8 Signs of a Bad Therapist
Starting therapy takes courage. Whether you’re seeking support for anxiety, depression, trauma, or life stressors, therapy should feel like a space that is safe, respectful, and supportive.
While many therapists are skilled and ethical, not every therapist is the right fit—and in some cases, a therapist may be doing more harm than good.
Let’s talk about clear signs of a bad therapist (or simply the wrong therapist for you).
1. They Don’t Listen—or Constantly Interrupt
A therapist should be curious about your experience.
Red flags include:
Frequently interrupting or talking over you
Redirecting sessions to their own agenda
Making assumptions without asking questions
Feeling unheard in therapy is not something you should ignore.
2. You Feel Judged, Shamed, or Invalidated
Therapy should never make you feel small or “wrong” for your feelings.
Warning signs include:
Minimizing your experiences (“It wasn’t that bad”)
Shaming language
Blaming you for your symptoms
This is especially harmful for individuals healing from trauma.
3. They Give Excessive or Rigid Advice
While some guidance can be helpful, therapy is not about being told how to live your life.
Be cautious if your therapist:
Frequently tells you what you “should” do
Pushes their personal beliefs or values
Effective therapy supports your inner decision-making, not dependence on the therapist.
4. There Are Poor or Unclear Boundaries
Ethical boundaries are absolutely essential for safe therapy.
Boundary no-no’s:
Oversharing personal details (especially those that burden you rather than foster your healing)
Blurring professional roles
Ignoring session limits or ethical guidelines
Boundary issues can feel confusing or uncomfortable—even if they seem subtle.
5. They Dismiss Culture, Identity, or Lived Experience
A good therapist is open to learning about your identity and background. A good therapist does not minimize experiences of racism, sexism, or discrimination, and does not assume their worldview applies to everyone. Cultural humility is an essential part of ethical mental health care.
6. Therapy Feels Stuck With No Discussion About Goals
Progress in therapy isn’t always linear—but it should be intentional.
Red flags include:
No clear treatment goals
No check-ins about progress
Months of sessions without direction or reflection
A skilled therapist collaborates with you and adjusts treatment as needed.
7. You Feel Worse Over Time With No Support or Explanation
Therapy can bring up difficult emotions—but this should be done safely and thoughtfully.
Be cautious if:
You consistently feel destabilized after sessions
The therapist pushes you to revisit trauma without preparation
There is no focus on grounding or regulation
Trauma-informed therapy prioritizes nervous system safety.
8. You Don’t Feel Safe Speaking Up
One of the clearest signs something is wrong is feeling afraid to:
Ask questions
Share concerns
Disagree or give feedback
A good therapist welcomes honest conversation and repair.
What a Good Therapist Does Instead
A healthy therapeutic relationship often includes:
Feeling heard and respected
Collaborative goal-setting
Clear boundaries
Openness to feedback
A sense of safety—even during hard work
Trust your instincts. Discomfort from growth feels different than discomfort from harm.
What to Do If You Think You Have a Bad Therapist
If something feels off, you have options:
Name it – If you feel safe, bring up your concerns directly
Seek a consultation with another therapist
Change therapists – This is allowed and often empowering
Report unethical behavior if boundaries or ethics are violated
You are not “failing therapy” by choosing a better fit.
Good therapy supports growth, safety, and self-trust. If you’re experiencing the opposite, it’s okay to walk away and seek something better.
Written by Mary Beth Stevens, LPCC, BCN
Intention Setting in Ketamine-Assisted Therapy: Why It Matters
If you are new to learning about KAP, check out our blog KAP: What You Need to Know
Ketamine-assisted therapy (KAP) has been increasingly popular, and while much attention is often placed on the medicine itself, one of the most important parts of the process happens before a session begins: intention setting.
Intention setting is about creating a gentle inner compass, something that helps guide reflection, emotional openness, and meaning-making throughout the therapeutic process.
What Is Intention Setting?
In the context of ketamine-assisted therapy, intention setting is a collaborative process between client and therapist that helps clarify what the client hopes to explore, understand, or approach during treatment. Unlike a goal, which is outcome-oriented (“I want to fix this problem”), an intention is process-oriented (“I want to approach this experience with curiosity” or “I want to better understand my emotions”).
In KAP, intentions help anchor the experience within a therapeutic framework rather than viewing it as something random or disconnected from personal growth. An intention is not a demand or expectation for a specific outcome. It is a point of focus that supports curiosity, emotional openness, and reflection throughout the therapeutic process.
Examples of intentions may include:
Developing greater self-compassion
Exploring emotional patterns with curiosity
Gaining insight into stress, mood, or relationships
Practicing openness to internal experience
Why Intention Setting Matters in KAP
KAP is designed to support new perspectives and emotional flexibility. Intention setting helps in several key ways:
Creates psychological safety
Reflecting on an intention beforehand can help a client feel more grounded and prepared.Provides direction without pressure
An intention offers a reference point. If the experience moves in an unexpected direction, the intention can still serve as a support to come back to.Supports integration after the session
Intentions give therapists and clients a shared language to reflect on insights and emotions during follow-up integration sessions.Keeps therapy values-centered
The focus stays on healing, self-understanding, and emotional growth—not on the medicine itself.
What Makes a Supportive Intention?
Clients are encouraged to keep their intention open, compassionate, and flexible. Helpful intentions tend to:
Be framed with curiosity rather than judgment
Focus on awareness instead of control
Allow space for emotions, memories, or insights to arise naturally
Examples of gentle, non-directive intentions might include:
“I want to listen to what my inner experience is showing me.”
“I want to explore my relationship with stress more kindly.”
“I want to practice letting go of resistance.”
There is no “perfect” intention. Even noticing uncertainty can be a meaningful place to start. For example, “I don’t know what I need, but I’m open to learning”
Intention Setting as a Collaborative Process
Intention setting is done in collaboration with a trained mental health professional. Your therapist will work with you to explore what feels meaningful, emotionally safe, and aligned with your therapeutic goals, taking into account your history, current concerns, and readiness for treatment. Intentions can evolve. What feels right before a session may shift afterward, and that’s part of the work. Therapy is not about getting it “right,” but about staying engaged with the process.
Integration: Where Intentions Come Full Circle
After a KAP session, intention setting continues to play a role during integration.—the reflective therapy work that helps translate insights into everyday life. Revisiting the original intention can help clients notice:
What themes emerged
What emotions felt significant
What new questions or perspectives arose
Areas for continued growth
Sometimes the most valuable outcome isn’t an answer, but a deeper sense of self-compassion or insight gained.
Intention setting can help transform an experience into meaningful therapeutic work.
When approached with care, guidance, and reflection, intention setting can help ensure that KAP remains what it is meant to be: a structured, ethical, and deeply human process of healing.
Written by: Olivia Clark, LPCC, BCN
Ketamine-Assisted Therapy in Cuyahoga Falls & Akron, Ohio: What You Need to Know.
Ketamine-assisted therapy (KAP) is emerging as a powerful and evidence-based approach for individuals seeking relief from depression, anxiety, and trauma. For those searching for ketamine-assisted therapy in Cuyahoga Falls or ketamine therapy in Akron, Ohio, this innovative treatment offers a unique blend of neuroscience and psychotherapy designed to support lasting mental health improvement.
If you’re exploring alternative mental health treatments in Cuyahoga Falls or Akron, understanding how KAP works, who it helps, and what to expect can guide your decision toward healing.
Why Consider Ketamine-Assisted Therapy for Mental Health?
Many individuals consider ketamine-assisted therapy after finding limited success with traditional therapy or medication. Ketamine works differently than standard antidepressants by increasing neuroplasticity and enabling the brain to shift rigid thinking patterns.
People seek ketamine therapy for concerns such as:
Treatment-resistant depression
Chronic anxiety or panic disorders
PTSD and complex trauma
Emotional numbness or burnout
Persistent suicidal ideation
Feeling stuck or disconnected
When combined with psychotherapy, ketamine-assisted therapy can help clients:
Increased emotional flexibility
Improved mood and hope
Greater insight and self-awareness
Enhanced trauma processing
Long-term symptom relief
This approach allows individuals to explore emotions and internal experiences with greater openness and reduced fear.
Who Is a Good Fit for Ketamine-Assisted Therapy?
A good candidate for ketamine-assisted therapy is someone who:
Feels stuck in traditional mental health treatment
Seeks deeper therapeutic work
Is psychologically stable and medically screened
Is committed to preparation and integration sessions
Has a safe and supportive environment
KAP may not be appropriate for those with:
Active psychosis or severe dissociative disorders
Uncontrolled medical conditions
Severe substance dependency without stabilization
Significant safety concerns
Professional assessment and careful screening ensure safe and ethical delivery of ketamine-assisted psychotherapy.
What Does Ketamine Feel Like in a Therapeutic Setting?
During ketamine-assisted therapy sessions, individuals typically describe the experience as:
Deeply introspective
Dreamlike or expansive
Emotionally open yet grounded
Temporarily dissociative
Calm and reflective
Clients often feel a gentle separation from their usual mental patterns, allowing them to approach difficult memories and emotions with increased clarity and compassion. Each session is guided by a trained therapist to ensure safety, integration, and therapeutic meaning.
The Importance of Set and Setting in Psychedelic-Assisted Therapy
In any form of psychedelic-assisted therapy, “set and setting” directly influence therapeutic outcomes.
Set (Mindset)
Preparation sessions focus on:
Clarifying intentions
Addressing fears or expectations
Emotional readiness
Building therapeutic trust
Setting (Environment)
A professional ketamine therapy clinic prioritizes:
Calming, private spaces
Comfortable options for resting during the dosing session
Soothing music and lighting
Trauma-informed therapist presence
Clear safety protocols
This intentional environment allows the nervous system to relax, helping clients feel safe enough to explore deeply emotional material.
Ketamine-Assisted Therapy in Cuyahoga Falls & Akron: A Modern Path to Mental Wellness
For individuals seeking advanced mental health care in Cuyahoga Falls and Akron, Ohio, ketamine-assisted therapy offers a transformative option grounded in science, compassion, and therapeutic support.
When delivered ethically and intentionally, ketamine-assisted psychotherapy can help individuals reconnect with themselves, process unresolved trauma, and cultivate emotional resilience.
If you’re considering ketamine-assisted therapy for yourself or a loved on, a consultation with one of our trained providers can help determine whether this approach aligns with your needs and goals.
7 Key Benefits of Group Ketamine-Assisted Therapy
Group Ketamine-Assisted Therapy (G-KAP) is an emerging therapeutic approach that combines the neuroplasticity-enhancing effects of ketamine with the supportive dynamics of group therapy. This modality offers several unique benefits:
1. Enhanced Emotional Processing
Ketamine can lower psychological defenses, allowing individuals to access and process deep-seated emotions and memories. In a group setting, sharing these experiences can amplify healing, as participants offer support and validation to one another.
2. Stronger Sense of Community
Participating in KAGT fosters a sense of belonging and reduces feelings of isolation. The shared journey creates a supportive network, which can be crucial for individuals facing mental health challenges.
3. Accelerated Healing
The collective energy and shared insights in a group can expedite personal healing. Observing others' breakthroughs can inspire and motivate participants, leading to faster and deeper therapeutic progress.
4. Diverse Perspectives
Engaging with individuals from varied backgrounds and experiences can provide new coping strategies and viewpoints, enriching one's own healing process.
5. Cost-Effectiveness
Group therapy sessions are often more affordable than individual ones, making ketamine-assisted therapy accessible to a broader range of individuals seeking treatment. Here at Alternative Therapeutics, we offer a sliding scale for G-KAP ranging from $150, $250 or $350 per 4 hour group session.
6. Reduced Stigma
Being part of a group normalizes the therapeutic process, reducing the stigma associated with mental health treatment and encouraging more individuals to seek help.
7. Integration of Experiences
Group discussions before and after ketamine sessions facilitate the integration of experiences, helping participants make sense of their journeys and apply insights to their daily lives.
Overall, Group KAP harnesses the power of community to enhance the therapeutic effects of ketamine, offering a holistic approach to mental health treatment. However, Group KAP isn’t for everyone. Those who struggle with severe social anxiety or feel strongly about privacy, may be better suited for 1:1 KAP.
Learn more about what we offer with KAP here. Reach out to britney@trainyourbrainohio.com with any questions or a free introductory consultation.
Understanding Attachment Theory in Counseling
Through the lens of attachment theory, all relationship behaviors are attempts to experience, maintain, or obtain connection and security. Attachment theory, developed by psychologist John Bowlby, suggests that the bonds we form with our caregivers in infancy and childhood determine how we perceive and engage in relationships as adults. We develop secure attachments when our caregivers provide consistent love, support, and responsiveness, fostering a sense of safety and trust in relationships.
In contrast, insecure attachments are developed when caregivers are unpredictable, neglectful, or absent, often creating difficulty trusting others and issues with emotional intimacy. These initial attachment experiences can influence the type of relationships we choose and environments we create later in life. In an environment of secure attachment, our needs for security and closeness are met, and so we feel safe to be vulnerable, connect with others, and explore the world around us. But in an environment of insecure attachment, we may develop dysfunctional behaviors in a misguided attempt to get our attachment needs met, often not knowing what a securely attached relationship even feels like. Looking at these behaviors through the lens of attachment theory helps us find better ways to achieve the same goal: To feel seen, heard, safe, and loved.
Understanding attachment theory helps put words to our body’s attachment experiences. Our body is wired with systems that are always working to gain and maintain safety and survival. For example, our body’s appetite system lets us know when we are hungry and cues us to eat. Similarly, our body is wired with an attachment behavioral system that causes our bodies to experience distress when our attachment feels threatened and maintain this distress until we get our attachment needs met. Just like we learn to recognize our body’s signals of hunger and how to communicate and meet those needs, counseling can help us learn to recognize our body’s signals for attachment and how to communicate and meet those needs in functional ways.
If your counselor practices attachment theory, you can expect them to:
Prioritize the therapeutic relationship
Create a safe, non-judgmental environment for you to explore painful feelings and experiences
Help you identify your individual attachment style and explore the role that it plays in your current relationships
Support you in exploring past experiences that shaped your attachment system and encourage you to reflect on how these experiences may impact the way you perceive and interact with the world now
Help you shift dysfunctional perspectives and engage in more functional behaviors to meet attachment needs
Attachment theory is not just about the past; it’s also about the future. The therapeutic relationship itself can serve as a corrective emotional experience, allowing us to process and challenge dysfunctional attachment patterns in a safe, supportive, and secure environment. By learning to recognize, communicate, and fulfill our attachment needs, counseling can help us develop and feel a more secure attachment with our loved ones and ourselves.
Curious about your attachment style? Take this free quiz!!
Written by: Hailey Adams, M.Ed., LPC
Polyvagal Theory and Our Nervous System: A Path to Healing Through Understanding
Our nervous system plays a central role in how we experience and respond to stress, trauma, and everyday challenges. When it becomes dysregulated, we can feel stuck in patterns of anxiety, anger, or overwhelm. Through Polyvagal Theory, we can learn about how our nervous system functions to better understand and regulate our emotional states.
Imagine yourself taking an afternoon stroll when you suddenly come face-to-face with a bear. You feel your adrenaline kicking in and you quickly assess how to respond to keep yourself safe. You first consider fighting back or running away (“fight-or-flight”) before deciding to lay down and play dead (“freeze”). Once the bear has returned to the woods, do you get up and calmly continue your stroll? No! You run back to the car as quickly as you can. Throughout your drive home you slowly start to notice your adrenaline subside and your body returns to a state of calm, but the next time you visit that path, you’re likely to find yourself more alert than before. Now imagine that happens again and again and again. You may find yourself extremely on edge and anxious even anticipating the walk, or you may avoid going on walks altogether. This is what it’s like for our system to experience chronic stress and trauma.
What is Polyvagal Theory?
Polyvagal Theory, developed by neuroscientist Dr. Stephen Porges, explains how our nervous system influences our emotional experiences and behaviors. This theory focuses on the vagus nerve. The vagus nerve is responsible for our autonomic functions like heart rate, breathing, and digestion, as well as how we respond to stress and danger. Our nervous system is constantly seeking a state of safety and connectedness, and our emotional and physiological states are deeply interconnected with our sense of safety.
The theory identifies three primary states of the nervous system:
The Social Engagement System (Ventral Vagal State): This is the state of safety and connection. When we are in this state, our body is calm, and we feel relaxed, present, and able to connect with others. We engage in healthy communication, and our emotional responses are balanced.
Fight or Flight (Sympathetic Nervous System): When we sense danger or threat, our body enters a state of heightened alertness. In this state, we may experience anxiety, rapid heart rate, or feelings of anger or fear. This response helps us survive, but when overactive, it can lead to chronic stress and difficulty calming down.
Freeze or Shutdown (Dorsal Vagal State): When the body perceives a threat as overwhelming, it may enter a state of collapse or shutdown. This is often linked to feelings of numbness, dissociation, or immobilization.
How Polyvagal Theory Can Help in Therapy
Utilizing Polyvagal Theory in therapy can help clients recognize where they are in their nervous system and how to shift toward more balanced states of being. Here’s some examples of what Polyvagal Theory may look like in therapy:
1. Building Safety and Connection
The relationship between the therapist and client is shown to be the biggest factor in determining client outcomes, meaning it is crucial to create a space where clients feel safe, heard, and understood. Polyvagal Theory emphasizes the importance of tapping into the ventral vagal state to increase social engagement and connection. Therapists trained in Polyvagal Theory will often work to establish a strong therapeutic alliance, offering a grounding presence for coregulation, attunement to the client’s emotional experiences, and unconditional positive regard. When a client feels safe, they are better equipped to engage in the therapeutic process.
2. Recognizing and Tracking States
Through the lens of Polyvagal Theory, clients can begin to identify their experiences within each state of their nervous system. Therapists may help clients track their emotions, noticing when they feel grounded, activated, or shut down. By learning to identify these states in real-time, clients can begin to develop tailored tools for self-regulation.
3. Regulating the Nervous System
Therapists can help clients develop strategies for shifting from dysregulated states back into a balanced, ventral vagal state. Techniques often used include:
Grounding exercises: Mindful movement and sensory awareness can help clients reconnect with the present moment and their bodies.
Somatic experiencing: Focusing on bodily sensations and using movement and stretching helps to release stored tension in the body.
Breathing exercises: Slow, deep breathing signals to your brain that you're safe.
Guided imagery: Clients may be guided to imagine a container to help hold heavy feelings and experiences, or imagine a safe, calming environment, which can activate the social engagement system and promote a sense of safety.
4. Healing Trauma and Chronic Stress
Trauma and chronic stress can keep us feeling stuck in a state of arousal or dissociation. Polyvagal Theory is particularly helpful in treating trauma because it helps clients understand how trauma can be stored in our bodies. Clients may explore how their trauma has influenced their nervous system and work to create a safety and stability before diving into deeper emotional work.
Moving Toward Healing and Regulation
By understanding the science behind Polyvagal Theory and learning how our nervous system works, we can take an active role in restoring balance within our system. The journey often begins with awareness—recognizing when we are dysregulated and learning ways to gently bring ourselves back into a grounded state. If you are feeling “stuck” in a state of overwhelm, anxiety, or disconnection, know that you are not alone. Your body is doing what it is designed to do… Keeping you safe! Through therapy, clients can begin to restore their sense of safety and heal the effects of chronic stress and trauma
Written by: Hailey Adams, M.Ed., LPC
Signs of High-Functioning Anxiety
I decided to write this blog post because well, it describes me perfectly. I recently came across the term “high-functioning anxiety” in an Instagram post and a lightbulb went off in my brain. “Hey! That’s me!”
To be honest, it wasn’t until the last few years that I was even able to admit to myself that I struggle with anxiety. It’s not because of the stigma because hey, who DOESN’T struggle with anxiety and/or depression these days?!? Plus, I work in the field of mental health, I should know what anxiety looks and feels like right? Probably, but for me, I missed the symptoms because my version of anxiety doesn’t look like most other versions of anxiety that I’m usually seeing in my office.
High-functioning anxiety is a term often used to describe individuals who experience symptoms of anxiety but are able to function well in their daily lives, sometimes masking the emotional distress beneath a façade of outward success. People with high-functioning anxiety may appear calm, composed, and successful, but they may be struggling internally with intense stress and worry.
Here are some common signs of high-functioning anxiety:
1. Overthinking & Perfectionism
Constantly analyzing every decision or action, fearing that making a mistake will have severe consequences.
Setting extremely high standards for oneself and being overly critical of mistakes or imperfections.
2. Constant Worrying
A constant feeling of unease or tension about the future, even when things are going well.
Often thinking about worst-case scenarios, even if there is no logical reason to expect them.
3. Difficulty Relaxing
Struggling to relax or unwind, even when there’s nothing to do.
Feeling on edge or restless, making it hard to "turn off" thoughts, especially before bed.
4. People-Pleasing
A strong desire to please others and avoid conflict, often at the expense of one’s own needs or well-being.
Feeling guilty for saying "no" or setting boundaries, even when it’s necessary for self-care.
5. Tendency to Hide Emotions
Masking feelings of anxiety or stress by keeping up appearances, often presenting a calm or composed exterior.
Not wanting to burden others with personal struggles and avoiding sharing vulnerabilities.
6. Physical Symptoms of Anxiety
Experiencing physical symptoms like muscle tension, headaches, stomach problems, or fatigue without obvious medical causes.
Difficulty sleeping due to racing thoughts or being constantly alert.
7. High Levels of Self-Criticism
A constant inner dialogue of self-doubt and harsh judgment, often thinking one isn’t doing enough or that they're not good enough.
Feeling like you need to constantly prove yourself to others, even when it's unnecessary.
8. Difficulty Saying "No"
Taking on more work or responsibilities than can be reasonably managed, out of fear of disappointing others.
Overcommitting to things even when overwhelmed or stressed.
9. Overachieving Behavior
Pushing oneself to achieve or perform at a high level in all areas of life (career, relationships, hobbies), often to compensate for internal anxiety.
Often feeling like you must be “the best” or always in control.
10. Avoidance of Negative Emotions
Trying to avoid or suppress negative feelings like sadness or frustration by staying busy or focusing on productivity.
Often dismissing or invalidating emotions because they’re perceived as a weakness.
11. Social Anxiety or Fears of Judgment
While still managing social interactions, there may be underlying anxiety about how others perceive you, leading to perfectionistic behavior or self-consciousness.
Fear of being judged or evaluated, even in routine situations like meeting friends or colleagues.
12. Chronic Stress & Burnout
Consistently feeling overwhelmed by daily tasks, responsibilities, and expectations, leading to mental and physical exhaustion.
Struggling to take breaks or prioritize self-care, often because there’s a sense of guilt or pressure to keep performing.
13. Difficulty Asking for Help
Preferring to handle everything independently, even when help is needed, due to a fear of appearing weak or incapable.
Reluctance to seek professional help, such as therapy or counseling, for fear of being judged or not being taken seriously.
14. Avoiding Change or Uncertainty
A strong desire for control and stability, leading to anxiety when faced with uncertain or unpredictable situations.
Reluctance to try new things or take risks due to fear of failure or not being perfect.
15. Imposter Syndrome
A persistent feeling of being inadequate or that one doesn’t deserve success, despite external achievements.
Feeling like a “fraud” or fearing that others will "find out" you don’t know what you're doing, even when there’s no real reason to feel this way.
While high-functioning anxiety can often go unnoticed because the person seems outwardly capable, it's important to recognize that these internal struggles can take a toll over time. If any of these signs resonate, it may be helpful to consider speaking with a mental health professional to explore coping strategies and manage anxiety in a healthier way.
For me, in my own work with my therapist, I’m learning to identify the parts of myself that constantly feel the need to “do” and “achieve” (also the why of how they got that way in the first place, HELLO childhood trauma!) and helping these parts to find more balance within my internal system. I’m learning (slowly but surely) to PLAY more, ask for help more, say NO more and navigate boundaries in a more healthy way.
Written by Britney Cirullo, MA, LPCC-S, BCN
The Neurobiology of Men’s Mental Health: Key Insights into Brain and Behavior
One of my biggest passions as a therapist is working to break the stigma surrounding men’s mental health. I hope we, as a society, can begin to have more open conversations and put more focus on this very important topic. Right now, there isn’t much education surrounding it which leaves a gap in care in my opinion. As a therapist, it is important to understand that men and women are wired differently and caring for their mental health should be treated as such. In order to better care for men, we need to understand why they are different.
Men’s mental health is shaped by a complex interplay of biological, hormonal, and neurological factors that influence how they experience and manage emotions, stress, and mental health challenges. By understanding these underlying mechanisms, we can gain valuable insights into why men may face unique mental health struggles, often different from those experienced by women.
One of the key differences lies in brain structure. The amygdala, which plays a central role in processing emotions such as fear and aggression, is typically larger in men. This difference can make men more prone to externalizing behaviors like impulsivity, risk-taking, and even aggression. This doesn’t mean men experience emotions more intensely, but it may explain why these emotions manifest in more outwardly expressive ways. On the other hand, the prefrontal cortex, responsible for decision-making, emotional regulation, and impulse control, tends to be smaller in men. This could make it more difficult for men to manage their emotions and reactions to stress, leading to a greater likelihood of acting on impulse rather than processing feelings calmly. Another important factor is the more pronounced hemispheric specialization in men’s brains. With the left hemisphere being dominant for logical reasoning and the right for emotional expression, men may find it harder to articulate their emotions, often suppressing them instead.
Hormonal influences also play a significant role in shaping men’s mental health. Testosterone, the primary male hormone, directly impacts mood and behavior. While high testosterone levels are linked to competitiveness and aggression, low levels can lead to feelings of depression, irritability, and anxiety. This hormonal shift becomes particularly relevant as men age and testosterone levels decline, leading to a condition sometimes referred to as “andropause,” which is marked by mood swings, fatigue, and depressive symptoms. Stress hormones, particularly cortisol, also impact men differently. In response to acute stress, men tend to produce more cortisol, which helps them handle immediate threats. However, chronic stress can lead to elevated cortisol levels over time, contributing to long-term issues such as anxiety, depression, and burnout. Men’s tendency to endure chronic stress without addressing it can exacerbate these challenges.
Neurotransmitters, the brain’s chemical messengers, further influence men’s mental health. For instance, serotonin, which regulates mood, sleep, and appetite, plays a critical role in depression. While serotonin deficiencies can lead to depression in both men and women, men may express this deficiency differently—often through irritability, anger, and aggression, rather than the sadness more commonly associated with depression in women. This difference in expression can make it more difficult for men to recognize when they are experiencing depression, as their symptoms may not align with traditional views of the condition. Dopamine, another crucial neurotransmitter, drives motivation and pleasure. Men, who often exhibit higher levels of dopamine-driven behaviors, may be more prone to risk-taking and thrill-seeking. These tendencies can lead to addictive behaviors, such as substance abuse, as a way to cope with underlying mental health struggles. Additionally, GABA, a neurotransmitter that helps calm neural activity, plays a significant role in managing anxiety. Low levels of GABA in men can contribute to feelings of heightened anxiety, restlessness, and difficulty relaxing, although this anxiety may manifest outwardly as irritability or frustration rather than nervousness.
The way men process and respond to trauma also differs. After experiencing trauma, men may develop heightened activity in the amygdala, which can result in a constant state of hypervigilance. This chronic stress response can contribute to long-term mental health challenges such as anxiety disorders and post-traumatic stress disorder (PTSD). For men, PTSD often manifests through anger, aggression, or emotional numbness, rather than the fear and avoidance behaviors more commonly seen in women. Trauma also impacts the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the body’s stress response. Chronic trauma can lead to long-term overactivation of this axis, causing persistent cortisol release. This not only increases the risk of developing anxiety, depression, and other mental health disorders but can also contribute to physical health problems, such as cardiovascular disease.
Despite the clear neurobiological underpinnings of men’s mental health challenges, many men struggle to seek the help they need due to societal stigma and underdiagnosis. Men are often socialized to suppress their emotions, avoid vulnerability, and adopt a self-reliant attitude. This reluctance to express emotional distress or ask for help can prevent men from acknowledging mental health issues and lead to untreated conditions. Instead, men may turn to unhealthy coping mechanisms such as substance abuse or risky behaviors. One of the most concerning aspects of men’s mental health is the high suicide rate. Men are significantly more likely to die by suicide than women, even though women tend to make more suicide attempts. This disparity is partly due to the fact that men are more likely to use lethal methods, but it also reflects the many untreated or undiagnosed mental health conditions that men often endure in silence.
Improving men’s mental health requires a multifaceted approach that takes neurobiology into account. For men experiencing mood disturbances due to low testosterone levels, hormone replacement therapy (HRT) may offer a solution. Neurobiologically informed therapies, such as cognitive-behavioral therapy (CBT), mindfulness practices, and trauma-focused interventions, can help men manage stress, process emotions, and heal from past trauma. Trauma-specific therapies like Eye Movement Desensitization and Reprocessing (EMDR) can be particularly effective in helping men reprocess traumatic memories and reduce their impact on brain function. However, breaking the stigma surrounding men’s mental health is perhaps the most important step. Creating an environment where men feel safe expressing their emotions and seeking help without fear of judgment is crucial for improving mental health outcomes. Normalizing conversations about mental health and challenging harmful stereotypes about masculinity can empower men to address their mental health concerns before they escalate.
In conclusion, the neurobiology of men’s mental health reveals unique challenges that stem from differences in brain structure, hormones, and neurotransmitters. By addressing both biological and social factors at play, we can develop more effective strategies for working with men on their mental health. Encouraging men to seek support and breaking down societal barriers around mental health is so important.
Written by: Grace Williamson, LPCC, BCN
Exploring the Subconscious Mind with Psychodynamic Therapy and EMDR
“Until you make the unconscious conscious, it will direct your life and you will call it fate” -Carl Jung (maybe)
“I am not what has happened to me, I am who I choose to become”- Carl Jung (allegedly)
These two quotes attributed to Carl Jung represent the lens through which I view therapy. Now, there is no general consensus whether he ever said these exact words. Likely people have condensed some of his longer teachings into these quotes. Unfortunately, Carl isn’t around to tell us, but the message remains the same: Becoming the person you want to be takes action.
In the ever-evolving landscape of psychotherapy, practitioners are continuously exploring new approaches and techniques to help clients heal and empower themselves. Two such methodologies - psychodynamic therapy and Eye Movement Desensitization and Reprocessing (EMDR) - offer distinct yet complementary tools for psychological healing. Their integration can offer a holistic approach to trauma recovery and personal growth.
At the heart of psychodynamic therapy lies the belief that much of our mental life operates outside of conscious awareness, driven by unconscious forces and dynamics. Through exploration of the unconscious mind, clients gain insight into the root causes of their thoughts, emotions, and behaviors, paving the way for lasting change and personal growth. Psychodynamic therapy often involves exploring early life experiences, attachment patterns, and the dynamics of the therapeutic relationship to uncover and resolve unconscious conflicts.
EMDR therapy offers a more structured approach to trauma treatment, focusing on processing distressing memories and resolving lingering symptoms. Developed by Francine Shapiro in the late 1980s, EMDR utilizes bilateral stimulation such as eye movements, tapping, or auditory tones to facilitate the reprocessing of memories. Through a series of guided protocols, clients are able to desensitize and reprocess past experiences, leading to symptom reduction and emotional healing.
Despite their differences, psychodynamic therapy and EMDR share a common goal: to help clients overcome psychological barriers and live more fulfilling lives. When integrated effectively, these two approaches can offer a powerful framework for trauma recovery and personal transformation.
Psychodynamic therapy and EMDR both emphasize the importance of the therapeutic relationship as a catalyst for healing by providing a safe and supportive environment in which to explore innermost thoughts and feelings. I believe this is the most important part of any therapy and what I focus on first.
Additionally, psychodynamic therapy and EMDR share a focus on the role of unconscious processes in shaping behavior and emotional experience. While standard EMDR primarily targets conscious memories of trauma, psychodynamic therapy delves deeper into the unconscious roots of psychological distress, exploring how early life experiences and relational patterns continue to influence clients' lives in the present. By integrating insights from psychodynamic theory into the EMDR process, therapists can help clients uncover and address underlying issues that may be contributing to their symptoms.
By blending these two modalities, I help my clients identify and explore the unconscious programming that has been running their lives, then rewrite it so they can begin living their most authentic life.
Written by: Grace Williamson, LPCC, BCN
Breaking the Silence: Men’s Mental Health Matters
Hey men, this one’s for you. Were you ever told growing up, or maybe even recently, to “man up” or “take it like a man”? Remember “Boys don’t cry”? Showing emotions, vulnerability? Never. That is a sign of weakness, right?
I’m guessing many of you answered yes to those questions. And if so, I’m sorry. We as a society have done you a disservice.
We live in a society where stoicism and strength are praised and vulnerability is seen as a weakness. We hear terms like “toxic masculinity” and “snowflakes” to describe either end of the spectrum. These societal norms and pressures put on men often make it challenging for them to seek help or even acknowledge their struggles. As a result, many men suffer in silence.
To help break this stigma, we have to start talking about it. In recent years, men have started to speak up more. Take NBA Player Kevin Love for example. His article in The Player’s Tribune was the first time I remember a professional athlete speaking up about his own mental health. The LA Dodgers are continuing to renew the contract of Andrew Toles so that he can have health insurance while he seeks help for Schizophrenia. We’re getting there, but it’s not enough.
I welcome all types of people into my office but my passion lies in helping men – the type of men that have been told to “toughen up”. The men that silently carry the burden of providing for a family in this economy. The “toxic masculinity” men. The men who, well, frankly, we wouldn’t expect to see walk into a therapist's office. If you are hesitant, resistant, and down right scared to try therapy, but still want to.. please call me. We can talk sports, work, kids, money, anything! I just want you in the door.
Try this on for size. What if strength looked like staring judgment in the face and telling it to… well… you know? What if it looked like facing your demons head on and defeating them? Strength can be found in between “toxic masculinity” and “snowflake”, the balance between tough and vulnerable. Strength comes in many forms; it doesn’t always look like what society has made it out to be. Maybe the strongest thing you can do is ask for help.
Grace Williamson, M.Ed, LPCC, BCN, CCTP