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

5 Ways Tidying Up Can Improve Your Mental Health

I remember as a girl coming home to what looked like a completely different house. This happened around season changes and times of conflict between my parents. The furniture would be re-arranged and we would have a brand new set of throw rugs in the bathroom. Why? Because my mother knew the power of the KonMari method long before there was such a thing. When mom needed to regroup, relieve stress and gain some emotional clarity, the house would get a good old fashion Spring cleaning - Spring or not.

In 2011 Marie Kondo published The Life-Changing Magic of Tidying Up. At the time of my writing this blog, her book has sold over 10 million copies worldwide. This didn’t just happen by accident. Marie has been studying the art of tidying since she was a child. She even wrote her college thesis on the topic. Marie’s book (and now Netflix series) briefly touches upon the overall benefits of sorting, organizing, and tending to the objects around us.

In her book, Marie touches on the idea of difficulty letting go of objects (attachments) as a kind of in-between place.This indecision can be a combination of both depressed (sad, nostalgic, longing) and anxious (worried about the future) states causing us to feel stuck.

“But when we really delve into the reasons for why we can't let something go, there are only two: an attachment to the past or a fear for the future.” “The space in which we live should be for the person we are becoming now, not for the person we were in the past.” “Keep only those things that speak to your heart.

Taking inventory of our things can be a powerful action step to finding our way out of stuck emotions. Let’s take a look at some of the ways tidying helps us feel better.

1. It Reduces Anxiety - Tidying can help relieve anxiety in a number of ways. One study looked at obsessive cleaning and it’s impact on anxiety. This article sites A study in the journal Current Biology found a link between temporary anxiety and obsessive cleaning. ... The study's authors hypothesize that in times of stress, people might turn to repetitive behavior like cleaning because it gives them a sense of control over an otherwise uncertain situation.

This article sites common experiences of individuals with anxiety and the benefits they receive from cleaning including likening cleaning to meditation, gaining the benefit of a tangible outcome and making their home a safe and comfortable space to relax.

2. Tidying Improves Focus - “By handling each sentimental item and deciding what to discard, you process your past. If you just stow these things away in a drawer or cardboard box, before you realize it, your past will become a weight that holds you back and keeps you from living in the here and now. To put your things in order means to put your past in order, too.” - Marie Kondo

Marie’s quote illustrates the power of clearing up emotional space as a way to focus. She isn’t just talking about getting rid of stuff, she is talking about looking at our attachments and deciding that it’s time to let go of things that are draining our energy, thus giving us more room to focus on the important things.

According to a study from The Journal of Neuroscience, the less clutter present in our vision, the more focused we can be.  

3. It Boosts Your Mood - Check out the results from a study by UCLA’s Center on Everyday Lives and Families (CELF) (from

A link between high cortisol (stress hormone) levels in female home owners and a high density of household objects. The more stuff, the more stress women feel. Men, on the other hand, don’t seem bothered by mess, which accounts for tensions between tidy wives and their clutter bug hubbies.

Women associate a tidy home with a happy and successful family. The more dishes that pile up in the sink, the more anxious women feel.

Even families that want to reduce clutter often are emotionally paralyzed when it comes to sorting and pitching objects. They either can’t break sentimental attachments to objects or believe their things have hidden monetary value.

Although U.S. consumers bear only 3% of the world’s children, we buy 40% of the world’s toys. And these toys live in every room, fighting for display space with kids’ trophies, artwork, and snapshots of their last soccer game.

4. Tidying Encourages Healthy Habits - Tidying up can help with overall life satisfaction and goal achievement. Being tidy is reflected in the habit of a chef preparing to make a meal. The first thing they do is set up their mise en place or everything in it’s place. Having things in their rightful place gives us a sense of readiness and preparation for challenges and projects.

5. Tidying Fosters Meaningful Relationships - To me this is the most important of all. In our therapy practice we believe that everything is a relationship. We believe that all relationship are significant and whether it’s your relationship to the clothing in your closet or your relationship to your mother, they are all worth examining.  

One very direct way that tidying can improve relationships is the impact a clean home has on romantic couples and domestic partners. In an article from the Huffington Post, two research studies were sited.

According to a 2016 survey of newly divorced people, 30 percent of respondents named “disagreements about housework” as the top reason for the split-ups, which came in third after infidelity (40 percent) and drifting apart (35 percent). A Pew Research Center study from the same year found that more than half of all married respondents (56 percent) said that sharing household chores was “very important” to a happy marriage.

Sometimes Letting Go Is Hard

Need help getting started with your tidying? Therapy is a great place to discuss barriers to getting started with things like the KonMari method. Contact us today for a free 15 minute consultation.

What is Identity and Why is it Important?

By Amanda Polster, LMSW

“The strongest force in the universe is a human being living consistently with [their] identity.”

~Tony Robbins

Our identities helps make up and define who we are. Our identities are comprised of both our personal lived experiences and environments (nurture), and our biological and genetic composition (nature). Our identities are made up of the intersection and layers of various characteristics, including gender, social class, age, sexual orientation, race and ethnicity, religion, age and disability to just name a few. These characteristics play a significant role in how we understand and experience the world, as well as shape the type of opportunities and/or challenges we face. Identities are very complicated, and can also vary based on the situation or circumstances we encounter.

As part of our identity, it is important to acknowledge that we all have certain biases that we have learned through our experiences and environments. Malcolm Gladwell, a well-known author and researcher, helps us identify that although we all come with certain biases, we have an ability to [unlearn] some of these assumptions by changing our perspectives, beliefs, and experiences (Gladwell, 2005).

Let’s look at a riddle below:

A father and son are in a car accident and are both badly hurt. They are both taken to separate hospitals. When the boy is taken in for an operation, the surgeon (doctor) says “I can not do the surgery because this is my son.”

How is this possible?

Now if you first guessed that the surgeon is the boy’s gay, second father, you could be right. However, a less common, yet accurate guess to this riddle is that the surgeon is the boy’s mother.

This riddle has been used in many studies to identify gender biases, and during these studies, only about 15% of individuals are able to identify that the boy’s surgeon is his mother (Barlow, 2014).

It is important that we acknowledge our own biases and assumptions to increase our openness and connection towards others. The more grounded we are in our own identities, the more openness and acceptance we can have towards others.

Tips to help us feel more grounded in our identities

Using mindfulness to enhance self awareness

Identity formation is a key part of life, and evolves and shifts over time. It is easy to feel insecure at times, especially when we find ourselves in challenging transitions (i.e. new relationship, moving to a new city, starting a new job, etc.) To help improve self-confidence, we can begin to learn ways of feeling more secure with our identity.

We can ask ourselves questions that prompt greater self-awareness:      

1.       What part of my identity am I insecure about?

2.       What have I experienced in the past that impacts my identity?

3.       What am I currently going through that can be impacting my identity now?

4.       What do I need right now to feel more grounded?

5.       Who can I seek help from to work through these challenges?

If these questions are too challenging in the moment, this is a perfect opportunity to use mindfulness techniques to be present and accepting of this challenge. Take a few moments to breathe into the discomfort of not knowing how to overcome challenges, and validate yourself for being courageous to learn ways of building self awareness.

Using affirming self talk can help reframe challenges we may have when attempting to feel grounded in our identity. We can use some of these statements to help us think about our relationship with ourselves and with others as learning experiences and opportunities to enhance our self awareness and overall confidence:

        1. “I reflect and explore pieces of me to learn about my talents, capabilities, and growth.”

        2. “Exploring my identity in comparison to others helps me learn new cultures and experiences.”

        3. “When I feel less secure, this is a normal human experience and part of me learning about


Using CBT to become more self aware and grounded

One way for us to feel more connected with our identity is to reflect on our beliefs, values, and actions. When we understand the beliefs and values that we feel closely connected with, we can assess whether our actions are in accordance with these values - i.e. if generosity is an important value to our identity,  do we treat others with generosity? If we find ourselves acting in ways that contrast our values - i.e. saying hurtful things during an argument - we can use these moments as opportunities to learn more about our triggers, become more self aware of what these triggers mean, and assess how they impact our behavior.


Asking better questions to get better answers

We all have the right to identity the way we prefer. When we generalize how we identify with others, we might be making assumptions about other people’s identities. These assumptions often come from our comfortability of wanting someone to identify the way we believe is most acceptable. We naturally categorize people into boxes to help us relate to them, yet we might be oversimplifying their identity or identifying them incorrectly. Although the intention of assuming identities may come from a place of wanting to connect with someone, we might be harming someone or minimizing their preferred identity through this process.

We can ask these questions to reflect on our experience with assumed identities

1.    “Have I ever assumed someone’s identity? (i.e. assumed someone’s gender)”

2. “What can I do in the future to prevent this from happening”

3. “Has someone ever assumed my identity? (i.e. assumed my race of ethnicity)”

4.  “What do I need in moments when I believe someone is making assumptions about me, and how can I communicate that appropriately?”

We all experience the ebbs and flows of forming our identity. While identities are naturally complicated, we have many opportunities to lean into our identity to increase overall self confidence and acceptance.

Barlow, Rich. 2014. BU Research: A Riddle Reveals Depth of Gender Bias.

Gladwell, Malcolm. 2005. Blink. Malcolm Gladwell.

The 4 Words That Are Ruining Your Self Esteem

Have you ever stopped to really listen to the negative chatter taking place in the background of your mind? Or possibly that chatter is more front and center. It might even be running the show.

Some people experience negative, critical inner dialogue quite frequently. Often it is described as the part of us that motivates us to do better. While it’s absolutely true that we can be motivated by critical (sometimes even cruel) inner dialogue, that doesn’t mean it has to be that way.

Just think back to bosses current and past. Have those bosses been compassionate, supportive and kind? Or have they been ruthless, uncaring and cruel? Who motivated you best? Just like in the outer world of our jobs, our inner world too has a manager of sorts. All of us have an internal manager (motivator) that drives our daily decisions. Pause for a moment and consider, what is the demeanor of your inner manager?

Possibly even take a minute to write down all the things your inner manager says to you. If your inner boss sounds anything like this:

“Why did you do that? Yo are so stupid.”

“No one really likes you.”

“You are a failure. Why can’t you do better?”

“You’ll never make it.”

“Why do you have to be that way?”

“I can’t stand when you act like that”

…then the core belief that you have about yourself is probably this:


Those four words are so damaging to everything that you want to do in your life. If you find yourself in a constant swirl of negative self talk, ask yourself: Do I really believe I am enough as I am? If the answer is yes, great! If its a no, then it’s time to talk it out. It’s time to find out where this core belief began. It’s time to stop making that belief stronger.

As one of my favorite author’s Louise used to say, “You are lovable because you exist.” If you are having a hard time believing that, you may want to explore the concepts of earned worth versus inherent worth. Earned worth is all those things we work really hard for and deserve because of merit. Inherent self worth is the idea that all humans have value because they are alive. Inherent worth can be strengthened without outside influences. It can be done through the practice of self love and deep respect for our individual experience.

Wherever you are, whatever you are doing right now - YOU ARE ENOUGH.

Be well - Ruschelle

Isolation Versus Dissociative Disorders: How to tell the difference

A recent survey of 20,000 U.S. adults found that nearly half of people suffer from feelings of loneliness and isolation. This is a normal part of life and can often be related to very common transitions such as moving away from home or the in ability to have time for friends and family due to work obligations. Other factors can also contribute to feeling lonely such as low self esteem or ending a romantic relationship. Lack of sleep (which impacts over 60 million Americans) can make feelings of loneliness and isolation more intense.

But how do we know when it’s something more than isolation?

One experience that feels similar to isolation but clearly isn’t is that of a dissociative disorder.

What are Dissociative Disorders?

According to the National Association of Mental Health (NAMI):

Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Its estimated that 2% of people experience dissociative disorders, with women being more likely than men to be diagnosed. Almost half of adults in the United States experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes.

Dissociative disorders differ from generalized anxiety, depression and loneliness due to their intense physical experience of being separate or “not real”. Dissociative disorders can increase and cause feelings of intense loneliness.

Do any of these symptoms seem familiar to you?

  • Significant memory loss of specific times, people and events

  • Out-of-body experiences, such as feeling as though you are watching a movie of yourself

  • Mental health problems such as depression, anxiety and thoughts of suicide

  • A sense of detachment from your emotions, or emotional numbness

  • A lack of a sense of self-identity

-        From NAMI website

If you have any of the above symptoms you may be experiencing something more than isolation, anxiety/panic or depression.

Dissociative disorders (DIDs) include depersonalization (not feeling yourself or like a human), derealization (not feeling real or feeling like you are viewing life as a movie) and dissociative amnesia (inability to remember chunks of time).

The causes of DIDs can range from unknown to severe anxiety to a trauma response as well as physical health issues like Lyme disease & other chronic infections. Dissociative disorders can be treated. Often practitioners will use a combination of psychotherapy like Dialectical Behavioral Therapy or Cognitive Therapy in conjunction with medications.

You can feel better despite having a dissociative experience. Call us today to learn more.

4 Tips for Letting Go Of Regret

By Paul Triggs, LMSW

Regret is defined as “sorrow aroused by circumstances beyond one's control or power to repair” (Meriam-Webster, 2019). Regret is a common challenge that most people face at one time or another during their lives. For example, anytime you think back on the past and what could have happened or how things should have gone differently may lead to feelings of regret. Although, regret maybe a strong negative emotion, letting go of regret is possible if you implement these four tips.

⦁ Stop focusing on the mistake and try focusing on the lessons learned.

The benefit of shifting your thinking from what you did wrong to how this affected your decision making is a very important first step. For example, if you ate too much food at lunch and are feeling a sense of regret instead of being upset about how you feel after the meal try to focus on the point you felt satisfied. In turn, by focusing on the point you felt satisfied, your frame of thinking goes from ruminating about the point of excess to appreciating the point of pleasure.

⦁ Accept the circumstances and validate the risk.

The theory of accepting the circumstances is difficult and maybe the hardest hurdle to eliminating regret. On the other hand, if you take a chance to accept the circumstances you can look at your own role in this mistake and see if you even had an impact (Shreenivasan & Weinberger, 2018). For example, in NYC its common to arrive late to a location due to transit issues which could lead to feelings of individual regret. Although, feeling regretful about being late is a bad feeling this sometimes cannot be avoided and even on days you leave early to counteract delays unexpected issues occur and spoil your due diligence. In this case, you did everything in your power to arrive at your location on time and the negative result was out of your control.

⦁ Determine your acceptable level of satisfaction.

The benefit of deciding your acceptable level of satisfaction in the planning process will aid you to determine the minimum standards to achieve happiness. In other words, spending less time worrying about what is enough will help remove the urge to reflect on what you could have done better. Another trick to establish an acceptable level of satisfaction is ignore unimportant things that will not bring you happiness. In turn, ignoring unimportant things will help you focus on what really matters and the goal you are trying to achieve. One tool that could help with setting a baseline of an acceptable level of satisfaction is setting time limits on a task. Setting time limits on how much you are willing to invest in a project will help you identify which results were within your control and which outcomes were out of your reach (Boyes, 2016). For example, if you are attempting to complete a project at work that is difficult, set a limit each day of how much you are willing time you are realistically able to invest each day and stick to that schedule. In response, by sticking to that schedule you are establishing a boundary of acceptable performance which will help in determining what was out of your control and you can experience satisfaction for the hard work you contributed.

⦁ Believe in your ability to bounce back.

Regret after a poor outcome is a very common feeling that could happen after many different types of disappointment. For example, during life transitions most people feel regret about what they should have done and ruminate about how things could have gone differently. Although, seeing the negative side of a result has its place, try seeing the benefit of your experience and appreciate the fact that many bad decisions lack permanent consequences (Boyes, 2018). In other words, the fact that you can look back on your mistakes without having to live with the consequences proves that you did something right. In turn, making mistakes is inevitable, everyone is prone to poor periods of poor judgement but it’s not how an individual reacts to a success that makes them a champion but rather how they learn from failure.

Boyes, A. (2018). 5 Tips for Coping with Regret. Retrieved from:

Boyes, A. (2016). How to Focus on What’s Important, Not Just What’s Urgent. Retrieved from:

Regret. 2019. In Retrieved February 18, 2019, from https://