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

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.

The Compounding Impact of Grief and Loss

Grief is rarely just about one specific event. Rather it is a collection of all the losses we have experienced in our lives. There are many different theories about how individuals grieve. The truth is while there may be some similarities in the grief process, each of us experiences grief in a vastly different way. You see, your losses are connected to your past losses and no one can ever accumulate the same losses as you. You have had a unique set of attachments to loved ones, to objects and to experiences. Your grief is unique.

Grief becomes very complex when we have not healed previous wounds. Sometimes feelings of loss can be overwhelming and appear unmanageable. Additionally there is research that shows our compounded grief doesn’t begin with us but with our ancestors. Just because we may have multiple experiences of loss doesn’t mean we cannot move forward in a healthy way. In fact, the majority of adults find healthy ways to process feelings of loss.

How do we know whether or not grief and loss are a problem?

Grief becomes complicated when we experience some of the following:

  • Anger, irritation or episodes of rage

  • An inability to focus on anything but the death of a loved one

  • Focusing intensely on reminders of the deceased or an excessive avoidance of such reminders

  • Intense feelings of sadness, pain, detachment, sorrow, hopelessness, emptiness, low self-esteem, bitterness or longing for the deceased's presence

  • Problems accepting the reality of the death

  • Self-destructive behavior, such as alcohol or drug abuse

  • Suicidal thoughts or actions (If you're experiencing suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 to speak with a professional counselor!)

(taken from this article)

Grief Isn’t Just About Death

Grief does not have to be based solely on the loss of a loved one. We can grieve any relationship, the loss of a job, we can grieve the loss of physical locations such as being misplaced by government turmoil or economic decline that devastates communities. We can grieve the loss of our identity due to an illness or injury. And we can grieve the loss of unfulfilled dreams.

Some things that complicate grief even further include:

  • When loss occurs due to a traumatic event such as an accident or natural disaster

  • In the event of multiple losses happening at once(ie you lost your home, your job and your health in a span of 3 months)

  • When your loss is unrecognized by your community (such as HIV/AIDS patients in the 80s who were shunned by their community).

Some Ways To Begin Healing From Grief/Loss

Below is a list of 10 things to do to begin healing:

  1. Find a supportive ear. Whether this be a professional or a trusted friend, find someone to validate your experience and be present with your emotions.

  2. Find a creative outlet such as journaling or painting. Many people find relief in emotional expression to heal from grief. Refrain from judging your creations and focus more on the process.

  3. Engage in gentle exercise such as walking, yoga or Tai Chi.

  4. Try acupuncture. Many people report relief from sadness and depression when they use acupuncture as therapy for grief.

  5. Find a grief therapist. Even short term therapy can be a powerful tool for healing from loss.

  6. Find a way to memorialize your loved one or experience. You may want to develop an alter in your home or go to a special place to reflect on your memories of the person or experience.

  7. Find an online memorial site to pay tribute to your loved one.

  8. Be patient with yourself and your experience. Try not to be critical if you are not feeling yourself right away.

  9. Read a book on grief and loss such as Healing After Loss.

  10. Take 3 minutes of reflection and quiet each day to be thankful for the relationship and to set an intention to heal.

If you enjoyed this article you may also enjoy Navigating Transitions.