslighting is to disrupt your internal compass. The antidote to gaslighting isn’t just leaving the relationship—it’s rebuilding your sense of what’s true.

Documentation can serve several purposes:

• It preserves your version of events.
  
• It provides a timeline of behaviors that may otherwise blur together.
  
• It supports your case if legal, HR, or custody issues arise.
  
• It interrupts the “maybe I imagined it” thought loop that gaslighters rely on to maintain control.

How to Document Gaslighting Behaviors Safely and Effectively

This section offers therapist-recommended, trauma-informed practices for gathering and preserving evidence while protecting your safety and emotional well-being.

1. Keep a Secure Daily Log

Use a password-protected digital journal (or a paper one stored safely) to log:

• Dates and times of incidents
  
• What was said or done (verbatim, if possible)
  
• Your emotional and physical reaction
  
• Any witnesses or evidence
  

For example:
April 9, 7:45 PM: I told him it bothered me when he ignored my messages. He said, “That never happened—you’re imagining things again.” I felt confused and ashamed. My hands were shaking after the conversation.

This type of record not only validates your experience but also helps identify patterns of behavior over time.

2. Save Screenshots of Messages and Emails

Digital communication can be powerful evidence. Gaslighters may later claim, “I never said that” or “You misunderstood.” Screenshots provide an irrefutable record. Store them in an encrypted folder and back them up to a secure drive.

3. Record Voice Memos (Where Legal)

If legal in your jurisdiction, audio recordings of conversations can help you hear the manipulation more clearly in hindsight. Always check local laws before recording.

4. Ask Clarifying Questions in Writing

When possible, communicate difficult or sensitive issues via text or email rather than in person. This creates a written record of how the gaslighter responds. You can also use reflective questions to elicit clarity:

• “Can you help me understand why you said that I’m ‘too emotional’ when I was describing how I felt?”
  
• “Just so I’m clear—are you saying that X never happened?”
  

Even if the responses are vague or dismissive, those patterns become part of the documented behavior.

5. Maintain Emotional Validation Logs

Gaslighters rely on emotional invalidation. Keeping a record of when you felt unseen, dismissed, or manipulated helps you maintain your sense of reality. Include physical sensations (racing heart, stomach tension, etc.) to connect with your body’s wisdom.

6. Share Documentation with a Safe Third Party

Therapists, close friends, or legal advocates can provide affirmation and perspective. In some cases, sharing your logs with a therapist helps establish a clinical record, which can later be helpful for legal purposes or safety planning.

7. Prioritize Digital Safety

Never store documentation on shared devices. Use incognito browsers, secure cloud backups, and password protection. Consider using apps with disguised icons or “panic delete” features if you are concerned about your safety.

8. Use a Code System for Logs if Necessary

If you fear discovery, use a neutral-looking note system with coded language. For example, “Client C” might mean your partner, and “Session 1” might mean a particular fight. Discuss safe methods with your therapist.

Healing Starts with Reclaiming Your Reality

Gaslighting corrodes the basic foundation of mental health: trust in your own mind. But documenting your experience—privately and safely—is the first step to reversing that damage. The act of writing things down, seeing patterns, and validating your truth is healing in itself. It’s not about revenge. It’s about repair.

If you feel confused, ashamed, or unsure whether you’re “overreacting,” that’s the conditioning talking. Trust the version of you who kept track. Trust the instincts that made you start looking into this in the first place.

How Therapy at Refresh Psychotherapy Can Help

At Refresh Psychotherapy, we work with survivors of covert emotional abuse, including gaslighting. We know how isolating and disorienting it can be to constantly second-guess yourself or feel invisible in your own story. Our therapists provide a validating, structured space where you can make sense of what’s happened, restore your confidence, and begin making decisions rooted in your own truth. Whether you’re preparing to leave a harmful dynamic or healing in its aftermath, we’re here to support you in documenting safely, processing deeply, and recovering fully.

Did you experience trauma due to gaslighting? Make an appointment with one of Refresh’s talented therapists at:

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Stark, E. (2007). Coercive Control: How Men Entrap Women in Personal Life. Oxford University Press.

Sweet, P. L. (2019). The Sociology of Gaslighting. American Sociological Review, 84(5), 851–875.

Waldron, J. J. (2012). Gaslighting in Interpersonal Relationships: A Form of Emotional Abuse. Journal of Psychosocial Nursing and Mental Health Services, 50(7), 20–27.

Stern, R. (2007). The Gaslight Effect: How to Spot and Survive the Hidden Manipulation Others Use to Control Your Life. Harmony Books.

In every friend group, there’s often that person—the one who offers calm advice, listens without interrupting, diffuses tension, and seems to have it all together. If you’re reading this, chances are that person is you. You’re the go-to sounding board, the unpaid life coach, the emotional anchor. You’re the one who gets the 2 a.m. crisis texts and the “Can I vent real quick?” DMs from friends, coworkers, and sometimes near-strangers.

You didn’t ask for the role, but it found you—and you’ve gotten good at it. So good, in fact, that people forget you have needs of your own.

From a mental health perspective, being the “therapist friend” can be a double-edged sword. On one hand, your empathy and insight are strengths. On the other, they can leave you overextended, resentful, or emotionally drained. The line between supportive and self-sacrificing gets blurry—and without boundaries, the burden can start to feel like burnout.

This article is for anyone who’s exhausted from being everyone’s emotional safety net. It explores why this dynamic forms, how it impacts mental health, and what you can do to protect your energy without abandoning your relationships.

Why You Became the Therapist Friend

People who become the “therapist friend” often share several psychological traits: high emotional intelligence, strong interpersonal skills, and a history of being hyper-attuned to the moods of others. Many have experienced childhood roles that required them to become peacekeepers, parentified children, or emotional regulators for overwhelmed adults (Hooper et al., 2011). These patterns create a tendency to step into caregiving roles automatically—even when it’s not explicitly asked of them.

Others grow into the role through professional or academic training. If you’re a mental health professional, medical provider, teacher, or coach, your identity is tied to helping others—and your friends may lean on you without realizing they’re treating you more like a therapist than a peer.

But regardless of how the role starts, the result is often the same: you end up holding more emotional labor than your fair share.

The Mental Health Toll of Constant Emotional Labor

Emotional labor refers to the invisible work of managing other people’s feelings, smoothing over conflict, and staying calm even when you’re not. When this becomes your default mode in personal relationships, it can lead to:

• Compassion fatigue
• Emotional burnout
• Suppressed anger or resentment
• Reduced capacity for self-care
• Enmeshment or codependent dynamics
  

What’s more, the therapist friend often doesn’t feel allowed to struggle. People expect them to always be calm, wise, and available. As a result, they might downplay their own problems, believing they should be able to handle everything on their own.

But this belief is both unrealistic and damaging. Everyone deserves support—not just those in crisis. And no one should have to perform emotional perfection just to be accepted.

How to Recognize When It’s Too Much

Signs that the “therapist friend” role is taking a toll include:

• You feel dread when a certain friend calls or texts.
• You avoid sharing your own struggles because you’re afraid they’ll seem small.
• You feel guilty saying no, even when you’re at capacity.
• You resent how much space others take up, but feel unable to stop it.
• You notice a pattern: others vent, you listen, and nothing changes.
  

These are warning signs that your boundaries have been eroded—and that it’s time to reevaluate how much emotional labor you’re willing (or able) to give.

Protecting Your Energy: What Therapists Recommend

You don’t have to cut everyone off to reclaim your bandwidth. Here are therapist-approved strategies for maintaining your empathy without sacrificing your well-being:

1. Differentiate Between Support and Fixing
Listening with care doesn’t mean solving the problem. Instead of jumping into advice-giving mode, ask: “Do you want to vent, or would it help to talk through solutions?” This sets a limit and invites shared responsibility for the emotional exchange.

2. Set Limits on Frequency and Duration
You’re allowed to say: “I really want to be here for you, but I can only talk for 15 minutes today.” Setting time boundaries preserves your energy without rejecting the person.

3. Name Your Needs—Out Loud
Let your friends know when you need support. If the dynamic is always one-sided, healthy friends will welcome the chance to show up for you, too.

4. Redirect to Professional Resources When Needed
You can say: “That sounds heavy—I think this is bigger than what a friend can help with. Have you thought about talking to a therapist?” This reinforces that your role is a friend, not a clinician.

5. Recognize Resentment as a Signal, Not a Failure
Resentment often means you’ve overextended yourself. It’s not a sign that you’re selfish—it’s a cue that you’ve ignored your own limits.

6. Practice Saying No Without Overexplaining
You don’t have to justify your boundaries with elaborate explanations. A simple “I’m not in the right space to hold that right now, but I care about you” is enough.

7. Reframe Boundaries as Connection Tools
Boundaries aren’t walls—they’re guidelines that make deeper connection possible. They prevent burnout, resentment, and emotional depletion, allowing you to show up more fully when you do choose to engage.

When Friendship Starts to Feel Like Therapy

It’s important to ask yourself: Is this a mutual friendship, or a one-sided support dynamic? If your relationship primarily revolves around the other person’s crises, needs, and processing, it may be time to reset expectations.

Therapy-saturated friendships often lack balance. You deserve relationships where your voice is heard, your needs matter, and your presence is valued for more than your insight.

And if setting boundaries causes conflict, that’s information—not failure. It tells you how safe the relationship really is.

How Therapy at Refresh Psychotherapy Can Help

At Refresh Psychotherapy, we help clients break free from emotionally overburdened roles—including the therapist friend dynamic. If you’ve been carrying too much for too long, therapy can offer a space to explore why that role formed, what it costs you, and how to create more equitable, energizing relationships. You don’t need to give less—you just need to stop giving everything. Our clinicians support you in reclaiming your right to rest, receive, and exist without always being the strong one.

Need help protecting your energy? Make an appointment with one of Refresh’s talented therapists at:

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Grabe, S., Ward, L. M., & Hyde, J. S. (2007). The Role of the Media in Body Image Concerns Among Women: A Meta-Analysis of Experimental and Correlational Studies. Psychological Bulletin, 134(3), 460–476.

Hooper, L. M., Doehler, K., Wallace, S. A., & Hannah, N. J. (2011). The Parentification Inventory: Development, validation, and cross-validation. The American Journal of Family Therapy, 39(3), 226–241.

Figley, C. R. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Brunner/Mazel.

For parents navigating immigration delays, asylum backlogs, or visa restrictions, family life doesn’t pause just because borders do. When you’re separated from your children—not by choice but by paperwork—the pain can feel relentless. Whether you’re waiting for reunification or forced to parent from afar, the distance often carries guilt, grief, and overwhelming questions: “Am I doing enough?” “Will my child still feel connected to me?” “What happens to our bond in the meantime?”

From a mental health perspective, long-distance parenting during immigration delays is a high-stakes, high-emotion experience. But it’s not one without hope. With the right combination of attachment-based rituals, secure communication routines, and tech tools that support emotional presence, parents can maintain meaningful bonds—despite miles and legal barriers.

This article explores how to protect emotional connection while physically apart, using evidence-based attachment principles and practical strategies tailored for cross-border families.

Why Long-Distance Parenting Hurts So Much

Human attachment is built on proximity, touch, and repeated daily interaction. But when immigration systems intervene—through deportation, visa denials, or protracted legal timelines—these foundations are disrupted.

Psychologically, this separation can activate grief, trauma, and helplessness. Research shows that long-term parental separation can trigger symptoms of depression, anxiety, and complicated grief in parents, particularly when the separation is involuntary (Suárez-Orozco et al., 2011). This is not “homesickness”—it’s the psychological pain of being unable to perform your role in a child’s life in real time.

The loss isn’t just about presence. It’s about missed firsts, unsaid goodnights, and the inability to comfort your child through their struggles. And for many, it’s also about the fear of being forgotten—or replaced.

Understanding Attachment Beyond Physical Proximity

While proximity supports attachment, it’s not the only ingredient. What truly matters is a child’s felt sense of connection—the belief that their parent is emotionally available, consistent, and invested in the relationship.

This means that even across distances, you can still:

• Show up emotionally
• Create predictability
• Reinforce your role as a secure base
• Celebrate the ordinary
• Repair moments of misattunement
  

These are the cornerstones of secure attachment. And they’re all possible—even when borders get in the way.

Attachment-Preserving Rituals and Routines

1. Anchor the Day
   Create a consistent time when your child can expect to hear from you—morning voice notes, bedtime video calls, or midday texts. Predictability builds trust. Even if you can’t speak daily, a structured routine (like “Tuesday story night”) becomes emotionally meaningful.
   
   
2. Mirror Real-Life Activities
   Do shared activities simultaneously—even while apart. Eat breakfast together on video. Watch the same show and talk about it. Take parallel walks and send photos. This mimics the rhythm of daily life and reminds your child you still move through the world with them in mind.
   
   
3. Rituals of Continuity
   Start shared traditions: a weekly question you always ask, a bedtime phrase, or a hand gesture that means “I love you.” These rituals act as emotional glue, especially when time zones or legal proceedings disrupt consistency.
   
   
4. Voice Over Video, When Needed
   Video calls can be overstimulating, especially for younger children or teens going through withdrawal or resentment. Don’t underestimate the intimacy of audio messages—your tone, warmth, and cadence all communicate care.
   

Tech Hacks to Sustain Emotional Presence

1. Recordable Storybooks or Audiobooks
   Record yourself reading a favorite story. Companies like Hallmark or custom audiobook platforms allow you to create tangible reminders of your voice and presence.
   
   
2. Shared Calendars and Countdowns
   Use platforms like Cozi or Google Calendar to share important dates—school events, visa hearings, or birthday countdowns. This helps your child feel like you’re part of their world, even if you’re not physically there.
   
   
3. Digital Memory Albums
   Create shared albums where your child can upload drawings, report cards, or selfies—and you can respond with comments or emojis. It mirrors the back-and-forth interaction of in-person parenting.
   
   
4. Care Packages with Symbolic Items
   Send a care package with one object that represents you—a scarf that smells like your cologne or perfume, a token from your culture, or a keepsake from your shared memory. Concrete items help reinforce abstract emotional bonds.
   

Repairing Disconnection from Afar

Every parent will miss calls. Forget a promise. Misunderstand a tone. Long-distance parenting requires you to become fluent in repair—the process of acknowledging misattunement and restoring trust.

Try using simple scripts:

• “I noticed I missed your call. I really wanted to talk. Let’s try again tomorrow.”
• “I’m sorry I seemed rushed. I was distracted, but that wasn’t your fault.”
• “I still want to hear what you had to say. Can we talk again soon?”
  

Consistent repair shows your child that your bond is resilient—and that mistakes don’t mean disconnection.

Mental Health Strategies for Parents in Limbo

You may be parenting through visa interviews, court dates, time zone gaps, and missed milestones. It’s okay if it feels like too much. Parenting from afar often leads to self-blame, but guilt is not proof of failure—it’s proof of love.

Supportive strategies include:

• Therapy with immigration-informed clinicians
• Virtual peer support groups for separated parents
• Scheduled worry time and emotional boundaries (Borkovec et al., 1993)
• Self-compassion practices to combat internalized guilt (Neff & Germer, 2013)
  

How Therapy at Refresh Psychotherapy Can Help

If you’re a long-distance parent navigating the emotional toll of family separation, therapy at Refresh Psychotherapy offers a space to process your experience without judgment. Our therapists understand the unique mental health challenges that come with immigration delays, identity strain, and attachment disruption. We offer expert-level care for parents who are striving to maintain presence and connection from afar—helping you manage guilt, anxiety, and emotional fatigue while reclaiming a grounded sense of self. You’re not alone, and you don’t have to carry the weight of this alone.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Borkovec, T. D., Wilkinson, L., Folensbee, R., & Lerman, C. (1993). Stimulus control applications to the treatment of worry. Behavior Research and Therapy, 31(3), 263–267.

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self‐compassion program. Journal of Clinical Psychology, 69(1), 28–44.

Suárez-Orozco, C., Bang, H. J., & Kim, H. Y. (2011). I felt like my heart was staying behind: Psychological implications of family separations & reunifications for immigrant youth. Journal of Adolescent Research, 26(2), 222–257.

In multicultural workplaces, language diversity is a strength. But for many professionals who speak English as an additional language, that diversity can come with a heavy emotional cost. If you’ve ever hesitated to speak up in a meeting, rehearsed simple sentences dozens of times, or felt your heart race just before saying your name aloud, you’re not alone. This experience is called accent anxiety, and it’s a widespread—but rarely discussed—mental health challenge for multilingual professionals.

Accent anxiety isn’t about your English proficiency. It’s about the fear of being judged, dismissed, or misunderstood because of how you sound. And it’s often rooted not just in interpersonal experience, but in internalized messages about competence, belonging, and authority.

This article explores the psychological impact of accent anxiety, why language-based shame is a form of trauma, and how to use CBT-informed tools to quiet your inner critic and reclaim your voice at work.

What Is Accent Anxiety?

Accent anxiety refers to the fear, shame, or self-doubt triggered by speaking in a non-dominant accent or dialect, particularly in professional or formal settings. It may include:

• Preoccupation with pronunciation or grammar mistakes
  
• Avoiding speaking roles in meetings or presentations
  
• Over-editing emails or scripts to sound more “native”
  
• Feeling like an imposter even with subject-matter expertise
  
• Shame or embarrassment after minor communication errors
  

These reactions are not simply about discomfort—they are manifestations of internalized linguistic bias, often reinforced by social cues, microaggressions, or subtle exclusion.

The Psychological Weight of Language-Based Shame

Psychologically, accent anxiety overlaps with phenomena like stereotype threat, imposter syndrome, and social anxiety. Research has found that language-based stigma and accent discrimination can lead to increased anxiety, lower self-esteem, and even depressive symptoms, particularly in environments where one’s accent becomes a marker of “otherness” (Gluszek & Dovidio, 2010).

What makes accent anxiety especially difficult is that it often triggers an internalized message: “I don’t sound right, therefore I don’t belong here.” Over time, these experiences shape identity and erode confidence, regardless of how capable or accomplished the individual may be.

For many people, their accent carries their history, culture, and personal story. When it’s met with condescension or correction, that rejection is deeply personal. And when these moments happen at work—where performance, status, and stability are at stake—they can feel especially threatening.

Why CBT Techniques Help

Cognitive Behavioral Therapy (CBT) is an evidence-based therapeutic approach that focuses on identifying and challenging unhelpful thought patterns. It’s particularly useful for accent anxiety because it targets the automatic thoughts and cognitive distortions that lead to emotional distress and self-sabotaging behavior.

CBT doesn’t aim to eliminate your accent—it helps you stop treating your voice as a problem. The goal is not to “perfect” your communication but to build self-trust, flexibility, and emotional safety when speaking authentically.

CBT Tools to Reduce Accent Anxiety at Work

1. Thought Monitoring: Name the Inner Critic
   The first step is noticing when self-critical thoughts arise. You might hear an internal voice say, “They won’t take me seriously,” “I’m going to mess this up,” or “I should let someone else talk.” Write down these thoughts and ask:
   

• Is this objectively true?
  
• What’s the evidence for and against this belief?
  
• What would I say to a friend in this situation?
  

This exercise helps create distance between you and your anxious thoughts. Thoughts are not facts—they’re habits of mind shaped by lived experience.

2. Cognitive Reframing: Challenge Distorted Thinking
   CBT teaches us to challenge cognitive distortions like catastrophizing (“If I say one wrong word, they’ll think I’m incompetent”) or mind-reading (“They’re judging me”). Replace these with more accurate alternatives:
   

• “Everyone has an accent. My expertise speaks louder than my pronunciation.”
  
• “If I stumble, it doesn’t mean I’m unqualified—it means I’m human.”
  
• “I’ve communicated successfully before; I can do it again.”
  

Reframing doesn’t mean lying to yourself—it means telling the whole truth, not just the anxious version.

3. Behavioral Experiments: Speak Anyway
   Avoidance reinforces anxiety. The more you stay silent, the more your brain associates speaking up with danger. CBT encourages small, planned behavioral experiments—like asking a question during a meeting or introducing yourself without rehearsing.
   

Afterward, reflect:

• What did I predict would happen?
  
• What actually happened?
  
• What does that tell me about my fear?
  

These exercises retrain the brain to see speaking as tolerable—even when imperfect.

4. Self-Compassion Scripts: Rewriting Internal Dialogue
   Many people with accent anxiety carry self-talk inherited from school, workplace discrimination, or family messages. Creating a new inner narrative is a crucial step. Try using phrases like:
   

• “My voice deserves space.”
  
• “I don’t need to sound like anyone else to be heard.”
  
• “Fluency is not the same as intelligence.”
  

Self-compassion is not indulgent—it’s a corrective for internalized harm.

Systemic Bias Isn’t Your Fault—But Healing Is Still Your Right

Accent anxiety doesn’t arise in a vacuum. Many workplaces reinforce linguistic bias by rewarding dominant norms and marginalizing others. You didn’t choose this system, and you didn’t create these fears. But you can choose to heal from them.

Affirming your voice, learning to speak with presence, and building emotional safety while navigating accent-based bias are mental health goals—not just professional ones.

Your Voice Is Enough

You may still worry sometimes. You may still overthink, freeze up, or replay conversations in your head. That’s okay. Healing is not about perfection—it’s about freedom. Freedom to speak, to share, and to be heard in the voice you actually have.You are not “less than” because of your accent. You are someone who navigates two or more linguistic worlds—and that’s a strength, not a flaw. You don’t have to lose your voice to find your place.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Gluszek, A., & Dovidio, J. F. (2010). The way they speak: A social psychological perspective on the stigma of non-native accents in communication. Personality and Social Psychology Review, 14(2), 214–237.

Tummala-Narra, P. (2021). Cultural identity, immigration, and mental health: Working with culturally diverse individuals and families. American Psychological Association.

Clark, D. A., & Beck, A. T. (2011). Cognitive Therapy of Anxiety Disorders: Science and Practice. The Guilford Press.

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self‐compassion program. Journal of Clinical Psychology, 69(1), 28–44.

Before the rise of remote work, most adults went through their day without seeing their own face more than once or twice. But since the shift to video-based communication, it’s now routine to have multiple hours of daily exposure to your own image. For many, this repeated self-view has triggered something deeper than annoyance—it’s activated a full-blown obsession with appearance.

This experience is now so common that it’s earned a name: Zoom dysmorphia—a term coined during the pandemic to describe the uptick in cosmetic dissatisfaction and body image distortion caused by constant video conferencing. But this isn’t just about vanity or self-absorption. It’s about the way prolonged self-surveillance alters our relationship with identity, confidence, and mental health.

From a therapist’s perspective, appearance obsession born from constant on-screen reflection is a modern mental health concern rooted in body surveillance, perfectionism, and chronic self-monitoring. It disproportionately impacts people in client-facing roles, those with marginalized identities, and individuals who already carry a complicated relationship with their body or image. In this article, we’ll explore how this phenomenon develops, its impact on emotional well-being, and evidence-based strategies to reconnect with your sense of self—without needing to disappear from your screen or your life.

How We Got Here: The Age of Self-View

It’s worth remembering that evolution did not prepare us to constantly monitor ourselves in real time. Before the digital era, people primarily saw their reflections in mirrors—briefly, occasionally, and usually in private. The webcam changed that. Now, when you’re in a meeting, you’re not just paying attention to what’s being said. You’re also watching yourself nod, smile, squint, frown, or shift. You’re both performer and audience.

Over time, this dual role alters how we experience ourselves. What might begin as mild self-consciousness can turn into ongoing appearance anxiety—where you’re constantly evaluating whether you look tired, unprofessional, aging, bloated, or disheveled. For individuals with perfectionistic tendencies or high self-monitoring, this experience becomes emotionally exhausting and psychologically disruptive.

The Psychology of Seeing Yourself Too Often

Research shows that increased exposure to one’s own image is associated with heightened body dissatisfaction and negative self-evaluation (Ratan et al., 2021). The phenomenon of body surveillance—viewing oneself as if through the eyes of others—has long been studied in feminist psychology and body image research. It’s linked to reduced cognitive functioning, poor emotional regulation, and even increased risk for disordered eating and depressive symptoms (Grabe et al., 2007).

From a therapeutic standpoint, frequent self-view often reinforces maladaptive core beliefs such as:

• “My worth is based on how I look.”
• “People won’t take me seriously unless I appear polished.”
• “I’m only successful if I look a certain way.”
  

These beliefs aren’t just irrational—they’re culturally reinforced. Western society prizes aesthetic control and links personal discipline with appearance. The camera, then, becomes both mirror and microscope: a place where identity is constantly edited, compared, and critiqued.

Zoom Dysmorphia Is a Mental Health Issue

Zoom dysmorphia isn’t a vanity issue—it’s a visibility issue. When your job, social life, or education depends on being “camera-ready,” it creates internal pressure to manage not just your image but how you feel about your image.

A 2021 survey of cosmetic surgeons found a sharp rise in patients citing video calls as a motivation for seeking aesthetic procedures—especially among those who had never before expressed concern about their appearance (Rice et al., 2021). The same report noted that many patients didn’t recognize that their self-image was being distorted by angle, lighting, lens curvature, and screen fatigue.

As therapists, we often see this manifest in increased reports of:

• Perfectionism and productivity anxiety
• Body image dissatisfaction and preoccupation
• Heightened social anxiety and avoidance behaviors
• Intrusive self-critical thoughts
• Fatigue from maintaining a “work face” even at home
  

These symptoms don’t meet the clinical threshold for Body Dysmorphic Disorder (BDD) in every case—but they represent real emotional suffering that deserves attention and care.

Why Some People Are Affected More Than Others

People of all genders experience appearance pressure, but women, BIPOC professionals, trans and nonbinary individuals, and anyone who deviates from Eurocentric beauty norms are more vulnerable. For these individuals, the camera doesn’t just reflect a face—it reflects years of internalized scrutiny, cultural trauma, and invalidation.

In therapy, this often sounds like:

• “I feel like I have to look perfect to be taken seriously.”
• “I worry about looking too masculine/feminine/queer/ethnic/young/old.”
• “I hate seeing my face because it reminds me of how I was bullied.”
• “I obsess over how much I’ve aged since switching to remote work.”
  

These aren’t superficial concerns. They speak to the intersection of identity, safety, and survival. When your livelihood depends on being palatable to others—especially through a screen—your brain adapts by monitoring your image more intensely. This is not vanity. This is vigilance.

Therapeutic Strategies to Address Appearance Obsession

As therapists, we don’t treat the camera—we treat the emotional relationship people have with it. Here are several clinical strategies clients find helpful when managing camera-triggered appearance anxiety:

1. Turn Off Self-View—Routinely
Platforms like Zoom now allow users to hide their own image while remaining visible to others. Using this function isn’t avoidance—it’s regulation. Reducing constant self-view can immediately decrease body surveillance and improve focus and presence.

2. Use CBT Techniques to Challenge the Inner Critic
Identify and reframe distorted thoughts like “I look unprofessional,” “Everyone is staring at my acne,” or “No one will take me seriously if I look tired.” Ask: What’s the evidence for this? What would I say to a friend who felt this way? Over time, this loosens the hold of shame-based beliefs (Beck, 2011).

3. Implement Rituals That De-Center Appearance
Start and end calls with grounding activities that bring attention back to sensation or intention—e.g., stretching, breathing, listing what you value about the meeting beyond how you appear.

4. Set Boundaries Around Video Use
Not every meeting requires a face. Offer phone calls when possible, and normalize “camera off” days in teams or social groups. Reducing the frequency of on-camera exposure reduces chronic overactivation of appearance monitoring systems.

5. Explore Emotionally-Rooted Associations with Appearance
In psychodynamic or integrative therapy, clients often uncover early experiences (bullying, criticism, family modeling) that shaped their beliefs about appearance. Processing these associations helps break the emotional link between image and identity.

6. Reconnect With the Body from the Inside Out
Somatic interventions—such as grounding, mindful movement, or breathwork—can help retrain the nervous system to experience the body as a resource, not just an object. This is especially effective for clients with trauma histories.

7. Redefine “Professionalism” and Self-Worth
Therapy can help clients dismantle internalized capitalism and ableism—beliefs that link productivity, polish, or attractiveness with moral or social value. Redefining success around authenticity, presence, and contribution is liberating and protective.

How Therapy at Refresh Psychotherapy Can Help

At Refresh Psychotherapy, we recognize that modern life brings new challenges—and constant self-view is one of them. If you’ve noticed increasing anxiety, self-criticism, or emotional exhaustion from seeing yourself on screen, you’re not alone. Our therapists specialize in helping adults untangle performance pressure, body image issues, and self-worth from external metrics. Through collaborative, evidence-based care, we’ll support you in reclaiming your time, your energy, and your sense of self—from the inside out.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond (2nd ed.). The Guilford Press.

Grabe, S., Ward, L. M., & Hyde, J. S. (2007). The Role of the Media in Body Image Concerns Among Women: A Meta-Analysis of Experimental and Correlational Studies. Psychological Bulletin, 134(3), 460–476.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. W. W. Norton & Company.

Ratan, R. A., Beyea, D., & Li, B. J. (2021). Zooming in on Zoom Dysmorphia: Exploring the Impact of Prolonged Self-Viewing on Body Image. Psychology of Popular Media. https://doi.org/10.1037/ppm0000380

Rice, S. M., Siegel, J. A., Libby, T. A., et al. (2021). Zooming into Cosmetic Procedures During the COVID-19 Pandemic: The Provider’s Perspective. Facial Plastic Surgery & Aesthetic Medicine, 23(3), 161–167.

If you’ve ever wondered, “Is this therapy even working?” you’re not alone. One of the most common questions clients ask—sometimes after a few sessions, sometimes after years—is whether they’re actually healing or just spinning their wheels. Therapy isn’t a quick fix, and it rarely feels like one. There are no instant results or universal milestones. But healing does happen—quietly, cumulatively, and often in ways you may not notice at first.

As a psychotherapist, I’ve seen firsthand how clients mistake discomfort for failure and expect transformation to look dramatic. In reality, healing is often marked by subtle shifts: you pause before reacting, you name your emotions more clearly, or you set a boundary you would’ve avoided last year. These are not small things. These are signs that the work is taking root.

In this article, we’ll explore what emotional healing really looks like, why it often feels confusing or incomplete, and how to know whether your therapy is actually working.

Why Healing Doesn’t Always Feel Like Healing

Most people associate healing with feeling better. But in therapy, healing can involve confronting the very things you’ve spent your whole life trying not to feel—grief, shame, anger, or fear. In fact, the early stages of effective therapy may feel worse than before you started.

This is because therapy dismantles your emotional autopilot. You begin to notice old patterns, unconscious beliefs, and unresolved pain that have been quietly running your life. That awareness is disorienting at first. But it’s also necessary.

The psychodynamic model refers to this process as “working through” (McWilliams, 2011). This means revisiting emotional themes repeatedly in order to metabolize them more fully over time. It’s not linear. It’s not comfortable. But it is how change happens.

The Myth of the Therapy Glow-Up

There’s a popular misconception—fueled by social media and self-help culture—that healing should look like a radical transformation. People imagine leaving therapy with perfect boundaries, crystal-clear self-worth, and zero anxiety. But real progress is often messier. You may still cry in your car. You may still second-guess yourself. You may even feel like you’re “backsliding.” But what’s changed is your awareness, your self-talk, and your recovery time.

Healing doesn’t mean becoming a different person. It means becoming more fully yourself, with more insight, more choice, and more capacity to hold discomfort without collapsing.

Common Signs You’re Actually Healing

Here are the signs therapists often look for to determine whether a client is truly progressing in therapy:

1. You react more slowly and recover more quickly.
You still feel triggered—but you catch it sooner. Maybe you pause before sending the angry text, or you notice the spiral and step out of it. This shows improved emotional regulation and nervous system flexibility (Porges, 2011).

2. You tolerate emotional discomfort instead of avoiding it.
Instead of numbing out, blaming others, or avoiding hard conversations, you sit with difficult feelings. You don’t like them, but you no longer feel controlled by them.

3. You recognize your patterns—in real time.
You begin to say things like, “This reminds me of how I felt as a kid,” or “This is the part of me that always tries to keep the peace.” Recognizing these patterns as they happen is a huge step toward interrupting them.

4. You feel less stuck in black-and-white thinking.
You can hold two truths at once: “I’m hurt, and I know they didn’t mean it.” Or, “This feels unfair, and I still have to deal with it.” Emotional nuance is a key indicator of healing.

5. You start to update your internal narrative.
You stop seeing yourself as broken or difficult and begin to understand your behaviors as adaptations. You shift from “What’s wrong with me?” to “What happened to me, and what can I do with that now?”

6. You’re more curious than reactive.
Instead of jumping into defensive mode, you begin to ask questions—of yourself and others. You want to understand, not just escape or win.

7. You begin to set boundaries—without needing to justify them.
Saying “no” becomes less loaded. You stop over-explaining or apologizing for taking care of your own needs.

8. You no longer rely on your therapist to “fix” you.
You show up as an equal in the room, bringing questions, insights, and challenges. You begin to trust your own internal compass.

9. You notice changes in your body.
Your sleep improves. Your breath is deeper. You feel less tension in your shoulders. Healing often shows up somatically, as the nervous system recalibrates to safety.

10. You bring hard things into the room—and stay.
You don’t ghost when things get tough. You name ruptures. You share anger or disappointment. This means you’re learning to repair, not just retreat.

Why Healing Can Feel Boring, Frustrating, or Pointless

If therapy doesn’t always feel “good,” what does it feel like? Sometimes: boring. Or repetitive. Or like you’re just talking in circles. This is not unusual—and often, it’s a sign that deeper integration is underway.

Clients often expect big breakthroughs each session. But healing doesn’t require constant insight. It requires repetition, consistency, and safety. Like physical therapy, change happens through ongoing relational work, not just intellectual “aha” moments.

Also, many clients don’t recognize progress because they’ve been conditioned to associate emotional growth with productivity or visible results. But mental health doesn’t always yield measurable outcomes. It often shows up as:

• Fewer panic attacks
• More neutral days
• Less emotional whiplash
• Clearer self-talk
• More present relationships
  

How the Therapeutic Relationship Reflects Healing

One of the most underappreciated signs of healing is a shift in how you relate to your therapist. Early on, many clients idealize the therapist or fear disappointing them. Over time, a more complex relationship forms—one where rupture and repair become possible.

If you’re willing to say things like:

• “I didn’t feel heard last session.”
• “I’m scared to tell you this.”
• “I’m angry at something you said.”

That means you’re practicing new relational patterns in a secure space. This isn’t a detour from the work—it is the work.

Research consistently shows that the therapeutic alliance is one of the most important predictors of positive outcomes (Wampold, 2015). A good therapist will not only tolerate your full emotional range—they’ll help you hold it with less fear and more agency.

When You’re Not Sure You’re Healing

Not feeling like you’re healing doesn’t necessarily mean you’re not. But it can be a cue to check in with yourself and your therapist.

You might ask:

• Are we revisiting the same issues without new insight?
• Have I stopped challenging myself in session?
• Do I feel emotionally safe—but also emotionally stagnant?
• Have I shared my uncertainty with my therapist?
  

A strong therapist won’t be defensive. They’ll explore your questions with you—and be open to adjusting the work, referring you elsewhere, or naming resistance if it’s present.

Therapy Is Working If You…

• Understand yourself more deeply
• React less destructively
• Communicate more clearly
• Stay connected during hard emotions
• Make choices that reflect your values
• See yourself as worthy of care—not just survival
  

Even if no one else notices. Even if you don’t always believe it. These are signs that something is shifting.

How Therapy at Refresh Psychotherapy Can Help

At Refresh Psychotherapy, we work with people who are tired of surface-level support. Our therapists are trained to spot subtle signs of growth and to help you build a toolkit that reflects your goals—not just your symptoms. Whether you’re in the middle of deep emotional work or just starting to untangle your history, we’ll help you track the real shifts—so you can stop wondering if you’re healing and start seeing the evidence for yourself.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Etkin, A., Büchel, C., & Gross, J. J. (2015). The neural bases of emotion regulation. Nature Reviews Neuroscience, 16(11), 693–700.

McWilliams, N. (2011). Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process (2nd ed.). The Guilford Press.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. W. W. Norton & Company.

Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270–277.

Most people wouldn’t list “height” as a leadership skill—but in the workplace, how tall or short you are can impact how you’re perceived, treated, and promoted. From meetings to interviews to everyday interactions, unconscious height bias subtly shapes who gets seen as competent, who commands attention, and who’s expected to lead. And this bias affects both ends of the spectrum—people who are considered “too short” and people who are seen as “too tall.”

While height is rarely acknowledged as a workplace barrier, the mental health toll it takes is real. Whether you’re constantly underestimated or always expected to dominate the room, being outside the “average” height range can affect self-concept, professional confidence, and even identity development. This article explores how height bias shows up at work, how it impacts people on both ends of the height spectrum, and what practical steps—including communication scripts, posture techniques, and therapy—can help you reclaim your authority and peace of mind.

Heightism Isn’t Just About Shortness

Most conversations about height discrimination focus on people who are shorter than average, and for good reason: research shows that taller people, particularly men, are more likely to be hired, promoted, and paid more (Judge & Cable, 2004). One study found that each additional inch in height correlated with roughly $800 more in annual income (Persico et al., 2004). Tallness is culturally coded as powerful, assertive, and competent.

But extreme tallness can also carry a burden—especially for women and nonbinary professionals, who may be perceived as “intimidating,” “masculine,” or “unfeminine” in traditional workplace cultures. Taller individuals may be told to “tone it down,” be softer, or “stop towering over people.” They may receive unwanted comments about their bodies, or be tasked with taking charge simply because of their physical presence.

Both experiences—being perceived as too small to lead or too big to be approachable—are rooted in unconscious bias. And both can have lasting impacts on how individuals show up at work.

The Emotional Cost of Height Bias

Height bias is often invisible until it accumulates. Over time, these messages—“You’re so cute,” “You’re so intimidating,” “Stand in the back,” “Let the tall guy handle it,”—start to shape a person’s internal narrative.

Shorter professionals may:

• Feel infantilized or overlooked
• Be interrupted more often
• Be talked over or not taken seriously
• Avoid assertive speech due to internalized beliefs about status
  

Taller professionals may:

• Be expected to automatically lead, even if they’re not in charge
• Receive comments about their appearance instead of their ideas
• Be perceived as aggressive or overbearing
• Shrink themselves to appear less threatening
  

These dynamics are rarely discussed, yet they can lead to chronic anxiety, self-monitoring, and emotional burnout.

Posture Hacks That Help You Take Up Space—or Soften It

Nonverbal communication plays a huge role in workplace dynamics. Posture, gesture, and spatial awareness can help reshape the way others perceive your presence—and how you perceive yourself.

For shorter professionals:

• Elevated posture: Keep shoulders open, spine long, and chin parallel to the floor. Use open gestures rather than keeping hands folded or hidden.
• Eye-level adjustments: Use seat cushions or adjust your chair height in meetings to bring your eyes to the same level as others.
• Movement anchors: When speaking, use confident hand gestures and pause occasionally to let your words land.
  

For taller professionals:

• Grounded posture: Keep both feet on the floor and soften your shoulders. Avoid looming or leaning directly over others.
• Center alignment: Stand or sit with centered, symmetrical posture to project calm presence rather than dominance.
• Boundary awareness: Use subtle shifts in distance to reduce intimidation if people seem uncomfortable.
  

Scripts to Interrupt Bias Without Creating Conflict

Because height bias is often subtle, direct confrontation may not always feel safe or effective. Instead, you can reframe the moment with language that redirects attention to your competence and role.

When you’re underestimated:

• “Actually, I’ve led similar projects before—here’s how I’d approach this one.”
• “I know I don’t take up a lot of space physically, but I’m very clear on my strategy here.”
  

When you’re perceived as aggressive:

• “I know my presence can be intense—please let me know if my tone ever feels off.”
• “I have a lot of energy around this topic, and I’d love to channel it collaboratively.”
  

When facing body-based comments:

• “I’d love to focus on the ideas—we’ve got important ground to cover.”
• “My height’s not on the agenda, but this analysis is.”
  

These responses allow you to hold authority without creating unnecessary defensiveness.

Internal Scripts for Reclaiming Self-Perception

Cognitive restructuring techniques from CBT (Cognitive Behavioral Therapy) can help challenge distorted beliefs reinforced by social feedback. Here are some reframes to practice:

• Thought: “I don’t look like a leader.”
  Reframe: “Leadership is about clarity, not appearance.”
  
• Thought: “They’re only listening because I’m tall.”
  Reframe: “My ideas matter. My body isn’t the only reason I’m being heard.”
  
• Thought: “They’ll never respect me—I look too young.”
  Reframe: “Respect comes from how I lead, not how tall I am.”
  

Over time, reframing helps neutralize the shame and self-doubt that height-based bias can create.

How Height Bias Intersects with Gender and Culture

Gender norms shape how height is perceived. Tall women are often expected to shrink themselves, while short men are often pressured to compensate through aggression or overachievement. Nonbinary individuals may struggle with conflicting gendered expectations about presence and demeanor.

Cultural context also matters. In some cultures, physical presence is strongly tied to perceived authority; in others, deference and humility are more valued. Height bias often intersects with race, accent, or weight—making it harder to isolate.

This is why therapy can be so useful: it allows space to untangle internalized messages that stem from multiple layers of bias.

How Therapy at Refresh Psychotherapy Can Help

At Refresh Psychotherapy, we understand that height bias isn’t superficial—it’s a workplace barrier that affects confidence, performance, and identity. Our therapists work with high-achieving professionals who’ve internalized feedback about being “too much” or “not enough” based on their appearance. Whether you’re navigating leadership expectations, cultural stereotypes, or persistent self-doubt, our clinicians can help you develop new internal narratives, assertive communication skills, and a healthier relationship with your body and role. You don’t have to carry this quietly. Book your appointment today: refreshtherapynyc.clientsecure.me

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Carney, D. R., Cuddy, A. J. C., & Yap, A. J. (2010). Power posing: Brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychological Science, 21(10), 1363–1368.

Judge, T. A., & Cable, D. M. (2004). The effect of physical height on workplace success and income: Preliminary test of a theoretical model. Journal of Applied Psychology, 89(3), 428–441.

Persico, N., Postlewaite, A., & Silverman, D. (2004). The effect of adolescent experience on labor market outcomes: The case of height. Journal of Political Economy, 112(5), 1019–1053.

It’s hard to build a future when your entire life is paused. For those trapped in visa backlogs and endless immigration processing delays, daily existence often feels like waiting for permission to start living. You may be trying to advance your career, support your loved ones, or simply plan your next year—but instead, you’re held in limbo by a system that offers no timeline, no clarity, and no control.

From a mental health perspective, this kind of uncertainty is profoundly destabilizing. When the mind can’t predict what’s next, it tends to over-anticipate every possible scenario, triggering hypervigilance, hopelessness, and intrusive anxiety. This phenomenon is what we call visa-freeze anxiety—a form of chronic emotional stress experienced by people stuck in prolonged immigration queues.

This article explores how visa delays impact mental health and offers concrete, research-based grounding tools to support emotional regulation and agency.

The Psychological Toll of Living in Limbo

Immigration-related uncertainty is a known psychological stressor. Studies show that prolonged delays in legal status processing are associated with increased symptoms of anxiety, depression, insomnia, and trauma-related stress, particularly in individuals who feel trapped between worlds or unable to plan for the future (Li et al., 2020; Bhugra, 2005).

These long-term delays can chip away at your ability to stay grounded in your identity, your goals, or your relationships. There may be shame in not having “answers,” fear of losing hard-earned opportunities, or exhaustion from constantly checking for updates that never come.

Common mental health symptoms of visa-freeze anxiety include:

• Racing thoughts about “what if” outcomes
• Difficulty sleeping due to uncertainty and hyperarousal
• Social withdrawal from feelings of shame or isolation
• Impaired focus or motivation at work or in relationships
• A sense of identity erosion from being unable to make progress
  

This is not a lack of resilience—it’s a natural psychological response to prolonged, high-stakes uncertainty with no clear resolution.

Why Grounding Tools Matter

When you’re caught in chronic uncertainty, the brain’s threat system is constantly activated. Grounding techniques help regulate this physiological stress response by bringing your attention out of the future—and back into the here and now.

Grounding doesn’t mean pretending the situation isn’t hard. It means offering your nervous system relief from relentless anticipation. The goal is not to “fix” the problem but to reclaim pockets of control that help you live with more peace and agency while the system takes its course.

Evidence-Based Grounding Tools for Visa-Freeze Anxiety

1. Time-Limiting Your Worry Window
   Research shows that scheduled worry periods can reduce generalized anxiety (Borkovec et al., 1993). Set a timer and allow yourself 15 minutes a day to think about your visa case—journal, research, or vent during this time. Outside of that window, gently redirect your focus.
   
   
2. Daily Somatic Anchors
   When anxiety is future-focused, somatic anchors pull you back into the body. Try placing a hand on your chest and one on your stomach while practicing slow breathing (inhale 4 counts, exhale 6 counts) for five minutes. This calms the vagus nerve and activates the parasympathetic system (Porges, 2011).
   
   
3. Naming What’s Out of Your Control—Then What Isn’t
   Using a method from Acceptance and Commitment Therapy (ACT), try writing down two columns: one labeled “Out of My Control,” the other “Within My Control.” Visa processing is out. But your daily routines, boundaries, relationships, and self-care are within. This helps shift your energy toward action.
   
   
4. Micro-Routines for Structure
   When life feels suspended, even small routines—morning stretches, daily walks, or a weekly check-in call—can restore a sense of movement and agency. Research suggests that predictable routines buffer against anxiety and depression during periods of uncertainty (Hobfoll, 2001).
   
   
5. Connection with People Who Get It
   Visa-freeze anxiety often feels invisible to others. Joining online forums or support groups with people in similar situations provides emotional validation. Connection is a protective factor, especially when isolation or shame creep in.
   
   
6. Therapy That Validates Limbo
   Therapists familiar with immigration stress and identity issues can help process the grief and helplessness that arise from extended limbo. Therapy can also support the rebuilding of meaning, confidence, and self-worth during a time when external progress feels impossible.
   

What You’re Experiencing Is Real

Living in legal limbo can undermine your sense of identity, autonomy, and control. People experiencing visa delays often report a sense of “disappearing”—not being seen by the systems around them and not being able to fully show up in their own lives. This invisible struggle can make even basic tasks feel burdensome.

It’s important to know: this experience is real. And you’re not overreacting. A nervous system stuck in a prolonged fight-or-flight state is working overtime, which explains the fatigue, the fog, and the frustration.

Recognizing that your worth is not contingent on progress or productivity is a major emotional shift. You are still worthy, even when your life is paused. You are still you, even if the system hasn’t moved.

You Don’t Need to Wait to Take Care of Your Mind

You may not be able to move forward in the ways you hoped. But you can still reclaim your mental space. You can still build emotional capacity. You can still show up for your relationships, your values, and your well-being.

Visa-freeze anxiety is real. But so is your resilience. Not in the sense of muscling through—but in the quiet strength of grounding, naming your needs, and refusing to disappear while you wait.

You don’t have to put your life on hold to protect your mental health.

Book your appointment today.

Works Cited
Bhugra, D. (2005). Migration and mental health. Acta Psychiatrica Scandinavica, 109(4), 243–258.

Borkovec, T. D., Wilkinson, L., Folensbee, R., & Lerman, C. (1993). Stimulus control applications to the treatment of worry. Behavior Research and Therapy, 31(3), 263–267.

Hobfoll, S. E. (2001). The influence of culture, community, and the nested-self in the stress process: Advancing conservation of resources theory. Applied Psychology, 50(3), 337–421.

Li, S. S. Y., Liddell, B. J., & Nickerson, A. (2020). The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Transcultural Psychiatry, 53(5), 524–545.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W. W. Norton.

If you’ve ever found yourself overwhelmed by worry or stuck in anxious thoughts, you might have wondered whether you’re dealing with Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), or something else entirely. Both GAD and OCD involve anxiety, intrusive thinking, and emotional distress. On the surface, they can look alike. But they’re not the same—and understanding the difference is essential for finding the right path to treatment.

GAD often looks like excessive worry about everyday life. OCD, on the other hand, involves distressing, irrational thoughts that often lead to compulsions—mental or behavioral acts performed to relieve the anxiety. Both conditions are treatable, but the tools that work for one don’t always work for the other. This article breaks down the core differences between OCD and GAD so you can better understand your experience or support someone else in theirs.

What Is GAD? What Is OCD?

Generalized Anxiety Disorder is characterized by persistent and excessive worry across many areas of life—finances, health, relationships, work, safety, and more. These worries are difficult to control and are often accompanied by physical symptoms such as fatigue, muscle tension, and trouble sleeping (American Psychiatric Association, 2013). People with GAD often describe a sense that their brain won’t “turn off,” and they may feel that worry is a part of who they are.

Obsessive-Compulsive Disorder involves two main parts: obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that cause anxiety. Compulsions are behaviors or mental rituals done to try to make the anxiety go away or prevent something bad from happening. These can include checking, counting, avoiding, confessing, or repeating thoughts silently. The thoughts in OCD are usually irrational or upsetting and may have nothing to do with real-life problems (Abramowitz & Jacoby, 2015).

The Nature of Thoughts: Worry vs. Obsession

One key difference between GAD and OCD is the kind of thoughts that show up. In GAD, people tend to worry about real-life problems. The worries may be excessive or hard to control, but they usually relate to things that could actually happen, like losing a job or getting sick (Dugas et al., 1998).

In OCD, the thoughts often don’t make sense, feel disturbing, or seem completely out of character. For example, someone might have a thought like “What if I hit someone with my car and didn’t notice?” or “What if I accidentally poisoned my partner’s food?” These are not typical worries—they are intrusive thoughts that feel stuck in the brain and cause distress, even though the person doesn’t believe them or want them (Clark, 2004).

The Role of Compulsions

Another major difference is how people respond to their anxiety. In OCD, people often develop specific rituals or behaviors—called compulsions—to deal with the distress caused by their thoughts. These compulsions can be visible (like handwashing or checking the stove) or invisible (like repeating phrases in their head or mentally reviewing past events). The compulsions may temporarily reduce anxiety, but they actually reinforce the obsessive thought and make the cycle worse over time (Rachman, 2002).

In GAD, there are no true compulsions. People may try to feel better by over-preparing, avoiding triggers, or asking for reassurance, but these behaviors are more general and don’t follow a rigid pattern. GAD tends to involve a constant, low-grade sense of worry, not a repetitive cycle of intrusive thoughts followed by rituals.

Emotional Tone and Insight

In GAD, people often feel like their worries are reasonable, even if they recognize that the level of worry is excessive. The thoughts may feel helpful, familiar, or necessary. Someone might say, “I worry because I care,” or “If I didn’t worry, I’d miss something important.”

In OCD, the thoughts often feel foreign and deeply upsetting. People may think, “Why would I have a thought like this? What’s wrong with me?” These thoughts are usually unwanted and don’t match how the person sees themselves. That’s why OCD often leads to shame, guilt, or fear about what the thoughts mean. Even though people with OCD usually know their thoughts aren’t true, the fear that they might be creates intense anxiety (Abramowitz & Jacoby, 2015).

Overlap and Misdiagnosis

Because both conditions involve anxiety, they are sometimes confused—even by clinicians. Someone with OCD may be misdiagnosed with GAD if they don’t mention their compulsions or are too ashamed to describe their intrusive thoughts. This is especially common when the thoughts involve taboo subjects like sex, violence, or religion (Storch et al., 2008).

On the other hand, someone with GAD might be assumed to have OCD if their worry is intense or very repetitive, even though they don’t have true obsessions or compulsions. The result is that people may receive the wrong kind of therapy, which can delay progress or make symptoms worse.

Treatment Considerations

The treatment for GAD and OCD overlaps in some areas, but key differences matter. GAD often responds well to general Cognitive Behavioral Therapy (CBT), which helps people identify and challenge distorted thinking, along with relaxation techniques, mindfulness, and sometimes medication like SSRIs (Stein & Sareen, 2015).

OCD, however, requires a more specialized approach. The most effective treatment is Exposure and Response Prevention (ERP), a specific form of CBT that helps people face their fears without doing compulsions. ERP works by teaching the brain that the feared outcome won’t happen—or doesn’t need to be prevented. General talk therapy, reassurance, or relaxation exercises may actually worsen OCD if they reinforce avoidance or compulsive behavior (Foa et al., 2005).

If you’ve been struggling with anxiety, unwanted thoughts, or repetitive behaviors, it’s important to get clear on what kind of anxiety you’re experiencing. OCD and GAD are both treatable—but they need different tools. An accurate diagnosis can make all the difference in choosing the right path forward.

You’re not overreacting, broken, or weak. These are real conditions with real solutions. If something about your anxiety doesn’t quite fit the label you were given, you’re not alone—and it’s worth asking deeper questions.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Abramowitz, J. S., & Jacoby, R. J. (2015). Obsessive-compulsive disorder in adults. In R. L. Leahy, S. L. Holland, & L. McGinn (Eds.), Treatment plans and interventions for depression and anxiety disorders (2nd ed., pp. 269–321). Guilford Press.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Clark, D. A. (2004). Cognitive-behavioral therapy for OCD. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 147–172). Guilford Press.

Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36(2), 215–226.Foa, E. B., Yadin, E., & Lichner, T. K. (2005). Exposure and response prevention for obsessive-compulsive disorder: Therapist guide. Oxford University Press.

Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40(6), 625–639.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059–2068.

Storch, E. A., Abramowitz, J. S., & Keeley, M. (2008). The effect of co-occurring anxiety disorders on treatment response in pediatric obsessive-compulsive disorder. Depression and Anxiety, 25(6), 547–553.

Dating apps promise connection at your fingertips, but for many users, the experience delivers something very different: disappointment, burnout, and a quiet erosion of hope. It’s not that dating apps don’t “work”—they do for some—but they were not built to prioritize emotional compatibility, self-worth, or long-term wellbeing.

To use dating apps without losing yourself, you need more than a profile and a few good photos. You need a strategy that centers your mental health, boundaries, and emotional energy. This article outlines how to approach dating apps with realistic, sustainable expectations—so you can date without spiraling, compare without collapsing, and swipe without self-loathing.

The Illusion of Limitless Options
Dating apps are designed to simulate abundance—unlimited profiles, constant matches, and the illusion of endless romantic opportunity. But psychologically, this triggers a phenomenon known as the “paradox of choice,” in which having too many options leads to more dissatisfaction and less follow-through (Iyengar & Lepper, 2000).

In reality, most users only engage with a small percentage of matches. The rest become background noise, fostering comparison fatigue and emotional disconnection.

People also tend to forget that swiping is not dating. It’s browsing. And browsing doesn’t always lead to intimacy. Without grounded expectations, many users mistake attention for connection—and then feel confused when conversations fizzle or never move offline.

Rejection on Repeat: The Emotional Cost of Swiping
Dating apps increase exposure to rejection, often in rapid succession. You may never know why someone unmatched or ignored you. Over time, this creates a low-level but persistent sense of being unwanted, even if you’re matching regularly.

Studies have shown that frequent dating app use is associated with lower self-esteem, increased anxiety, and higher levels of body image dissatisfaction, particularly when users tie their sense of worth to responses received through the app (Strubel & Petrie, 2017).

To protect your emotional energy, treat dating apps as a tool, not a mirror. They are not designed to reflect your value or readiness for love. They’re algorithms—not oracles.

Swipe Fatigue and Burnout
Dating app fatigue is real. Many users report feeling emotionally depleted, cynical, or numb after weeks or months of swiping. This is particularly true for those looking for long-term relationships, who may feel they’re engaging in endless small talk with no payoff.

App-based dating can also trigger performance anxiety, especially when users feel pressure to “sell themselves” in a way that’s clever, attractive, or nonchalant—all at once.

Without clear internal boundaries, dating apps can shift from exciting to exhausting. You begin to log in out of boredom, loneliness, or self-doubt, not with genuine relational intent. And that’s when burnout sets in.

Setting Emotionally Sustainable Expectations
Approaching dating apps sustainably requires a shift in mindset. You are not auditioning for approval. You are screening for compatibility.
To keep your experience emotionally grounded:

• Limit time spent swiping. Try 10–15 minutes a day, not hours.
• Don’t expect chemistry from text. Text-based banter rarely predicts real-life connection.
• Set a timeline. If chatting doesn’t lead to a date within 7–10 days, it’s okay to move on.
• Let go of “the one.” Focus on finding someone curious, respectful, and interested in knowing the real you—not just a fantasy match.

Boundaries Are Not Optional
The fastest way to lose yourself in dating apps is to forget your own boundaries. Whether you’re dating casually or seeking a relationship, you need guardrails that protect your time, energy, and sense of self.

Ask yourself:

• What am I available for emotionally and practically?
• How many conversations can I manage at once without feeling overwhelmed?
• What is my plan if I start to feel depleted or discouraged?

Establishing exit strategies (e.g., breaks from the app, accountability check-ins with friends, or journaling your experiences) can help you stay attuned to your own needs.

What Success Actually Looks Like
Success on a dating app doesn’t always mean finding a partner. It can also mean:

• Gaining insight into your preferences and values
• Practicing communication and boundary-setting
• Learning to tolerate rejection without collapsing
• Reaffirming your worth, even when someone else doesn’t see it

By broadening your definition of success, you reduce the pressure to “win” and increase your capacity to show up as yourself—without the emotional whiplash of constant judgment.

Offline Integration: Where Real Connection Lives
It’s important to remember that the app is not the relationship. Sustainable dating means transitioning off the app and into real-world interactions.

Don’t linger in endless texting. Initiate or suggest a phone call. Make low-pressure plans. Pay attention to how you feel before, during, and after—not just whether the date “went well.”

And most importantly, don’t treat matches like scarce resources. If it’s not a fit, trust your gut and move on. Dating is about discernment, not perfection.

Conclusion: Swiping With Sanity
Dating apps are not inherently bad. But they are emotionally loaded, algorithm-driven environments that reward superficiality and fuel insecurity if you’re not careful.

You can use them—but don’t let them use you. Stay grounded in your values. Date with boundaries. Take breaks when needed.

Real connection doesn’t require perfect banter or a polished profile. It requires presence, patience, and the emotional endurance to stay soft—even when the apps make you want to shut down.

Swipe thoughtfully. Love is still possible. But your well-being comes first.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Iyengar, S. S., & Lepper, M. R. (2000). When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79(6), 995–1006.

Strubel, J., & Petrie, T. A. (2017). Love me Tinder: Body image and psychosocial functioning among men and women. Body Image, 21, 34–38.

Modern dating is supposed to make connection easier. But for many men, the current dating landscape—dominated by apps, inconsistent communication, and shifting social norms—is a minefield of anxiety, confusion, and rejection.

What was once a series of face-to-face interactions is now a gamified, algorithm-driven process that can leave men feeling more disposable than desired. Add in changing expectations around gender roles, consent, emotional literacy, and vulnerability, and many men find themselves navigating terrain for which they were never emotionally prepared.

While conversations about dating stress often center women’s safety and emotional labor—important issues in their own right—there’s another side of the story that gets little attention: how dating in the modern era affects men’s mental health. From rising loneliness to identity confusion, the effects are real, and they’re growing.

Dating Apps and the Illusion of Infinite Options
Dating apps have become the default platform for romantic connection. While they offer convenience, they also promote comparison, superficiality, and performance-based self-worth. Research shows that men receive fewer matches and responses on dating apps compared to women, contributing to feelings of inadequacy and low self-esteem (Timmermans & De Caluwé, 2017).

For men, especially those who are neurodivergent, socially anxious, or introverted, apps can create a sense of constant evaluation and rejection. You are swiped left on—not for your values or integrity—but often for arbitrary reasons like height, photos, or word choice.

This repeated micro-rejection can lead to what psychologists call “rejection sensitivity,” a heightened emotional reactivity to perceived rejection that has been linked to depression and social withdrawal (London et al., 2007).

The Pressure to Perform Masculinity
Despite progress in gender equality, many men still feel an unspoken expectation to initiate, lead, and perform confidence in dating—regardless of their actual emotional state. This performance of masculinity can create a significant gap between how men feel internally and how they are supposed to behave externally.

In fact, studies show that men who endorse traditional masculine norms (e.g., emotional control, dominance, risk-taking) report higher rates of psychological distress in romantic relationships (Wong et al., 2017). They’re also less likely to seek help, communicate vulnerability, or admit to confusion or fear in dating.

The result? A paradox in which men are expected to be emotionally intelligent and respectful partners, but still punished—by peers or themselves—for showing emotional need or softness.

Ghosting, Breadcrumbing, and Emotional Burnout
One of the most mentally destabilizing aspects of modern dating is ambiguity. Where relationships once followed a relatively clear set of steps, today’s dating scene is marked by blurred boundaries and inconsistent commitment.

Ghosting—cutting off all contact with no explanation—is now a common experience. So is breadcrumbing (sending intermittent flirty messages with no intent to follow through) and “situationships” (non-committal, undefined connections).

For men seeking meaningful connection, this can lead to emotional burnout. One study found that people who are ghosted experience feelings of worthlessness, confusion, and intrusive thoughts, all of which can worsen anxiety and self-doubt (LeFebvre et al., 2019).

In a context where everyone is supposed to be cool, casual, and unbothered, there’s little room for authentic expression of emotional pain.

Loneliness, Disconnection, and Erosion of Self-Worth
Men are already experiencing a loneliness epidemic. A 2021 report from the Survey Center on American Life found that the percentage of men with no close friends has increased fivefold since 1990 (Cox et al., 2021). When dating becomes another arena of rejection and disconnection, it deepens this emotional void.

For some men, repeated dating failures can trigger a collapse in self-worth, leading to withdrawal from relationships altogether. Others may internalize blame, believing they are “not enough” or unlovable. This cycle of effort → rejection → self-doubt → retreat is especially common in men with a history of social trauma or attachment insecurity.

The Rise of Dating-Related Depression and Anger
While some men respond to dating fatigue with withdrawal, others cope through anger or entitlement, particularly if they’ve been influenced by toxic online spaces like the “manosphere” or incel forums.

These subcultures weaponize dating disappointment into misogyny—but underneath that is often unacknowledged pain, shame, and emotional neglect. The danger is that without constructive spaces to process dating-related grief, many men turn inward (depression) or outward (hostility).

Clinical psychologists are seeing more men report dating-related depression, marked by hopelessness, rumination, low motivation, and social anxiety. In therapy, these men often express confusion: “I’m doing everything right—why am I still alone?”

What Actually Helps: Building Emotional Skills for a Modern Landscape
The mental health toll of dating isn’t solved by quitting apps or memorizing better pickup lines. What’s needed is a deeper internal shift:

• Recognizing that rejection doesn’t reflect worth
• Building emotional resilience and boundaries
• Expanding emotional vocabulary and relational skills
• Learning to tolerate ambiguity without abandoning self-respect 

Men who engage in therapy—particularly emotionally focused or relational therapy—learn how to regulate feelings of rejection, express vulnerability in safe ways, and create more meaningful, values-aligned dating experiences.

It’s also essential to redefine success in dating. Instead of fixating on romantic “wins,” men benefit from evaluating how aligned their behavior is with their values, how much agency they’re exercising, and how authentically they are showing up.

Connection Without Collapse
Dating in the modern era is psychologically demanding—for everyone. But for men raised with rigid emotional norms and social conditioning around performance, the emotional cost can be particularly high.

The solution is not to opt out of dating, but to opt into self-awareness. Men deserve support in navigating emotional pain, romantic uncertainty, and rejection—not shame for struggling.

When men have the space to explore their internal world, they show up in dating—not as performers—but as people. And that’s where true connection begins.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Cox, D., Orrell, B., & Suls, R. (2021). The state of American friendship: Change, challenges, and loss. Survey Center on American Life.

LeFebvre, L. E., Allen, M., Rasner, R. D., Garstad, S., Wilms, A., & Parrish, C. (2019). Ghosting in emerging adults’ romantic relationships: The digital dissolution disappearance strategy. Imagination, Cognition and Personality, 39(2), 125–150.

London, B., Downey, G., Bonica, C., & Paltin, I. (2007). Social causes and consequences of rejection sensitivity. Journal of Research on Adolescence, 17(3), 481–506.

Timmermans, E., & De Caluwé, E. (2017). To Tinder or not to Tinder, that’s the question: An individual differences perspective to Tinder use and motives. Personality and Individual Differences, 110, 74–79.

Wong, Y. J., Ho, M. R., Wang, S. Y., & Miller, I. S. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology, 64(1), 80–93.

Mental health treatment has historically pathologized neurodivergence—treating autism, ADHD, and other cognitive differences as deficits to be corrected. Neurodivergent-affirming care takes a radically different approach. Instead of trying to make someone appear or behave neurotypical, this model recognizes neurological differences as valid, meaningful variations in the human brain. In short: neurodivergent-affirming care rejects the idea that being different is being disordered.

At its core, neurodivergent-affirming care is grounded in the principles of the neurodiversity movement (Singer, 1999; Kapp, 2020). It emphasizes acceptance, autonomy, and authenticity over compliance, masking, or assimilation. Clinicians practicing affirming care aim to support the individual’s well-being—not just their functionality in neurotypical systems. For example, instead of teaching an autistic person to make eye contact because it’s socially expected, a neurodivergent-affirming provider would explore whether eye contact causes distress and whether it’s actually necessary for meaningful connection.

This approach matters because traditional interventions, particularly those rooted in behaviorism, have often been harmful to neurodivergent individuals. Research has shown that masking—suppressing natural behaviors to appear neurotypical—is linked to increased anxiety, depression, and suicidality in autistic adults (Cage et al., 2018; Cassidy et al., 2018). Neurodivergent-affirming care provides space to unlearn masking and begin exploring what it means to be one’s true self.

Affirming care also recognizes that many mental health challenges in neurodivergent people are not intrinsic to their neurotype, but rather the result of chronic invalidation, trauma, sensory overwhelm, and inaccessible environments (Botha et al., 2022). Instead of diagnosing these responses as standalone disorders, affirming clinicians take context into account and work collaboratively to build sustainable coping strategies that align with the individual’s needs—not societal expectations.

In practice, neurodivergent-affirming care might look like:

• Supporting stimming as a form of self-regulation rather than discouraging it.
  
• Recognizing that burnout in autistic individuals is real and distinct from depression (Raymaker et al., 2020).
  
• Questioning assumptions around “independence” and instead focusing on interdependence and sustainable living.
  
• Using identity-first language if the client prefers it, based on the growing consensus among autistic adults (Kenny et al., 2016).
  

Neurodivergent-affirming care also invites mental health professionals to challenge their own training and biases. Most clinical models were built without neurodivergent input—and certainly without their leadership. To provide affirming care, therapists must be willing to step outside traditional frameworks and make space for different ways of thinking, feeling, and communicating.

Ultimately, affirming care is not a trend—it’s an ethical imperative. As more adults seek support after a late diagnosis or self-identification, they need care that validates their identity, understands their lived experience, and promotes true well-being—not just superficial functioning.

Call to Action (CTA):
At Refresh Therapy NYC, we offer virtual therapy for adults who are looking for affirming, intelligent, and actionable support. Whether you are newly diagnosed or have known you were different your whole life, we understand the unique challenges of being neurodivergent in a neurotypical world.

Book your appointment today.

Written by: Refresh Interns

Single fatherhood comes with an image: resilient, self-sacrificing, holding the world up for your kids with quiet strength. But behind that image, many single dads are quietly drowning in anxiety. Not the momentary kind that passes after a deadline or a tough day—but a persistent, all-consuming worry that runs beneath the surface of everyday life.

It’s the anxiety of being the only one. The only one to sign the papers. The only one who shows up to parent-teacher conferences. The only one to worry, day after day, if you’re enough. While single motherhood is often publicly acknowledged and socially supported, single fathers are expected to carry the same load—silently. And that silence is costing them their health, their confidence, and in some cases, their sense of self.

Why Anxiety in Single Fathers Is So Common—And So Invisible
Anxiety in single fathers often flies under the radar because it doesn’t look like the media version of panic attacks or emotional breakdowns. Instead, it looks like overworking, chronic irritability, perfectionism, emotional shutdown, or obsessive planning.

Men are socialized to suppress emotion, solve problems alone, and measure success by productivity. Single fathers, already navigating an emotionally demanding situation, may feel they have no space to acknowledge their internal distress. But the numbers tell a different story.

According to a large-scale study, single fathers report higher levels of psychological distress and sleep disturbances than both partnered fathers and single mothers, even when controlling for income and employment status (Weitoft et al., 2003). And yet, they are significantly less likely to seek help.

In part, this is because support systems are rarely built with fathers in mind. Parenting groups, pediatrician visits, and school communications often default to addressing mothers. The absence of space creates a false narrative: that fathers don’t need support, or worse—that asking for it signals failure.

Living With the Pressure to Perform—and Never Break
Single dads are often caught in an impossible contradiction: they’re expected to do it all, but never need help. Many carry the full weight of parenting, finances, emotional labor, and logistics, with no backup and no break.

This level of chronic pressure activates the body’s stress response system—raising cortisol levels, reducing immune function, impairing memory, and increasing vulnerability to anxiety and depression (McEwen, 2000). You might feel “on edge” all the time, unable to relax even when things are going okay.

Some fathers report a specific anxiety around being perceived as an unfit parent. You might feel like every mistake is being watched more closely, every emotional lapse scrutinized. This hypervigilance can lead to self-doubt, obsessive self-monitoring, and isolation.

How Anxiety Shapes Your Relationship With Your Child
Even when you don’t express your anxiety outwardly, your child feels it. Children are incredibly attuned to the emotional states of their caregivers. When a father is stressed, tense, or emotionally withdrawn, kids can become more anxious themselves—mirroring the emotional tone of the home.

A 2016 study found that paternal anxiety and depressive symptoms significantly predict emotional and behavioral problems in children, especially when emotional attunement is low (Gustafsson et al., 2016).

That doesn’t mean your anxiety is harming your child—but it does mean that how you relate to your anxiety matters. When children see their parent acknowledge stress and still show up with care, they learn emotional resilience. When they see their parent deny, suppress, or snap under pressure, they may internalize those same coping patterns.

The Guilt-Anxiety Spiral
One of the most corrosive patterns single fathers fall into is the guilt-anxiety spiral. You feel guilty for not being “enough”—so you try harder, stretch thinner, do more. But that overextension leads to burnout and anxiety, which then triggers more guilt.

This cycle is especially common in fathers who experienced emotionally absent or critical parenting themselves. You may feel driven to give your child a radically different experience—but without adequate support, this goal can lead to perfectionism and emotional exhaustion.

You might believe you have to earn your child’s happiness, your right to rest, or even your legitimacy as a single parent. But guilt is not a good parent. It clouds judgment, narrows perspective, and leads to reactive decisions. What your child needs isn’t more guilt-driven effort—they need you, grounded and emotionally safe.

The Role of Financial and Legal Stress
For many single fathers, anxiety isn’t just emotional—it’s practical. Custody arrangements, child support, legal battles, and job insecurity add another layer of stress that can’t be resolved with mindfulness alone.

Financial pressure is a leading cause of anxiety in single-parent households, with fathers reporting high levels of distress related to housing stability, food security, and medical costs (Kendig & Bianchi, 2008).

You may find yourself constantly calculating, forecasting, and preparing for worst-case scenarios. This kind of anticipatory stress is a hallmark of generalized anxiety disorder and often goes undiagnosed in men who attribute their distress to “just being responsible.”

You’re not just carrying your own future—you’re carrying someone else’s. And that weight can become unbearable without emotional and logistical support.

Why Single Dads Don’t Seek Help—and Why That Has to Change
Despite their vulnerability, single fathers are among the least likely groups to seek mental health support. A 2020 analysis of service utilization found that only 16% of single fathers had accessed therapy in the past year, compared to 32% of single mothers (Langton et al., 2020).

Common barriers include:

• Fear of being judged as emotionally unstable or incapable
• Difficulty finding male-friendly or father-specific services
• Lack of time and financial access to therapy
• Internalized beliefs that “strong dads don’t need help”

But suppressing anxiety doesn’t eliminate it—it relocates it. It turns into irritability, insomnia, disconnection, or hopelessness. Seeking help isn’t just about you. It’s about showing your child that strength includes vulnerability, and that love includes self-respect.

Therapy Is Not Indulgent—It’s Survival
For many single dads, therapy is dismissed as something “extra.” But addressing anxiety is not optional—it’s essential. The cost of untreated anxiety includes cardiovascular strain, lowered immunity, relationship breakdowns, and poor parenting outcomes (Hofmann et al., 2012).

Therapy offers a space to:

• Disentangle thoughts from fear
• Process guilt without letting it define you
• Build strategies for sustainable parenting
• Learn how to soothe your nervous system—not just push through it
• You don’t need to be in crisis to deserve support. You need only be human, raising a child in an overwhelming world.

What Healing Can Look Like—Even If Your Circumstances Don’t Change
Your anxiety may not disappear overnight. Your custody situation may not change. Your financial strain may persist. But healing doesn’t require everything around you to shift. It requires you to shift how you respond to what’s around you.

You can:

• Breathe before reacting
• Name your feelings aloud, even if it’s just to yourself
• Make space each day for something nourishing, no matter how small
• Connect with one other adult who can hear the truth without fixing it
• Anxiety tells you the worst-case scenario is inevitable. Healing reminds you that even in uncertainty, you still have agency, dignity, and worth.

You’re Doing More Than Surviving
You are not just holding it together—you are parenting through pressure most people can’t see. You may feel exhausted, resentful, afraid, or numb. That doesn’t make you weak. It makes you real.

Single fatherhood is hard. Not because you’re doing it wrong, but because it asks everything of you. And while the world may not always recognize your effort, your nervous system does. Your child does. And somewhere inside, you do too.

You don’t have to carry all of this alone. You were never meant to.

Anxiety thrives in silence—but healing begins the moment you tell the truth about what this really feels like.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Cairney, J., Boyle, M., Offord, D. R., & Racine, Y. (2003). Stress, social support and depression in single and married mothers. Social Psychiatry and Psychiatric Epidemiology, 38(8), 442–449.

Coles, R. L. (2015). Single-father families: A review of the literature. Journal of Family Theory & Review, 7(2), 144–166.

Gustafsson, H. C., Sullivan, E. L., & Keenan, K. (2016). Paternal depression and child development: A review. Child Psychiatry & Human Development, 47(3), 397–408.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

Kendig, S. M., & Bianchi, S. M. (2008). Single, cohabiting, and married mothers’ time with children. Journal of Marriage and Family, 70(5), 1228–1240.

Langton, C., Yoshioka-Maxwell, A., & Madkour, A. S. (2020). Mental health service use among U.S. single fathers. Journal of Men’s Health, 16(1), e12–e20.

McEwen, B. S. (2000). Allostasis and allostatic load: Implications for neuropsychopharmacology. Neuropsychopharmacology, 22(2), 108–124.

Weitoft, G. R., Hjern, A., Haglund, B., & Rosén, M. (2003). Mortality, severe morbidity, and injury in children living with single parents in Sweden: A population-based study. The Lancet, 361(9354), 289–295.

Not Just a Midlife Crisis: The Silent Mental Health Struggles of Aging Men
For many men, aging is not just a physical experience—it’s a psychological reckoning. In Western society, aging is often painted as a slow unraveling of relevance. Gray hair, softer bodies, and the creeping aches of time are not just reminders of mortality—they’re framed as signs of diminished masculinity. For men taught to associate their worth with virility, strength, and productivity, aging can feel like a profound identity crisis. But because male emotional pain is so often hidden beneath stoicism and performance, the psychological toll of aging goes largely unspoken—and unaddressed.

This silence is costing lives.

Suicide rates are highest among middle-aged and older men. Yet mental health conversations still tend to center youth or women, bypassing the distinct experiences of men as they age. As roles shift, bodies change, and careers slow down, men face a complex internal world with very few social scripts for navigating it.

This article explores how men’s mental health is shaped by aging—and how psychological tools, cultural shifts, and relational support can help rewrite the aging experience into something far more meaningful than decline.

Aging and the Collapse of Masculine Ideals
From early on, boys receive a clear—if unspoken—message: strength is value, emotion is weakness, and independence is virtue. As long as a man remains physically capable, sexually active, and economically productive, he stays within the safe bounds of culturally sanctioned masculinity.
But what happens when aging disrupts those domains?

Testosterone levels decline gradually starting in a man’s 30s, often accelerating after age 50. This can result in fatigue, irritability, sleep disruption, loss of muscle mass, and a drop in libido (Wu et al., 2008). These physiological changes, though natural, can feel like betrayals—especially in cultures that equate masculinity with physical dominance and sexual prowess.

At the same time, aging brings professional transitions. For men whose identities have been fused with career success, retirement—whether planned or forced—can trigger a loss of purpose and status. One longitudinal study found that men who retire involuntarily experience significant increases in depressive symptoms, especially when retirement is linked to declining health or economic instability (Dave et al., 2008).

In short, aging confronts men with a brutal question: Who am I when I’m no longer the provider, protector, or performer?

The Psychological Toll of Isolation
Research consistently shows that older men tend to have smaller social networks and are less likely to seek emotional support than women (Courtenay, 2000). Many rely heavily on their spouses for emotional intimacy. When relationships shift—due to divorce, widowhood, or illness—men may find themselves adrift without any close confidants.

This lack of emotional scaffolding contributes to increased rates of depression, anxiety, and suicide among aging men. The CDC reports that men over 65 have the highest suicide rate of any demographic in the U.S. (Hedegaard et al., 2023). And because depression in men is often masked by irritability, substance use, or physical complaints, it is frequently missed by both physicians and family members.

The result? An enormous burden of unspoken grief, loneliness, and self-doubt.
Even among those who do have social contact, conversations often remain superficial. Without cultural permission to speak vulnerably, many older men are isolated not by circumstance—but by silence.

Grief, Loss, and the Myth of Resilience
Aging also brings waves of grief—some visible, some invisible.

There is the grief of losing friends or siblings, the grief of changing health, and the grief of missed opportunities or unresolved regrets. But for men, who are often taught to suppress emotion and “push through,” grief can calcify into numbness, anger, or emotional withdrawal.

One insidious myth that haunts older men is that “real men” age gracefully and without complaint. But research shows that unprocessed grief and loss can manifest in somatic symptoms, chronic illness, substance use, or disconnection from others (Galdas et al., 2005).

Emotional suppression may have served earlier in life to navigate demanding careers or societal expectations. But in later life, it becomes a trap—limiting access to healing, connection, and new meaning.

How Men Can Age With Emotional Integrity
Psychological flexibility is key to navigating aging with well-being. This doesn’t mean “thinking positively” or denying real losses. Rather, it means developing the capacity to adapt, reflect, and shift one’s self-concept beyond outdated masculine ideals.

Men who are able to redefine success, find value in relationships over productivity, and embrace emotional complexity report significantly better mental health outcomes in later life (Wurm et al., 2007).

Therapeutic approaches that affirm men’s values—such as Acceptance and Commitment Therapy (ACT), Interpersonal Therapy (IPT), or even existential therapy—can help aging men make meaning of their transitions. These models avoid pathologizing and instead support identity exploration, legacy reflection, and relational depth.

Additionally, behavioral activation—an evidence-based treatment for depression—can be helpful in encouraging older men to engage in pleasurable, meaningful activities, even when motivation is low (Dimidjian et al., 2011).

Reimagining Masculinity in Older Age
To support men’s mental health as they age, we must rewrite the cultural narratives surrounding masculinity. Aging can no longer be seen as a loss of power—it must be reframed as a gain in perspective.

This requires a shift in how we talk about strength. Strength can mean showing up to therapy, crying when it hurts, admitting when you feel lost, and learning how to ask for help. Resilience is not the absence of struggle; it’s the willingness to stay emotionally present through struggle.

Peer groups, social programs, and therapeutic spaces need to be designed with men’s psychological and cultural experiences in mind. For example, “men’s sheds”—a movement originating in Australia—offer low-pressure environments where older men can gather around hobbies, projects, and skill-sharing. These spaces offer indirect pathways to connection and can reduce depression and isolation (Ballinger et al., 2009).

What Loved Ones and Clinicians Can Do
If you’re close to an aging man who seems distant or emotionally withdrawn, know that silence doesn’t mean all is well. Offer consistent presence. Ask open-ended questions without pushing for disclosure. Normalize therapy and speak positively about emotional expression.

For clinicians, don’t wait for men to report sadness. Screen for depression using questions that target irritability, sleep changes, and anhedonia. Explore their views on masculinity, aging, and identity. Many aging men are not afraid of therapy—they just haven’t had the language or models to understand what therapy can offer them.

Aging as Evolution, Not Erosion
Aging is not the enemy. For men willing to reexamine their values and embrace vulnerability, it can be a profoundly liberating phase of life. The challenge lies not in aging itself—but in the cultural narratives that shame men into silence as they age.

Mental health is not about “fixing” what aging has changed. It’s about adapting, grieving, and rebuilding a self that is no longer shackled to outdated ideals.
It’s time to stop asking men to age like machines. Instead, let’s offer them the tools, spaces, and dignity to age like humans.ur whole life, we understand the unique challenges of being neurodivergent in a neurotypical world.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Ballinger, M. L., Talbot, L. A., & Verrinder, G. K. (2009). More than a place to do woodwork: A case study of a community-based Men’s Shed. Journal of Men’s Health, 6(1), 20–27.

Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Social Science & Medicine, 50(10), 1385–1401.

Dave, D., Rashad, I., & Spasojevic, J. (2008). The effects of retirement on physical and mental health outcomes. Southern Economic Journal, 75(2), 497–523.

Dimidjian, S., Barrera, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38.

Galdas, P. M., Cheater, F., & Marshall, P. (2005). Men and health help-seeking behaviour: literature review. Journal of Advanced Nursing, 49(6), 616–623.

Hedegaard, H., Curtin, S. C., & Warner, M. (2023). Suicide mortality in the United States, 2001–2021. National Center for Health Statistics Data Brief, No. 464.

Wu, F. C. W., Tajar, A., Pye, S. R., Silman, A. J., Finn, J. D., O’Neill, T. W., … & EMAS Group. (2008). Hypothalamic–pituitary–testicular axis disruptions in older men are linked to frailty and overall health. The Journal of Clinical Endocrinology & Metabolism, 93(7), 2737–2745.

Wurm, S., Tesch-Römer, C., & Tomasik, M. J. (2007). Longitudinal findings on aging-related cognitions, control beliefs, and health in later life. The Journals of Gerontology: Series B, 62(3), P156–P164.

We live in a world that praises being busy, rewards burnout, and treats rest like a privilege instead of a necessity. The pressure to be constantly productive isn’t just a workplace issue—it’s become a deeply internalized belief system. And it’s quietly harming our mental health.

Productivity culture teaches us that our value lies in what we produce. That rest must be earned. That slowing down is the same as falling behind. But chasing constant output comes at a steep cost: anxiety, disconnection, burnout, and a fragile sense of self-worth that’s entirely performance-based.

The Hidden Cost of Constant Output
For many people, the pressure to keep producing feels personal. It’s not just about work—it’s about being “on” all the time. Answering emails late at night, turning hobbies into side hustles, filling every open hour with tasks. Productivity becomes a coping mechanism for discomfort, uncertainty, or feelings of inadequacy.
But here’s the truth: always doing more doesn’t mean you’re doing well. And constantly pushing yourself doesn’t mean you’re emotionally okay. Over time, living this way leads to:

• Difficulty relaxing without guilt
  
• Feeling behind, even when you’re ahead
  
• Chronic exhaustion and irritability
  
• Disconnection from joy, creativity, or purpose
  

Why We Buy Into It
Productivity culture is seductive. It promises control, certainty, and a sense of accomplishment. It gives us something to point to and say, “See? I’m doing enough.” For people who struggle with self-worth, it can feel like proof that you’re good, valuable, or safe.
And in some environments, being overextended is celebrated. Hustle is glorified. Boundaries are labeled as laziness. Eventually, internal restlessness becomes a lifestyle.

You Don’t Have to Burn Out to Be Valued
Your worth is not tied to how many tasks you complete, how fast you reply, or how much you squeeze into a day. It can feel radical to stop measuring success in output—but that’s where mental health begins to improve.
When you stop equating busyness with value, you make room for:

• Rest that isn’t guilt-ridden
  
• Presence instead of pressure
  
• Boundaries that protect your energy
  
• A deeper connection to what actually matters
  

What to Do Instead
You don’t have to quit your job or abandon your goals. But you can begin to shift your relationship with productivity.
Try this:

• Start noticing when you’re doing something out of fear vs. purpose
  
• Schedule rest like it’s non-negotiable
  
• Take breaks before you’re at capacity, not after
  
• Define success by how aligned you feel, not how exhausted you are
  And if that feels hard, it’s not because you’re failing—it’s because you’ve been taught to ignore your limits. Unlearning that is the real work.
  

Mental Health Isn’t a Productivity Hack
You don’t need to optimize your way out of burnout. You need space to slow down, reconnect with your needs, and stop measuring your value by your output. Therapy can help you unlearn productivity-based self-worth and build a more sustainable, intentional life.

Ready to work with a therapist who understands what it means to feel driven, overwhelmed, and tired of it all?

Book your appointment today.

Written by: Refresh Interns

Discomfort is a part of life, but most of us spend a lot of time and energy trying to avoid it. We stay busy to avoid loneliness. We overthink to avoid uncertainty. We people-please to avoid conflict. But in the effort to escape discomfort, we often make things worse—and we miss the opportunity to build real emotional resilience.

Learning to sit with discomfort is one of the most powerful, underutilized skills in mental health. It doesn’t sound exciting or glamorous, but it’s the foundation for everything from self-trust to boundary setting to lasting growth. Here’s why it matters—and how to start practicing it in real life.

Why We Avoid Discomfort
Discomfort isn’t just unpleasant. For many people, it feels threatening. Our brains are wired to protect us from pain, and discomfort often gets coded as danger. That means we instinctively reach for something—anything—that will make the feeling stop: distraction, reassurance, control, perfectionism, withdrawal, or even numbing behaviors like overworking or scrolling.
The problem is, these coping mechanisms often reinforce the belief that we can’t handle discomfort. Over time, we lose confidence in our ability to feel hard things and survive them.

The Cost of Avoidance
When we avoid discomfort at all costs, we end up:

• Staying stuck in unhealthy patterns
  
• Struggling to set or hold boundaries
  
• Reacting impulsively instead of responding thoughtfully
  
• Missing out on growth because it feels too uncomfortable
  Discomfort isn’t the problem. Our reaction to it is.
  

What It Actually Means to Sit With Discomfort
Sitting with discomfort doesn’t mean forcing yourself to suffer. It means allowing space for an uncomfortable feeling without immediately acting on it, fixing it, or pushing it away. It means recognizing that discomfort isn’t a danger signal—it’s information.
This can look like:

• Noticing the urge to fix something right away—and pausing instead
  
• Letting yourself feel anxious without jumping into overthinking
  
• Saying no to something and tolerating the guilt or fear that follows
  
• Staying present in an awkward or vulnerable moment without shutting down
  

Why This Skill Is So Hard (But So Worth It)
Most people aren’t taught how to tolerate discomfort. If anything, we’re taught to avoid it. But the ability to stay grounded during emotional discomfort is the difference between reacting and responding, between fear-based decisions and intentional ones.
It’s also a major part of what makes therapy transformative. The therapy space helps you learn how to stay with discomfort long enough to understand it—and eventually, to move through it.

How to Start Practicing
You don’t have to dive in headfirst. Start small. When a feeling comes up—anxiety, frustration, guilt—try the following:

• Name the feeling out loud or in your mind
  
• Notice where it shows up in your body
  
• Remind yourself, “This is uncomfortable, but I can tolerate it”
  
• Stay with the feeling for 60 seconds without distracting or acting on it
  Over time, your nervous system will learn that discomfort is survivable—and that you’re capable of navigating it.
  

Discomfort Is Where Growth Happens
Sitting with discomfort doesn’t make the hard parts of life easier. But it makes you stronger. More self-aware. More emotionally flexible. And far more equipped to make choices that align with who you actually are, not just what feels safe in the moment.

Ready to work with a therapist who can help you build emotional resilience from the inside out?ty without losing their drive. If you’re ready for something deeper than coping, let’s talk about what real transformation can look like.

Book your appointment today.

Written by: Refresh Interns

When we think of body image issues, we often think of women. But an increasing number of men are experiencing significant mental health challenges related to body perception—without the public awareness or social support to address it. In fact, research shows that up to 25% of individuals with body dysmorphic disorder (BDD) are male, and men are more likely to struggle with a specific subtype known as muscle dysmorphia, in which they perceive themselves as small or weak, despite being muscular or fit (Olivardia et al., 2000).

The result? A silent crisis—where men chase idealized bodies, restrict eating, overtrain, and spiral into anxiety, depression, or obsessive behavior. But because emotional distress about appearance is considered unmasculine, these issues are often hidden, dismissed, or misunderstood.

The Pressure to Look “Like a Man”
Masculine body ideals have changed dramatically over the last few decades. Where the 1950s ideal emphasized lean athleticism, today’s media presents the ideal man as hyper-muscular, vascular, and low in body fat. Superheroes, action figures, athletes, and even social media influencers all promote an unattainable physique.

This ideal is not just aesthetic—it’s tied to identity, power, and worth. Men who do not align with this image may internalize shame or inadequacy. A study published in JAMA Pediatrics found that adolescent boys who were concerned with muscularity were more likely to develop depressive symptoms and use substances like steroids (Field et al., 2014).

Men are also less likely than women to talk about body dissatisfaction or seek treatment, due to stigma. Body image concerns are often mislabeled as vanity, when in reality they can stem from deep-rooted anxiety, perfectionism, and trauma (Griffiths et al., 2015).

What Is Muscle Dysmorphia?
Muscle dysmorphia (MD) is a subtype of body dysmorphic disorder where individuals obsess over not being muscular or lean enough. It primarily affects men, and often involves compulsive exercise, rigid dieting, anabolic steroid use, and social withdrawal.

In contrast to anorexia nervosa, which is characterized by fear of fatness, muscle dysmorphia centers around the fear of being too small. But both disorders share distorted body image, impaired functioning, and co-occurring depression or anxiety (Pope et al., 2005).

Men with MD may feel intense distress if they miss a workout, avoid situations where their bodies could be judged (like beaches or locker rooms), or structure their entire lives around training and food. Left untreated, this condition can severely impact mental health and social life.

The Mental Health Effects of Poor Body Image in Men
Poor body image in men is associated with a range of mental health issues:

• Low self-esteem
• Social anxiety
• Obsessive-compulsive tendencies
• Eating disorders
• Steroid misuse
• Depression and suicidal ideation

Men who struggle with body image are also more likely to engage in compulsive behaviors like mirror checking, body comparisons, and excessive grooming (Veale et al., 2016). These behaviors are often dismissed as “normal male behavior” but can become obsessive and impair daily life.

Because body image struggles are seen as a “female issue,” men often delay or avoid seeking help. This leads to prolonged suffering and increased risk of co-occurring conditions, such as substance use disorders.

How Social Media and Gym Culture Reinforce Body Anxiety
Instagram, TikTok, and fitness apps flood men with images of shredded abs, bulging biceps, and “transformation” reels. Even fitness communities that claim to promote wellness often encourage overtraining, extreme discipline, and unrealistic goals.

Studies have shown that time spent on appearance-focused social media correlates with higher body dissatisfaction in men, particularly among those prone to social comparison (Rodgers et al., 2020).

 “Gym culture” can also fuel anxiety. While exercise can support mental health, obsessive or identity-driven exercise can worsen it. When fitness becomes a tool to fix a perceived flaw rather than support the body, it turns into punishment—not health.

Treatment and Support: What Actually Helps
Cognitive Behavioral Therapy (CBT) is the most evidence-based treatment for body dysmorphic disorder and body image distress. CBT helps individuals challenge distorted beliefs about appearance and reduce compulsive behaviors.

Other helpful approaches include:

• Exposure and Response Prevention (ERP) for mirror checking and reassurance-seeking
• Acceptance and Commitment Therapy (ACT) to shift focus from control to values
• Medication, such as SSRIs, for severe cases of BDD (Phillips et al., 2002)
  Treatment must also address underlying masculine norms—helping men expand their identity beyond appearance and performance. Therapy is not about “loving your body” in a superficial way. It’s about reclaiming your relationship with your body from shame, fear, and control.
  

What Families, Partners, and Clinicians Can Do
If you suspect a man in your life is struggling with body image:

• Avoid making comments about weight, size, or muscles
• Ask about how he’s feeling, not just how he’s looking
• Normalize therapy and mental health support
• Recognize that excessive gym behavior may be a coping mechanism

For clinicians, screening tools for BDD and eating disorders should be adapted for male presentations. Ask about appearance-related distress, not just weight concerns. Understand that “healthy” gym behavior may be masking significant psychological distress.

Men Deserve Better Than Silence
Men’s mental health and body image issues are real, common, and underrecognized. It’s time to stop framing body dysmorphia as a “women’s problem” and acknowledge the growing number of men suffering in silence.

Every man deserves to age, change, and exist in his body without shame. Muscles don’t define worth. Control doesn’t equal confidence. The most powerful transformation is internal—toward compassion, flexibility, and wholeness.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Field, A. E., Sonneville, K. R., Crosby, R. D., Swanson, S. A., Eddy, K. T., Camargo, C. A., … & Micali, N. (2014). Prospective associations of concerns about physique and the use of anabolic-androgenic steroids in adolescent boys. JAMA Pediatrics, 168(1), 34–39.

Griffiths, S., Murray, S. B., & Touyz, S. (2015). Drive for muscularity and muscularity-oriented disordered eating in men: The role of set shifting difficulties and weak central coherence. Body Image, 15, 116–121.

Olivardia, R., Pope, H. G., & Hudson, J. I. (2000). Muscle dysmorphia in male weightlifters: A case-control study. American Journal of Psychiatry, 157(8), 1291–1296.

Phillips, K. A., Albertini, R. S., & Rasmussen, S. A. (2002). A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Archives of General Psychiatry, 59(4), 381–388.

Pope, H. G., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics, 38(6), 548–557.

Rodgers, R. F., Slater, A., Gordon, C. S., McLean, S. A., & Jarman, H. K. (2020). The role of social media in body image concerns among adolescent boys: A brief review. Current Opinion in Psychology, 36, 86–90.

Veale, D., Gledhill, L. J., Christodoulou, P., & Hodsoll, J. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image, 18, 168–186.

When your child is struggling with depression, your world shrinks to their pain. You might spend nights watching them sleep just to make sure they’re safe, or spend days wondering if anything you say even matters. You try to stay calm, grounded, and supportive—but under the surface, your own mental health may be unraveling.

For fathers, this is often a silent collapse. Many were taught to be protectors, problem-solvers, and providers—not emotional anchors. And yet, when a child is facing depression, what’s needed most is precisely what men are rarely taught to develop: emotional stamina, self-awareness, and grief tolerance.

This article is not about how to fix your child. It’s about what happens to you—your identity, your mental health, and your emotional life—when the child you love is in pain.

The Invisible Toll of Holding It All Together
Most fathers don’t talk about the panic that creeps in when their child won’t get out of bed. Or the shame they feel when they get frustrated instead of compassionate. Or the confusion that comes from doing everything “right” and still watching their child spiral.

Research shows that parents of children with depression are at increased risk for anxiety, depressive symptoms, sleep disturbance, and even PTSD-like experiences, especially if they lack adequate emotional support (Wickersham et al., 2021).

Men are especially vulnerable because they tend to suppress their emotional distress, fearing that breaking down would make them less effective or less useful. But repressing grief, fear, or helplessness doesn’t protect anyone—it just isolates you.

You Can’t Pour From an Empty Self
When your child is in crisis, it can feel selfish to take care of your own well-being. But parenting a child with depression is not a sprint—it’s a marathon. You don’t need to be constantly strong. You need to be sustainable.

Ignoring your own exhaustion, guilt, and emotional confusion will only erode your capacity to parent with clarity. Research on parental burnout shows that unprocessed emotional overload in caregivers leads to detachment, irritability, and emotional numbing (Mikolajczak et al., 2018).

You are allowed to grieve. You are allowed to feel angry. You are allowed to say “I need help too.” None of this makes you a weak father. It makes you an honest one.

Masculinity, Shame, and Silent Suffering
Many fathers feel shame for even admitting how much this hurts. Society rarely gives men permission to collapse under the weight of parenting, especially when the struggle is emotional rather than logistical.

You might feel like you’re failing. You might believe you caused this. You might wonder if you missed the signs. These thoughts are common—and corrosive.

In a qualitative study on fathers of children with mental illness, researchers found that many men experience intense guilt, self-blame, and emotional isolation, yet hesitate to reach out for support due to stigma or internalized masculine norms (Moses, 2010).

But emotional suppression does not make you a better father. Presence does. And presence requires caring for your own mental health with the same dedication you offer your child.

Therapy Isn’t Just for Your Kid
It’s common for fathers to get their child into therapy, but never consider it for themselves. Yet your child’s healing may trigger long-dormant wounds in you—childhood trauma, emotional neglect, or long-held insecurities.

Fathers often report feeling like they’re “not allowed” to fall apart while their child is struggling. But therapy gives you a protected space to feel everything that parenthood has stirred up.

Men in therapy often report improved parenting, better emotional regulation, and a greater sense of meaning—even during ongoing family stress (Feinberg & Kan, 2008). You don’t need to be in crisis to go. You just need to be human.

Redefining Fatherhood During Crisis
When your child is depressed, it’s easy to feel like you’ve lost control. But this is also a powerful moment to redefine what kind of father you want to be—not the one who has all the answers, but the one who shows up with honesty and compassion.

Ask yourself:

• Can I be present, even when I feel powerless?
• Can I soften, even when I want to shut down?
• Can I let go of fixing, and instead build trust through consistency? 

These questions won’t solve everything. But they will move you toward a version of fatherhood that includes your full humanity—not just the parts that feel competent.

You Still Matter, Even Now
You may not be able to make your child feel better today. But you are not powerless. You are not invisible. And your emotional well-being is not secondary to theirs—it’s part of the healing environment they need.

A father’s love never ends. But it can—and must—include love for yourself. You are not just a witness to your child’s depression. You are a man navigating heartbreak, confusion, and uncertainty—and you deserve support too.

You’re not alone. You’re not failing. You’re just finally feeling it.

Book your appointment today.

Written by: Refresh Interns

Works Cited
Feinberg, M. E., & Kan, M. L. (2008). Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent–child relations. Journal of Family Psychology, 22(2), 253–263.

Mikolajczak, M., Gross, J. J., & Roskam, I. (2018). Parental burnout: What is it, and why does it matter? Clinical Psychological Science, 7(6), 1319–1329.

Moses, T. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985–993.

Wickersham, A., Sugg, H. V., Epstein, S., Stewart, R., Ford, T., Downs, J., & Fazel, M. (2021). Caregiver burden and mental health difficulties associated with adolescent depression: A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 30(5), 751–761.

You’re successful, driven, and highly dependable—but beneath the polished exterior, anxiety is often calling the shots. If you’re a perfectionist, the pressure to be everything for everyone all the time may be quietly eroding your mental health.

This guide explores the connection between perfectionism and anxiety, why high achievers are more vulnerable than they appear, and how to protect your mental well-being without losing your ambition.

Perfectionism and Anxiety: A Hidden Relationship

Perfectionism isn’t about loving excellence. It’s about fear—of failure, disapproval, or not being enough. For many high achievers, perfectionism began as a coping strategy in childhood and evolved into an identity built on overfunctioning.

But the cost of high-functioning anxiety is steep:

• Constant tension and worry
  
• Fear of disappointing others
  
• An inability to rest without guilt
  
• Feeling like your value depends on performance
  

Despite appearances, high-performing individuals often don’t feel “fine.” They’re simply productive and anxious.

Signs of Perfectionist Burnout

Because perfectionism is often praised, it’s easy to miss the toll it takes. If you recognize yourself in the following, you may be experiencing burnout driven by perfectionism and anxiety:

• You feel behind, even when you’re ahead
  
• You struggle to relax, even when you’ve “earned it”
  
• You dread failure more than you desire success
  
• You procrastinate out of fear of doing something imperfectly
  
• You minimize accomplishments and focus on what’s next
  

High-functioning anxiety is real—and it’s unsustainable.

Can You Be Ambitious and Mentally Healthy? Yes.

The good news: You don’t have to choose between mental health and ambition. The key is redefining how you measure success and learning to meet your own needs without perfection as the price of admission.

How to Support Your Mental Health as a High Achiever

1. Redefine What Success Means
Success isn’t only about flawless execution. Try measuring success by:

• Progress over perfection
  
• Honest effort, even with imperfect results
  
• How aligned your work is with your values
  
• Resting when you need to, not when you’re “allowed”
  

2. Build Discomfort Tolerance
Perfectionism is often a way to avoid discomfort. Challenge yourself to:

• Send that email without triple-checking
  
• Take a break before finishing a task
  
• Leave space for things to be “good enough”
  

Each act of tolerating imperfection strengthens your resilience.

3. Talk Back to Your Inner Critic
Your inner critic might sound convincing, but it’s often just a fear-based habit. Practice asking:

• What am I afraid will happen if I don’t do this perfectly?
  
• Is this expectation reasonable—or punishing?
  
• What would I say to a friend in the same situation?
  

4. Develop Self-Worth Outside of Achievement
Explore who you are outside of what you do. This might mean:

• Trying hobbies with no productivity outcome
  
• Setting boundaries around work
  
• Valuing your presence, not just your performance
  

When your worth is no longer tied to outcomes, anxiety loses power.

5. Consider Therapy for Perfectionism and Anxiety
Working with a therapist who understands high-functioning anxiety and perfectionism can help you untangle these patterns at their root. You don’t need to be in crisis to benefit from therapy—especially when you’re tired of keeping it all together.

You Don’t Have to Earn Peace

Your ambition doesn’t need to disappear—but it shouldn’t come at the cost of your well-being. When you learn to recognize anxiety for what it is—not motivation, but fear—you gain the freedom to move through life with more peace, less pressure, and a deeper sense of self-worth that isn’t up for negotiation.

Ready to work with someone who understands the mental load of high achievement?
I help ambitious professionals untangle perfectionism and anxiety without losing their drive. If you’re ready for something deeper than coping, let’s talk about what real transformation can look like.

Book your appointment today.

Written by: Refresh Interns

Venting can feel good in the moment. You get things off your chest, release some frustration, and maybe even feel validated. But there’s a point where venting stops being helpful—and starts becoming a way to avoid real change.

In therapy and in life, there’s a difference between processing an experience and circling the same story over and over. One creates movement. The other keeps you stuck.

What Venting Does (and Doesn’t Do)
Venting gives us temporary relief. It helps us feel heard, especially if we’re used to suppressing emotions. But on its own, venting rarely leads to clarity, insight, or growth. It’s often reactive, focused on what happened and why it was unfair—without asking, “What now?”

This doesn’t mean you shouldn’t express your emotions. But when venting becomes the only thing you do, it can keep you in a cycle of frustration and powerlessness.

Doing the Work Means Looking Inward
Doing the work means asking yourself harder questions. It means going beyond how something felt and exploring what it triggered in you. It asks, “What patterns am I noticing?” “What do I actually need?” “How can I respond differently next time?”

This process requires emotional honesty, accountability, and a willingness to move through discomfort. That’s why many people avoid it. But it’s also where actual transformation happens.

Venting Looks Like:

• “I can’t believe they did that to me.”
  
• “This always happens to me.”
  
• “They’re the problem.”
  
• “I just needed to get that out.”
  

Doing the Work Looks Like:

• “Why does this pattern keep showing up in my relationships?”
  
• “What boundary was crossed, and how did I respond?”
  
• “What’s my role in this dynamic?”
  
• “What am I feeling underneath the anger or frustration?”
  

You Deserve More Than Temporary Relief
Venting has its place. Sometimes you need to let it out before you can even think clearly. But staying in vent mode can give the illusion of processing—without ever helping you move forward.

Doing the work means committing to self-awareness, emotional growth, and deeper insight. It’s not always comfortable. But it’s the difference between repeating the same story and writing a new one.

Ready to move beyond venting and start making real changes?

Book your appointment today.

Written by: Refresh Interns

Ever feel like you’re the one always checking in, managing emotions, anticipating needs, and holding space—while your partner, friend, or family member just… exists? That’s emotional labor, and it’s quietly exhausting. Often invisible, emotional labor is the mental and emotional energy required to maintain relationships, solve problems, and keep everyone feeling okay—even when you’re not.

While it’s normal for care and support to flow both ways in close relationships, emotional labor becomes a problem when it’s one-sided. If you’re constantly managing the emotional temperature of your relationship, you’re likely carrying more than your fair share—and it’s draining.

What Is Emotional Labor?
Emotional labor in relationships isn’t about performing grand gestures. It’s the subtle, constant effort of making sure everything runs smoothly emotionally. This includes things like:

• Soothing your partner when they’re upset, even if you’re overwhelmed yourself
  
• Anticipating emotional needs before they’re spoken
  
• Keeping the peace to avoid conflict
  
• Suppressing your feelings so others won’t feel uncomfortable
  
• Being the emotional “glue” in every dynamic
  When you’re the one doing most of the emotional tending—without reciprocation—it takes a toll on your nervous system, your self-esteem, and your capacity to actually enjoy the relationship.
  

Signs You’re Carrying Too Much Emotional Labor
You might not call it emotional labor, but you’ll feel it. Common signs include:

• Feeling responsible for other people’s moods
  
• Apologizing often, even when you’re not at fault
  
• Being emotionally exhausted after conversations
  
• Noticing that others rarely ask how you’re doing
  
• Feeling unseen, underappreciated, or taken for granted
  Over time, this kind of imbalance can lead to resentment, disconnection, or even burnout.
  

Why It’s So Hard to Stop
Many people—especially those who were raised to overfunction—find it hard to stop performing emotional labor. You might worry that if you stop holding it all together, everything will fall apart. Or you may have learned early on that being attuned, accommodating, or selfless was the way to earn love or avoid conflict.
But constantly prioritizing other people’s emotions doesn’t create closeness—it creates imbalance. And it teaches the people around you that your needs are optional.

What to Do About It
You don’t have to burn it all down to reset your role in a relationship. But you do have to start doing less of what’s draining you—and tolerating the discomfort that may come with it.
Here’s how to begin:

• Notice when you’re managing someone else’s emotional experience
  
• Pause before jumping in to soothe, fix, or accommodate
  
• Practice expressing your own emotions, even if it feels awkward
  
• Set small boundaries around how much you give—without overexplaining
  It may feel selfish at first. But it’s not. It’s rebalancing a dynamic that was never sustainable to begin with.
  

Healthy Relationships Share the Load
In a healthy relationship, emotional labor is mutual. You check in with each other. You support one another. You both take responsibility for emotional connection—not just one of you.
You don’t have to carry it all. You were never meant to.

Ready to work with a therapist who understands the emotional toll of overfunctioning in relationships?

Book your appointment today.

Written by: Refresh Interns

Despite growing awareness of mental health, therapy still carries stigma and misunderstanding. For many people, outdated beliefs about therapy create hesitation, shame, or unrealistic expectations. These myths don’t just keep people out of therapy—they also prevent those already in it from getting the most out of the experience. Here are the most common myths about therapy—and the truth that might help you see it differently.

Myth #1: Therapy is only for people in crisis
Reality: Therapy isn’t just for when everything falls apart. Many people go to therapy to better understand themselves, process everyday stress, or break patterns that no longer serve them. Therapy can be proactive—not just reactive.

Myth #2: Talking to a friend is the same as therapy
Reality: While friends can offer support, therapy is a professional relationship with boundaries, training, and evidence-based strategies. Therapists are trained to notice blind spots, help you tolerate discomfort, and support you without projecting their own experiences onto you.

Myth #3: Therapy is just talking with no real progress
Reality: Therapy involves reflection, but it’s not aimless. Good therapy helps you recognize patterns, develop insight, and take action. What might feel like “just talking” is often where deep cognitive and emotional shifts begin.

Myth #4: Needing therapy means something is wrong with me
Reality: Going to therapy is a sign of self-awareness, not weakness. Mental health maintenance is part of taking care of yourself. You don’t have to be in crisis to deserve support.

Myth #5: Therapy will fix me
Reality: Therapy doesn’t “fix” you—it gives you the tools to better understand yourself, set boundaries, cope with stress, and move through life more intentionally. The goal is growth and alignment, not perfection.

Myth #6: If it didn’t work before, it won’t work now
Reality: There are many styles of therapy, and not every therapist will be the right fit. If past therapy wasn’t helpful, it may have been the wrong timing, the wrong approach, or simply a mismatch. That doesn’t mean therapy can’t work for you.

Myth #7: Therapy is only for people with a diagnosis
Reality: You don’t need a diagnosis to benefit from therapy. Many people seek therapy for things like burnout, relationship challenges, career transitions, or personal growth. Therapy can help you think clearly and make intentional decisions—no diagnosis required.

Let Go of the Myths. Keep the Insight.
Therapy is not about being broken or weak. It’s about creating space for honest reflection, intentional growth, and mental clarity. The myths about therapy keep people stuck. But the truth? Therapy is one of the most powerful tools you can use to better your life.

Ready to work with a therapist who meets you where you are—without the myths?

Book your appointment today.

Written by: Refresh Interns

While scrolling through Instagram recently, I came across a pair of Irish dancers my son and I often enjoy watching together. To my surprise, I learned they’re currently touring with Beyoncé. Yes—Beyoncé. Something about that moment brought me straight back to my 13-year-old self: completely absorbed in Riverdance, dreaming of becoming a professional Irish dancer, and feeling inspired by the way Irish dance embraced other cultures. I was flooded with joy watching these dancers perform—living the kind of dream I once imagined for myself.

(For the record, that dream didn’t happen. I became a psychotherapist—and later, founded Refresh.)

But alongside that joy came something else. I also remembered the strain Irish dance placed on my mental health. I remembered teachers yelling at us, weighing dancers in front of the entire class and telling some how much they needed to lose before the Oireachtas. I remembered the guilt for not placing at a feis—or in my case, skipping one altogether because I had another commitment, and the criticism that followed.

So when my neurodivergent son showed interest in Irish dance at age three, I was careful about the environment I chose. Many schools turned him away because of his gender, age, or neurodivergence. I found a teacher who welcomed him exactly as he was—no yelling, no shame, no rigid expectations. Her school emphasizes joy, inclusion, and encouragement.

Morgan Bullock, star of Riverdance and Beyonce dancer, poses with my son at his Irish dance class.

That Instagram moment sparked more than nostalgia. It led me to reflect on what it means to process a dance history that, for many adults, is emotionally complicated. I work with high-achieving adults every day—people who, like me, often revisit childhood passions only to uncover both joy and injury.

So what does it mean to care for your mental health as an adult with a history in competitive dance?

What Irish Dance Can Teach Us About Mental Health

1. Acknowledge what it took to survive that culture.
   If you danced competitively as a child, you probably developed certain coping mechanisms to navigate high pressure, public evaluation, and perfectionism. Some of those habits might have helped you succeed—but they may no longer serve you today. It’s okay to outgrow them.
   
2. You’re allowed to grieve what dance took from you.
   Grief doesn’t only come from loss—it comes from absence, too. If your dance years were full of shame, fear, or missed developmental support, you might feel anger or sadness. That doesn’t mean you didn’t love dancing. It means you’re honoring your full experience.
   
3. Joy doesn’t have to be tied to performance.
   Many of us learned to associate joy with external validation—winning, impressing others, getting praise. Relearning what joy feels like without a scorecard is a powerful mental health practice, whether in dance or daily life.
   
4. The body remembers, even when you’ve moved on.
   The stress of being told your body wasn’t “right” for dance doesn’t just go away because you aged out of competition. Adults who grew up in performance-based environments often continue to carry unspoken tension around their bodies, productivity, or worth. Therapy can help untangle that.
   
5. You can reclaim dance on your own terms.
   Maybe that means going back to a class just for fun—or maybe it means never dancing again and finding peace with that decision. Either way, you get to redefine your relationship to dance now, free from the rules that shaped your past.
   
6. Excellence doesn’t have to cost you your well-being.
   You can still be ambitious and have boundaries. Rest and limits don’t make you less serious—they make you sustainable. There’s no prize for burning out.
   
7. Visibility can be healing—but only when it’s on your terms.
   Being seen for who you actually are—not the version others expect—can be profoundly liberating. But it has to feel safe. You’re allowed to choose what parts of yourself you show to the world, and when.
   

As adults, many of us carry childhood experiences that were both beautiful and bruising. Irish dance was one of those for me. Returning to it—even just as a spectator—has become an unexpected window into understanding myself more deeply.

If you’re beginning to reflect on the intensity of your own childhood passions—whether in dance, academics, athletics, or another performance-based environment—therapy can help you explore how those early structures shaped your current patterns.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Every April, Autism Awareness Month rolls around. We hear calls for “inclusion,” “understanding,” and “support.” But inclusion isn’t about inviting autistic people to sit quietly at the edge of a neurotypical world. It’s about recognizing that the systems, norms, and expectations of that world weren’t built for us—and we shouldn’t be the only ones expected to adapt.

This is what masking is: the lifelong, exhausting effort autistic people make to appear non-autistic.

It’s learning to mimic the tone, rhythm, and pacing of neurotypical speech. It’s suppressing stims. Forcing eye contact. Smiling at the “right” time. Making small talk that feels pointless. Sitting through sensory overload without showing it. Memorizing social rules that change depending on who you’re with. And doing it all while hiding the fact that you’re doing it.

Most people never see it. And that’s the problem.

When autistic people communicate in ways that are considered “normal,” we’re praised for how well we’re doing. When we don’t, we’re dismissed, ignored, or corrected. Either way, the message is the same: adapt.

And we do. Autistic people are trained from an early age to meet the non-disabled world where it is. We’re taught to communicate in their way. To relate on their terms. To work, socialize, and exist in their environments. To push down who we are so we can be more “acceptable.”

But here’s the part no one likes to talk about: the non-disabled world isn’t asked to meet us halfway.

No one teaches neurotypical children how to recognize autistic communication as valid. No one expects non-autistic adults to slow down their conversations, to interpret literal language without judgment, to accept alternate body language as equally meaningful. No one rewrites classroom environments or workplace expectations unless they have to—and even then, it’s met with resistance.

It’s not just that autistic people have to do all the adapting. It’s that we’re expected to do it silently, invisibly, without recognition—and without reciprocal effort from the world around us.

That’s not inclusion. That’s compliance.

The burden to communicate, relate, adjust, and contort falls entirely on the disabled person. And when we can’t—or simply won’t—do that anymore, we’re told we’re difficult, rude, cold, or too sensitive.

So this Autism Awareness Month, let’s stop asking autistic people to do more. Let’s stop celebrating how well someone masks their disability and start asking: Why do they have to?

Why is the non-disabled world so rarely expected to change?

Why do we treat accessibility as a favor instead of a responsibility?

And why are neurodivergent people expected to make themselves understandable, while everyone else is free to stay exactly the same?

It’s time we stop calling this “inclusion” when it’s really just assimilation.

It’s time the world starts doing its share of the work.

—

I’m a neurodivergent psychotherapist, and one of my areas of specialization is working with adults who were diagnosed with autism later in life. I know firsthand how much effort goes unseen—how hard it is to untangle who you are from who you’ve been trained to be. This month isn’t about raising awareness of autism as an abstract concept—it’s about recognizing the people who’ve been here all along, quietly doing the work to fit into a world that rarely makes space for them. We deserve better. And we shouldn’t have to keep asking.If you’re looking for a therapist who truly understands the complexity of late-diagnosed autism and the lifelong experience of masking, our team is here to help.
Book an appointment with one of our therapists today.

Written by: Keeley Teemsma, LCSW, MA

Every day, people in the United States consume news and updates from social media outlets about political, social, environmental, and economic changes. These ongoing changes can often feel overwhelming and frightening, leading to a sense of hopelessness. Such feelings can significantly impact mental health, affecting our sense of stability and safety. During challenging times, it’s essential to seek a safe space to express feelings and process complex emotions. At Refresh, we are committed to protecting all patients, especially those most affected by harmful policies.  Everyone deserves dedicated time and space for safety, advocacy, and healing.

II. Protecting LGBTQIA+ Patients

In the current political climate, we recognize that LGBTQIA+ clients face specific challenges and targets. Our practice is committed to gender-affirming therapy and LGBTQIA+ mental health. At Refresh, we understand the importance of living as your most authentic self and its positive impacts on overall life satisfaction. We will never share private information that could put patients at risk. We can provide referrals to LGBTQIA+ organizations that provide legal support and community resources.

III. Protecting BIPOC Patients

At Refresh, we are committed to providing culturally competent, trauma-informed care that acknowledges and addresses the racial trauma uniquely experienced by BIPOC individuals. We actively foster an anti-racist therapeutic environment where discrimination is never tolerated, and every client feels safe, respected, and heard. Our strong connections with BIPOC-led community organizations ensure our clients can access additional, culturally relevant support resources. By promoting racial equity within therapy, we empower our BIPOC clients on their healing journey and advocate for lasting systemic change.

IV. Protecting Patients with Immigration Concerns

At Refresh, we deeply value the safety and well-being of patients facing immigration concerns. We strictly protect privacy and confidentiality, ensuring that immigration status and patient records remain secure and confidential. Our therapists provide specialized, trauma-informed care to help clients navigate the stress, fear, and uncertainty that often accompany immigration challenges. Additionally, we maintain trusted partnerships with legal experts and immigration advocacy groups, offering reliable referrals to support clients in securing essential legal and social services. Our goal is to foster a secure, compassionate, and informed environment where immigrant clients can confidently pursue their mental health and personal well-being.

V. Protecting Women’s Health and Autonomy

Political uncertainty significantly impacts women’s health and autonomy, particularly as shifting policies around reproductive rights create barriers to essential healthcare. Trauma-informed therapy can play a critical role in supporting individuals affected by abortion restrictions and limited access to reproductive services, helping them process complex emotions and experiences. In addition, addressing gender-based violence remains vital, with accessible resources and therapeutic support needed for survivors of domestic violence and sexual assault. At Refresh, we address mental health advocacy as equally important, as women often face heightened stress and anxiety when navigating policy changes that threaten their rights and personal agency.

VI. Protecting Individuals with Disabilities

We are committed to protecting and supporting individuals with disabilities by recognizing the systemic barriers that impact their daily lives. Our therapists provide care that acknowledges the emotional toll of policy changes affecting healthcare, accessibility, and necessary accommodations. We offer a validating space for clients to process the stress, frustration, and isolation that can come from navigating a society shaped by ableism. By centering the lived experiences of disabled individuals, we provide affirming, inclusive therapy that fosters resilience, self-advocacy, and emotional well-being. Refresh Psychotherapy stands with the disability community, offering compassionate support amidst ongoing systemic challenges.

VII. Protecting Neurodivergent Individuals

We are dedicated to protecting and uplifting neurodivergent individuals by providing therapy that validates and honors their unique experiences. Our clinicians support clients in exploring their neurodivergent identity beyond societal expectations and the pressure to conform, creating space for self-discovery and empowerment. We also help individuals process the emotional toll of masking and the burnout that often results from navigating environments that lack understanding or accommodations. Most importantly, we encourage authentic self-expression, helping clients find ways to be authentic without fear of judgment. At Refresh, we believe in celebrating neurodiversity and fostering a therapeutic space where every mind is respected and supported.

VIII. Protecting Those Affected by Religious and Political Oppression

At Refresh, we understand that religious and political oppression can profoundly impact our clients’ lives and well-being. Our approach is to provide a non-judgmental space where clients can process their experiences of discrimination, family rejection, and/or social isolation. This process involves exploring identity conflicts that can arise as our beliefs shift or evolve in response to changing political or religious views. At Refresh, we support our clients through their emotions, always honoring their authentic selves and personal journeys. We work to strengthen their resilience, especially in the face of religious or political oppression, and to develop coping strategies and emotional tools that build self-worth and confidence.  

IX. How We Take Action

At Refresh, we are committed to advocating for the rights and needs of marginalized communities within the mental health system. We stay engaged with current advocacy efforts, particularly those addressing religious and political oppression, to ensure these issues are recognized and addressed. Our strong partnerships with human rights organizations and support networks provide excellent resources for clients needing additional support. We believe that knowledge is power and are dedicated to informing our clients about their rights, available resources, and support options. Our mission is to empower our clients to make informed decisions about their healing journey and access the range of support services available.At Refresh, we stand firmly by our commitment to your safety, confidentiality, and advocacy. We understand that the decision to seek therapy can be overwhelming, but you’re not alone in this. Many others have felt uncertain and have found the support they needed to heal and grow. You don’t need to go through this alone; our therapy space offers a secure environment for you to heal and grow. To schedule a session or learn more about our services, call (646) 685-4422 or visit www.refreshtherapynyc.com. Remember, we are here to support you every step of the way.

As May unfolds, the United States observes Mental Health Month, a time dedicated to raising awareness, reducing stigma, and promoting mental wellness. In the bustling metropolis of New York City, where the pace is fast and the demands are high, prioritizing mental health is not just an option but a necessity, especially for adults navigating the complexities of urban life.

The Urban Experience and Mental Health

Living in New York City offers a unique blend of opportunities and challenges. The city’s vibrancy, diversity, and endless possibilities attract millions of individuals seeking success, fulfillment, and belonging. However, beneath the glittering skyline lies a landscape of stressors that can take a toll on mental well-being.

The fast-paced lifestyle, competitive work culture, and constant sensory overload can lead to feelings of anxiety, burnout, and isolation. Commuting woes, financial pressures, and the high cost of living further exacerbate stress levels, making it increasingly difficult for adults to maintain mental equilibrium in the city that never sleeps.

Stigma and Seeking Help

Despite the city’s abundance of resources, including mental health clinics, support groups, and therapy services, stigma remains a significant barrier to seeking help for many New Yorkers. The pervasive belief that seeking mental health support is a sign of weakness or failure can prevent individuals from reaching out for assistance when they need it most.

Moreover, the fear of judgment, confidentiality concerns, and logistical challenges, such as finding affordable and accessible care, can deter adults from seeking timely support for their mental health concerns. As a result, many suffer in silence, grappling with their emotional struggles alone, unaware that help is within reach.

Navigating Culturally Diverse Needs

New York City’s population is a melting pot of cultures, languages, and identities, each with its own unique perspectives on mental health and well-being. For adults from immigrant communities or marginalized backgrounds, accessing culturally competent mental health care can be particularly challenging.

Language barriers, cultural differences in understanding and addressing mental health issues, and mistrust of mainstream healthcare systems can all contribute to disparities in mental health outcomes. Recognizing and addressing these diverse needs is essential to ensuring that all New Yorkers have equitable access to mental health support and resources.

Promoting Mental Wellness

As Mental Health Month unfolds, it’s crucial for individuals, communities, and policymakers to come together to prioritize mental wellness in New York City. This includes:

1. Raising Awareness: Increasing public awareness about mental health, reducing stigma, and promoting open dialogue about emotional well-being are essential steps toward fostering a more supportive and inclusive city.
2. Expanding Access to Care: Investing in mental health services, expanding insurance coverage for mental health treatment, and increasing the availability of culturally competent care are vital to ensuring that all New Yorkers can access the support they need.
3. Building Community Support: Creating safe spaces for individuals to connect, share experiences, and seek support can help combat feelings of isolation and foster a sense of belonging in a city known for its hustle and bustle.
4. Prioritizing Self-care: Encouraging individuals to prioritize self-care, set boundaries, and practice mindfulness amid the hustle of urban life can help mitigate stress and improve overall well-being.

In conclusion, as New Yorkers navigate the complexities of urban life, let us remember the importance of prioritizing mental health. By raising awareness, reducing stigma, and fostering a culture of support and resilience, we can create a city where every adult can thrive emotionally, mentally, and socially. This Mental Health Month, let’s commit to prioritizing mental wellness for all New Yorkers.

May marks an important time in the United States as it celebrates Asian American and Pacific Islander (AAPI) Heritage Month, a time dedicated to recognizing the contributions, culture, and history of these diverse communities. However, amidst the celebrations and acknowledgments, it’s crucial to shed light on a significant yet often overlooked aspect: mental health within the AAPI community.

The AAPI community is not a monolith; it encompasses a rich tapestry of cultures, languages, and traditions. Yet, within this diversity lies a shared experience of navigating cultural stigmas, intergenerational conflicts, and systemic barriers that can impact mental well-being.

Cultural Stigma and Silence

Mental health remains a taboo subject in many AAPI communities due to cultural stigmas surrounding mental illness. There’s often pressure to maintain a façade of strength and success, leading individuals to internalize their struggles and suffer in silence. Seeking help for mental health issues can be perceived as a sign of weakness or failure, causing many to forego treatment or support.

Moreover, the model minority myth perpetuates the stereotype that all Asians are academically successful, financially prosperous, and emotionally resilient. This myth not only undermines the diverse experiences of AAPI individuals but also creates unrealistic expectations, further exacerbating mental health challenges.

Intersections of Identity

The AAPI community intersects with various identities, including gender, sexual orientation, immigration status, and generational differences, each influencing mental health experiences uniquely.

For instance, LGBTQ+ AAPI individuals often face additional challenges, including rejection from family, cultural invisibility, and discrimination within both mainstream and LGBTQ+ communities. These intersecting identities can contribute to feelings of isolation, shame, and internalized prejudice, affecting mental well-being.

Similarly, immigrants and refugees within the AAPI community may grapple with acculturation stress, language barriers, and trauma from displacement, all of which can impact mental health outcomes. The pressure to assimilate while preserving cultural heritage can create a sense of identity conflict, leading to psychological distress.

Barriers to Access and Treatment

Despite the growing awareness of mental health issues, AAPI individuals encounter numerous barriers to accessing culturally competent care. Language barriers, lack of culturally sensitive resources, and limited representation of AAPI mental health professionals contribute to the underutilization of mental health services within these communities.

Furthermore, the perpetual foreigner stereotype, which portrays AAPI individuals as perpetual outsiders regardless of their citizenship or cultural integration, can deter seeking help due to fears of discrimination or misunderstanding from healthcare providers.

Cultivating Resilience and Support

Amidst these challenges, it’s essential to highlight the resilience and strength within the AAPI community. Cultivating culturally responsive mental health resources, promoting community-based support networks, and destigmatizing conversations around mental health are critical steps toward fostering well-being.

Encouraging open dialogue within families and communities, providing culturally competent mental health education, and advocating for policies that address systemic inequities can help break down barriers to care and promote holistic wellness.

Conclusion

As we celebrate Asian American and Pacific Islander Heritage Month, let us not forget the importance of addressing mental health within these communities. By acknowledging the complexities of identity, challenging cultural stigmas, and advocating for equitable access to care, we can create a more inclusive and supportive environment where all individuals can thrive mentally, emotionally, and culturally. This month, let’s not only honor the rich heritage of the AAPI community but also commit to prioritizing their mental health and well-being.

As Autism Awareness Month draws to a close, it’s a fitting time to reflect on the progress made and the work that still lies ahead. Throughout April, individuals and organizations around the world have come together to raise awareness about autism spectrum disorder (ASD), advocating for acceptance, understanding, and inclusion. While awareness is crucial, it’s only the first step on the journey towards creating a more supportive and inclusive society for autistic individuals.

Over the years, there has been a significant increase in awareness surrounding autism. More people than ever before recognize the term “autism” and have a basic understanding of what it entails. This increased awareness has led to improved diagnosis rates and access to services for individuals on the spectrum. It has also sparked important conversations about neurodiversity and the unique strengths and challenges of autistic individuals.

However, awareness alone is not enough. We must move beyond awareness to foster genuine understanding and acceptance of autism. Understanding goes beyond recognizing the existence of autism; it involves learning about the diverse experiences of autistic individuals, their strengths, challenges, and perspectives. It requires us to listen to autistic voices and amplify their stories, allowing their insights to shape our perceptions and actions.

Acceptance is perhaps the most crucial aspect of creating an inclusive society for autistic individuals. Acceptance means embracing neurodiversity and recognizing that autism is a natural variation of the human experience, not a defect to be corrected or cured. It means respecting the autonomy and dignity of autistic individuals and valuing their contributions to our communities. Acceptance is about creating environments where autistic individuals can thrive and be their authentic selves without fear of judgment or discrimination.

As we reflect on Autism Awareness Month, let us recommit ourselves to the pursuit of understanding and acceptance. This means advocating for policies and practices that promote inclusivity and support for autistic individuals in education, employment, healthcare, and beyond. It means challenging stereotypes and combating stigma through education and advocacy efforts. It means creating spaces where autistic voices are heard, valued, and included in decision-making processes.

Building a more inclusive society for autistic individuals benefits us all. When we embrace neurodiversity and create environments where everyone can thrive, we unlock the full potential of our communities. We learn from each other, grow together, and create a world that celebrates diversity in all its forms.

So, as Autism Awareness Month comes to a close, let us carry the spirit of understanding and acceptance forward into the months and years ahead. Let us continue to work towards a world where every individual, regardless of their neurotype, is valued, respected, and included. Together, we can create a more compassionate and inclusive future for all.

In our journey through life, our mental health is influenced by a myriad of factors, with hormones playing a pivotal role, especially in women’s health. From the joys of pregnancy to the challenges of menopause, hormonal fluctuations can significantly impact mental well-being. In this blog post, we delve into how hormonal conditions like postpartum depression, pregnancy, Premenstrual Dysphoric Disorder (PMDD), and menopause can affect mental health and explore how psychotherapy can offer support and guidance through these complex times.

The Ripple Effect of Hormonal Changes

Pregnancy: Pregnancy is a time of profound hormonal changes designed to support fetal development and prepare the body for childbirth. However, these hormonal shifts can also affect mood and emotional well-being. While many expectant mothers experience the “glow” of pregnancy, others may struggle with anxiety, depression, or antenatal depression, which can impact their ability to bond with the unborn baby and prepare for the challenges of motherhood.

Postpartum Period: Following childbirth, the sudden drop in hormones like estrogen and progesterone, along with sleep deprivation and the pressures of caring for a newborn, can lead to postpartum depression (PPD). PPD goes beyond the “baby blues,” presenting a more severe and long-lasting form of depression that requires professional support.

Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe form of premenstrual syndrome (PMS) that affects a small percentage of menstruating women. Characterized by debilitating physical and emotional symptoms, PMDD can significantly disrupt daily life and strain personal relationships.

Menopause: The transition to menopause involves a gradual decrease in hormone production, particularly estrogen and progesterone. This period can bring about a range of symptoms, including hot flashes, sleep disturbances, and mood swings, which can contribute to anxiety and depression in some women.

The Role of Psychotherapy

Understanding the interplay between hormones and mental health is crucial in providing effective care. Psychotherapy offers a supportive space to navigate these challenges, employing various strategies tailored to each individual’s needs.

Cognitive-Behavioral Therapy (CBT): CBT is effective in addressing negative thought patterns and behaviors associated with hormonal changes. It can help individuals develop coping strategies to manage symptoms of anxiety and depression, improving overall well-being.

Interpersonal Therapy (IPT): IPT focuses on the interpersonal relationships and social roles that may be affected by hormonal changes. It can be particularly helpful in addressing issues related to the postpartum period and menopause, offering strategies to improve communication and strengthen relationships.

Mindfulness-Based Stress Reduction (MBSR): MBSR techniques can be beneficial in managing the emotional and physical symptoms associated with hormonal conditions. Mindfulness practices encourage present-moment awareness and acceptance, helping to alleviate stress and improve mood.

Lifestyle and Nutritional Counseling: Integrating lifestyle and nutritional counseling into psychotherapy can enhance treatment outcomes. Regular physical activity, a balanced diet, and sufficient sleep can mitigate the impact of hormonal fluctuations on mental health.

Conclusion

Hormonal conditions can profoundly affect mental health, but with the right support and strategies, individuals can navigate these changes more smoothly. At our psychotherapy practice, we are committed to providing compassionate and evidence-based care to help our clients manage the psychological aspects of hormonal conditions. By understanding the complex relationship between hormones and mental health, we empower individuals to take control of their well-being and lead fulfilling lives.

Written By: Kat Heidelberger, LMSW

In the bustling heart of New York City, where the pace of life never seems to slow down, it’s easy to lose touch with the creative spark that ignites joy and vitality in our lives. However, creativity isn’t just an artistic endeavor; it’s a vital component of mental health. Here are some ways that nurturing creativity can enhance overall well-being.

Rediscovering Your Inner Child Through Creativity:

Creativity is often associated with childhood — a time when we freely expressed ourselves without fear of judgment or failure. As adults, especially in a goal-driven city like NYC, we tend to suppress this creative freedom, but it remains a core part of our being.

Engaging in creative activities allows us to revisit the uninhibited joy of our inner child. This might be through painting, writing, dancing, or even cooking. It’s not about the outcome but the process — allowing yourself to play, explore, and make ‘mistakes’ without self-criticism. This reconnection with your inner child can be incredibly healing, offering a sense of freedom and spontaneity that adult life often lacks.

The Therapeutic Power of Being in Flow:

Flow states, a concept popularized by psychologist Mihaly Csikszentmihalyi, occur when you’re fully immersed in an activity, losing track of time and self-consciousness. This state of ‘flow’ or ‘being in the zone’ is not only deeply satisfying but also contributes to mental well-being. 

Creative activities are a perfect gateway to these flow states. Whether it’s through writing a piece of music, getting lost in a drawing, or crafting, these activities can shift your focus away from stressors and negative thoughts, providing a mental break that’s both refreshing and rejuvenating. In flow, the mind gets a chance to rest from the constant chatter of life. It allows for a unique form of mindfulness, where the present moment is all that matters. The result is often a sense of peace, accomplishment, and a deeper connection to self.

Expressing the Inexpressible: 

Another crucial aspect of creativity in mental health is its role in emotional expression and healing. Creative expression offers a unique outlet for hidden underlying emotions, providing a way to articulate and process them when words alone may fall short.

Many times, emotions are complex and layered, making them difficult to verbalize. Creative pursuits enable you to express these feelings in a more abstract yet profoundly personal way. This process can lead to significant insights and catharsis, aiding in emotional release and healing.

Fostering Self- Understanding:

Engaging in creative activities can also be a journey of self-discovery. As you create, you might uncover hidden aspects of yourself, understand your desires and fears better, and cultivate a deeper connection with yourself. This self-discovery can be empowering, leading to greater self-acceptance and a more authentic life.

Creativity in Everyday Life:

You don’t need to be an artist to incorporate creativity into your life. It’s about finding what resonates with you. Simple acts like rearranging your living space, experimenting with new recipes, or journaling can spark creativity. The key is to approach these activities with a sense of curiosity and playfulness.

We are all inherently creative. By embracing these elements, not only do we improve our mental health, but we also enrich our lives with color, passion, and vitality. Let’s start this creative journey together, and rediscover the joy of living in the moment, one brushstroke, word, or dance move at a time.

Written by Kat Heidelberger, LMSW

It is common to experience work-related anxiety when there is so much pressure to perform at a high level while managing the responsibilities and dynamics that exist in professional contexts. While we may already experience stress related to the nature of our jobs, the sources of anxiety at work can be attributed to factors like job security, fear of failure, social hierarchies or environment, and vary across professions.

Anxiety also often spikes when it is time to bring up professional development conversations. This can look like asking for a raise or resigning from your current position. Thankfully, there are ways to feel less anxious when approaching these challenging but necessary exchanges. Here are some places to start:

Evaluate Your Reasons

Reflect on your reasons for having this conversation. How would it support your values and goals on a professional and personal level? Understanding your motivations can help you feel more confident in your choice and express yourself clearly at the time of the discussion.

Prepare Thoroughly & Rehearse

Is there any valuable information you could gather, such as details about the industry standards and the salary structure within your organization to support your points? Who are the right people to approach with your request?  Make sure to do your research ahead of time, document important points, and consult with trusted colleagues and mentors prior to the conversation. Practicing ahead of time can also significantly lower your anxiety around the flow of the conversation and its possible outcome. Write a script and practice it with a trusted friend or family member who can offer you feedback and encouragement.

Choose the Right Time

Make sure to request a private and scheduled meeting with your supervisor or HR professional. This way, you will ensure it receives the attention it deserves. If the conversation is related to a career advancement request or additional opportunities, choosing a time when your performance has been strong may also help.

Be Flexible and Open to Discussion

Approach the subject with flexibility and be prepared for negotiation. Understand that your employer may not be able to meet your initial request, so be open to hearing about other beneficial options or future considerations. Thinking of a backup plan can also lower the pressure and expectations related to the conversation at hand.

Focus on Positive Self-talk

Challenge and reframe negative thoughts by replacing them with positive affirmations or statements. Be kind to yourself and acknowledge your achievements and strengths as an employee. Remind yourself that you are worthy of having your needs met in order to maintain personal and professional fulfillment, and communicate from a place of self-compassion and confidence.

Stay Calm

Practice deep breathing and mindfulness techniques before the meeting to manage anxiety. Meditation, breathwork, writing a gratitude list, journaling, or a quick walk on a lunch break will allow you to feel more grounded and balanced.

Seek Professional Support

Consider speaking with a mental health professional as a highly effective way to manage work-related anxiety, especially when you feel nervous about navigating difficult conversations with your employer. A collaborative therapeutic process will provide you with guidance, support, and strategies for building confidence and effective communication. 

Whatever the professional development conversation you are approaching, you got this!

Written by Natallia Khalpukova, MHC Fellow