Men's Mental Health

Why You Need a Therapist Even if You Have Great Friends

By Kacie Mitterando, LMSW

This past week I came across a post on Instagram regarding friendships and therapists that led me to do some thinking about my practice with clients, friendships and psychotherapy in general. In this specific post, an individual was asking what the difference is between a friendship and a therapist but more specifically they were wondering if we have healthy friendships in which we feel open talking with them about our emotions, is seeing a therapist necessary?

This question got me thinking…

Healthy friendships are undeniably important and having friends that we feel like we can reach out to during good times along with the bad can make a huge difference in our well being. Research has consistently shown that healthy relationships with those around you can be an indicator in longevity as well as overall health. More recently, studies have shown that older individuals who haven’t maintained friendships are more likely to develop chronic diseases such as heart disease, diabetes and depression (1).

Seeing a therapist is also important and can help increase our overall wellbeing and feelings of support as well! A relationship with a therapist can even seem similar to a friendship in some ways but also has some major differences. For example, therapists disclose much less about themselves and the therapeutic relationship does not extend into one’s personal life, such as celebrating an event like a birthday together. However, while we have conversations with our friends, therapy often isn’t a conversation and rather, can feel a lot like learning. This learning isn’t the typical learning such as sitting in a science class but rather, learning about yourself as well as tools you may use to help conquer some of your current concerns (2).

Despite this, there are many parts of friendships that can feel therapeutic. In fact, there’s an activity I’ve been using with my clients lately that I wanted to share as an activity that can definitely be done between trusted and caring friends.

For your next wine night, TGIT Shondaland date, or just a typical-hang out, use the “Miracle Question” with your BFF to help think about your goals and ways in which you may want to tailor your life to reach these goals.

Begin with this prompt:

"Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, you notice that a miracle has happened and your most positive dreams for the future have come true. Remember, a miracle has occurred and you have just woken up to your life as you would ideally like it to be.”

After this prompt, some things may come up for us: we might be thinking about a beautiful home we would have purchased or having the fastest car on the recent market. However, it can be more difficult to plan what our day to day would actually look like. I like to start by asking:

1. “How do you feel when you wake up?”

After allowing them to respond I normally repeat what they said, “So you wake up, you feel content and then…”

2. “What is the first thing you will do?”

3. “Afterwards, your best friend comes over. As soon as they arrive they noticed that something in your life has drastically improved. What is this improvement they have noticed?”

4. “Your best friend leaves, what is it that you do next?”

5. “What does the rest of this day look like?”

6. “What day of the week is this?”

7. If it is a weekend: “What does a weekday look like?” If it is a weekday: “What does a weekend look like?”

The Miracle Question is an example of an activity from a model of psychotherapy called Solution Focused Therapy. This therapy is centered on each person’s goals and the steps needed to take to reach these goals (3).

I hope you enjoy spending some time bonding with your most trusted friends. If you feel ready to add a therapeutic relationship into your life and complete more activities such as The Miracle Question, reach out to us to schedule a phone consultation.

Why Do We Need Friends? Six Benefits of Healthy Friendships. (n.d.). Retrieved from

Are Therapists Just Rent-a-Friends? (n.d.). Retrieved from

Cool Intervention #10: The Miracle Question. (n.d.). Retrieved from

Are You Feeling Guilty For Going to Therapy?

Do any of these sound familiar?

“My problems aren’t big enough to come to therapy.”

“There are so many people who have it worse than me.”

“Coming to Therapy Seems Indulgent”

For many people new to therapy, feelings of guilt and shame are common. Specifically it can be common to feel guilty about having problems. If this is you I completely understand how difficult it may be to give yourself space and permission to have problems. You may have come from a life of privilege. Possibly you have two loving parents and plenty of friends. You might even have all that AND a fulfilling job that many people would love to have.

EVEN IF you have those things, none of those make you immune to being human. Being human means you have complex emotional experiences from moment to moment. Being human means some things can be upsetting without you fully understanding why. Being human can also mean always wanting to be better no matter how great life seems on paper.

Allow Yourself To Have Unpleasant Emotions

If you don’t take anything else from this brief article, please understand this:

You deserve permission to feel and work through the full range of human experience

Yes I’m talking to you, CEO and father of two. Yes I’m talking to you, Vice President of the banking world. Yes I’m talking to you, college graduate with the world ahead of you.

No matter your background or ethnicity or social class, you will have down moments, you will struggle with decisions and identity and your place in the world. And that’s ok. Your therapy sessions are meant for you to be the best version of yourself and that just can’t happen if you don’t look at the dark, shadowy unpleasant parts. We all have them. (If you want to learn more about exploring our shadow selves, you may enjoy this article.)

Consider giving yourself permission to take care of all the complex parts of yourself Therapy is a great place to start. Want to chat about how therapy can help? Connect with us today.

4 Tips For Overcoming Rejection

By Kacie Mitterando, LMSW

Researchers have spent years trying to pin down exactly how many emotional experiences we have a day and it turns out… it’s pretty tough.

One study shows that there are five basic emotions: anger, disgust, fear, joy, and sadness (1). This study has prevailed throughout most other research and is even the basis behind the Pixar movie Inside Out (if you haven’t seen it’s a must!). If you’re one of my clients, you’re pretty familiar with these emotions- mainly because of my “emotions list” (a colored wheel with a variety of different emotions written down) that I hand out when someone is trying to describe the reaction they’ve had to an event. Not everyone likes this wheel and for the most part this makes sense because dealing with our emotions is hard and can trigger many different conditions. In handing this emotion wheel over, something kept popping up for my clients and my clinical skills tell me “if something pops up more than once, there’s something deeper there.”


I’m not sure if there’s another emotion that feels more like a gut punch than the emotion of rejection and it doesn’t help that we normally feel rejected with situations that mean the most to us: relationships, our careers and dream chasing.

Interestingly enough, rejection has a physical reaction that can cause physical pain. In a study published in 2011, the pain of seeing a picture from an ex-relationship that was unwanted is similar to the pain of spilling hot coffee on oneself. Additionally, the brain regions that are activated when we experience physical pain – such as being punched are the same brain regions activated when we are turned away in a social setting or a prospective career (2).

It makes sense that you’re hurting when you’re rejected.

Some reminders that can hopefully be emotional medicine for your rejection pain:

1.     Embrace avoidance and use it productively:

Did you get turned down from the job of your dreams? Remind yourself of your goals and even make a list if needed. Ask yourself some questions such as “why did I want this job?” “What is the job of my dreams?” and “How can I get myself to this goal?” Sometimes after a rejection it can be easier to avoid feeling vulnerable in the future, however, using this moment to fuel productivity can help you find something that may be even better.

2.     Reframe your thoughts:

When feeling rejected it makes sense to fall into a thought pattern that can be harmful, as you are feeling hurt and negative self talk can thrive in this state. Be mindful of these thoughts, embrace them, nurture the part of you that created them and then reframe. There are many reasons why you may have gotten rejected that have nothing to do with you and are in fact a result of where the source of the rejection is in their current life. Maybe a potential place of employment was looking for someone with less/more experience than you had. It’s possible that your romantic interest is simply in a relationship, or going through a tough time and can’t give you the attention you deserve romantically right now. The outlining factors are endless and spending some time thinking about what they may be can help ease some pain (3).

3.     Use this time to practice self-confidence:

One of the most important times to practice confidence is when dealing with rejection. Make a list of all the positive attributes you have and read that list to yourself a few times throughout the day. Text a friend and ask them what their favorite quality about you is and add that to the list. When you’re feeling rejected, it’s a crucial time to be your own best friend and lean on the supports you have to help you with this.

4.     Give yourself a time limit:

Let yourself be sad, hurt and experiencing the range of the “emotions list” when this happens. It’s important to validate and embrace these emotions as they come. While doing so, give yourself a time limit on your grieving. For example, “I will give myself three days of feeling this way and then I will apply to three new jobs (2).”


If the feeling of rejection is something you’re struggling with, as always, we’re here to help.


1.     5 Basic Emotions - Motivation and Emotion. (n.d.). Retrieved from


2.     5 Ways to Shake Off the Pain of Rejection. (n.d.). Retrieved from


3.     How to Conquer the Fear of Rejection. (n.d.). Retrieved from



Take Control of Feeling Overwhelmed

By Kacie Mitterando, LMSW

“I am feeling so overwhelmed today”

“Life is just becoming extremely overwhelming.”

These are few of the statements surrounding overwhelm that I’ve recently heard in several of my sessions. Interestingly enough, I’ve noticed the majority of these statements expressed by those who are experiencing “all-or-nothing” behavior that is causing mild to moderate stress and anxiety in their day to day.

What is overwhelm anyways?

Webster’s dictionary defines overwhelm as “defeat completely” and “give too much of a thing to someone else.” As a therapist, I have been discovering that there’s much more than a simple dictionary definition to this emotion of overwhelm and where it initially stems from. Research led me to an important topic that many of us struggle with from time to time… balance.

Answer emails, answer your friends’ phone call, maintain a relationship with your partner, take the dog for a walk, keep up with the dishes and don’t forget to try to make it to the gym for your cardiovascular health. How do we manage all of this plus more without completely falling over backwards? Defining what’s a priority, reducing multitasking and setting boundaries may help us lead a more balanced life, however, why is this more difficult when we also find ourselves experiencing an “all or nothing” mentality (1)?

Our adult selves are able to handle stressors, threats to our emotional wellbeing and emergencies by using tools we have, such as self-soothing and coping modalities. Conversely, often times and especially when we’re experiencing “all or nothing” mindset we find ourselves thrown into our child self. This is described in theory as transactional analysis. Transactional analysis is a concept based in the principle that we can switch between a parent, adult and childlike ego state and therefore, assess and react to situations based on whichever state we are in (2).

So how do we move away from an all-or-nothing approach and towards our adult-like states to help us efficiently practice balance and reduce overwhelm?

Observe the ego state you are in throughout a conversation with someone you are close to:

When a conversation goes poorly it is often attributed to the conversation being on a sensitive topic. This may be a conversation about politics, religion, or sex. Ask yourself what ego state you were in when a conversation goes wrong. Did my child-like self respond when someone was seeking a parent response? What did I say that could have triggered the child-like self in this person that matters to me (4)?

Identify all or nothing language:

Recognize times in which you are using words such as “always,” “never,” and “every-time.” Some examples of instances in which we all may fall victim to using all or nothing language is statements like “my anxiety ruins everything,” “I will never fight the right person,” or possible to your partner- “you always forget to take the garbage out.” Once recognizing, spend some time thinking of ways in which you can replace this all-or-nothing language with a more realistic approach.

Avoid black and white extremes:

Black and white thinking is not always bad. In fact, it may have helped you get through some tough and challenging moments in life. However, black and white to the extreme can be dangerous and impact overall mood and well being. Once recognizing this thinking, ask yourself another way to look at this situation? For illustration, if a family member did something hurtful and you find yourself thinking “they are a completely terrible person.” Try and reframe this situation by asking yourself “could there be a reason why they made this decision (3)?”


Make a list of what is important to you right now as well as your goals for the upcoming month. Lean on this outline to remind you to place importance on what you would like to get done so balancing tasks becomes a habit. This list doesn’t have to be limited to accomplishments at work or organizational tasks at home but should address many different parts of your life. It is perfectly OK to include in your prioritization list satisfying your social needs or setting a self-care schedule.

If you find yourself struggling with all-or-nothing thinking and your ability to achieve balance is not working, therapists are here to help.

How To Achieve Balance. (n.d.). Retrieved from

Description of Transactional Analysis and Games by Dr. Eric Berne MD. (n.d.). Retrieved from

5 Ways Black and White Thinking Poisons Your Perspective. (2018, September 11). Retrieved from

Morad, N. (2018, February 28). How to Use Psychology to Communicate Better and Avoid Conflict. Retrieved from

Why Entrepreneur Dads Need Mental Health Support

Becoming a father can be an overwhelming experience. Being an entrepreneur AND father can feel unmanageable.

In a world where we are improving to take note of women’s metal health, dads are getting left behind. For many men new parenthood can be an overwhelming trigger leading to depression. There is a gap in mental healthcare for dads for a number of reasons. Did you know that dads go through a tremendous amount of biological changes to prepare for fatherhood?

According to

  • Approximately 68% of women and 57% of men with mental health problems are parents.

  • The most common mental health problems experienced during pregnancy and after birth are anxiety, depression and post-traumatic stress disorder (PTSD).

  • A 2013-2014 study found that 38% of first-time fathers are concerned about their mental health.

  • Around 10% of all new fathers worldwide experience postnatal depression.

According to an article in Scientific American, …”A 2014 behavioral study of expectant fathers showed that midpregnancy ultrasound imaging was a “magic moment” in the dads' emerging connection with their baby. Yet the emotional bond was different than it is in expectant moms. Instead of thinking about cuddling or feeding the baby, dads-to-be focused on the future: they imagined saving money for a college fund or walking down the aisle at their daughter's wedding. “

Now imagine the toll this takes on fathers in the midst of a start-up. Building a business is like birthing a baby on it’s own. Because of the pressure and isolation that comes with being your own boss, entrepreneurs have higher rates of depression than the general population. Add becoming a dad to that and the need for support increases dramatically.

What’s At Stake For Entrepreneur Dads?

1. Bonding Matters for Dads Too

Entrepreneur dads need to set aside time in their schedule to devote to parenting. This means time with out electronics. Even if it’s 30 minutes a day, being unplugged matters.

2. Self Care Is Not Just For Moms

Dads need self care too. This means help scheduling in time for things like the gym, socialization, medical and mental health appointments.

3. Emotions Aren’t Just For Moms Either

Dads experience the same emotions of fear, overwhelm and isolation as new moms. It is important to remember to validate dads and give them time to process how they are feeling about this incredible life change.

It can be helpful to utilize things like in-person or online therapy with someone who understands the challenges of starting a business and being a parent. Sites can match you with the perfect mental health professional in your price range.

Additionally, daily inspirational support resources like Headspace can help keep dads grounded and relieve stress.

4. Parents Need Support Systems

Mommy groups abound, but it might be a bit more challenging finding a group of supportive fathers to spend time with. As a father it may take some searching to feel supported. Don’t be afraid to ask others for help. One place to start is on the web. Sites like has a list of places to find support.

If you or someone you know is struggling with the stress of new parenthood, connect with us today.


National Suicide Prevention Lifeline

We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.


4 Tips To Begin Prioritizing Your Mental Health

By Kacie Mitterando, LMSW

From the moment we wake up to the moment we go to sleep we are faced with a multitude of choices. In fact, some research has even shown that each and every one of us makes roughly 35,000 decisions a day. When broken down that equals 2,000 decisions an hour and even further… one decision every two seconds (1). Hopefully, on the majority of these days the choices are decently simple, which is why we don’t notice we are making them. What will I wear to work today? What will I eat for lunch? Do I want to workout in the morning or at night? Other times these choices can be much more difficult, these are the choices we seem plagued with and find ourselves thinking about often. Do I want to stay in this relationship? Is it time for me to move on from my place of employment? Do I continue to rent or do I purchase a home?

Research shows that decision-making, will power and self-control are all similar concepts in the sense that they can be fatigued. Essentially, this means that we each have a limit to the amount of decisions we are successfully able to make in a day. For some this may be 35,001 and for others this may be 34,000. Picture your decisions as a glass full of water and each time you take a sip, you begin to deplete your cup. Once all of the water is drained, there isn’t anywhere else to tap into, unless of course your cup is refilled. This may help explain why you feel extra exhausted after coming home from a long day at work in back-to-back meetings and also explains why many successful entrepreneurs, such as Mark Zuckerberg, wear the same outfit every day- to save his decision making ability for tougher and more important tasks (2).

This brings me to a tough decision that many of us face each day, the decision to heal from our emotional struggles when we sense our defense mechanisms, particularly denial kicking in during emotional pain.

Denial is normal.

Defense mechanisms are there to protect us and when you think about it intensely, they illustrate the true beauty and intelligence of the mind as it goes to such lengths to keep us emotionally safe. Sometimes we don’t even realize that we are using them.


Switching from denial to emotional healing:

1.      Acting as though a painful situation did not exist and discounting your feelings:

Sometimes it can be easier to deny a heartbreak or stressful situation at work than to face the challenge head on. However, honoring your pain and facing the facts of hurt are a pivotal piece in eliminating any unhappiness you may be experiencing.

2.      Allow this to teach you:

If denial is taking over during a stressful or emotionally painful situation, we take away from the powerful lessons that we may learn from it. While getting through the messy part of facing our fears or hurt can be excruciatingly difficult, asking yourself what this situation can teach you can allow you to grow in ways that may have not been possible.

3.      Punishing yourself and shoving the feelings deeper:

Remember that it is OK to take a break when things become difficult. While it is important to always do your best, it is equally important to remember that your best changes from day to day. Punishing yourself will only dig a deeper hole of emotional pain.

4.      Reach out to support systems:

Remind yourself of the people in your life that are positive supports and you can count on. Make a list of these people with their phone numbers if needed. The key to this is keeping track of those in your life who are positive. A piece of emotional healing may be facing those in your life who are not having a positive impact. In denial, we may continue a friendship or romantic relationship, or even pretend that all is well. However, to emotionally heal we must make the shift to healthy relationships.


Are you struggling with emotional healing? We understand. Schedule a 15-minute phone consultation with us today.


1. How Many Decisions Do We Make Each Day? (n.d.). Retrieved from


2. Mesh, J. (n.d.). We Make 35K Decisions a Day-Here's How To Beat Decision Fatigue. Retrieved from