Therapists are fonts of wisdom, sages when it comes to secrets and stories, and guides through some of life’s most complex experiences. As such, we tend to be incredibly quotable! How well do you know your therapy quotes? We put a handful of legendary therapeutic aphorisms alongside sayings from world-famous philosophers, comedians, movie stars, rappers, writers, painters, chefs, and even superheroes to put your therapist’s intuition to the test. So, who said it, a therapist or … someone else?!

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Remember the racial reckoning sparked by the police murder of George Floyd in the summer of 2020? From almost everywhere, we heard calls for immediate, transformative change in policing and other institutions, and we vowed to have more open conversations about race in our institutions. Five years later, national attention has moved on to AI and tariffs, while DEI trainings quietly go away. Far from a consensus about policing in the Black community, we see a growing segment of the country denying that officer Derick Chauvin was even responsible for Floyd’s death. It’s dizzying and dangerous.

What can therapists do other than tend to the clients in their offices, one at a time? Might we contribute to the larger issue as what I call “citizen therapists,” bringing our clinical skills to bear on social problems? In my case, it’s my couple therapy skills where I know how to promote healing by helping people access their best selves in the face of intractable conflict. Although I was already in the fray as a citizen therapist when George Floyd was murdered, my work took a new, meaningful direction as we tried to navigate the ensuing moral panic over race and policing.

I recount the story below in hopes that other therapists might see how we can bring about social change amid the good guy/bad guy dichotomy that dominates our current milieu.

****

In the summer of 2016, days after Philando Castile was killed by police during a traffic stop in my neighborhood—his girlfriend and her young daughter watching, recording—I dropped in on my longtime colleague Guy Bowling at his office. We’d worked together for years on fatherhood initiatives in Minneapolis. Guy is upbeat by nature, someone with resilience in his voice even when he’s tired. But this time he looked worn out. “I’ve got outrage fatigue,” he told me. That caught my attention.

Guy, who is Black, was grappling with what so many Black men in America feel after police shootings: grief, fear, and the sense that no amount of caution guarantees safety. “This time,” he said, “the brother did everything right. And he still got killed.” There was nothing he could tell his son that would make it make sense.

I listened. I didn’t have a response. I’m a white family therapist, not a racial justice activist or a policing expert. I’d been watching these events like everyone else—sick at heart, angry, and unsure what someone like me could do that wouldn’t be symbolic or performative.

Then Guy asked a question that changed my life: “Do you think the Citizen Health Care model could work here?”

Over the years, I’d developed and tested what I call Citizen Health Care—community-based initiatives where everyday people come together with professionals to address the chronic dilemmas in their lives. We’d done it with middle-class parents facing pressures to overschedule kids, American Indians demoralized by widespread diabetes, and low-income fathers trying to reclaim their roles in their children’s lives. Guy had been part of several Citizen Health Care projects. The idea was always to create a small group of people with lived experience, connect them with professionals, help the group build trust and insight, and then support them in offering something back to their communities.

But apply it to police officers and Black men? I spun out an idea: bring together a small group of Minneapolis police officers and Black men from the community, build trust over time, and then see if they could so something together to bridge the gap between police and the community, and promote safety for everyone.

Getting Started

Guy and I both agreed: if this project was to have any chance, it had to include male officers from the Minneapolis Police Department and Black men from the community. That was the volatile flash point, where the hurt, the fear, and the stereotypes collided. We could find community members through our existing networks. But the officers? We had no direct connections. And no margin for error. One misstep, one whiff of an anti-police agenda, and the project would die before it began.

I called Sylvia Kaplan, a friend and former therapist who was deeply connected in Minneapolis politics. She invited another contact to lunch with me—someone who also understood the inner workings of the city. I laid out the idea: a long-term, cocreated group of officers and Black men, not to hash out policy, but to build real relationships and decide together what could be done. They listened and then gave me pointed advice: “Don’t start with the police chief. Start with the police union. The officers won’t trust anything that looks like it’s coming from the top.”

That’s how I found myself nervously calling the administrative assistant to the head of the police union. I hoped she could get my pitch in front of the union leader. But after I explained the project—how it would involve long-term dialogue, personal storytelling, and joint action—she surprised me. “This sounds important,” she said. “Send your email, and I’ll make sure he sees it.”

Within days, I was meeting Officer Dave O’Connor, a union board member, at a coffee shop. He brought a police colleague. I told them what the project wasn’t: It wasn’t a listening session where officers sit silently while people yell at them. It wasn’t a program with a pre-written agenda. And it wasn’t a one-off. We would meet regularly for a year before taking action. We would start with stories, not solutions. We would build trust before trying to change the world.

They listened. They didn’t say yes right away, but they kept nodding. This was a different approach to a gap that troubled them. “We’ll run this buy some of our colleagues and see if there are green lights before getting the chief involved,” Dave said.

When I finally sat down with the chief, she’d brought along her community liaison, Sherman Patterson, a respected Black leader. I told the story of being on the streets of Washington, D.C., in 1968 after Martin Luther King’s assassination. I remembered the police looking helpless as the looting intensified, which showed how little the police can do without public support. That, I said, was what our project was about: forging partnerships between law enforcement and communities, so they weren’t trying to go it alone.

She was in. She tasked Sherman with helping us recruit officers. We were off the ground.

Finding a Rhythm

We launched with seven Black community members and six officers—five white, one Black. We decided to meet every other week, alternating between a police training facility and a neutral community space. The goal was simple but ambitious: to build relationships strong enough to hold hard truths and then act together from that foundation.

The first two meetings were cordial but tense. No one let down their guard. The officers showed up in uniform. One community member told me later that he expected to be frisked upon entering the first meeting. (He was not.)

Our third meeting was a turning point—for better or worse, I wasn’t sure at the time. One of the senior officers, a Black man, had asserted authority at the second meeting. When I tried to redirect two group members from an argument going nowhere back to our agenda, he cut me off with “Let them finish.” I felt the whole process slipping away. Too much heat too soon could derail us. If this turned into a series of arguments about who was right and who was to blame about police shootings, it would collapse under the weight of mistrust.

I didn’t sleep well the night before our third session. I knew I had to win what family therapist Carl Whitaker called “the battle for structure.” I had to be able to use my judgment as the group facilitator without being derailed.

When we gathered, I laid it out. I told them I needed their trust to facilitate. Not to control what they said, but to shape how we moved through the process. “If we don’t have structure, this can blow apart,” I said. “It’s like therapy. You need safety before you go into the deeper stuff.”

The pushback came fast. One community member said, “We’re tired of always being told how to behave in groups. We want to speak freely and not be shushed.” The senior officer stayed quiet but watchful.

I held my ground. Fortunately, I knew the community member well. “When have I ever shushed you?” I said with a chuckle. “You wouldn’t let me if I tried.” He laughed. “If you want to push back because you think I’m cutting you off, look me eye and tell me yourself,” I said to him and the group, “but don’t be sticking up for other people by saying ‘Let him finish.’” That was my signal to the senior officer, who let me know he heard me by quietly smiling.

That cracked something open. The tone shifted. A few group veterans—people who’d worked with me before and trusted my skills—spoke up in support. “I wouldn’t come to this if Bill wasn’t leading it,” one man said. “But yeah, maybe this group needs a different rhythm.” Another chimed in: “Let’s try it. If it feels wrong, we’ll adjust.”

We agreed to a basic structure. I’d bring an agenda. We’d follow it unless someone objected up front. If a topic needed more time or depth, we’d set it aside and revisit it later. And everyone would get a turn to speak.

The group took a collective breath. The session ended with a white officer saying, “When you see me in uniform, you probably think I’m just another cop. But now you know me. I’m a person, not a threat.” A community member replied, “And when you see me walking down the street in dreadlocks, maybe you won’t think I’m one either.”

We weren’t healed. We weren’t unified. But we had a rhythm. And we had momentum.

Stories, Stereotypes, and Kinship

We committed to storytelling as the foundation of our work. No cross-talk—just each person, five minutes on the clock, answering questions we’d agreed on: What were your early experiences with police officers? What were your early experiences with Black men? What were your early experiences with white men? The stories poured out.

The officers often spoke of admiration. “My dad was a cop,” one said. “I always wanted to help people.” Another remembered doing ride-alongs in high school and feeling called to serve.

For the community members, the stories were different. Many spoke of fear and humiliation—being stopped, questioned, sometimes roughed up. One described how an officer who once arrested him later helped him turn his life around. “He taught me how to box,” he said. “Saved me.”

Then we turned to our fathers. The contrast hit hard. Most of the officers had involved dads who modeled order and discipline. For many of the community members, their stories were steeped in pain—absent fathers, abusive ones, or longed-for ones they never knew. “But I’m not him,” one man said. “I’ve raised my kids different.”

The white officers seemed reluctant to talk about racist attitudes when they were growing up. So I decided to talk about growing up in 1950s working-class Philadelphia, hearing the N-word regularly. I shared how my Archie-Bunker-type father had negative, stereotypical views of Black people in general—and yet, when I saw photos of his retirement party, most of the guests were Black coworkers. “Where are the white people?” my wife asked, half-joking. My parents were perplexed; they hadn’t noticed. It was complicated, like all of us.

I could feel the Black men in the group exhale a little at that moment. It wasn’t confession for its own sake. It was making visible what they already knew: that racism isn’t always about open hatred—it’s in the air, in the jokes, in the silences.

The white officers were younger than me. They spoke about integrated schools and Black friends. I wasn’t sure if the difference was generational, or if they were holding back. But we weren’t scoring points. We were building a shared history.

Through those stories, something strange began to happen: the officers and the community members started seeing themselves in one another. Not completely. Not evenly. But it became clear that both groups were, in the public eye, often seen through a single lens.

“We’re both stereotypes,” one officer said.

That moment hit. Black men and police officers—two groups often portrayed as dangerous, volatile, dehumanized. Both blamed for systemic failures far bigger than any individual. That insight began to reshape our group identity. We weren’t adversaries sitting across from each other. We were men who knew what it felt like to be feared, misjudged, blamed. We didn’t all agree on the causes—the white officers never came around on the term “white privilege,” but the bonds of something deeper—maybe even brotherhood—started to take root.

A New Narrative

One community member stepped forward with an idea: Let’s write a shared narrative. Not a mission statement, not a press release, but a coauthored story about what we believe, what we’ve learned, and what we want for our community. Something we could share with others.

It sounded simple. It wasn’t. We spent months wordsmithing. Every sentence mattered. We weren’t writing from a single worldview. Even terms like white supremacy had sparked long debates. The officers bristled—it reminded them of Apartheid. The community members pushed back: How else do we name what we’ve lived? Eventually, we found language we could all agree on. We aimed for shared meanings, not slogans.

We called our narrative statement a Partnership for Community Safety. Not just better policing. Not just more personal responsibility by community members. Something broader and deeper: a partnership with mutual accountability. We agreed: you can’t police your way into a safe community. You need trust, opportunity, and stability. That means jobs, housing, healthcare, and education. And it means police officers and Black men seeing themselves as stakeholders in the same project, not adversaries in opposing camps.

We began sharing this narrative in community forums, one with high school students and another with a fatherhood group. We asked them the same questions we’d asked each other: What are the sources of mistrust between police and the Black community? What does a safe community look like? What could partnership mean?

To our amazement, the young people often echoed what we’d written without knowing it.

“We need more respect,” one teen said. “And we need to work together.”

We also began training police cadets. In our first session, the room was electric. These were new recruits, some skeptical, but most open. We told our story and led a conversation. The feedback forms overflowed with comments. One cadet wrote, “This changed how I think about the badge I’m about to wear.”

That moment carried us. It wasn’t a revolution, but it was a start.

A Hard Road Back

I was at home when I got the call.

“Bill, you need to see this video.”

It was one of the community members. I opened the link. George Floyd was dying on the street just a few miles from where our group had been meeting. The knee of officer Derek Chauvin was on his neck. For over nine minutes. The look in Chauvin’s eyes—the disregard, the control—was unmistakable. I felt sick. I watched it all. I had to. Not just as a citizen, but as someone who’d sat with cops and Black men in the same room for years, trying to build something better.

We called an emergency Zoom meeting for the next day. No agenda. Just space to speak.

The officers looked hollow. The community members looked gutted. Some wept. Others seethed. One said, “That could have been me. That could have been my son.”

Two of the officers said outright that Chauvin’s actions were indefensible. They didn’t offer legal parsing or departmental procedure. Just plain moral clarity. That mattered. It didn’t erase the pain, but it cut through the fog of deflection and gave some relief to the Black men in the group.

Then came a second blow.

As we processed what we’d seen, someone scanned the video footage and said, “Wait—those rookies… weren’t they in the cadet class we trained?”

A quick check confirmed it. Two of the officers who had stood by as George Floyd was killed had sat with us, just a couple weeks earlier, in one of our very first cadet training sessions. We’d talked with the cadets about trust, partnership, mutual respect. They’d written glowing evaluations.

Now two of them were silent accomplices in a national nightmare. I don’t know how to describe what that felt like. Grief. Shame. Rage. Futility. Worry. All of it.

None of our officers defended Chauvin. But some defended the rookies, noting the brutal hierarchy inside the department—that speaking up against a training officer could be career-ending. Some community members asked what good our efforts had done if these very men couldn’t act when it mattered most. “What would I have done,” one asked, “if I’d been standing on that sidewalk watching it happen? Intervene and get arrested? Or watch another brother die?”

We didn’t make any grand decisions that day. We just agreed to keep meeting. To hold the thread.

But outside our group, the world was exploding. Protests. Fires. Calls to defund the police. Our home city became the global symbol of everything broken between law enforcement and Black America. The officers in our group were taking heat on the streets—mostly from young, white protestors, oddly enough. “You’re all murderers,” they heard. Meanwhile, some Black residents—especially in neighborhoods seeing a spike in crime—told them, “We want more police, not less.” The dissonance was dizzying.

A community member called me in the middle of the night, worried that one of our officers might be at the Third Precinct as it burned. He was. Later, the officer told me he’d feared he wouldn’t make it out, that he’d have been shot or burned alive.

It was chaos. Personal. Professional. Moral.

And our group began to fray. After his precinct burned down, one officer went on medical leave for PTSD. “I can’t take another riot,” he told me. I helped him find a therapist. Another transferred to a rural police department. Two community members moved out of town. A third took a job that made meeting impossible.

Our meetings, now on Zoom because of the ongoing pandemic, were down to a skeleton crew: three officers, four community members. No more community forums like the ones we’d been leading. No police training. No new initiatives.

It felt like everything we’d built was slipping away. But we kept showing up. And eventually, slowly, hesitantly, the thread we’d been holding began to spool into something new.

Somewhere in that long, hard season between George Floyd’s death and the long tail of pandemic shutdowns, our project began to breathe again. It started not with a new plan, but with a reaffirmation: We were still here. We still cared. And we weren’t done. Those who remained often said the same thing: “We’re family now.”

Then, a rebirth. We raised a little money and all went to the Legacy Museum and the civil rights sites in Montgomery, Alabama. It gave us three days experiencing and processing the origins of what went wrong between police and the Black Community. Afterwards, we knew we needed fresh voices around our table and decided to invite new officers and community members on a second trip to Montgomery. Some of them joined our ranks, and now we’re up to 16 members. Half are officers and half are community members. We’re back to doing community presentations and will soon return to cadet training. A media crew followed us and shared our work. We’ve had inquiries from other cities. We’re still meeting, still dreaming about how to build a community that is safe for all.

***

Sitting with these community members and police officers, week after week, year after year, I came to see therapy in a new light. What we were doing wasn’t traditional therapy, of course, but it was healing work. It was people sitting in pain, telling their truths, trying to stay in relationship even when trust was thin and arguments weren’t resolved. But as community member Justin Terrel says, “We kept coming back to the table.” We knew the community and the police force depended on us staying together.

And it taught me that the therapeutic stance—presence, patience, structure, humility—isn’t just for the office. It’s needed in civic life, too, especially when the stakes are high.

There were moments I didn’t think I could hold it. Like the late night I got a message from one of our white officers. He’d been searching in the snow for evidence after a drive-by, and a ten-year-old girl had been shot in the face during the crossfire. She was his daughter’s age. He found her bloody tooth. “I can’t do this anymore,” he texted me.  “I can’t take any more intensity.” I responded back with supportive words and suggested he hold off on a final decision about the group. We would be there for him.

After another night with troubled sleep, I called two of the community members first thing the next morning. I said that one of our police brothers was hurting and thinking of leaving the group. They reached out to him—not to challenge or persuade, just to care. He stayed.

This is the brotherhood we’ve built.

We’ve laughed, too. There were running jokes about which group members were most intense, and which pairs got into the most arguments with each other. Group members teased me for my tight facilitation, for my agendas, and insisting on meeting check-ins and check-outs, and for my redirections. Over time, as trust deepened and the group matured with the process, I loosened the reins. But they knew I held them.

Eight years into this work and counting, I’m still trying to understand my contribution. I’m neither Black nor a police officer. In that sense, I have the least expertise in the room. I think my role has been to hold the container for the group, to begin and sustain their conversations. I’m not trying to change or enlighten anyone. I’m not here as a white social justice activist. I don’t use anti-racist language. I don’t mention my race at all. As one community member said, “We know you’re a white man.”

I’ve decided what I am is a citizen therapist, with a role in addressing our society’s serious divisions. And I do love these guys.

****

Adapted from Becoming a Citizen Therapist: Integrating community problem solving into your work as a healer, by William Doherty and Tai Mendenhall. American Psychological Association, 2024.

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Our magazine has won awards not only for its insightful articles, but for its beautiful design. Want to flip through the pages of the latest issue? Check out the digital magazine on your e-reader or any favorite device—and dive in from cover to cover!

The terrain that therapists today are navigating is full of surprises, some of which could seriously trip them up, or worse, pull them under. If you’re regularly crossing boundaries between therapy and life coaching, how do you make sure you’re doing it ethically—in ways that won’t jeopardize your license or land you in court? If you want to grow your public-facing media presence, how do you successfully build your “brand” as a therapist without sacrificing your integrity? (Nine of today’s most successful therapists told us how they did it.) How do you avoid becoming a line item in a venture capitalist playbook if you join a mental health startup?

Join the conversation today!

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As therapists, we train rigorously and passionately because we want to get better at easing other people’s suffering. We want to support and understand our clients in new ways so they can grow into their best selves. We don’t become therapists because we crave the spotlight or want to be recognized on the street for our massive social media following. And we certainly don’t become therapists to create Instagram reels between sessions, scroll through website templates, or distill a mission statement into a catchy logo or six-word tagline.

And yet, in today’s world, branding has become an essential tool for therapists who want to attract clients, build a career, and even shape the cultural conversation around mental health. Time magazine’s most influential people list includes psychiatrists Vikram Patel and Bessel van der Kolk, and psychotherapist Esther Perel has been named to Oprah Winfrey’s list of visionary leaders. Even though developing a brand may feel uncomfortable and overwhelming to many introverted therapists, few can opt out of it entirely.

To help, we asked nine successful mental health practitioners about the most powerful steps they’ve taken to brand themselves—and learned that great branding can be counterintuitive. So don’t be surprised if you’ve never heard advice like this before.

SAHAJ KAUR KOHLI: Go Public with Your Story

The founder of Brown Girl Therapy shares her countercultural secret to building an online community.

NEDRA GLOVER TAWWAB: Keep Social Media Simple and Real

One of the world’s most popular Instagram influencers offers her evolving take on social media.

ALEXANDRA SOLOMON: Collaborate Wisely

After landing a Masterclass series, a renowned relationship expert shares her hard-won formula for discerning what projects to accept and which to turn down.

TERRY REAL: Find the Right Mentors

The developer of RLT recounts the surprising path he took to write his first bestselling book.

SARA KUBURIC: Tell the Truth—Even When It’s Hard

The Millennial therapist who took social media by storm shares what sets her apart from other influencers.

VIENNA PHARAON: Let Changing Priorities Shape Your Focus

Bestselling author and podcaster shows you how less can be more in branding.

DENÉ LOGAN: Be Willing to Challenge Norms

Popular podcast host and author reveals the key she discovered to showing up authentically in the public sphere.

ELIZABETH EARNSHAW: Do the Opposite of Branding

A renowned therapist, author and influencer challenges the popular wisdom behind branding yourself as a therapist.

MARIEL BUQUÉ: Align Your Brand with Your Mission

Trauma expert and author offers some key questions she used to bring meaning into branding a practice.

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One key thing I did to enhance my “brand” as a therapist was share my own story publicly.

I’ll be honest—this wasn’t an easy thing to do, nor was it supported by all my colleagues. As therapists, we’re trained to hold space for others, to listen, to be safe and nonjudgmental. The unspoken rule is that we should maintain a bit of mystery about who we are and what we’ve gone through.

Before becoming a therapist, I’d worked in media/journalism, so writing about myself didn’t feel particularly difficult. However, I was told early in my graduate program by an older professor to delete everything I’d written online about myself and even forgo building Brown Girl Therapy, the first and largest mental health community for adult children of immigrants (now at a quarter of a million people!), which was born of my early struggles as a child of immigrants.

Early in my counseling career, I was faced with difficult questions: What if being honest makes me seem unprofessional? What if I’m not allowed to be a therapist and share my story?

Thankfully, I had professors and mentors who supported my work and believed in what I was doing. After all, I’m a community member first, who identifies as bicultural, who’s navigating many firsts in my immigrant family, and who’s been in therapy on and off for a decade and takes antianxiety medication.

As a narrative therapist, I firmly believe that storytelling shapes the way people make sense of their lives. We all have a story we tell ourselves about who we are, where we’ve been, and where we’re going. But I’ve also realized something else: the stories we don’t tell, the parts we hide or skip over, often hold the key to our healing.

My vulnerability is what’s created connection in the enormous online community I’ve built, one that’s a bridge for so many of us who’ve been left in the margins when it comes to mental health care.  When I shared my story, beyond the confines of an individual therapist’s office, it became a conversation and a shared experience between lonely humans who didn’t see themselves—or their experiences—represented in the culture at large.

Since then, I’ve continued to be open about my mental health journey, most recently in my book, But What Will People Say?. Turns out, the parts of myself I thought were too raw or messy to share were what resonated the most with others. And far from being a hindrance to building my career, it’s made me a more authentic, relatable, and effective therapist.

For me, success hasn’t been about “branding,” but about showing up honestly and truthfully, and meeting the community—my community—where they are. The process has been humbling. I’m not the expert of other people’s lives, but by being more forthcoming about my own experiences, I’m able to help others live a little more well.

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I welcomed my second child into my life eight months ago, and it’s reshaped my relationship not just to my work, but to the way I think about “brand development.” We often hear that parenthood helps us develop the capacity to say no and get clearer on the things that are a wholehearted yes. That’s been true for me. Parenthood has helped me reshuffle priorities personally, socially, and professionally.

Branding and visibility have become less about numerical growth (such as getting more followers on social media platforms) and more about nurturing the people already in my life and practice, encouraging them to deepen their interest in the work I’m putting out into the world. Instead of chasing expansion, I’m focusing on depth and fostering richer engagement with the community I’ve already built—the clients I still see; the people who’ve read (or will read) my book, The Origins of You; my current followers on Instagram, and the people who’ve subscribed to my newsletter.

This shift has meant making some big decisions. I’ve said yes to fewer things, and been deeply intentional about what I take on. Now, I only step onto stages with people I respect and admire, recognizing that part of building your brand or your business is about allowing yourself to be influenced by others and to collaborate with those where reciprocal elevation is available.

One way I’m doing this is by co-creating a course with a friend and colleague called “Secure and Thriving: A Nervous-System-Based Path to Healthy Love.” This project feels expansive and aligned with my values, but also my bandwidth. There’s hard work involved, of course, but because I’m doing it within the context of a richly nurturing friendship, there’s also laughter, play, and fun. These kinds of sustainable collaborations have taken center stage for me, right now.

I’ve also made the difficult decision to see fewer clients. I adore working with people one-on-one, and in an ideal world, I’d still see 25-30 clients per week. But this chapter of my life requires something different. Instead of pouring all my energy into the therapy room, I’m channeling it into work that reaches more people while also allowing me to be present for my family.

This change hasn’t been easy. Friction accompanies shifts in identity, but friction and tension contribute to growth and expansion. I remind myself that evolving my brand doesn’t have to mean losing what I love—instead, it can mean reshaping it. Right now, my brand isn’t about more. It’s about meaning. It’s about creating with intention, collaborating with care, and building something that sustains not just my career, but my life.

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When I think back on what I’ve done over the years to grow my work as a therapist and my business—which includes my couples therapy practice, my writing, and my social media presence—I realize that I often did the opposite of what many influencers tell people to do.

Many influencers encourage therapists to grow their income and build their practice by charging for almost any service, including speaking engagements and consultations. But as my online presence has grown over the last decade, I’ve taken an approach that might be counterintuitive. I don’t charge for everything, and this has helped me grow my income. Even now, after writing books, cultivating a large online following, and creating a successful practice, I still agree to free speaking engagements, offer consultations to other practices at no cost, and do pro bono sessions.

Of course, we all need to make a living. However, I’ve found that there are often opportunities—like connecting with others and lifting them up or taking a meaningful speaking engagement—that are priceless in many ways. In fact, it’s often the unpaid events that have had the largest impact for my career, even years later.

When I first started my practice years ago, I sold almost everything I owned so that I’d have the money to rent an office space and buy a new computer. I spent many nights cobbling together a website and learning the nuts and bolts of SEO. I also did a ton of networking to grow my clinical skills. I reached out to supervisors I admired (paying for their services with credit cards I knew I wouldn’t be paying off for a while), and drove all over the country to learn from experts I felt drawn to and maybe take them out for coffee, just to pick their brain and share a little bit of who I was.

I also held free workshops for churches and universities and shared my therapy knowledge on Instagram (before it was a thing). I knew many people didn’t really understand what couples therapy entailed, and I wanted to demystify it. Since then, my Instagram account has grown to nearly 300K followers. I’ve founded A Better Life Therapy, a group practice dedicated to helping people improve their mental and relational health. I’ve also written several books for couples and developed my signature couples weekend intensives aimed at helping couples get through crisis.

There’s a lot of noise out there claiming that therapists wanting to grow need to brand quickly so that eventually they’ll create an easy life for themselves where they’re simultaneously doing important work, enjoying lots of free time, and making loads of cash. But I’ve found that when it comes to growing professionally, that’s the exception, not the rule. Instead, I think we should be willing to make sacrifices and stay open to opportunities. Fortunately, that’s been the formula for success for me, and I’m grateful for where I’ve landed.

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Not long ago, my heart leapt the moment I saw the email in my inbox from my talent agent. “Please be a TV show, please be a TV show,” I whispered to myself as I clicked. It was! A network was looking for a therapist … yes … for a new television series … yes … on a major network … yes … about nude psychotherapy … no.

I’ve been building my brand as a public-facing relationship educator and clinician for many years, and I’ve had to learn how to practice discernment regarding partnerships. At the start of this journey, I was so grateful for any opportunity to get my name out there that I said yes to everything.

“Want to be a guest on my podcast?” Absolutely!

“Can you write a 500-word article for my website?” Of course!

“Can you come speak to my group of 30 people? We don’t have the budget for compensation, but it’ll be great exposure.” I’ll be there!

As my platform grew, so did the number of inquiries I received. Soon, I was feeling overscheduled and on the road to burnout. I quickly realized that my inclination to say yes to everything was going to lead me to a point where I’d have to say no to everything.

To prevent this from happening, I use a simple formula to rein myself in. I like to visualize the formula as a triangle with a question in each corner. Corner 1: Is it financially lucrative? Corner 2: Does it expand my audience? Corner 3: Is it an inherently fun, rewarding, and/or meaningful experience? To qualify as a potential yes, it needs to hit two of the three corners.

You should know that I have a love-hate relationship with this formula. Just like a budget keeps you from buying everything that looks cute at Nordstrom, and just like a portion keeps you from eating a full sleeve of Thin Mint cookies, this formula keeps me from straining my neck from nodding yes too much. This formula is both good for me … and a total buzzkill.

The nude psychotherapy show was a clear no, but another opportunity I recently had easily hit all three corners: creating a new series for MasterClass, called MasterClass In Practice. My yes wasn’t just about their enormous audience (4.2 million on Instagram?!) or the fact that I’d be one step closer to meeting my icon, Gloria Steinem. It was also about an opportunity to do what I’m passionate about—teach people how to practice Relational Self-Awareness—on a scale I can’t possibly reach on my own. Being part of the MasterClass faculty is a BHAG (Big Hairy Audacious Goal) for sure, a peak experience built atop thousands of my Instagram posts, blogs, talks, books, and podcast and media interviews.

Had I not implemented this formula years prior, I wouldn’t have had the bandwidth to say yes to this incredible opportunity. I wouldn’t have had the time or the mental energy to put together a quality curriculum. Saying yes to too many okay things would’ve forced me to say no to the really big, incredible thing. As I continue to grow as a public-facing clinician and thought leader, the triangle formula ensures that I keep moving forward and let go of things that no longer serve me.

Still, it’s never a perfect journey. Each next step is a risk. You may say no to something that takes off, leaving you feeling like you missed the boat (been there!), and you may say yes to something that ends up being largely a dead-end. What I try to come back to again and again is that each risk is a learning experience that teaches me and readies me for what’s next. Regardless of what happens, I feel sure I won’t regret saying no to nude therapy.

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Surprisingly, I was hesitant to embrace social media at first. I’d heard all the stories—clients talking about online arguments, blocking loved ones, feeling left out or overwhelmed. It didn’t sound like a space I wanted to be in. I dabbled here and there but never fully committed. For years, I didn’t have any social media apps on my phone and didn’t consider it part of my daily life.

I stumbled upon Instagram in the early 2010s and thought it was just a photo-editing app. I’d spend time tweaking images—editing and re-editing—without realizing it was also a platform to share content and connect. It wasn’t until a friend mentioned its broader potential that I created a public personal account.

At first, I didn’t use it much. But around 2017, I really started to pay attention to what clients were doing while waiting for their sessions: scrolling. I was trying to grow my group therapy practice at the time, so I decided to begin posting content. I didn’t fully understand all the features then and still don’t. My formula was to keep it simple: words I say to clients, placed on a plain background.

To my surprise, many of those words resonated well beyond the therapy room. I was featured in a New York Times article, “Instagram Therapists Are the New Instagram Poets,” and within months, my following grew from a few hundred to 100,000. Soon after, I published my first book, Set Boundaries, Find Peace, followed by Drama Free.

In the end, social media has given me a space to be more direct about what I think and see than I may be in sessions with clients, and that honesty isn’t always received well. I’ve gotten pushback in comments and DMs, like when I posted “Reasons Why Someone Might Ghost.” Some people were upset, thinking I was condoning the behavior when I was simply naming something many of us have done, myself included. After all, understanding why something painful happens can be more healing than pretending it doesn’t.

Beyond being a tool to humanize uncomfortable experiences, share insight, and stay connected to my community, social media has also helped me understand people more deeply. I read the long DMs people send—even the ones that begin, “You probably won’t see this.” I may not always reply, but I see them.

Sure, I still struggle with social media. I’m quick to block mean or harmful messages. I post a lot, then I remove Instagram from my phone to take a break. But for me, the value of social media lies in its potential to share joy, spark learning, and build community, and that’s where I try to keep my energy focused.

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How did a blue-collar kid from a poor New Jersey neighborhood not only end up a couples therapist, but writing books, consulting, keynoting, and traveling the world? It’s been quite the journey. I once told my wife, Belinda, that I was the Prince of Precarious Mobility.

Like many people raised in tough places, I had a few guardian angels who periodically reached down to grab me by the scruff and hoist me up. One of them was the legendary therapist Olga Silverstein. Even though she stood barely five feet tall and was well into her 80s when I met her, it was immediately clear that she was not to be messed with. Lower her into the therapy pit with wife-beaters, cheaters, and abusers? They didn’t stand a chance. As a young trainee in my mid-20s, I soon asked her to be my official mentor.

Ten years later, when we were both teaching at Smith College, Olga whispered in my ear one day, “Meet me under the bridge after dinner.” So I did. The meeting felt like a scene out of an old film noir. There we were, standing in the summer heat, shrouded in shadow. “I’m gonna change your life,” she said confidently.

She proceeded to tell me that I was going to write a book on male depression. Her agent had told her when she’d searched for books about male depression (which her husband had been suffering from), she’d found none—and saw an opportunity. “She’s got all sorts of famous therapists lined up to write this book,” Olga told me. “But I told her there’s this kid in Boston…”

“Olga, I’m a family therapist,” I protested. “I’m not one of those psychology types. I know nothing about depression. Why would I write this book?”

Olga shot me one of those steely, grandmotherly looks. “When I wrote my book, they gave me a $350,000 advance.”

“I’m in,” I said.

“Okay,” she replied. “But first, you’ll need to convince the agent this is your book to write.”

A few days later, on a flight to New York to meet the agent, I began to feel a crushing sense of shame. Who am I to write this book? I wondered. I’ve never studied male depression.

As far as I was concerned, male depression was the consequence of our cultural tendency to push boys out of connection, teach them to cut themselves off from vulnerability and feelings, and pull away from others. Depression was a relational disorder. Then, I had a lightbulb moment: Say that!

I grabbed a napkin and began scribbling. The cost of enforced disconnection in boyhood is a disconnected adult. Belinda made me save that napkin. Most of the ideas in my first book are on it.

Over my lifetime, I’ve had many teachers, colleagues, and friends who’ve influenced me professionally. But it was Olga who taught me how to transform a client entirely comfortable with an objectionable behavior or trait into someone with a permanent allergy to it. And while I’d dabbled in writing for decades, it was Olga who opened the door for me to make it a career.

Olga passed away in 2009, and I think of her often. I miss her tartness. She was an immigrant, a mother, a poet, and a genius. No one has ever wielded the therapeutic reframe the way she did, and no one ever will.

When I first met her, years before that fateful night under the bridge, I was a promising but paralyzed man who’d been struggling mightily to write for two years. “I know why you have writer’s block,” she’d said to me during one of our supervision sessions.

“Why?” I’d asked, desperate for the answer.

Olga leaned back in her chair. “Your parents don’t deserve to have a successful son.”

Clever, I thought, but I didn’t fully buy it. I thanked her politely but confessed that I thought her assessment had been a bit off. She just smiled and shrugged, as if to say, “What do I know?” Later, as I was about to catch a flight home to Boston, she called to say that while I’d correctly written her a check for that day’s session, I’d forgotten to sign it. “Interesting slip,” she said, “given our conversation.”

Annoyed, I continued on my way home. But a few weeks later, I began writing again!

Like a brash youngster, I once asked Olga if she believed her own reframes. “Do you think they’re really true, or just useful?” I challenged.

She shot me another one of her textbook tough, grandmotherly looks. “Well, it’s certainly more useful if you think it’s true,” she said, and quietly grinned, clearly pleased with herself.

I imagine Olga with God these days. I know she’s pointing out, with a shrug and in her strategically humble way, a thing or two that God just might want to look into—or not.

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The most significant factor in the development of my personal brand as a therapist has been my willingness to contradict established views and be seen as controversial. My early life struggles were often centered on others’ perceptions—especially as a woman of color growing up in environments where I longed to be like “everyone else.” Putting myself and my perspectives out into the world has rubbed up against pain points from my early history in ways that have exposed me to feelings of fear and rejection.

Perspectives I’ve been vocal about that might be considered polarizing include my belief that colonization and patriarchal structures have continued to distort our views of what constitute “healthy” and “normal” ways of relating to one another. I also believe a community-based model of healing, working, and raising families would reduce many of the challenges that exist within the current traditional nuclear-family ideal. And I’ve been quite vocal on social media, with clients, and within the groups I facilitate about the validity of mysticism, spirituality, and metaphysical principles—and the profound impact these practices have had on my own healing.

Revealing my honest thoughts on healing in a way that feels authentic has required me to embrace my difference like never before. I’ve had to accept that some of my colleagues won’t approve of the tools and frameworks I believe are crucial to our collective liberation during this tumultuous time. Ultimately, despite my fear of others’ judgement and rejection, my desire to take risks in my branding journey has led to the publication of my book, Sovereign Love and my podcast Cheaper Than Therapy, which I cohost with therapist Vanessa Bennett.

I’ve also been extremely fortunate to have friends and mentors whose career paths served as evidence that there’s more than one way for therapists to show up in this work. Speaking up about the impact of our cultural and historical context, and the ways it affects how we relate to ourselves and one another, has catalyzed deeper layers of my own healing and self-acceptance. The less I’ve concerned myself with being judged or misunderstood by others, the more I’ve been able to show up authentically. Over time, my perspectives have resonated with those meant to be supported by the work I do.

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One key thing I did recently to develop my brand as a therapist was intentionally center the intersection of trauma and neurodiversity in every aspect of my work—from clinical practice to public presence. While these have long been the core values of my approach, I realized that for my brand to reflect the depth of my mission, I had to make that intersection unmistakably visible, consistent, and unapologetically central.

This shift began with deep reflection on the values that drive my work within my therapy practice, Break the Cycle Trauma Center. I asked myself: What do we stand for beyond just high-quality care? What impact are we hoping to make on the field, not just on our clients? The answer was clear: We’re not just offering therapy, we’re reimagining what healing looks like when we center people whose minds have been historically misunderstood, marginalized, or pathologized. That clarity prompted me to take bolder steps in aligning our branding with our mission.

One of the biggest changes I made was revising how we talk about ourselves—not only on our website and social media, but in how we show up in conversations with colleagues, referral partners, and within broader public discourse. I led a rebranding initiative that made it clear: We’re a trauma-responsive practice that centers neurodivergent voices and experiences, and we’re committed to disrupting cycles of harm in the process. This meant using language that resonates deeply with our ideal clients and their communities—not overly clinical jargon, but affirming, liberatory language that invites people into a healing experience that feels safe and culturally attuned.

I also began training my clinicians through a new internal framework that integrates trauma-informed care, cultural responsiveness, and neurodiversity-affirming practices. This ensures that our brand isn’t just something we say—it’s something we live. Every therapist on our team is supported in embodying the values of our mission, which in turn makes our brand consistent, trustworthy, and impactful.

Branding, for me, is not about aesthetics or slogans—it’s about clarity, integrity, and alignment. It’s about ensuring that when people encounter our work, they know exactly what we stand for, who we serve, and why it matters. And that level of alignment is the foundation for both meaningful healing and lasting impact.

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On an unremarkable Sunday afternoon in 2019, my eight-year-old, K, texted me from her bedroom, which was one floor above me in the kitchen. She’d just gotten her first iPad, and she was obviously feeling giddy with her newfound messaging power.

“Mom?”

“Yes K.”

“Do people grow out of autism? Can they?”

“Nope. It’s not a disease or an illness. It’s just a unique brain. You can’t outgrow something that isn’t broken.”

“Ok, that was touching and informational.”

“Thanks for the feedback.”

While my kiddo has always had a propensity for deep, existential curiosity, the brain she was wondering about that day was her own. Years before I was an “autism expert,” and decades before my own late diagnosed autism and ADHD, I was a 30-something school social worker, single parenting two young and wildly different kiddos. K was my brilliant, creative, outspoken, dog-loving and very sensitive little girl, who introduced me to the world of what sure as hell didn’t look like Autism to me at the time.

She was chatty, adventurous, and socially fearless. She was walking at eight months and running two days later. She was potty trained by one and reading fourth-grade novels by five. K was truly a force of nature from the moment she entered my life, with a smile that could light up a room. It was unexpected and confusing to see such a small body ride a bike, spell words backward before she could read, and display a photographic memory of facts and details. Simultaneously, it was impossible to ignore the three-hour meltdowns after transitioning home from school, the anxiety she felt from the shock of having a substitute teacher, or the intense pain she seemed to experience when riding in the car or wearing shoes. K visibly had a nervous system that always seemed to be at odds with the world around her.

We’d spent years auditioning a rotating cast of helpers in an attempt to decode K. Our ever-evolving professional squad took us on a diagnostic tour that began with “everything seems normal,” went to sensory processing disorder, then ADHD, anxiety, and depression. Eventually, we arrived at autism.

While the “A-word” terrified many parents at the time, it felt like a relief to me. After all, the autistic kids on my caseload were my favorite ones. I didn’t initially see autism in K, but in the early 2000s, there wasn’t much talk of autistic girls. Her struggles and strengths seemed to make sense in this framework. So, I did what moms do: I became obsessed with learning as much about autism as I could, a decision that would eventually transform not just my parenting, but also my career, my relationships, and my approach to my own lifelong struggles.

Autism is genetic. This quest to understand K’s brain would lead me to understand mine. It was the BOGO deal of a lifetime. For the low price of one neuropsychological report, we changed our lives and redefined our entire lineage. Once I let go of outdated medical model frameworks and the white, cis male version of autism I’d been trained in, and once I saw autism as a neurotype rather than a pathology, it was like flipping on the lights in a room I’d been stumbling around my entire life.

Suddenly, my grandfather wasn’t cold when he avoided his entire family to build clocks in the basement on Christmas Day: he was overstimulated. My favorite family members weren’t rude: they were direct and unfiltered, which I’d always preferred. My childhood memories would reorganize themselves with clarity as my awareness grew: the sense of isolation, the intense passions, the struggles with relationships, and the lifelong anxiety. This new perspective didn’t heal the harm I’d suffered as a result of being misunderstood, but it reframed it. It didn’t rewrite the history of my trauma, but it contextualized it.

I’d come to see myself in this framing, not as a failed version of who I was supposed to be, but as part of a lineage—of artists, engineers, feelers, builders, creators, and “obsessors.” Some had thrived. Some hadn’t. But all of them had deserved to be seen and validated.

This understanding changed how I related to my daughter, my family, my clients, and ultimately myself. When I look back at that text from my daughter, I’m proud of how quickly I responded, and how sure I was of myself. But I’m even more proud that what I texted her was true. You can’t outgrow, heal, prevent, cure, or fix something that isn’t broken. You can only stop pretending that it is.

What’s Spreading Isn’t Autism

In 2025, K is a thriving teenager, well supported with academic accommodations, a network of friends, a newfound love of volleyball, and copious amounts of time at her job as a volunteer at the SPCA. Our love language is built on humor, capybara Tik Toks, and discussions of Love on the Spectrum. K knows who she is, and her neurodivergence is not one of the most interesting things about her. I don’t worry about how she views her neurodivergence, but I do worry about the hatred, ableism, and exclusionary mistruths that are being spewed all around us.

If anything is causing danger to our children and families, it’s the unraveling of progress. Just months ago, I was glowing with the buzz of palpable change. Federal agencies, large corporations, therapy practices, and treatment facilities were hiring neurodivergent consultants. They were hiring me. They were hungry for better interviewing practices for neurodivergent applicants. They took notes as I presented a steady stream of PowerPoints on how to create a neuro-affirming workplace. Managers were learning about sensory accommodations, better communication, ableism, and ways that all of us could make the workplace safer for ND brains. Therapists were finally getting trained to recognize autism in women and gender-diverse clients. After each talk, I’d receive emotional emails thanking me for making invisible struggles visible, for helping people feel seen.

And then, almost overnight, it stopped.

Those same initiatives have been gutted. In some federal spaces, you can’t even say the word inclusion. Training budgets for neurodivergent-affirming workplaces have dried up. My presentations for government employees have been canceled. At the FBI Academy in Quantico, the word diversity was removed from our core values and literally painted over on the walls. It was erased from a mural that once included words like fairness, compassion, and integrity. DEIA programs and Employee Resource Groups have been forcibly disbanded, as if equity itself became too offensive to name. My marginalized clients are under attack for being disabled, for being female, for being queer, for being trans, for needing supports. And now, the U.S. Secretary of Health and Human services—a man with no medical, psychological, or therapeutic training—is telling the world that autistic brains are tragedies.

My caseload of high-masking autistic adults is suddenly facing categorical denials of the accommodations that allow them to stay employed. These aren’t people in entry-level positions. My clients are physicists, linguists, engineers, computer programmers, app developers, intelligence analysts, cybersecurity specialists, architects, data scientists, and more. All highly specialized. All highly sought-after. All tax-paying professionals whose brains power critical systems. Oh, and they’re all Autistic. But they now risk being pushed out, not because they can’t do their jobs, but because we’ve begun denying them the ability to remain supported enough to work.

The Danger of “They’ll Never”

Control is a fallacy. Nobody can predict the children we’ll have, the people they’ll become, or the struggles we’ll face parenting them. Therapists often appreciate this unpredictability, and revel in the beauty of the kind of growth, resiliency, and hope people committed to showing up for themselves can find in the face of uncertainty. Hope may be the most valuable gift we can give our clients. And yet RFK Jr.’s recent declarations about Autistic children present them in a tired, outdated, “less than” view that’s not only wildly inaccurate, but incredibly damaging.

His exact words were: “Autism destroys families, and more importantly, it destroys our greatest resource, which is our children. These are children who should not be suffering like this,” he said. “These are kids who will never pay taxes. They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.”

This kind of language is cruel. “Never will” strips Autistic people of their complexity, their capacity, their self-determination, and their dignity. It paints them as burdens, not as full humans who deserve support, accommodations, and agency. And it’s the kind of language that historically precedes harmful policy. When we tell the world that a certain kind of brain is a public health crisis, we open the door to treating people with those kinds of brains as problems to be solved, rather than people to be understood and supported. Framing autism as something that “destroys families” reinforces outdated, ableist stereotypes. I’ve worked with hundreds of Autistic clients raising Autistic children, and I can tell you: our families are whole. Our lives are valuable. And our differences are not a tragedy.

If Autism is an “epidemic,” as RFK, Jr. says, what do you have to say about those of us who are thriving? For those of us with high-support needs, who live full lives with assistance, where do you draw the line of human value? What does baseball and toileting have to do with human value? Yes, some individuals need more support. That’s not just a reality of autism—that’s a reality of being human. Bodies and brains exist in many forms and capacities. None of us should have to prove our worth to exist. So let’s talk about funding, access, inclusion, and real services to support those who need it. But blaming environmental toxins or vaccines doesn’t get us any closer to helping actual people. It just distracts from the truth: Autistic people have always existed. We’re just finally being seen.

Autism is not caused by ultrasounds, food dyes, or pesticides. It’s genetic. This is not a fringe opinion, it’s a well-established, evidence-based reality that’s supported by decades of research. The rise in diagnoses reflects better awareness, expanded criteria, and the long-overdue recognition of Autistic people who were previously ignored, especially women, LGBTQIA+ folks, and those in BIPOC communities. We’ve been forced to seek our own care through social media and online spaces because far too often, our medical system is run or influenced by people like RFK Jr., and awareness, guidance, and resources are dangerously lacking.

Today, people flock to get diagnosed, often later in life, because they’re finding that diagnosis can lead to something transformative: acceptance, understanding, and accommodations. Everyone deserves to have what I was able to experience when I realized what autism actually meant for me. When I was able to look back at my struggles and successes through an autism lens, I didn’t just “find myself,” I found that I actually like myself. Not the masked self I presented to others in an effort to make them accept me, but the self I found when I stopped forcing my own conformity, the quirky, intense, creative, emotional, sensitive, fast-talking, always moving, forever thinking, nerd that I am. I like her. And when I welcomed her, I also found a framework to understand my challenges and, better yet, the tools I needed to navigate them. When neurodivergent brains learn to properly accommodate themselves, everything changes. Safety, connection, peace, and even success can be found in places many of us thought were off-limits.

For years, people thought the “full spectrum” of autism was represented in stereotypical, media-generated, male savants like Dustin Hoffman’s character, Raymond Babbitt in Rain Man, Sam Gardener from Atypical, or Dr. Shaun Murphy on The Good Doctor. But autism in women and other non-male genders is often undetectable to the untrained eye. Their Autism, and mine, is hidden in layers of careful mimicry and an intense focus on “fitting in.” Many Autistic women and gender-diverse adults learn to blend in so well that they don’t even realize they’re assimilating. We’re often trying to survive in a world that feels confusing, unfamiliar, and “off,” but we’re told it’s us who needs fixing. With understanding, we can often find empathy—for ourselves and from others.

Autism isn’t new. It was never caused by vaccines. Neurodivergence is a part of your genetic wiring, and this is the reality of your human experience from the day you’re born. In essence, it’s caused by your grandpa—the straight shooting business owner/professor at Georgetown, who loves woodworking and reading, and doesn’t get all caught up in his feelings,” who married your grandma, who has a pottery studio in the backyard, makes her own wool yarn from sheep on her farm, becomes an expert in dozens of unique types of crafts, and then goes on to breed rare Australian dogs. That’s where it’s from: your family.

Autistic adults, like the forementioned ones in my family, are regularly called quirky, unusual, a little off, emotionally immature, narcissistic, bipolar, borderline, OCD, addicts, and weird. All of these labels detract from the fact that they were born neurodivergent. Before they were “off,” before they picked up a drink, before they took on unique hobbies, puns, and obsessive interests, their brain was different. Some unique brains become famous; some die by suicide because the world has repeatedly and relentlessly failed to support them. And as helping professionals, we haven’t been trained to identify or support these brains. Instead of developing evidence-based practices to prevent neurodivergent burnout, mental health crises, or the worst case, suicide, we’re diverting the attention to places where we’ve proven it doesn’t need to go: debunked theories of autism that serve a distinct financial purpose.

The Epidemic We Should Be Naming

Theodore Woodward, a medical researcher and Nobel Prize nominee, famously said to his students at the University of Maryland School of medicine, “When you hear hoofbeats, think horses, not zebras.” He wanted to remind them that doctors should prioritize obvious and common explanations before considering rare and unusual ones.

Autism is no longer a mysterious anomaly of the human condition, whispered about only in the halls of special education. What we once thought of as a rare zebra is actually a common horse. But here’s the thing: we neurodivergent people might be everywhere—we’re the business owners, the CEO’s, the scientists, the doctors, the therapists, the government agency leaders, the public speakers, the entertainers, the authors, the comedians, the creators, the tech gurus, the code writers—but we’re also burning out, dropping out, and dying at higher rates than our neurotypical peers. The difference between those of us who thrive and those of us who don’t often comes down to one thing: accommodations. Autistic people are not a puzzle to be solved. We’re a population to be supported with funded services, inclusive classrooms, and neurodiversity-affirming care.

The push to find a single environmental culprit to explain the prevalence of autism—mold, pesticides, vaccines, or air pollution might seem like science-driven curiosity, but it’s rooted in the belief that our existence requires an explanation, and better yet, a villain. Sure, there are complex interplays of genetics and environment that shape every human brain, but don’t dress up fearmongering and call it advocacy. If there’s an epidemic afoot, it’s that of misinformation paired with the death of empathy. I am not an epidemic. My family wasn’t taken out by a wave of environmental toxins that made us anxious and socially unique, any more than mold gifted us our brilliant minds and creativity.

Further complicating an already concerning situation, this administration is now proposing the creation of an Autism Registry to “track the disease.” Let’s be clear: this registry is not about research, services, or support. It’s about monitoring and control. The Autistic community is terrified.

So, here’s my promise, and I hope others will make it theirs, as well: I’ll keep doing what I do best. I’ll keep offering safety, acceptance, accommodations, and real support to my family, my clients, and my community. I’ll also be pushing back, right alongside every single passionate helper in the Autistic community, on every harmful, misinformed word RFK and others like him speak from behind podiums, now, and for as long as we need to.

We are raising the first generation of Autistic kids who know they’re not broken. We are healing Autistic adults who are learning they never were.

We are not a disease or illness. We have unique brains. And we can’t and don’t need to cure or outgrow something that isn’t broken.

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What if you were living a parent’s worst nightmare, and despite all your efforts to intervene, your child was slipping into a deadly world of drug overdoses, physical violence, and child predators? After exhausting all other options, would you subject your child to a treatment that could save them, but could also expose them to danger and trauma? Would you make that choice?

Will Claxton did. Which is exactly how he found himself gripping a cold parking garage railing and peering over the edge, watching as the two chaperones he’d arranged for led his 15-year-old son toward an unmarked van below. Claxton hadn’t made this choice lightly. It had come after 14 months of trying to handle his son’s growing list of offenses: stolen credit cards out of mom’s purse, illegal drug purchases in the seedy corners of cyberspace, stints of disappearing from home, and threats of suicide.

A long list of mental health professionals had been enlisted to help, but even their best efforts fell short. “When he hit me,” Claxton explains, “we asked for inpatient therapy.” Still, the problems persisted. “Soon, I was in therapy,” Claxton continues. “I was on an SSRI. My wife was on an SSRI. Somehow, our son wound up in charge of the family. We were just trying to make it.”

One day, seconds after his son left for school—and neglected to lock his computer—Claxton bolted up the stairs to his son’s bedroom. It wasn’t long until he found something that sent a shockwave through his entire body: provocative messages between his son and someone who was clearly a child predator. This was the last straw. Claxton picked up the phone and arranged for his son to be taken to the wilderness therapy program he’d found online a week earlier, where he’d spend months under strict supervision, with barely any contact with the outside world.

Now, looking down from the garage, Claxton held his breath and waited to see if his son would go willingly. Would he try to run? Would he fight? He knew that at a moment’s notice, the situation could take a dark turn: the chaperones had been authorized to take him away by force, if necessary. “These people are going to take you to your new school,” he’d told him minutes earlier, as the van had pulled up. “I love you, and I hope this helps you.” His son had stood silently, frozen in place as Claxton drove away.

There’s nowhere to go now but up, he’d thought. This is the strongest medicine we can provide—and if this doesn’t work, nothing will.

Then, it happened: by some stroke of luck, his son willingly got in the van. Claxton felt a surge of relief as it drove off, quickly replaced by trepidation. Now what?

More Harm Than Good?

Wilderness therapy may sound benign enough. But although it’s a well-established industry with decades of history, these programs have also been operating under the radar and largely unchecked, attracting an enormous amount of controversy over accusations of duplicitous marketing as well as dangerous—and sometimes deadly—practices.

A branch of what’s often referred to as the troubled teen industry, which includes facilities like youth residential treatment centers, boot camps, and therapeutic boarding schools, wilderness therapy programs have been used to treat at-risk adolescents and teenagers for over half a century. There’s a shortage of public information about these programs, but there are estimated to be between 25 and 65 operating in the United States today, with about 12,000 children enrolled annually. Most of these programs have three components: they take place in nature, involve overnight stays, and include group activities, usually under the supervision of mental health professionals.

Wilderness therapy programs are well-suited to “children who offend,” notes a 2022 study from the National Institutes of Health, as they “offer excitement and perceived risk, which meets the desire for high arousal.” They “promote peer relationships, emphasize community collaboration, and offer the opportunity for the development of trust, effective communication, and problem-solving abilities.” A 2022 meta-analysis published in the journal Criminal Justice and Behavior calls them “a potentially effective tool for addressing delinquent behaviors among youth,” and “a promising form of diversion programming.”

But since becoming popular in the 1970s, wilderness therapy programs have been marred by countless accusations of child abuse, including kidnapping and false imprisonment, forced labor, stress positions, strip searches, solitary confinement, and psychological abuse. At least 10 deaths have been attributed to wilderness therapy programs, the most recent occurring in a North Carolina program last February, where a 12-year-old boy died less than 24 hours after arriving at camp. His death was later ruled a homicide, from “asphyxia due to smothering.” Days later, a woman filed a lawsuit against the same organization, saying she’d been sexually assaulted by a fellow camper in 2016.

Even when these programs aren’t causing overt harm, many people question whether they’re as therapeutically informed as they claim to be. Some employ no therapists, or only hire them as consultants, while others employ clinicians who are underqualified or improperly trained to work with high-risk youth. Although bills to regulate troubled teen facilities have been proposed in Congress every year from 2007 to 2018, nearly all of them have failed to pass.

Additionally, there’s virtually no regulation within the industry, with no governing body or licensing board that dictates how these programs should be run or by whom. The National Association of Therapeutic Schools and Programs (NATSAP), a self-governing membership organization founded in 1999, does offer “best practices” as well as “ethics and values” recommendations for programs, but has no jurisdiction over those that aren’t members—and notably, it’s previously opposed legislation seeking to impose health and safety standards.

It turns out that some of the most successful efforts to reform wilderness therapy programs have been spearheaded by former attendees. In 2023, Netflix released the documentary Hell Camp: Teen Nightmare, which interviews survivors of the infamous Challenger camp, which came to prominence in the 1980s and included a 63-day, 500-mile hike through the Utah desert. “[The campers] were emaciated, they were dirty,” says one witness interviewed. “You couldn’t even tell they were kids.” One of the most prominent reform advocates has been Paris Hilton, who’s spoken publicly about the abuse she suffered during her 11-month stay at a Utah troubled teen program in the 1990s, where she was reportedly beaten, subjected to strip searches, and force-fed medication. Appearing before the Utah State Legislature in 2021, Hilton’s testimony helped pass a bill that increased state oversight and required documentation of the use of restraints.

“No child should experience abuse in the name of treatment,” she told reporters afterwards.

It’s hard to understand why any parent would send their child to a wilderness therapy program after hearing horror stories like these. But every year, thousands of them, like Claxton, take this leap of faith. Why?

A Most Desperate Hour

“When one learns to live off the land entirely, being lost is no longer threatening,” wrote Larry Dean Olsen in his 1967 book Outdoor Survival Skills. A flinty, bearded outdoorsman, widely considered the father of modern wilderness therapy programs, Olsen cut his teeth leading failing college students from his alma mater, Brigham Young University, on month-long expeditions across the Utah wilderness throughout the 1970s. Taken with the success of the recently founded Outward Bound, Olsen and a handful of collaborators soon decided to create their own wilderness program, only theirs would have a more defined treatment element. The wilderness, he wrote, could be incredibly transformative: It bred “survivors.”

“A survivor possesses determination, a positive degree of stubbornness, well-defined values, self-direction, and a belief in the goodness of humankind,” he wrote. “He does not fear pain or discomfort, nor does he seek to punish himself with them.” In Olsen’s mind, the wilderness wasn’t just restorative; it was curative. Hardship built character—especially in those he dubbed “comfort-oriented individuals.” With Paul Bunyan-like spirit, Olsen implored his followers to “rise above the comfort-seeking,” to tame themselves in wild acts of self-sufficiency and self-discipline.

Over 50 years later, Olsen’s message still resonates in wilderness therapy program marketing. Websites left and right are peppered with images of flannel-clad hikers, winding trails, fog-capped mountains, and luminous foliage. There are photos of smiling children and facilitators, and hands gently placed on shoulders. There are phrases like healing hearts and rebuilding trust. And your son or daughter isn’t “violent” or “addicted,” they’re maladaptive. It’s easy to see how a parent, in a moment of desperation, might think to themselves, Hey, this place doesn’t sound half bad.

But by the time they start considering a wilderness therapy program, many parents are also reckoning with a hard truth: “the system had failed us,” as Claxton says. By the time he began looking, his son had been to every mental health practitioner imaginable. He’d seen therapists, psychiatrists, and a pediatrician. He’d been to hospitals and outpatient facilities. One clinician treated his ADHD. Another tried body work. And another worked on minimizing his suicidal thoughts. But the problems continued. Claxton says he knows why. “Nobody worked together, so nothing was getting fixed,” he explains. “I was at my wit’s end.”

This is exactly what wilderness therapy programs are banking on: families are burned out, disillusioned, and feel like they’ve exhausted all other options. Many parents know deep down that these programs aren’t perfect, or that their agendas are opaque, but for those in crisis, they feel like the only option—which is why they charge a fortune, critics say. Wilderness therapy is a multibillion-dollar industry—worth $300 million in Utah alone, where many programs are based.

“It’s a money-making machine,” says therapist Kate Truitt. “It’s a franchise, like McDonalds.” A trauma and resilience specialist who estimates she’s worked with roughly 30 wilderness therapy campers and their families over the years, Truitt says that many of these programs begin with “good hearts and hopes” but eventually get corrupted by money and prey on parents’ desperation. “They have the marketing machine behind them,” she says, “and they’ll use search engine optimization to home in and describe someone’s child to a tee: If your child is doing this, then you need to intervene immediately, otherwise they will die or they will end up homeless.”

For parents like Claxton, the promise of relief in exchange for fistfuls of cash is a no-brainer. He says his son’s program cost about $400 a day, totaling almost $50,000 with transportation and gear. “We were fortunate,” he says, “but most people don’t have 50k sitting around. I’ve heard of parents taking second or third mortgages on their house to pay for this—and we would’ve if we’d had to.”

A Subtle Kind of Trauma

Therapist Britt Rathbone says he empathizes with parents who find themselves in Claxton’s position. “We have a mental health delivery service problem in our country,” he says, “and a lot of the time, it’s not visible.” In the ‘80s and ‘90s, “you might’ve sent your teen to a local psychiatric hospital, where a team could tinker with medication and see how they responded while providing good therapy. That doesn’t happen anymore, and these programs have emerged in their absence.”

But Rathbone says wilderness therapy programs are often a poor and dangerous substitute. In his 40 years working with “difficult to treat” adolescents and teens, including about two dozen who’ve been to wilderness therapy, children almost always return from these programs with some form of trauma. There are obvious traumas to process, like when Rathbone worked with a teenager who’d witnessed a fellow camper’s suicide, but there’s another, more subtle kind of trauma these children often experience.

“They frequently come back with an acute stress reaction that’s very similar to PTSD,” he says. “The way you get out of these programs is compliance. They say, ‘If you do what you’re told, you’ll get out—and you will not leave here until you do.’ It’s like how people talk about ‘breaking a horse’—getting it to comply. In a sense, these kids are broken. And many of them were already distrusting of adults to begin with. Can you imagine how much angrier and distrustful this would make you? It’s heartbreaking. It’s unconscionable and unacceptable.”

There’s little about these programs that even constitutes treatment, Rathbone adds. Learning how to live in the wilderness doesn’t translate to being able to function back home. And in many instances, he says, program facilitators ignore diagnoses and resort to one-size-fits-all behavioral interventions. But even if treatment is ineffective, Rathbone says parents can be reluctant to call the experience a failure.

“It’s hard for parents to admit,” he explains. “They’ve spent tens of thousands of dollars on this, and when their kid calls and says, ‘Get me out of here,’ the staff tell them it’s a normal response. What are they supposed to think?”

Other parents, Truitt adds, struggle with deep shame after their child returns home from wilderness therapy, wrestling with the fact that a choice they made has caused their child immense harm and pain. “Many times there’s a massive and sometimes irreparable rupture between parents and children,” she explains, “where the work becomes holding the space for that grief and loss, those feelings of responsibility and failure.”

But therapy with these families isn’t just trauma work as usual, says Truitt. “There’s incredible attachment disruption, and their sense of self has been deeply harmed. Some campers are recruited as enforcers, or do things they would normally never do to another human being because it’s the only way they know how to survive, so there’s a moral injury, too, which is such a tender wound. On top of this, the mental health providers who were supposed to help them were often a big part of the harm, so by the time they come to us, there’s a significant level of distrust and guardedness—and I fully respect it. I get it.”

Helping kids process trauma and parents untangle the truth of their wilderness therapy experience can be a long, complicated process. But Rathbone says therapists are often consulted by parents before they enroll their child in a wilderness therapy program, which presents a good opportunity to propose something similar to what inpatient treatment used to provide 30 years ago: “a reset,” as Rathbone calls it.

“We’re looking for containment,” he explains. “We can do that by removing the stimulus, the thing that’s creating the child’s problem, whether it’s the peer group or an illegal substance. The hope is that we get them in a different environment where we can see what’s really going on with them. That’s when parents realize it’s not just a matter of ‘my child just doesn’t listen.’”

Rathbone acknowledges that these resets are hard to come by nowadays, since effective, care-focused inpatient hospital stays are no longer widely available. But this doesn’t mean that wilderness therapy—which he says promises this kind of reset in its slick marketing and sleek websites—is necessarily the answer.

Still, some parents may ultimately choose wilderness therapy anyway, and Rathbone says that’s their right. “I tell them they’re going to have to make their own decision as a family,” he adds. “Our job is to help them look at the potential benefits and risks. But those of us who work with kids and teens can give them a less varnished view.”

One of the Lucky Ones

Will Claxton’s son spent four months in wilderness therapy, where he was grouped with seven other teens, including one who’d been addicted to meth and another who’d killed a family member. Within two weeks, six of the campers had tried to run away—and were quickly caught. After all, they were in the middle of nowhere. But Claxton’s son wasn’t one of them.

Every day, the teens and facilitators would hike, make camp, cook dinner, and clean pots. “We intentionally make the day boring,” one of the coordinators had told Claxton. This was shock therapy, in the sense that life suddenly became very simple for these boys. “That’s when you start working on yourself,” Claxton says. “The day becomes all about solving your problems.”

On Tuesdays and Thursdays, Claxton’s son would meet with his assigned therapist, who’d rendezvous with the campers along their route. Participation was expected, but not obligated. There was homework, too. Every Wednesday, the therapist would relay to Claxton how his son was progressing. A month in, he was doing well.

Claxton’s only direct communication with his son came through letters. And slowly, he says, those letters began to show more introspection. “He wasn’t mad at the world, and he wasn’t angry,” Claxton recalls. “Maybe it was the writing, or the therapy, or because he was working on things.” Maybe, he thought, there’s hope after all.

Ten weeks into the program, Claxton and his wife were offered the chance to see their son in-person. So they got in their car and drove eight hours west. When they arrived at the camp, they were shocked by what they saw. For the first time in years, Claxton says, his son was thankful. “I’m not ready to go,” he said. It was a moment of catharsis, a light at the end of the tunnel. “He starts crying, I’m crying, mom’s crying,” Claxton recalls. They snapped a photo together, which now hangs on Claxton’s refrigerator. One month later, their son had graduated from the program.

Today, Claxton’s son is 16. He’s at a boarding school, where he’s on the honor roll, well-liked by his teachers, and interested in a career in computer science. He’s not completely through the woods yet, Claxton adds, but the darkest days are behind them. “He was a smoking ball of fire,” he says, “but now, he will launch.”

So what happened? Why did this wilderness therapy story have a happy ending? Claxton thinks back to the morning his son was taken away. “I’d heard that the deciding factor for kids’ success in therapy is their relationship with their parents,” he says. “Maybe I just want to believe that, but I like to think that on that morning, there was still a piece of him that knew he could trust his dad, and that as he went through the program, he still trusted us.”

The research backs this up. According to a 2021 study in the journal Child & Youth Services, campers are likelier to have positive experiences after treatment based on their experience with involuntary transport. “I have seen these programs be effective when the child has some willingness,” adds Rathbone. “Some of these kids basically get kidnapped, which is a trauma criterion. We know that therapy works when we have buy-in.”

Claxton acknowledges that he’s one of the lucky ones. Yes, wilderness therapy is a poorly regulated industry, he admits, and yes, there are some horror stories. “But I think that paints a broad stroke on an industry in which there are a hell of a lot of people doing a lot of good,” he adds. “Without them, a lot of kids are going to fall through the cracks.”

Truitt says parents who are contemplating wilderness therapy for their child need to do one thing and do it well: research. “Call around,” she says. “Call therapists. Ask them about the program beforehand. Call that program. Ask them about other programs. The marketing is really good, and this can feel like the answer, especially when we’re fearful.”

With its checkered past and ongoing problems, is there still hope for wilderness therapy? Some signs indicate it may be turning a corner. In December, the Stop Institutionalized Child Abuse Act, a bipartisan bill that aims to protect children in residential programs, was signed into law by President Biden. That same month, the National Association of Therapeutic Schools and Programs (NATSAP) merged with another membership organization, The Outdoor Behavioral Health Council, to provide a more robust oversight body.

As for Claxton, he isn’t shy about sharing his story, and hopes it will inspire other struggling parents to keep the faith. But there’s also a weariness in his voice, a lilt that only comes from going through hell and back, and living to tell the tale.

“Wilderness therapy is a little like Fight Club,” he says. “You usually don’t talk about it unless you’re with a parent whose kid was also in wilderness therapy. This isn’t something you advertise. It’s something you’re incredibly happy is behind you, and you’re ready to move on.”

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Ahh, 2025. A new year! A chance to shake off the rust, leave the December doldrums behind (we can think of a few things we’d rather forget!), and charge bravely over the horizon. But what lies ahead? When it comes to your practice and the future of the field, the last thing you need is more uncertainty. Well, it may not exactly be soothsaying, but we drummed up the next best thing: we sat down with five therapy superstars, including Steve Hayes, Ruth Lanius, and Nadine Burke Harris—each with an ear to the ground in their respective fields—and got the inside scoop on the hot clinical developments you won’t want to miss in the coming year.

Nadine Burke Harris on the Revitalization of Trauma-Informed Care

Will We Resist the Urge to Return to Business as Usual?

Former California Surgeon General Nadine Burke Harris predicts that 2025 will bring a lot more talk about trauma, particularly childhood trauma.

As a pediatrician and public health clinic founder, Burke Harris has spent nearly two decades studying adverse childhood experiences (ACEs) and the toxic stress response, which refers to the prolonged activation of the biological stress response that disrupts brain structure and function, hormonal systems, the immune system, and even the way that DNA is read and transcribed. Over the years, she and her team have trained more than 40,000 healthcare providers on how to screen for ACEs and respond with evidence-based, trauma-informed care.

In 2025, she hopes more people will effectively mobilize against ACEs. That means more primary care physicians will be able to handle early detection—and loop in more therapists to assist with treatment. “Therapists create the time and space to unpack which ACEs a patient has experienced, how it’s impacting their mental and behavioral health, and what to do about it.” Which begs the question: what’s the most effective intervention for addressing the dysregulated biology that results from ACEs? Is it a new med? Or perhaps a flashy piece of wearable tech?

Neither, actually. Burke Harris says that good old child-parent psychotherapy is a perfect intervention, and that it’s experiencing a renaissance for this reason. “The research shows that it not only improves outcomes for young children when it comes to distress, anxiety, and attachment, but that it can actually improve genetic markers of stress reactivity,” she explains.

“In 2010, I traveled to Haiti as part of a relief mission after the earthquake,” she shares. “Some of the buildings were still standing, and looked safe on the outside, but they were seismically unsafe. If we don’t want to deal with even bigger problems downstream, now is the time for a seismic retrofit in terms of how we’re treating childhood trauma. I’m seeing a lot more communication between primary care and mental health providers,” she says, “and that’s a great place to start.”

Ingmar Gorman on the Psychedelics Rematch

After a Series of Setbacks, Will MDMA and Psilocybin Finally Find a Foothold?

For a good while, it felt like 2024 might be The Year of the Psychedelic—until it wasn’t. Last summer, numerous media outlets (including this magazine) held their breath as biopharmaceutical company Lykos bandied with the FDA, eagerly awaiting the coronation of MDMA-assisted therapy as a legal treatment for PTSD. Anticipating good news, clinicians flocked to psychedelic-assisted therapy trainings, and patients felt a bright hope for a new treatment option. Then, in August, the sobering news arrived: it’s a no-go, said the FDA.

Well, not a total no-go. According to the FDA’s response, more research on safety and efficacy is needed. And in 2025, psychologist Ingmar Gorman speculates, Lykos will figure out how to address those shortcomings and regroup for another—hopefully more fruitful—round of FDA deliberations. Gorman, who trains mental health providers in psychedelic treatments as the co-founder of psychedelic education company Fluence, notes that a key factor in creating more convincing data will be determining what role therapists might play in MDMA-assisted psychotherapy.”

Wait, the FDA cares about therapy? Yup.

“It’s fascinating to me,” Gorman says. “The FDA is stepping into a debate that’s been in psychotherapy for 40 years, except they don’t use terms like evidence-based practice or empirically supported treatment. They think more along the lines of the current standard of care.” Will the psychedelic-assisted therapy research hinge on using something seemingly complementary with MDMA, say, a nondirective approach, or will a treatment like prolonged exposure be used? “That’s a big question,” Gorman says. “And I think in 2025, Lykos will have a protocol that determines what the study looks like.”

But plot twist: the first big psychedelic to get FDA approval may not be MDMA after all, but psilocybin. A number of drug companies, most notably Compass Pathways and Cybin, both of which have been studying psilocybin for depression, will likely be submitting the results of their own Phase Three studies for FDA approval soon. Keep your eyes peeled, Gorman says.

In the meantime, it’s tempting to view the FDA as an annoying speed bump en route to greenlighting what many study participants, covert clients, and more than a few therapists have found to be a life-changing experience. But Gorman says it’s important to keep in mind that all this caution and protocol is in the interest of public safety.

“There are companies that say psychedelic-assisted therapy comprises a synergistic effect between the psychotherapy and the drug,” he explains. “Then there are other companies that don’t include psychotherapy or psychological support, even though there might be therapists monitoring in the study room. My worst nightmare is that a psychedelic would get approved with the bare minimum ‘monitoring,’ and then outside the lab, people won’t experience benefit—or may even be harmed because they’re not getting enough support alongside it. This will be addressed by research, but in my view, it’s quite risky.”

Ruth Lanius on the Promise of Stabilization

How Will We Address One of the Hardest Parts of Trauma Treatment?

According to trauma expert Ruth Lanius, a scientist at the London Health Sciences Centre Research Institute and a psychiatrist at the London Health Sciences Centre who’s been studying trauma for almost 30 years, the key to effective trauma treatment is helping clients reach a mind-body state where they can begin to absorb the treatment—“grounding and stabilization,” as she calls it. And she says the momentum around several stabilization interventions will continue to grow in 2025. “We’re at an incredibly exciting point in our field,” she says. “I’m seeing more trainings about stabilizing and grounding before delving into the deepest pain of trauma than ever before. It’s the most excitement I’ve witnessed in my entire career.”

Lanius says one of the most common ways to stabilize a client is to help them “find solid ground.” Most therapists know it’s important to help clients “ground,” but don’t focus enough on it. Trauma survivors are naturally fearful and resistant to grounding since they use detachment as a survival mechanism. “But if you’re disconnected from your feelings and your body, you can’t pick up on danger,” she explains. “We help clients understand that grounding will help them feel safe, that it’s the only way to be truly safe in the world.”

Lanius is particularly excited about the use of videos for stabilizing and grounding interventions. “In our studies, we found that people would go back to their videos over and over again,” she says. “It makes sense: when you’re highly dissociative, you often don’t remember what went on in session. We got feedback from some clients that they’d return to their videos at two in the morning!”

Then, there’s neurofeedback, another intervention that can be used for stabilization. “Neurofeedback brings us home to what trauma is really about,” Lanius says. “Trauma has adapted the brain, which controls the body, so survivors live with the feeling of inescapable threat.” But neurofeedback targets those brain adaptations directly, Lanius adds, quieting the brain and guiding it to safety—a feeling most traumatized brains have never known. “When you experience trauma, you’ve lost all control,” Lanius says. “But when you’re changing how your brain is firing, second by second, you start to feel like you’re in control again.”

These stabilization techniques don’t just streamline therapy for clients, Lanius says. They make it smoother for therapists, too. “These are complex individuals,” Lanius says of the clients. “Many engage in self-harm, or substance use, or they’re severely depressed, suicidal, or dissociative. It’s a population that can make us feel helpless and hopeless.” But stabilization and grounding techniques, she adds, reduce all of these symptoms—and increase self-compassion, which she calls a critical part of reducing the shame and self-loathing that so often accompanies trauma.

Could stabilization and grounding be the shot in the arm that trauma therapy’s been missing? Lanius thinks so. “You can feel the collective excitement around this,” she says. “People have had profound experiences that are propelling these treatments. There’s interest, and there’s hope.”

Steve Hayes on Rethinking Everything You’ve Been Told About Diagnosis

Tearing Down the DSM, Treating the Individual, and Why We’re Losing Therapists to Coaching

When it comes to the DSM, Steve Hayes doesn’t mince words: “When I say I want to kill it, 90 percent of clinicians agree,” he says. “Signs and symptoms and syndromes are so yesterday.”

As a clinical psychologist, professor of psychology emeritus at the University of Nevada, and the co-developer of acceptance and commitment therapy (ACT), you might think Hayes has his hands full. But even at 76, he remains committed to a singular mission: “I’ve spent 40 years trying to hack the human mind,” he says, “trying to do the most good for the most people.”

At the forefront of Hayes’s hackathon has been an effort to take down the much-maligned DSM—and to put in place a fresh, client-centered, whole-person model that does more than boil clients down to walking, talking bundles of symptoms. We’re long overdue for such a model, Hayes says. But hey, he adds, 2025 is as good a year as any for it to catch fire.

“We need to prioritize bio-psycho-social change processes instead,” Hayes says of his ideal diagnostic model. “Whether you’re talking about healthy attachment or emotional acceptance abilities or being able to form healthy relationships or the therapeutic alliance, these are all processes of change.”

So what does this look like in therapy? It’s simple, Hayes says. “We need to ask our clients what the heck is going on in their lives. We help them learn how to be more open, aware, and actively engaged in a meaningful life, extending that to their relationships and taking care of their bodies. Then, those processes need to be focused on where they will do the most good.”

One way Hayes is championing this process-based vision is by making the body more central in treatment. For example, he says, between 15 and 25 percent of adults have ringing in their ears, and a quarter to a half are significantly distressed by it. Many say it’s the most distressing thing in their lives. But this is information they’ll rarely share with a therapist, nor will clinicians ask about it, because as far as they’re concerned, it has nothing to do with therapy. “But of course it does,” Hayes explains. “And research shows we can apply the very processes that help someone with anxiety or substance abuse to the ringing in their ears, or the pain in their foot, or the limitations they’re facing because of an injury or cancer.”

Is a seismic diagnostic shift underway? Hayes thinks so. More therapists and clients are beginning to think outside the diagnostic box—or jumping ship entirely. “This is why so many therapists want to be coaches,” he adds. “They don’t want to put people inside tiny little boxes.” A therapist may not be a pain expert, Hayes says, but they can help the client redirect attention from the pain. They can ask about sleep, or diet, or exercise when doing intakes. As for clients? “They want to stand up during sessions and do something physical. We’re already beginning to see a move toward the holistic. It’s a natural extension of what we do.”

Steve Duke on the Hope for Teletherapy Apps

As Tensions Over Pay, Support, and Mission Come to a Head, What’s Next?

There’s a popular stereotype when it comes to teletherapy apps: they’re morally corrupt juggernauts run by shadowy suits and slick, Silicon-Valley tech bros who prey on fresh-out-of-grad-school therapists and pay them a pittance, reducing the art and soul of therapy to ones and zeroes.

Steve Duke doesn’t contest that there are flaws in how some teletherapy companies run their business. Yes, in many cases, therapists’ grievances over pay, workload, and company ethics are justified. But the truth, he says, is less black and white—and in 2025, therapists and these organizations may finally find common ground.

“All the books on my bookshelf are about mental health,” Duke tells me. “I find it fascinating.” It’s unsurprising for someone who was transformed by therapy after being diagnosed with OCD at age 11. Years later, after working in the health tech space, Duke decided to apply his knowledge toward the profession that changed his life as a young boy. Today, he manages and writes for The Hemingway Report, an online publication that tracks the business happenings in the mental health world, including those involving therapy apps.

Historically, therapists on these apps have felt disempowered, Duke says. “There’s been a lot of tension bubbling under the surface for quite some time.” But he also says he’s excited and hopeful that this tension will get resolved soon. “I think these platforms are starting to understand just how important therapists are to their business,” he says. “They’ve experienced the pushback from parts of the therapy community, and the more forward-thinking ones are starting to change their behavior, whether through better compensation or provider tools, like scheduling or note-taking functions that make it easier for them to do their work—which will also be good for clients.”

But Duke says some teletherapy platforms are going a step further, providing services he playfully refers to as “a therapy practice in a box”—so that therapists can get their own businesses off the ground, practice the type of therapy they want to practice, and see the kinds of clients they’re most interested in supporting. “Companies that promote this kind of therapist empowerment are growing rapidly,” Duke says. “It’s a really interesting trend.”

Will other companies continue to take advantage of clinicians just trying to make ends meet? Sure, Duke says. “I definitely see some of these companies lacking adequate clinical guidance. And we should hold them accountable. But we shouldn’t paint all therapy businesses with the same brush. We should be assessing them based on their actions and outcomes, whether they’re doing the right thing for clinicians and patients.”

Tension between therapists and platforms will linger in the year ahead, Duke anticipates, but he’s hopeful we’ll be hearing more positive stories too. “I see a bunch of organizations taking different approaches to support their therapists, and many of those therapists are happy. That gives me hope,” he says. “They’re putting clinicians first: they have them as cofounders and on their leadership teams. Therapists are speaking up about what isn’t working, and many of these businesses are listening. They have to. As long as people are talking to each other, I’m hopeful that things will get better.”

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Listening to podcasts has become a worldwide pastime, more so than watching TV, tossing a ball around in the backyard, or even reading a magazine or book. And hosting your own podcast seems to be almost as popular an activity for many therapists as listening to them. For listeners and creators alike, podcasts of all kinds can provide a bevy of mental health benefits.

With so many to choose from—and recommend to clients—finding the right one to enjoy can be challenging. The best podcasts offer validation, creative solutions to common problems, and new perspectives on current issues or events, often garnished with a healthy dose of humor. We asked six therapists for their listening recommendations. Here are the ones that made the cut.

Laughing It Out

As a fan of comedians and how they think, the You Made It Weird podcast ranks as one of my favorite podcasts. The host, Pete Holmes, is hilarious! When he’s most on point, you can hear my guffaws echo throughout the house. But he’s also highly intelligent and sincerely interested in a broad range of topics. One week, he’ll interview a fellow comedian; the next, he’ll feature an author on Stoic philosophy. A week or two later, he’ll talk to a rabbi or Neil DeGrasse Tyson. Pete asks the kinds of questions that push for real depth and insights, and he has the kind of vulnerability and relatability that makes listening feel like you’re sitting around enjoying coffee with a good friend.

Another good one is Good One: A Podcast About Jokes with Jesse David Fox. E.B. White apparently once said, “Explaining a joke is like dissecting a frog. You understand it better, but the frog dies in the process.” Fox disregards this warning and devotes Good One to deconstructing jokes with many of the best comedians in the world. With all due respect to E. B. White, even after they’ve been picked apart, the jokes remain funny!

Pro tip: According to research, laughing before bed helps us sleep better.

Adam Dorsay, PhD

In-Depth Therapy

I love being a work-a-day therapist and seeing clients. But for those times when I’m looking to tap into my inner grad student and dive into some of the more challenging topics in the field, David Puder’s cerebral but engaging podcast Psychiatrist and Psychotherapy Podcast always gives me with something to chew on.

Popular enough to now have 220 episodes that cover topics like the unconscious, free will, the Goldwater rule, and the finer points of psychiatry treatment, Puder’s show leans into areas I already appreciate, like depth psychology and existentialism, and expands my understanding of topics like psychopharmacology and ethics. He has plenty of his own wisdom to bring to discussions of these topics but invites experts in to unpack them with him.

When I listen to the conversations he’s had with Judith Beck, Jonathan Shedler, Steven Hayes, and many others, I not only gain deeper insights into their perspectives, but get tips and inspiration for how to frame my own interviews for Psychotherapy Networker’s Point of View column.

Ryan Howes, PhD, ABPP

Cozying Up with the Nervous System

Sarah Baldwin’s podcast You Make Sense is one of the most skilled somatic experiencing practitioners I’ve heard discuss her craft. She has a real gift for helping people understand and work with their nervous systems. I’m loving her new podcast, where she helps clients feel less alone, confused and stuck by making sense of their psychology.

I’m also a fan of All There Is with Anderson Cooper, a podcast that focuses on grief. I love how brave and honest he is about his own grief. His interviews will help anyone who’s grieving feel less alone.

Vienna Pharaon, LMFT

Unpacking the Enneagram

As an enneagram teacher and practitioner, I’m a big fan of the Fathoms podcast, helmed by Seth Abram and several other bright and creative co-hosts (Seth Creekmore, Lindsey Marks, and Drew Moser), who do a brilliant job of guiding us into the deeper aspects of applying the enneagram’s ancient wisdom to help ourselves and clients. The wide-ranging conversations and interviews with experts in the field of spirituality, psychology, and the enneagram do an excellent job of taking the conversations far beyond type.

Katie Gustafson, MA, LPC

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It’s 7 p.m. on a Thursday evening, and I’m at an intersection, jogging in place. Typically, urban dance music motivates me to exercise, but I’m not in the mood for music. I’m in the mood for wise words, which I’m hoping a podcast called Wiser Than Me will provide.

Earlier in the day, my doctor informed me that my breast biopsy had come back positive, and I have something called ductal carcinoma in situ—a precancerous condition that required surgery and possibly radiation. The news has unsettled me. I’m disoriented and my body feels strange—like it belongs to someone else. All of a sudden, the familiar identities of writer, spouse, mother, and therapist don’t fit. I’m a person with cancer, now.

Soon, I’ll need to call or text friends and family members, have emotional exchanges, answer questions, schedule an MRI appointment—but not yet. The thought of putting my news into words gives me vertigo. The problem with sharing something scary with other people is that it makes the scary thing true. As long as I can keep it to myself, then it might still be a mistake—a false positive. Plus, I can’t imagine talking about what’s happening, how I’m feeling, or what I’m going to do about it. How would I begin? “I’m scared of dying”? That’s not an ice-breaker—it’s a conversation killer. What I can do, though, is go for a three-mile run around my neighborhood. I can listen to a podcast.

A couple of weeks ago, I saw an Instagram reel of Julia Louis-Dreyfus—of Seinfeld and Veep fame—giving an acceptance speech at the 2024 Webby Awards after Wiser Than Me was selected for Best New Podcast. She holds a trophy, leans toward a mic, and proclaims, with perfect comic timing, “Listen to old women, motherfuckers!” That’s what tipped me off to her latest creative venture, in which she interviews accomplished women who’ve lived a long time and gotten wise from their experiences.

I’ve always known older women are a national resource, one that’s widely underappreciated and underpaid. In every field, in every culture, throughout history, older women have always been unsung spiritual leaders, social change agents, community activists, shamans, healers, nurturers, and public servants. In a youth-and-beauty-obsessed culture, “Listen to old women, motherfuckers” should be a perennial crie de couer. This evening, for me, it’s more than that. It’s personal. I need to hear older women talk about crises they’ve faced and overcome.

In the podcast, Julia Louis-Dreyfus has interviewed dozens of accomplished older women like actress and comedian Carol Burnett, fashion designer Diane von Furstenberg, blues singer Darlene Love, The Joy Luck Club author Amy Tan, and feminist icon Gloria Steinem. When she and her guests talk to each other, they generate a free-floating sense of shared sisterhood—like an all-girls slumber party for women aged 50 to 90. There’s an intimate, conversational flow to the episodes, and it’s easy to forget I’m listening to a recording as I run down a street. I commiserate, wince, laugh.

This evening, I choose an episode with writer Anne Lamott, who’s 70.

Lamott and Louis-Dreyfus talk about aging and different parts of their bodies hurting. Then Lamott says, “By a certain age, we’ve all had unsurvivable losses, right? And I know how you come through them. I know what helps, and I know what doesn’t. Platitudes and nice little Christian bumper stickers don’t help. What works is that you show up, and you sit with a person, and you’re willing to feel like shit with them, and you don’t try to get them to feel any better than they do for as long as it takes.”

This, I realize, is what I’ve tried to get better at as a therapist for most of my career—the art of feeling like shit with people—particularly when my clients are in the white-hot center of a frightening situation, like the one I’m facing now. I’ve always tried to settle into the shared emotional experience of another person’s pain without losing myself in it, but also without jumping to fix it. Just sharing a shitty feeling with someone you trust can be incredibly healing. But it’s hard to share shitty feelings. It’s natural to want to get rid of them, in yourself and others. Right now, listening to older women discuss love, regret, illness, aging, ambition, sex, and death is my way of being with my own shitty feelings.

Now and then, I’ve wished Louis-Dreyfus pushed her guests to go a little deeper with their answers than they do, but then I’ve reminded myself she isn’t a clinician in session intervening with a client. She’s riffing, chatting, and drawing people out. It’s entertainment. There’s joy in quirky, funny moments—like when 82-year-old Isabel Allende, bestselling Chilean-American author of House of Spirits, talks about eating marijuana-infused, chocolate-covered blueberries before getting frisky with her younger husband. There’s tenderness in sad moments—like when 90-year-old actress and political activist Jane Fonda, who starred in films like On Golden Pond—admits to regretting the kind of mother she was. Burdened as women are by outsized societal expectations, what mom can’t relate to that?

I’ve reached the top of a steep hill and rounded a corner. Finally, I feel a little lighter. The endorphins are kicking in. White panicles on a crepe myrtle tree by a local Dunkin’ Donuts have exploded into bloom. For a moment, I marvel at the pleasure of swinging my arms, lifting and lowering my legs, and feeling the sidewalk slap my feet in a way that carries me forward through space. A benefit of fearing death is appreciating life.

Lamott and Louis-Dreyfus talk about how difficult it can be to write a book—an assessment I agree with, having written a few self-help books over the course of my career. Lamott says E.L. Doctorow—the novelist and professor who wrote Ragtime—compared the book-writing process to driving at night with the headlights on: “You can only see a little ways in front of you, but you can make the whole journey that way.” I stop mid-sidewalk, tap the arrow that rewinds the episode, and listen again. It doesn’t just apply to book-writing, I realize. It applies to everything. Do we ever see more than just a little ways in front of us? I don’t think so, although our mind is good at tricking us into thinking we can plan out our entire future. So maybe I can refocus on looking just a little ways ahead of me now. Maybe I can make my whole upcoming cancer journey that way, whatever ends up happening.

“If you could go back in time,” Louis-Dreyfus asks Lamott, “is there something you’d tell yourself at age 21?”I’ve heard her ask other guests this same question. Jane Fonda’s answer was: “No is a complete sentence.” Gloria Steinem’s was: “It’s going to be all right.” Isabel Allende’s was: “Be compassionate with yourself.” My favorite was author Fran Lebowitz’s. She said: “At 21, I’d tell myself, ‘Whatever you do, don’t buy that first apartment.’” Now it’s Lamott’s turn to answer. She says, “I’d tell myself, you are so beautiful as is.” Of course she’s right. All of us are. We just don’t always see ourselves clearly.

The podcast ends with Louis-Dreyfus ringing up her 90-year-old mom. Endearingly, at age fifty-five, she still calls her “mommy.” The two review highlights from the episode, one of which, Louis-Dreyfus shares, is WAIT, an acronym for “Why am I talking” that helps Lamott resist the compulsion to tell her grown son how to live his life. I remove my AirPods, slip them into my pocket, and walk up the front steps of my house. Am I wiser having listened to all that? Probably not. But I’m in my body again, and that’s a good thing.

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Therapists may not don red capes, or thwart bank robberies, or travel faster than a speeding bullet, but that doesn’t mean we aren’t superheroes in our own right. We occupy a special place in the world, one that separates us from nearly all other professions. Like any caped crusader, we’re helpers. In our case, we rescue people from emotional peril when few else will answer the call.

And we have our own superhero’s trusty utility belt—our modalities, frameworks, theories, interventions, and intentions, which we can strategically deploy in the face of awful anxiety, dastardly depression, treacherous trauma, sneaky shame, and slippery self-doubt.

But the truth is we may not always feel like superheroes, especially when our connection with clients gets frayed or we’re on the edge of burnout. Perhaps that’s when it’s time to remember a few of the ways we continue to stay strong and put our superpowers to work every day!

Stretching to Fit the Situation

Different clients need different things. And when you’re seeing clients back-to-back, the mood and issues you’ll face can shift at a moment’s notice. Like Elastigirl from The Incredibles, therapists can instantly stretch and shift when responding to clients’ emotions. And they do it all while drawing from myriad tools, skills, and observations.

We might go from helping a teenager explore his depression in one session to helping a business manager speak confidently in the next. We might see parents, siblings, couples, or thruples. We might help someone role-play coming out to their mom in one session, then jump right into another session where we’re coaching a belligerent dad on how to keep calm. Yes, the diversity of this work can be fulfilling, but the variability requires that we be continuously alert and ever-flexible.

Assessing Situations with Alacrity

Most people mired in a concerning situation or conflict are naturally myopic. One of the powers that an objective observer like a therapist can bring to the table is a bird’s-eye view of the situation. By stepping back and considering the context, we can come up with more informed solutions.

While a friend or family member might provide some helpful perspective, therapists are better suited to the task, as they regularly rise above conflicts to get the bigger picture. We recognize clients’ patterns, take note of symptoms that could inform a diagnosis, and stay attuned to potential problems that could ensue if the client continues on their trajectory. We may not have ESP or a crystal ball, but we do have special skills that allow us to assess situations calmly, carefully, and objectively.

Weaving a Powerful Web of Knowledge

Just like Spiderman, we have webs at our fingertips—webs of knowledge, that is. We can deploy psychoeducation at a moment’s notice. But we can deploy something much simpler but no less significant: all the interwoven details we hold about a client’s life.

We can remember the name of a client’s family member, or the fine details about a recent loss, or a song that brings them to tears. We hold on to the metaphors our clients use, their bucket lists and dreams, the places they’ve lived, and the company they keep. The little, random details we remember are expansive, and this remembering is a significant superpower that helps us connect with clients in authentic, meaningful ways. Yes, notes may help us refresh our memories from time to time, but most of us could probably create a detailed genogram for any client we’ve seen for a while.

As impressive as this might be, it can also be daunting to hold so much information about our clients’ private lives. As Spiderman’s Uncle Ben once said, “With great power comes great responsibility.”

Wielding a Lasso of Truth

We hope our clients will be open and honest with us in sessions, but research shows that dishonesty is quite rampant in therapy. Wonder Woman wielded the Lasso of Truth, which magically compelled people to tell the truth. We don’t, can’t, and shouldn’t have this power, yet we aim to create an environment that’s safe, nurturing, accepting, and positive, which fosters trust and truthfulness on its own.

When we learn that a client has been dishonest, we tend to respond differently than others in their life: often, we’re much more interested in the reason for the fib than in shaming the client or getting defensive. We understand that people respond best to compassion and gentleness. And we know that some clients need to move more slowly than others when opening up, which requires us to be patient and persistent.

It might be more accurate to call what we have The Lasso of Dedicated Space, which helps us create an environment where clients can feel comfortable being their authentic selves.

Being a Time-Keeper Extraordinaire

Many professions follow strict schedules, but therapists have an interesting and complex relationship with time. Most of us have developed a fairly accurate sense of how many issues we might cover in a single session, when to practice a new set of skills, or whether we have the time to provide more multifaceted feedback about a particular issue. We might ask a complex question at the start of a session but then glance at the clock later on to decide whether we have enough time to delve even further.

In some sessions, time seems to move slowly, which can be either torturous or terrific. Meanwhile, other sessions feel so speedy that, by the end, much feels unfinished or undiscovered. There are myriad factors that impact the speed of the session, including the client’s personality, emotional openness, communication style, comfort level, and the stage of the work. But like the Flash, who darts quickly to-and-fro, we’re often using time constraints as a means of figuring out how to maximize our impact.

Casting Spells of Self-Care

Although we do need our boundaries, it’s often that we do our best work when we’re immersed in it. But the longer we’re immersed in it, the more we tend to feel fatigued and strained. Just as Hermione Granger from Harry Potter was a magical prodigy who could conjure up a spell to deal with the most dire situations, we therapists conjure up ways to address our immediate needs.

We pay attention to the signals that let us know when we’re getting close to expending the last of our energy, and we develop self-care strategies like strategically scheduling certain clients at particular times. We use both micro- and macro-level self-care, everything from eating lunch outside or sitting in a comfortable chair, to making ventral-vagal maps. These spells of self-care can evolve as our life or caseload changes, but using them regularly allows us to stay active and effective.

Taking on the Role of Sidekick

In the end, the real superheroes are our clients. They are the ones who’ve summoned the bravery to come to treatment, to face their fears, conflicts, and stuckness. At the end of the day, they are the ones who have to confront their problems. They are the ones who draw from what they’ve learned with us to grow and respond to difficult situations.

They might express gratitude for our help or try to give us all the credit, but we know that they are the ones who ultimately did the hard work. Just as Robin used his keen detective skills and acrobatics to help Batman fight crime, we help the main characters in our offices—the ones out in front—take down their own emotional villains, whatever they may be. And from the sidekick role, we celebrate our clients as they learn to stand proud and summon their own inner superheroes.

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By the time my wife and I arrive at the DAR Constitution Hall venue—well in advance of tonight’s scheduled event—the chaos has already begun. Messy lines of people sporting their evening finest—pressed checkered shirts, buffed tan loafers, and sparkling sequined dresses—coil around the building’s classical Roman columns, guests twisting and bumping into each other like well-dressed salmon moving upstream. This is Washington, DC, a town that prides itself on order and discipline, but by the time we squeeze into the nearest throng, it feels more like a Bowery punk rock mosh pit.

For nearly half an hour, nobody, it seems, can find a way inside—until, finally, a handful of ushers dressed in black and white emerge, scattering like sheepdogs to extricate us from our heavily perfumed scrum and guide us into the warm confines of the venue lobby.

“I need a drink,” my wife says flatly as we pass through a pair of metal detectors, making a beeline for a nearby bar cart. I wince as she comes back with a pitifully small cup of vodka tonic, $16 poorer. But I hold my tongue. After all, it’s date night.

Once we settle into our seats, my heart rate begins to slow. Soft pink and purple lights cast a gentle glow over the crowd. Guests chatter between sips of wine, eyes scanning the stage for any signs of life. I’ve been to my fair share of rock concerts, and this feels like a rock concert. But tonight’s main attraction doesn’t shred guitar like Jimi Hendrix or strut like Mick Jagger. And she’s not a rock star—at least not in the traditional sense. She’s a therapist.

Suddenly, the lights dim and a voice bellows through the loudspeakers above. “What you are about to experience,” the voice says, “is a night with Esther Perel. It’s a night where everything can be said, and nothing can’t be said.”

Then, the woman we’ve all been waiting for appears. Esther Perel. The Esther Perel. Couples therapist, New York Times bestselling author, TED Talker, podcast host, enneaglot (that’s fluency in nine languages), and Millennial-whisperer. A slayer of the sleepy dragon that is boring therapy.

Perel glides to the front of the stage with a megawatt smile, radiating a hip, Nouveau York sophistication. There’s the trademark pantsuit—dove-white, a web of golden bangles splashed across her right hand, and a stylish, slightly asymmetrical haircut. If Coco Chanel was reincarnated as a therapist in 2024, she might look a little like Esther Perel.

As Perel waves to the crowd and the crowd roars back, I can’t help but think of an old Beatles documentary I saw years ago, in which a raptured concertgoer sobbed, “I can’t believe I’m breathing the same air as the Beatles!”

I can’t believe I’m breathing the same air as Esther Perel, I think to myself. And that’s when I realize it: I’ve fallen under her spell.

A Star (and Then Some) is Born

Perel’s eight-stop U.S. tour, “An Evening with Esther Perel: The Future of Relationships, Love, and Desire,” which began in April and runs through September, has been a massive hit, packing concert halls with thousands of starry-eyed fans. Of course, a large part of this success is due to Perel’s intelligence, wit, and charm—and some very savvy marketing. “Join Esther for a 3,000-person group date,” her site reads, “to talk about topics we usually only discuss with the lights off.”

But that doesn’t fully explain the Esther Perel phenomenon. How has a therapist captured the public attention to the point where she can sell out concert venues—where people will line up in the cold and buy tiny, $16 cocktails—to hear her speak about relationships, of all things? When did therapists become celebrities? When did mental health become entertainment?

It’s undeniable: therapy is having a moment right now. In March, crowds packed the Syndey Opera House for a discussion on trauma from Bessel van der Kolk. And last year, trauma and addiction specialist Gabor Maté sat down with Prince Harry for a widely televised interview. But some experts say the surge in public interest in mental health is due to the fact that our society is in particularly bad shape, and therapists are in high demand. Nine out of 10 adults believe the country is in the throes of a mental health crisis, according to a 2022 survey from CNN and the Kaiser Family Foundation.

Young adults, research suggests, are hurting the most. According to the American Psychological Association’s 2023 Stress in America Survey, 58 percent of adults ages 18 to 34 say that most days, their stress is “completely overwhelming,” the highest among all age groups. Most say they’re especially worried about the economy, housing costs, discrimination, global conflicts, and climate change.

So perhaps it’s no surprise that young adults have been the catalyst in a resurgent demand and appreciation for therapy, and are helping dismantle stigma in the process. Even pre-pandemic, the 2019 Stress in America report showed that a higher percentage of young adults had received mental health care than all previous generations.

These digital natives are also the driving force behind the rise of clinicians who’ve achieved minor—if not Perellian—levels of fame on social media, enticing viewers with colorful, musical, easily shareable, bite-sized videos that deliver their thoughts on everything from intergenerational trauma to romantic relationships to autism self-diagnosis. Some clinicians have gained hundreds of thousands of followers and millions of views in the process. Therapy has become such a juggernaut on TikTok that the hashtag #mentalhealth has garnered over 75 billion views, and even received its own honorific from the online masses: TherapyTok.

But although public appreciation for therapy may be at an all-time high, some say the concept of the celebrity therapist isn’t really all that new. “In the 1960s and ’70s, therapists had a powerful influence on the culture,” says therapist Bill Doherty, emeritus professor at the University of Minnesota’s Marriage and Family Therapy Program. “There were psychologists like Irvin Yalom who wrote bestselling books, and Hollywood therapists like Dr. Ruth who became household names.” That interest waned, Doherty says, until the arrival of the internet brought new, exciting, and profitable branding opportunities that put therapists back in the public sphere.

But Doherty says there’s a difference between today’s celebrity therapists and those who came before. “In the old days,” he explains, “people would see videos of Salvador Minuchin or Virginia Satir in session and think, Wow, how’d they do that? Now, they’re more impressed with the therapist’s charisma than their clinical skills. The older clinicians had charisma too—and many of today’s therapists are very talented—but these predecessors were exemplars of teachable models, and people built entire institutes around them.”

What’s Your Story?

Perel may be a therapist for the modern age, but she’s also studied under some of family therapy’s biggest icons, namely Salvador Minuchin. Listening to her speak, their influence is clear. Not only does she exude clinical wisdom, but she also deftly brings complex concepts down to earth, not only demystifying and normalizing therapy, but helping people see the connection between what unfolds in her office and what’s happening in their own lives—whether they’re in therapy or not.

“When people come to see me,” she says, slowly pacing the stage, “they come with a story. And each of you has come here with a story about your relationship. Sometimes we hold so tightly to our stories that we confuse them with the truth.” Then, she issues a challenge: “This evening, I want you to bring nuance to your story. What do you want to leave behind? What do you want to change?”

It feels as if Perel has reached into the crowd and grabbed ahold of my heartstrings. These are questions I’ve never been asked before, let alone bothered to ask myself. What is my story, exactly? I wonder. What would I change?

Perel continues to captivate, effortlessly cool and instantly quotable. “We have never been more free, and we have never been more alone,” she opines. She condemns our culture of “emotional capitalism,” where relationships have become reduced to swiping and ghosting and alchemizing people into bundles of statistics as we size them up against other potential mates. “We drown at a thousand options at our fingertips,” she declares. “Do we want too much? No, but maybe we want too much from one person.” I look around the room and see dozens of attendees frantically taking notes, trying to keep up.

Later, the evening takes a particularly emotional turn when Perel asks us to take out our cell phones. “I know this is unusual,” she says, “but certain things are easier to talk about in the dark.” Suddenly, the pink and purple lights fade, and the room turns to black.

“If sexuality was central in your upbringing, turn on your flashlight,” Perel’s voice calls out. Slowly, the room begins to brighten, as hundreds of tiny bulbs flicker to life and throw shadows across the audience. This really is a rock concert! I think to myself. “Now, if it was hidden, forbidden, or obfuscated,” Perel says. Another several hundred lights appear. “If sexuality was violated or misused or abused.” More lights. “And if there was infidelity in your family life.” Even more. There are some whispers of amazement, but otherwise, the arena is silent as we linger in a moment of collective awe and vulnerability.

“Okay,” Perel says with a smile. “Put your fetishes away.”

The crowd chuckles, the lights twinkle and fade, and we brace for what comes next.

Careful What You Wish For

For decades, therapists have been imploring the public to recognize the value of therapy. But now that society has embraced it more fully, if not vigorously, have we reached a tipping point?

David Bowie said it well: fame is a fickle thing. So maybe it’s no surprise that a therapy countermovement seems to be brewing. In recent years, much criticism has come from the conservative right, from the likes of Fox News and Breitbart, who not only argue that psychotherapy has become too bloated, too drunk on its own power, and turned a generation of Americans into fragile, therapy-dependent victims, but that it’s actually the source of our mental health crisis—that we’re only more anxious, more depressed, and more traumatized because therapists have enabled us to be.

In a 2022 publication from Clinical Psychology Review, a handful of mental health professionals referred to the simultaneous growth of therapy and society’s mental health problems as “the treatment prevalence paradox.” Despite the increase in services and public awareness, “mysteriously, the general population prevalence of depression has not decreased,” they wrote, blaming an epidemic of “misdiagnosing distress as depression,” greenlighting ineffective treatments, and bias in clinical trials, among other things.

It might seem easy enough to dismiss these voices as radical outliers, whose wacky ideas could never really gain traction. But they, too, have platforms and book deals and speaking engagements. They have an audience, and that audience is listening.

Take the Sounds Like a Cult podcast, which recently wound up on Spotify’s Top 50 chart, in which host and author Amanda Montell called social media therapists an “emerging cultish group” and a “pending threat” that’s “manipulating our culture.” Or Abigail Shrier, one of the loudest critics of late and the author of Bad Therapy: Why the Kids Aren’t Growing Up, released earlier this year.

“Nobody has gotten more therapy than the rising generation,” she said in a March Fox News interview. “No one’s had more psych meds. No one’s had more talk about feelings. No one’s had more therapeutic parenting, therapeutic intervention in school, and social-emotional learning. And you know what? It’s not doing them any good.” Therapists, she continued, are claiming, “‘Oh, we’re just the firemen. We’re just responding to the fire.’ Not true. They’re the arsonists. They’re the worry-makers, and they’re creating the problem.”

Of course, some therapists disagree. “To say that therapy is the source of our so-called mental health crisis is laughable,” says therapist Scott Miller, co-founder of the International Center for Clinical Excellence. “And the reason I think it’s laughable is because it overestimates the power of the very simple, cultural-bound activity that is psychotherapy. Its theories are embedded in the culture, and if you look back, you can see how the dominant themes and concerns of each era—like trauma and oppression today—were adopted and utilized by therapists.”

But Miller says many people—clinicians included—overestimate therapy’s role and responsibilities. “It’s a little bit of hubris and narcissism that we continue to talk about psychotherapy as if it’s this hugely potent thing,” he says. “That’s not to downplay the impact it can have on people’s lives. But to assume it’s the cause of all these problems is not only laughable, but dangerous. It puts us at the center of the universe, and we’re not.”

Are celebrity therapists part of the problem? “I see humility every day in clinical practice,” Miller says. “But I see no humility in our thought leaders. The big talking points are all about how great we are, and how we’ve finally discovered the essence of true helping. I think it’s holding us back.”

Beyond Four Walls

It’s said that history repeats itself. And sure enough, the cultural criticism of therapy feels like familiar territory. In his 1992 book We’ve Had a Hundred Years of Psychotherapy—and the World’s Getting Worse, psychologist James Hillman leveled critiques oddly similar to what we’re hearing today: “People are getting more and more sensitive,” he wrote. “We’re disempowering ourselves through therapy.” Treatment, he continued, had become “sedation: benumbing, an aesthesia” designed to suppress pain and worry instead of helping clients learn to grapple with it.

As long as therapists are in the public eye, Doherty believes therapy will always experience some sort of blowback. “I think it’s inevitable that mental health professionals will influence the culture through our work,” he says. “And I’m okay with celebrity therapists. It’s a big mistake to think we should only operate within the walls of the therapy room. That’s missing the idea that we’re also citizens of a larger community.”

But how are therapists supposed to manage the public’s great expectations, especially when so many people are suffering and clinicians have the knowledge and tools to help?

“It’s a challenge,” Doherty says. “There are people who might want to see you because you’re a celebrity, or the director of a big therapy program or city clinic, not necessarily because you’re the best therapist for them. I’ve known celebrity therapists who stopped practicing because clients were expecting quick fixes or bowing down in front of them, and it was impacting the therapy. But you have to manage that just like anything else. It doesn’t mean you can’t do good, ethical work: you just need to be aware of the dynamics and take responsibility for your influence.”

Magic, with a Grain of Salt

Perel is no stranger to the responsibility—and controversy—that comes with fame. Over the years, she’s been described as “a provocateur” (Elle magazine), accused of “trivializing the scourge of infidelity,” and “inspiring wariness and even hostility among some of her colleagues” (The New Yorker). But listening to her onstage, it becomes clear why she’s managed to emerge largely unscathed. Perel may be all the things—likeable, smart, stylish, and eloquent—but she’s also incredibly self-aware, self-effacing, and humble.

As the night winds down, she agrees to take questions from the audience. Dozens of people line up behind strategically placed microphone stands, many with questions about their own relationships, and visibly nervous. Perel doesn’t accept many new clients nowadays, so for these lucky few, this is a rare, valuable moment. There’s the feeling that whatever bite-sized, uber-quotable morsel of knowledge Perel will offer can be tucked in your back pocket forever, that it won’t just fix whatever problem you’re dealing with, but feed your relationship for a lifetime.

Yes, Perel gives these people answers—good answers—but she also does exactly what Miller and Doherty say a good therapist should do: she doesn’t overpromise. She couches her responses in the fact that she, like the rest of us, is only human.

“People come to me and say, ‘How do I know if I’ve found the one?’” Perel says. “My answer is, ‘How the fuck should I know?!’” The audience laughs. “I cannot give you a clear map to a destination,” she tells us. “All I can offer you is the scenic route paved with bumps. I don’t have tips, but I do have invitations.” Later, another moment of humility: “Do not confuse longevity with success,” she says. “I sound confident, but I am sure of nothing.”

One woman in the audience asks Perel what advice she’d give a new clinician. “You can’t be good for everybody, and the fit matters a great deal. How good are you at what you’re doing apart from the modality? This or that model doesn’t matter. I used to lose sleep for three weeks when I made a mistake. Now I’m very good: it’s three days.” The audience laughs.

In July, Perel posted a short interview on her Instagram page, in which she was asked about her journey from therapist to thought leader. “I sat in the office for 34 years,” she says. “I didn’t set out to become a thought leader…. I feel that the role was bestowed upon me, that it’s people who chose me as one of their teachers in this moment where there’s so much confusion and chaos around relationships.”

Before Perel departs, she leaves us with one last nugget of wisdom, and it’s perhaps the most valuable of the night. “I tell my clients a good session isn’t just what happens in my office,” she says. “It’s what happens when you leave. And the same applies here.” Perel may have given us much to ponder, but what we do with that knowledge is up to us. She’s put the power in our hands. And that’s an incredible gift.

Will therapists continue to surf the celebrity wave? And if so, how long will the ride last? Surrounded by Perel’s starstruck fans, I entertain the thought of a future where therapists walk at the front of ticker-tape parades, where they grace movie screens and stand on podiums with medals around their necks. Who knows? Maybe one day we’ll have a therapist in the Oval Office.

I can’t predict the future, but one thing’s for certain: I wouldn’t be where I am today without a certain celebrity therapist in my own life. Bruce, who I first started seeing in elementary school, used to close every session with a silly, spirited farewell: “As they say in my native Timbuktu, Good day, sir!” he’d exclaim with an outstretched hand. It wasn’t always Timbuktu—sometimes it was Bangkok or Baghdad or Casablanca—but it always made me smile, even on sad days.

Years after parting ways, we met for an emergency session after a devastating college breakup. As I wiped away tears, he promised me that one day I’d meet the woman who’d be my future wife, that one day we’d find ourselves in the middle of a crowded restaurant, slow-dancing to our favorite song. I just shook my head in disbelief. “I’m telling you, man,” he said. “It’s gonna happen.”

That was 16 years ago, our last session. If I could talk to Bruce today, I’d tell him he was right. Some of the best celebrity therapists, I know, don’t stand on a stage. They’re not on talk shows, bestseller lists, or magazine covers. Besides their clients, nobody knows how skilled they are, nor likely ever will. But to the people they’ve helped, they will always be stars.

Once Perel has finished, the applause is thunderous. She takes a graceful bow and exits, and my wife and I stand up from our tiny, cramped seats and stretch. I put my hand in hers, take a deep breath, and we both smile. We have so much to talk about.

ILLUSTRATION © ZETHX

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You’re watching that series again?” my spouse asks, passing through the living room where I’m huddled on the couch with a box of Kleenex. “How many times is this?”

“I don’t know,” I confess. “Three?” I love watching stories about psychological healing in which there’s no therapist present. They showcase a type of resilience that’s organic to humans and that sometimes we therapists forget is there in the midst of all our fancy techniques and inventions.

The award-winning FX series Reservation Dogs, which concluded last year after three seasons, is more than another heartwarming comedy-drama about teenage friends, like Derry Girls or Sex Education, which I also loved and watched more than once. It’s more than another brilliantly acted, expertly scripted, character-driven story about the coming-of-age journeys of hardscrabble but adorable youth. As a psychotherapist who’s treated trauma survivors for over three decades—steeped in the rational-empirical constructs of a white, Western medical establishment—the stories of Bear Smallhill, Elora Postoak, Cheese Williams, and Willie Jack Sampson have taught me something about the power of community, myth, and spirituality in healing trauma. These Indigenous characters and their beloved elders reframe our relationship to past and future, a shift essential to trauma healing that many Western-trained therapists like me often miss.

“This is Daniel,” 16-year-old Bear tells us in the first episode, gesturing toward a photograph of a smiling teenage boy. Played by D’Pharaoh Woon-A-Tai, Bear is the self-appointed ringleader of the Rez Dogs. “He died last year. We’re having a memorial for him in a couple days. RIP MY DAWG.”

Contemporary conventions of storytelling—what The New Yorker’s Parul Sehgal has called the trauma narrative—sets us up to expect that the story we’re about to enter will unfold from Daniel’s suicide and its effects on the surviving Rez Dogs. But Reservation Dogs overturns those expectations.

“This place killed him,” Bear adds, referring to Okern, the impoverished reservation town in the Muscogee Nation in Oklahoma, where the Rez Dogs live. “That’s why we’re saving our money, so we can leave this dump before it kills us too.” The show, then, is not about an isolated tragedy affecting one individual, but about the youths’ relationship to place and history. Daniel’s suicide—likely compounded by a struggle with bipolar disorder, inadequate healthcare, and his parents’ tumultuous marriage—was one of many effects of the brutal history that landed him, and all of the Rez Dogs, in Okern: the government betrayals, the forced relocations, the Trail of Tears, the boarding schools, a long unacknowledged history of genocide and cultural erasure. Daniel’s death wasn’t a mental health crisis. It was a crisis of history, the nightmare from which the Rez Dogs are trying to awaken.

Despite this underlying darkness, the youths embark on a series of mischievous, often hilarious, money-making scams—at one point, they hijack a Doritos delivery truck, which they try to sell—to escape to California, which was Daniel’s unrealized dream. Along the way, they grapple with their identities and relationship to a community they initially think is out to destroy them.

How do we free ourselves from the traumatic legacies into which we’re born? Androgynous Willie Jack, the Rez Dogs’ healer-in-training, portrayed with surly deadpan by Paulina Alexis, seeks out her community’s elders for guidance. Against her parents’ wishes, she braves a visit to the prison, with its metal bars and brusque guards, where Hokti, her aunt and Daniel’s grieving mother, are incarcerated. While Willie Jack awaits clearance to visit, an old man with a handlebar moustache and a cowboy hat speaks to her. (She later discovers he’s the first of many spirit visitors.) “The people who built this [prison] had lost their way,” he tells her. “It’s a travesty to take people away from their families and communities.”

Hokti (brilliantly acted by Lily Gladstone) is an angry, cynical medicine woman, who’s being frequently visited by a ridiculously cheerful spirit urging her to rise to the occasion of Willie Jack’s need.

“I just feel like we’re broken up,” Willie Jack tells Hokti as they sit in the concrete visiting room. “We’re supposed to be the dream team. Fuckin’ Rez dogs. It’s like everyone is walking around in the sunshine. But we’re just in the darkness.” Willie Jack is the first to reframe that Daniel’s death did not happen to one of them, an individual injury, but to all of them. She misses her friends. She longs for the easy camaraderie they had before the loss of Daniel. She doesn’t know how to make things right.

After Willie Jack offers Hokti snack food from the vending machine—the episode is called “Offerings”—Hokti, dressed in green institutional garb, leads her in breathing and prayer. “Remember the stories I told you when you were growing up,” Hokti reminds her, holding out her hands. “Generations of medicine people, caretakers. These are the ones who held us as we arrived from our homeland, the healers who carried us and buried us as we marched.”

It’s a chilling scene. It’s as if history comes into the room. As Willie Jack closes her eyes and breathes, a cadre of Muscogee ancestors encircle her, gazing down with kindness—so unexpected in the spare gray environment of the visiting room patrolled by scowling guards. One of the spirits puts her hand on Willie Jack’s shoulder. “Oh shit,” she says, tearing up.

“You don’t need me,” Hokti tells her niece. “You have them. This is the power we carry.”

Watching this scene of spiritual intergenerational connection, I found myself wondering what would happen if Willie Jack had taken her sadness and confusion to a Western-trained psychotherapist. Would she have been given medications, grief counseling, or EMDR? Not that those modalities wouldn’t have helped her, but what would she have missed? That connection to community, both living and in spirit; that sense of her suffering unfolding within greater forces of history; and a reminder of the power of her ancestors’ love, which has gotten her to this place, alive.

Indigenous myths offer another portal to healing. After the botched scramble to California, Bear separates from the Rez Dogs, lost and famished, a thousand miles from home, without even a charged cell phone. Seeking water at a roadside diner, he encounters a mysterious smiling woman (Kaniehtiio Horn), who offers him cherry pie. When he notices her hooves, he realizes he’s talking with Deer Lady. In Indigenous lore, this figure—part woman, part deer—seeks revenge against any man who hurts women and children. “Are you really real?” he asks. “I thought it was a story to keep uncles in line.”

“Yeah, well some uncles need more than stories to keep them in line,” Deer Lady tells him grimly. “Those are the ones I visit.”

“Are you gonna kill me?” Bear asks her.

In a series of flashbacks, Deer Lady recalls the tragedy of Catholic boarding schools, where Indigenous children were taken from their communities, held hostage, forbidden to speak their language, physically and mentally abused, and often killed and buried in unmarked graves—all at the hands of nuns and priests. Deer Lady holds on to memories of lost children, especially one boy, her friend, who was murdered by a man named James Minor. “You remind me of a boy I once knew,” she says, “I’ll take you home.”

On the way back to Okern, Deer Lady stops at the ranch of James Minor, now an old man with reduced faculties, and goes inside his house. “Did you kill someone?” Bear asks fearfully when she returns. “I killed a human wolf,” she answers unapologetically, her fur coat stained with blood. Indeed, rage has a role in healing from historical injustices—which may make some white people uneasy, but Bear gets it. “You’re going to be okay, Bear,” she tells him after she’s driven him home. “And don’t you worry about becoming [a bad man like] your dad. Your mama saw to that.”

We therapists trained in the dominant-culture construct of healing tend to view trauma as discrete catastrophic events that happen to individuals in a linear fashion: before, BAM!, then after. We join our clients during after and focus on establishing safety, expanding coping skills, facilitating catharsis, and enabling meaning-making. If we’re successful, our clients integrate the experience into an expanded sense of self, become asymptomatic, and move on.

Reservation Dogs has paradigm-shifting lessons about how humans heal from soul-robbing tragedies. It recasts healing as something that evolves over time and generations, not an individual life. Imagine the relief if our clients realized they didn’t have to resolve all their suffering in a single lifetime, that they’re just intended to do a piece of the work in a long, historical progression. This Indigenous perspective invites people seeking healing to open their awareness to dreams, archetypes, and ancestral spirits, who light the way toward freedom, if we can open ourselves to their messages.

By the end of the series, none of the Rez Dogs leave Okern, although, with the help of elders, spiritual ancestors, and other mythic visitors, they grow into a deeper appreciation of community and their traditions. It’s not individuals who heal, but communities. “It’s how community works,” Hokti tells Willie Jack during another prison visit. “It’s sprawling. It spreads. The thing about community is, you gotta take care of it. You have to play your part.”

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There are so many ways clients can engage in healing work between sessions—and reading great books is one of them. We asked several therapists what book they most recommend to clients, and here’s what they said.

The Cancer Journals by Audre Lorde

In this book, a black, lesbian feminist, who’s also a mother and activist, grapples with a breast cancer diagnosis, treatment, and convalescence in the 1980s. It offers divine, existential insights that will resonate with clients facing all kinds of hardship today. Bursting with the kind of wisdom drawn from urgent circumstances, her journals explore political, historical, and sociocultural aspects of breast cancer survival, alongside her personal experience. The book is a roadmap to viewing suffering as an affirmation of existence. As Lorde says, “I work with the consciousness of death at my shoulder, not constantly, but often enough to leave a mark upon all of my life’s decisions and actions.”

Wayne Scott, LCSW,
Portland, Oregon

Are You My Mother? by Alison Bechdel

Described as a “comic drama,” this book encourages us to reflect on our relationship with our caregivers. It also conjures the multilayered experience one often has in therapy, when the present meets the past in a way that emboldens you to move toward the future. There are even a few literal—and delightful—cartoon therapy scenes woven in, and an exploration of Winnicott’s concept of “hate in the countertransference” that may be the best elucidation of his work I’ve ever seen. Ultimately, with the help of Winnicott and her therapist, Bechdel accepts that though her mother loved her very much, she was also limited (as we all are), and had moments (as we all do with people we love) in which she struggled to give the care and attention Bechdel needed. But to experience through Bechdel’s eyes the deeply loving connections we can find with people when we accept them and ourselves as we are, is nothing short of a revelation.

Mark O’Connell, LCSW-R, MFA
New York, NY

10 Foundations for a Meaningful Life (No Matter What Happened) by Pam Cordano

In this under-the-radar gem, a therapist who was born to a mentally ill 18-year-old, adopted by unloving parents, and unsure she wanted to be alive for the first 45 years of her life manages to emerge in midlife as a playful, vulnerable, and wise woman who’s deeply attuned to what makes life worth living. An homage to Victor Frankl, whose writing was a life-saving influence, Cordano shares her hard-won wisdom through a mix of memoir, core ideas, questions for reflection, and “actions to immediately increase your life force.” Drawn from her work with cancer patients, widows, and adoptees, Cordano’s writing is funny and compassionate, and challenges readers to choose bravely between what she calls “healthy suffering vs. misguided suffering,” “creativity vs. holding back,” and “unconditional love vs. against-ness.”

Ethan Seidman, PhD
Cambridge, MA

Keys to Unlocking Depression by Michael D. Yapko

Young people—and particularly those that are struggling—can be both rigid in their beliefs and fed up with therapeutic pablums; so when you suggest a book, it better be digestible and intriguing enough to pull them in. Yapko’s book is exactly that. “Your feelings can deceive you” and “Dare to be superficial” are just two examples of nuanced concepts he accompanies with clear explanations and concrete actions for readers to try. In sessions, I hand teens a copy of the book and have them mark it up, putting stickies on the most compelling pages. The conversations that follow are amazing. Getting an anxious and depressed teen curious is a victory—the opposite of what their disorder demands—and this book makes it possible. Works with adults, too!

Lynn Lyons, LICSW
Concord, NH

Come Together by Emily Nagoski

My current favorite book for women and their partners experiencing low sexual desire, Nagoski’s most recent work is grounded in the latest sexuality research. It also identifies—in a wry, friendly, conversational tone—common barriers to intimacy and the powerful impact of cultivating a pleasure-focused mindset. Her practical, actionable strategies can even provide conversational starting points for sessions, where clients dig into what it will take to prioritize and create their own conditions for responsive desire.

Megan Fleming, PhD
New York, NY

Barakah Beats by Maleeha Siddiqui

Sometimes, when I’m working with a parent who wants to build a connection with their older elementary school-aged child or young teen, I recommend they read a book together. Barakah Beats touches on the diversity of faith practices as a young Muslim woman decides which interpretation of Islam she’ll follow, and how to remain in connection with others who choose differently than she does. It’s a dynamic canvas for families parenting through puberty as minorities who also often feel marginalized and stigmatized.

Fatima Mirza, PhD, LCSW
McLean, VA

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The film All of Us Strangers opens with Adam (Andrew Scott), a sad-eyed, mid-40s queer writer in the early aughts, sequestered in his apartment to work on his next book, a memoir—but really he’s just staring at a blank laptop screen. When he stands by the floor-to-ceiling window, the London cityscape gleams in the distance with its promise of bustle and noise, yet his sense of apartness is stark, as if he’s in some hermetically sealed bubble of his own psychological construction. (No one achieves a pitch of tender, lost-boy vulnerability better than Irish actor Andrew Scott in this Golden Globe-nominated performance.)

A knock on the door. His neighbor, Harry (Paul Mescal), whom we’re led to believe is the only other occupant in this high-rise building, and whom Adam has only seen from a distance, leans on the frame. “Hello, I saw you looking at me from the street,” he says, holding a half-empty bottle of sake, then slurs, “How about I come in? If not for a drink, then for whatever else you might want.” Smiling, Adam blocks his entry, even though we viewers know he’s desperately lonely (and Paul Mescal is gorgeous). Then he sits on the couch and stares and pines.

What strange world are we in here, where we know we’re in a crowded city but barely see any other people? Where two gay men are the only occupants in a tall, sleek building with desirable views? Where out of nowhere an Irish heartthrob, brimming with longing, knocks on the door of his gay neighbor and, intuiting his loneliness, asks the question on both their minds: “How do you cope?”

And it gets stranger.

Adam wanders in the city, but there are no people. In a grocery store, he notices a mustachioed stranger (Jamie Bell, of Billy Elliot fame, all grown up), who’s somewhat reminiscent of Harry. The stranger brushes past and Adam follows him into a wooded area. There’s the intimation this might be some kind of hook-up. When the two men see eye to eye, they smile. The stranger invites Adam to follow him and, bizarrely, they return to the home where Adam grew up. The man is his father, the same age he was when he was killed in a car crash. Adam’s mother (Claire Foy), killed in the same wreck, opens the door. “Yes, it is you,” she says wide-eyed. “Don’t just stand there. Get yourself inside.” The parents—Are they ghosts? Hallucinations? Dream figures?—behave casually, as if settling in for an evening at home. How about a snack? They want to catch up on the last 30 years of his life. Confused, he doesn’t ask questions, enraptured with the chance to visit with them.

All of Us Strangers, now available on Hulu, is loosely adapted from Taichi Yamada’s 1987 novel, Strangers, which was translated from Japanese into English in 2003. Although the novel is billed as a “ghost story,” the film adaptation gives no such hints about genre and leaves us wondering what’s real and what’s imagined and if what’s imagined could actually be what’s true. The adaptation is the rare film that improves upon the book, deepening the story’s interiority and psychological heft.

As a psychotherapist watching the narrative unfold, Adam reminds me of every trauma survivor I’ve ever known: the shame, the inability to find the words to describe their experience, the looks of far-off dissociation, and the profound sense of stuckness and isolation. After the death of his parents, Adam went to live with his grandmother and wasn’t allowed to go to the funeral for fear it would compound his misery. He now has no friends, no family, no lovers, no community. He can’t move on with his life. His journey feels less like a ghost story—although what else can we call these apparitions?—and more like a dreamy allegory about healing from traumatic loss.

Definitions of trauma abound these days, but I’m partial to the simplicity of Resmaa Menakem’s in My Grandmother’s Hands: “Too much, too soon, too fast.” The lightning-quick onslaught of tragedy leaves no room for someone to make sense of what happens. Somatic responses go haywire, leaving painful effects that linger into adulthood. If we invert Menakem’s elegant formulation, to understand what the antidote for trauma might be, we come up with another simple catalogue: break down what happened into manageable bits; slow down the pace of sense-making and digestion; and grapple with the lifelong implications of “too soon.” There’s no therapist in All of Us Strangers to guide the way. There doesn’t need to be. The human figures, especially the ghosts, seem to find their way, and it’s moving and instructive for anyone thinking about how we live our lives after personal calamity.

Adam’s slow-burn romance with pensive Harry is intertwined with his conversations with the ghost parents, who are so curious about the life he’s made since they left him. Scenes of the men talking and dancing and having sex are interspersed with Adam’s furtive journeys back to his childhood home, where his parents wait for the next conversation. Even though it’s a strange situation, no one asks questions about ghosts or hallucinations or how long the time together will last. No one wants to pop the illusion.

“Death ends a life,” the psychologist Robert Jay Lifton tells us, “but it does not end a relationship.” Rather than rewind and replay scenes that have already happened, All of Us Strangers fast-forwards into new action, tackling conversations people wish they’d had. The ghost parents knew they had had a misfit son who didn’t fit in, couldn’t play sports, and suffered bullying at school. “You make me sound like a terrible cliché,” Adam laughs uncomfortably. “Well, can you throw a ball?” his dad asks. “No, not at all,” Adam answers quickly. When Adam comes out to them as a gay man in his 40s, they have the predictable uneasy reactions that parents in the late 1980s might have had. But their discomfort is soon overshadowed by an acute awareness of missed opportunities. Adam’s dad acknowledges he’d once heard his son crying in his bedroom after school but didn’t try to find out why. He admits that he himself might’ve been the kind of kid who bullied a “girlie boy.” “Yeah, I know,” replies Adam. “I think that’s why I never told you.” But his dad’s expression shifts. Grief, rooted in a place of urgent gratitude, propels him into a better version of himself. “I’m sorry I never came into your room when you were crying,” he says, tearfully. Adam starts to say it’s okay, it was so long ago, but the longing for comfort is too much, and he starts crying.  “Can I give you a hug now?” his father asks.

Both ghost parents come around quickly to accepting Adam’s queerness. The ghosts realize, in a way that people often don’t, that time can’t be wasted on grudges or judgment. When later Adam impulsively tries to bring Harry home to meet them, he can’t find them. When his mom and dad reappear, to him alone, they acknowledge their time with him is short. They go out for one last meal together at Adam’s favorite childhood restaurant.

“It hasn’t been long enough,” Adam tells them. “It hasn’t been close to long enough.”

“It never could be, could it?” answers his mother.

All the petty interpersonal flaws and human prejudices that infect relationships line up alongside the reality of the grave and lose their power. Maybe the parents are hallucinations, or dreams, or apparitions, but their truth seems indisputable.

“Trauma is not what happens to us,” Peter Levine, developer of Somatic Experiencing, reminds us, “but what we hold inside in the absence of an empathetic witness.” Indeed, the discovery of his ghost parents leads Adam to a blooming of eroticism and creativity. He finds he can tell the story of his loss to Harry, who responds with empathy. Adam starts to write again.

All of Us Strangers reshapes how we think about traumatic loss, as conversations that were cut short or never happened, but that can be excavated, conjured. It underscores the important role of imagination in healing. How do we complete or bring to closure stories that are cut brutally short? After much therapy, drawing on all the science-based tools, I’ve often found myself advising clients to wait for a sign from the universe, something that can shift an unsatisfying narrative, if we’re alert to its arrival. Imagination has a critical—and underacknowledged—role in healing.

After the ghost parents fade, the film gets stranger, if you can believe it, but I won’t give any spoilers. I only suggest that you watch it with friends who can help you figure it out and decompress afterward. After seeing the film in a theater in Portland, Oregon, my friend and I wandered outside in a daze and bumped into another theater-goer. “Do you understand what happened?” we asked at the same time, and we all puzzled together on the sidewalk in the dark.

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If someone asked you how important your voice is in your therapy sessions with clients, what would you say? Maybe you’d answer, “My presence is important, not my voice.” Or maybe you’d say, “I focus on my client and what they’re saying, not on what I’m saying or how I’m saying it.” Or maybe you’d respond, “My voice conveys my authority in the room, so in that sense, it’s important, but otherwise, it’s mostly a neutral tool I use to convey ideas and guide my client.”

Before reading the bestselling book Permission to Speak: How to Change What Power Sounds Like, Starting with You, by Samara Bay, a Los Angeles-based speech coach, I’d have said many, if not all of those things. But now, I’m looking at my voice in an entirely different way. Do I have a therapy voice? Why or why not? How does the tone of my voice convey the empathy, concern, education, or gentle authority I use in the therapy room? And what is my voice saying about me as a person, about my life experience, my values, my identity?

Although Bay works with everyone from Hollywood celebrities to high schoolers on embodying their true, authentic voice, she’s not your run-of-the-mill public speaking coach who’s solely interested in helping people go viral on YouTube, win an election, sell their ideas to a group of wealthy entrepreneurs, or land a coveted role in the next Guardians of the Galaxy movie. Her motivations are deeper and broader than that.

Bay wants us all to challenge traditional ideas about what a powerful voice sounds like. She believes our verbal power doesn’t necessarily come from emulating the deep, serious, masculine voices of many of today’s leaders. Instead, our true power arises from speaking to others from our authentic core about what matters to us. Since therapists are in the business of helping clients access authenticity, healing, and a sense of empowerment, maybe it’s time we reconsidered the importance of our voices and how we use them in the consultation room.

Ryan Howes: You often tell the story of losing your voice at age 24. Why was that so significant for you?

Samara Bay: I was in a graduate acting program, talking all day as one might expect, and over many months, it became too painful to speak. I didn’t know why. I wasn’t sick. I didn’t have any other symptoms. My voice was just gone. I’d try to push through in the mornings by communicating minimally with people, but by evening, the pain of speaking would force me into silence.

Finally, a doctor diagnosed me with vocal nodules, which are small blisters on the vocal cords. I had to go on vocal rest for a few months and seek out a speech pathologist to help me relearn how to talk. It turns out I’d picked up a habit of speaking below my body’s “optimum pitch.” This led me to consider—why? Permission to Speak came out of that inquiry. The answer took years to unpack, but the gist of it is that we all get messages from our culture about how we’re “supposed” to sound if we want to be taken seriously. One message is, “Talk low if you want to be powerful.”

RH: Some people may not feel like they have the freedom to even have a voice.

Bay: Precisely. I talk about a man who overheard me telling a cashier that I was working on a book called Permission to Speak, and he said, “Permission to speak? That’s not something I’ve ever asked for.” He had enough privilege that he never needed permission. But even that guy—who clearly isn’t approaching speaking the same way most women, people of color, somebody queer or with an immigrant story might—probably still has some drama around his voice. There’s an awareness in our bones for many of us that we don’t “talk right.” Many of us feel uncomfortable and insecure about showing up and being seen when we talk. Every human can relate to this on some level.

RH: So you’re saying I might believe I need to sound similar to powerful people around me if I want to be heard, right?

Bay: Yes, but those standards are invisible. We need to make them visible, so we can look at them. What are those standards? Where do they come from? How many thousands of years old are they? Who says that if you want to get taken seriously, you must speak in a low-pitched, unemotional voice, avoid singsong intonations, and come across as firm and confident? Maybe that’s bullshit.

If you google “How do I sound more authoritative?” you’ll find stuff like, slow down, avoid smiling, lower your voice. It’s like, ugh! This is why many of us, including men who fear that they don’t come across as alpha enough, are afraid they’re doing it wrong. The definition we have for good public speaking is too narrow. I offer many examples of people who speak differently and get taken seriously. There’s a growing body of evidence that the sound of power is changing. We need to know this so we can free ourselves from old, constraining standards.

RH: Is there any example that comes to mind?

Bay: Jane Goodall is one. I grew up in a science-focused household, and when I saw her in an old TED Talk, I was really struck by her voice and speaking style. She wasn’t presenting as a scientist with a detached, clinical demeanor—qualities often associated with credibility. I thought, There’s something brave, mischievous, delightful, and instructive about how she’s speaking. It felt like a deliberate choice. This choice is a way we can spend the currency of our power and privilege once we have it. She’s Jane Goodall, she’s on the TED stage, sure, but she’s also choosing to speak in her own voice.

What power or privilege do each of us have in our own lives right now to ask, “Am I allowed to show up more emotionally connected, with more softness, more mischievousness?” For some people, the answer will feel like, “No, my institution is too clinical,” or “No, I’m too low on the ladder,” or “No, I literally don’t feel safe showing up as me.”

Our voices reflect the life we’ve lived and whatever has influenced us. Those influences include where we grew up and how our parents sounded, but also whatever criticisms we absorbed. We sound like the choices we’ve made, and the ones made for us. Getting curious about our voice is the first step. What speech habits did you pick up to get by that helped you hide or maybe sound intimidating? Linguists will say, every vocal habit we’ve picked up, we’ve picked up for a reason. It worked at some point. So in exploring our answers, let’s love on the ways that we’ve been resilient, rather than shame ourselves for the habits we picked up that don’t serve us anymore.

RH: Therapists often talk about how shame impacts a client’s tone of voice, making it sound like they’re trying to hide while speaking. Your message seems to be about trying to bust some of that shame.

Bay: It is. That’s literally the whole thing. We can talk about voices all day long, but I don’t actually care about the sound coming out of your mouth, I care about your relationship to it.

You might wonder, How do I come across in a room? How am I perceived? Do I feel like I deserve to be in that room? If I tell myself, “I’m going to talk wrong,” my relationship to my voice will be evident in things like how often I say um and uh, lose my words, come across as inarticulate, hold my breath, sound too high-pitched, or too aggressive. Too this, too that. We know from the nervous system that the human body can either connect or protect. It can’t really do both at the same time. So how do we move out of protection mode and into connection mode when we talk about what matters to us in front of a lot of people? Or even in front of one client?

RH: When I hear my own recorded voice, I wonder, Am really that nasally?!

Bay: Almost everyone has to face the anatomical reality that they sound different to themselves on the inside than they do on the outside. What’s important is that we then ask, “Okay, yes, I sound different, but is the story of me that’s coming across to people different than I think it is?” Here’s where we tend to tell ourselves, “God, I sound stupid.” We foist cultural standards we’ve absorbed from other people—otherwise known as biases—onto ourselves. We have voice biases like “I prefer a low-pitched, masculine, standard American voice.” If that’s our bias, we conclude, “I don’t sound right,” and dismiss ourselves before anyone else can.

It helps to question our biases. Are they true? Are we trying to sound like someone else? It can be helpful to collect for ourselves a list of people we notice, like Jane Goodall, who make us think, Oh, I like how she shows up. They offer us a new narrative. It’s not, Okay, well, now I want to show up like Jane. It’s Oh, there’s a new possibility here, a new way to be in public, to pitch my idea, to be more human, to focus on connecting and what I care about. This is what I call caring out loud, rather than hiding the fact that we care, or pretending we care when we actually don’t.

Caring out loud inspires a sense of trustworthiness in your listener or your audience. Are you showing your humanity? The thing that’s so cool about our voices is that they simply reveal how willing we are to show up as a person. Or they reveal that we’re not willing to show up.

RH: In the therapy world, people sometimes develop a “therapist voice” in graduate school as they’re learning the craft because they think, understandably, I need to talk how my supervisor talks. We talk about this voice in a bit of a derisive way because it can come across as insincere. “Ooh, mmm, ahh. Tell me more about that.” It’s not just the words, it’s also the intonation.

Bay: Almost every industry has a vocal norm. We know how pilots are supposed to talk to us when the plane hits turbulence. We know how a newscaster is supposed to vocally signal, “I’m a professional in the news world.” Do those standards serve our culture at large in terms of the diversity of background and expression we hope for? I don’t think so, but it’s hard to change industry standards. A useful approach in your profession might be to ask, Is the norm helping? Does it feel good? Do I have the leeway to explore other ways of showing up?

Humans are beautifully complicated. Sometimes, a “therapist voice” might help the therapist have a boundary to avoid connecting with their client like a friend. That’s valuable. But that’s protection, not connection. That’s signaling, “I care about you, but in my role as a therapist we don’t have the kind of relationship where you share your shit and then I share mine.” So you’ve set up a guardrail: “I’m going to talk to you like I’m not quite a person.”

The juicy question is, “When does that not work?”

RH: As a therapist, if you’re working with a client who has experienced marginalization, what steps do you take to help them speak with power in their own way?

Bay: I think it’s irresponsible as a coach to say, “Talk this way. This is the standard. If you want to get taken seriously, you must do this,” but I think it’s equally irresponsible to say, “Just be yourself. You’ve got this. Bye.” We need to help clients ask questions like, “In what ways have I negotiated myself away?” “What aspect of myself could I bring back?” “What if I started to tell people stories or joke more or spend less time worrying about my accent?” “What if I started to bring the version of me that shows up around my favorite people into this other space?”

When we’re exploring how we talk about things that are dear to our hearts we have an almost spiritual opportunity to show up for ourselves and for our ideas. That’s when this conversation is so vital, especially with people who’ve been marginalized.

If they’re going to talk in front of people on this day and at this time, the pressure in on. We can help them recalibrate toward what feels good in their body. What would it feel like if they honored their idea, the people they’re talking to, and the people they’re presenting their idea on behalf of? When the focus is on these kinds of things, it makes the question of, “How do I sound” much less distracting. Ultimately, your outward focus when you speak can help you talk in a way that’s more human, that sounds more like you in front of your favorite people. It’s a more love-based approach to public speaking.

RH: Focusing on the message and on the people you’re talking to sounds like it would reduce self-consciousness.

Bay: The final chapter of my book is on how to make it about your audience, because shifting your focus to what really matters (and away from the “should” of how to sound) works wonders. It’ll accomplish much more than working on your pitch or avoiding ums. It gets at the heart of what speaking is all about, which is connection.

Samara Bay joined us for a Networker Live interview. Watch here.

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What would you do if you knew you could not fail?

These words were famously spoken by Eleanor Roosevelt, but they could’ve also been a mantra for the fictional freewheeling therapist Jimmy Laird in the Emmy-nominated TV comedy Shrinking, whose second season is tentatively scheduled for release later this year on Apple TV+.

In the first season, we meet Jimmy in the throes of grief. His wife, Tia, has recently died in a car crash, and Jimmy, as one might expect, is hurting. He self-medicates with alcohol and painkillers, invites female escorts over for nighttime swims in his backyard pool, and neglects his teenage daughter, Alice, who’s grieving too. In an early scene, he’s so consumed by sorrow that he absent-mindedly rides his bike into a car door. He’s sad, burned-out, and adrift.

“I have to ask,” says Jimmy’s concerned neighbor. “Is this you forever?”

“I don’t know,” Jimmy replies flatly.

Jimmy is expertly played by Jason Segel, best known for his roles in the TV sitcom How I Met Your Mother and a handful of early 2000s comedy movies, including Forgetting Sarah Marshall. Here, as in many of these precursors, Segel excels in playing the sad clown, a mopey, loveable goofball viewers can’t help but root for, even in his most self-destructive moments.

In Shrinking, Jimmy’s sadness begins to bleed into his job at the Cognitive Behavioral Therapy Center, where he works in a group private practice. Short on energy and empathy, he rolls his eyes, accidentally yawns, and mentally checks out whenever his clients articulate their stuckness or unwillingness to change, which occurs frequently. I suspect many therapists watching will relate to Jimmy’s frustrations with his clients’ inertia, and to trying—and sometimes failing—to keep personal struggles from interfering with your work.

Soon enough, however, Jimmy becomes so fed up with his clients’ stagnation that he decides to abandon all therapeutic protocol. He cuts to the chase, giving honest opinions and straightforward advice. When his longtime client Grace, played by Saturday Night Live’s Heidi Gardner, once again starts making excuses for her verbally abusive husband, it’s the straw that breaks the camel’s back. Jimmy loses it.

“Your husband is emotionally abusive,” he says, voice loud and quivering. “He’s not working on it, and he doesn’t intend to.” He clasps his hands together, pleading. “Just leave him.” Then comes an ultimatum: “Leave him or I’m done being your therapist.”

“Okay,” she replies.

Jimmy has just indulged every therapist’s secret fantasy: saying what you really think. It’s a religious experience of sorts, and Jimmy, a new convert of telling it like it is, is off to the races. “I’m a psychological vigilante!” he later declares.

His interventions become unconventional. Just two sessions into working with Sean, a young veteran with a history of angry, violent outbursts related to his wartime trauma, Jimmy decides the best outlet for that anger is taking Sean to a nearby mixed martial arts gym—a questionable, sophomoric stunt that most therapists would dismiss outright.

“Do you trust me, Sean?” Jimmy asks.

“No,” Sean replies.

“Doesn’t matter. Let’s go find you someone to beat up!”

Flash forward a few minutes, and Jimmy and Sean are sitting on a curb outside the gym while Sean ices his bruised face with a cold slushie. The “therapy session” continues, and before long, Jimmy’s telling Sean about his wife’s death and the regrets he carries. It’s self-disclosure on overdrive, and will make even the most vulnerable therapists cringe with ethical concerns.

“You supposed to tell me this shit?” Sean asks.

Jimmy smiles. “Probably not,” he replies.

Against the odds, Jimmy’s rule-breaking begins to pay off. Grace separates from her abusive husband and reports back that she’s discovered a newfound freedom. Sean slowly starts opening up about his wartime trauma and begins to repair his fractured relationship with his father. Meanwhile, Jimmy’s mood improves, as does his relationship back home with Alice.

But Jimmy’s boundary crossings continue to pile up. Spoiler alert: he soon allows Sean to move into his guesthouse after a run-in with the law, and Sean develops a close, flirtatious relationship with Alice. It’s not long before Jimmy strikes up a secret sexual relationship with his sassy coworker, Gabby (played by Daily Show alum Jessica Williams), adding another wrinkle to Jimmy’s already messy life.

But all of this occurs largely without consequence. Jimmy’s gruff but caring supervisor, Paul, masterfully played by Harrison Ford—a well-known and loveable grump offscreen—gives him little more than a slap on the wrist, leaving Jimmy to his disinhibitions. Any conflict that befalls him—whether in his personal or work life (and Jimmy is an expert at blending the two)—is usually quickly and soundly resolved.

As a viewer, I found these micro-conflicts frustrating. Granted, Shrinking is first and foremost a comedy, not a drama, but it does contain dramatic elements, and for me, the hallmark of good dramatic writing is trusting that your audience can sit with anxiety and discomfort for longer than a few minutes. The show’s writers never really give viewers that chance, probably because this tack is a tried-and-true formula for sitcom success. Producer Bill Lawrence happens to be the creator of the series Scrubs and co-creator of the hit Apple TV+ show Ted Lasso. The blend of conflict-lite, goofy humor, hard subjects, and a cast of colorful characters that made both shows such big hits is on display here, too. Does it work? Yes. Is it saccharine and a little tiring? Also yes.

This isn’t to say Shrinking doesn’t have depth or explore its characters’ thinking and behaviors. It shines a light on grief and the vital role of a strong support system in navigating it. It’s also a decent, albeit fictional, case study of the wounded healer, and showcases well the power of a good mentor.

“Who knows how you grieve?” Paul says to Jimmy during something resembling supervision. “You haven’t even begun.”

“What are you talking about?” Jimmy responds. “I’ve been grieving for a fucking year.”

“No, you’ve been numbing: drugs, booze, women.”

“I told you that I stopped all that.”

“Yeah, but you’ve replaced it by being overly involved in your patients’ lives.”

I imagine therapists watching Shrinking will be split. It’s hard to believe any clinician in their right mind would ever attempt to rewrite the therapy playbook the way Jimmy has—at least not without suffering some kind of fallout. Last January, a review in Time magazine described Jimmy as “a casual perpetrator of gross therapeutic malpractice.”

But enjoying Shrinking demands that you suspend disbelief. Everything in the show feels polished and perfect, all the way down to Sean’s fast-healing black eye. Supervisor Paul is the perfect blend of fatherly wisdom and hard-ass tough love. (Who wouldn’t want Harrison Ford as a mentor?) Setting aside her sexual relationship with Jimmy, coworker Gabby is funny, supportive, and just the right amount of pushy. They’re great colleagues and reliable copilots as Jimmy haphazardly navigates the grief journey.

Jimmy may have suffered a tragedy, but he’s built like Teflon. At one point, he parks his shiny, baby blue Ford convertible truck on a downtown sidewalk.

“You’re just gonna leave your car here?” Sean asks.

“I’m a white guy in Pasadena,” Jimmy replies. “The cops will probably just take it back to the house for me.”

Jimmy, I think to myself, you’re insufferable. I hope you get a reality check in Season Two.

But maybe I’m too much of a critic. My wife, who happens to be a clinical psychologist at a VA hospital, absolutely loves the show. She’s watched it several times now, and ranks it in her Top 10 Favorite Shows of All Time. She’s also shared it with a handful of therapist friends. They love it too.

My wife tells me she enjoys Shrinking for the same reason she enjoys junky reality TV: it’s a low-impact watch. There’s nothing wrong with that. The show is funny, fluffy, and sweet. It’s always 72 degrees and sunny in Jimmy’s world. The friends are quality, and always there. It’s comforting, like a fairy tale for grown-ups.

Whether you’re a therapist or not, Shrinking is a respite from the grind. And for therapists, it’s both an echo of their work and an escape from the parts that are wrenching and complicated. Therapists watching can live vicariously through Jimmy as he brings his big, wacky ideas to life. It allows them to dream a little, too, to imagine what their work might look like if they threw caution to the wind—to wonder, What would I do if I knew I could not fail?

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We’ve written a lot about love: what makes it, what breaks it, what keeps it alive. But recently, we’ve felt an urgent push to home in on how we do conflict. One of the big reasons is that our conflicts aren’t going anywhere. The data tells us that whatever you’re fighting about, you’ll very likely always be fighting about. Overwhelmingly, the conflicts we have with our partners are not fleeting, situational, or easily fixable—they are perpetual.

There are two basic types of fights that couples have: solvable and perpetual. Your solvable fights are the ones that have some kind of solution. They are fixable. Let’s say you’re feeling put upon because you always have to load the dishwasher after your partner makes a mess preparing dinner. You and your partner might fight about this once you finally reach your boiling point (side note: talking about these types of things before you hit critical mass is definitely something we’ll be talking about!), but in the end you can probably find a solution of some kind: you’ll swap dinner prep and cleanup, or he’ll do the cleanup too while you take care of other household tasks that need doing. It’s a logistical problem, one that can be figured out once everybody has a cool head.

Perpetual fights are different. These are the issues that don’t go away. These are the things we end up fighting about time and time again, because they tap into some of the deeper differences between us: differences in personalities, priorities, values, and beliefs. And no matter how perfect someone is for you, these are always going to be there. We don’t fall in love with our clones. In fact, we’re often drawn to people who are very different from us in certain ways: people who don’t replicate us but complement us.

It comes down to this: the vast majority of our problems—69 percent, to be precise—are perpetual, not solvable. That’s a lot! That means that most of the time, whatever you and your partner are fighting about is not going to have a simple solution or any easy fix. And of these perpetual fights, 16 percent become gridlocked: the partners go round after round on the same topics, not only not getting anywhere, but causing more hurt, anger, and distance. And this is why fixing the way we fight is such an urgent issue. How we fight is, as we’ve said, how we communicate and connect. But (and we feel comfortable saying this, because of the sheer number of couples we’ve studied and tracked over the years) we are doing it wrong. We’re rushing in, wounding each other, missing opportunities, and then repeating the cycle again, the next time we fight about the same old thing.

This particular moment in human history also demands a different approach to conflict. Couples are more in distress now, in the COVID era, than ever before. Rates of domestic violence are up: in our international study with over forty thousand couples, we found that in couples seeking therapy, 60 percent were experiencing some degree of domestic violence. And there were other concerning statistics. In these couples, we found high rates of anxiety (27 percent), depression (46 percent), and suicidality (29 percent). Almost a third of all couples were struggling with issues surrounding substance abuse. And 35 percent were dealing with the fallout of an affair.

Our world seems to become more and more uncertain, and so often, we end up taking out our stress and anxiety on the people closest to us. When we fight with a partner, we aren’t fighting in a vacuum. The world gets in. By the time we arrive at a point of conflict with a partner, we’re often already carrying so much—our emotional bandwidth is short, we’re cognitively overloaded, and that shrinks our capacity to be gentle with each other. We carry the residue of the day with us when we interact—the worries and the pressures that we’ve experienced, and that weigh on us in ways we might not be aware of. And beyond the walls of our homes, conflict abounds. It proliferates in the virtual world, where the format of the interaction makes true understanding vanishingly rare. Our world has never been as polarized.

We are at a critical point in human history—a point where across the board, in every arena, we need to learn to set aside our defenses, open up, and fight for peace and understanding. This starts within the four walls of the home. Our romantic partnerships are the building blocks of our larger communities. They have ripple effects on our children, our friendships and extended families, our collaborations in the workplace. They influence our capacity to give back to the world and make change; they affect how we come together as a society. As we learn to fight better in our homes, we can learn to fight better in our communities, across political divides, in our society, and even as a human race.

It’s only human to have conflicts. It’s even humane to have conflicts—often, it’s exactly the right thing to do. But we need to bring our best humanity to our conflicts.

When we fight, we should be trying to create something better. That’s the ultimate goal of conflict: to create something better for yourself, for you and your partner as a couple, and for the world. Conflict doesn’t have to break us apart. Conflict and peace are not mutually exclusive. We can arrive at peace through conflict. We can combine kindness and gentleness with fighting. We can grow closer because of conflict. But to do this, we need to get to the heart of our conflicts.

Excerpted from Fight Right: How Successful Couples Turn Conflict into Connection by Julie Schwartz Gottman, PhD and John Gottman, PhD. Copyright © 2024 Julie Schwartz Gottman, PhD and John Gottman, PhD. Excerpted by permission of Harmony Books, an imprint of Penguin Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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