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Online Therapy vs Private Therapy vs In-Person: What Actually Makes Therapy Work?

Online Therapy vs Private Therapy vs In-Person: What Actually Makes Therapy Work?

Therapy is easier to access than ever before using various online platforms plus virtual and in-person options. Having many options can feel overwhelming, so it’s important to choose what actually fits your needs, not just what’s convenient or popular.  So let’s break it down to 

When Therapy Turns Into a “Bitch Session” — And How to Make It Productive

When Therapy Turns Into a “Bitch Session” — And How to Make It Productive

Therapy is not just about talking, it is supposed to help you change. When therapy slips into venting may feel like it’s just a “bitch session.”

Why Many Men Struggle With Emotions (And What Actually Helps)

Why Many Men Struggle With Emotions (And What Actually Helps)

The reason men struggle with emotions is not because they don’t have them. They struggle because they are usually not taught how to express them. Removing some barriers can make connecting with their emotions possible and help them learn to deal with emotions in a positive way.  Let’s talk about it.

Why Emotional Language Doesn’t Always Come Naturally to Men

Everyone feels emotions but not everyone has language for them.

Feeling an emotion happens automatically in the body and within the nervous system.  It can prompt tightness in the chest, racing thoughts and other physical responses.

Emotional language is not automatic, it is taught and modeled by others. It is developed by connecting what you feel to words. 

It’s not common for men to be taught how to name emotions, and if they do it’s very basic like “fine,” “angry,” or “stressed.” If you cannot label what you feel, it’s hard to communicate it. As a result, emotions can feel overwhelming, confusing, or unsafe to share.

There is some social conditioning that happens around being strong and restraining emotions. From a young age, many boys learn that showing sadness, fear, or vulnerability equals weakness. They may be told to “man up,” or “don’t cry” when things get hard and this can lead to them suppressing their feelings rather than understanding or expressing them. Those emotions that do not get expressed do not just go away, they are internalized.

“More often, men are conditioned not to ask for help or be vulnerable. Studies show that males who ask for help become viewed as less competent, capable, and confident. Further, showing vulnerability might have you perceived as having a lower status” (“Are Men Who Show a Broader Range of Emotions Punished?” Choice House Colorado. October 28, 2021. https://choicehousecolorado.com/are-men-who-show-a-broader-range-of-emotions-punished/)

Boys are often rewarded for performance over emotional awareness.  There are spoken and unspoken messages being sent to boys from a young age that say what they do is more important than how they feel. When boys are scoring the winning goal, being tough, showing independence, or pushing through something hard without complaining, they are celebrated and get a pat on the back. 

But if they show a moment of weakness, sadness or insecurity they are usually told to shake it off, or “you’re okay”. Eventually this tells them that if they are successful that’s good and everyone is proud of them, but if they struggle with anything emotionally, they should quickly move on.

 

Why “Just Talk About It” Often Doesn’t Work

Sometimes venting helps, and it is usually encouraged, but venting without direction can feel pointless. If venting is not done in a structured way where the person has support, it may not help at all, or it could even make things worse.

And you don’t want to fall into the habit of emotional dumping, which we discussed in a previous blog here.

There needs to be emotional processing so that reflection and understanding can take place. This is what helps to calm the nervous system down and help the individual gain some insight so they can begin working through their emotions.

There is a difference between processing and problem-solving. Processing helps settle the nervous system so that the emotion does not get stuck in the body, creating physical responses or triggering behaviors. 

Problem solving is an action that one takes to change a situation by coming up with a strategy and making decisions. This can include seeking advice from others, brainstorming options to do things differently in the future, and taking intentional steps to avoid the same problems. 

Some therapy experiences can feel like they are turning into repetitive complaint cycles. This can happen when a person keeps their focus on what happened instead of what it means.  It can feel productive to recount events, but in order to gain insight one needs to ask why it is affecting them so deeply and what beliefs are being reinforced.

What Effective Therapy Looks Like for Men Who Want Real Change

Therapy is effective when it balances emotion and direction.

Direct, structured conversations are helpful.  They can explain how their nervous system responds to stress, why they shut down, get angry, or avoid, and show how past experiences shaped current reactions. These conversations can lead to emotions being explored with the goal of understanding and change.

Effective therapy builds skills, not just awareness.  Men need to know what to do to work through their emotions, not just be able to recognize that they exist.  Awareness without a plan of how to address emotions can feel frustrating. 

“When we engage in naming and taming our emotions, we activate specific brain regions associated with emotional regulation. Neuroimaging studies have shown that labeling emotions activates the prefrontal cortex while reducing activity in the amygdala, the brain’s alarm system.” (“Powerful Strategies for Naming and Taming Your Emotions: A Guide to Emotional Mastery.” Chicago Psychoanalytic Institute. April 10, 2025. https://chicagoanalysis.org/blog/elements-of-psychoanalytic-technique/naming-and-taming-emotions/)

Practical skills taught in therapy can be used as tools for responding differently in real life.  They can include communication for conflict, boundaries, how to pause instead of immediately reacting, body regulation, naming emotions and patterns without shaming. 

Change doesn’t just happen during sessions, it happens between sessions when these skills are practiced.

For men, opening up can feel dangerous; especially if past experiences led to judgment, dismissal, or shame. When strength is re-defined as self-awareness, honesty, and resilience, and the old thinking patterns are overcome, men are far more willing, and able, to engage in emotional work.

 

If you, or someone you love, is struggling with emotions, contact us, we are here to help.

 

 

Understanding Isolation in Teenage Boys

Understanding Isolation in Teenage Boys

When teenage boys isolate, it is often misinterpreted as independence or defiance.  In reality, it’s more of a protective response to the stress they are feeling inside.  They don’t withdraw because they don’t care, rather because they don’t feel safe expressing what they are experiencing.  

The Hidden Self-Criticism Teenage Girls Carry

The Hidden Self-Criticism Teenage Girls Carry

Teenage girls can quietly carry a persistent self-criticism that others can’t see from the outside. They may appear to have it all together, but internally they question their worth, don’t acknowledge their strengths, and assume they are falling short.  Because this struggle is mostly internal, 

The Role of Secrecy in Eating Disorders (And Why It Makes Sense)

The Role of Secrecy in Eating Disorders (And Why It Makes Sense)

When it comes to eating disorders, secrecy typically plays a big role. But what leads to the secrecy and why is it so central for individuals who struggle in this area? Let’s talk about it. 

Why Secrecy Is So Common

An eating disorder is not just about food and weight, it’s a way to cope with overwhelming emotions and a need for control.  In order to continue using this way of coping, the behaviors have to be hidden. So the secrecy helps it survive. 

Eating disorders rely on privacy.  When no one sees the food intake, it’s easier to restrict it.  Having rules around food can be followed if no one knows and does not challenge them. 

Purging needs to be done when no one is around or will notice, and exercise may also happen in secret because if it becomes compulsive, it will throw up red flags. 

“You may have noticed a change in the way someone close to you behaves and relates to other people, such as withdrawing from friends, relationships or avoiding social contact all together.” (“Recognising an Eating Disorder.” NHS Lothian. https://services.nhslothian.scot/seeds/recognising-an-eating-disorder/)

Secrecy is a symptom of the disorder and a reflection of the pain the person is experiencing. The first step to recovery is typically not stopping the behaviors, but reducing the secrecy and allowing others to see what is happening.

Shame and Self-Blame

Many people with eating disorders feel deep shame about their behaviors and thoughts. A person can truly want help but still believe that it’s something they should be able to do on their own, so they are ashamed to seek out the help.  

It’s painful to think about exposing themselves and sharing with others what is going on.  There can be a strong desire to not let others down or disappoint people they care about.

It’s common for people to tell themselves that they are the problem, because something is wrong with them, and it can’t be fixed. They place all the blame on themselves and don’t consider that outside pressure and stress could be to blame.

Hiding it takes away the risk of a painful exposure. 

Judgment 

Most people think of eating disorders as being a choice the individual makes, rather than an illness they are dealing with.  This makes the individual fear that they will be seen as weak or attention seeking. They can’t control what others think and they don’t feel like they can explain the real cause of their behavior, so others form their own opinions and that’s hurtful.

This leads to hiding their behaviors to avoid being morally judged for something that isn’t actually a moral failure.

Losing Control

For a person living with an eating disorder, the associated behaviors can feel like the one thing they can predict or count on, and it can be their only way to experience relief. 

“Most people with eating disorders feel an inadequate sense of control in other areas of their lives. A false and misleading sense of control based on food intake and behaviors such as purging and/or compulsive exercise develops.” (Indiana Bloomington University. “Student Health Center – Disordered Eating.” https://healthcenter.indiana.edu/health-answers/psychological-stress/disordered-eating.html)

Exposure, or telling someone, can make them feel like that one area of certainty has been ripped away.  When this happens they fear they could lose their autonomy or have their coping system taken away.  Maybe they want to change and they aren’t ready; they want to control the timing of making a change so they protect their secret at all costs.

Secrecy is a big part of maintaining control, so it becomes important.  It’s not about manipulating the people they care about, it’s about protecting themselves and surviving.

 

How Relationships and Past Experiences Affect Disclosure

Attachment

A person’s attachment experience can shape how they handle emotional situations like sharing and being vulnerable, because it triggers what they think will happen when they are exposed.

Growing up with attentive, consistent caregivers can cause them to expect others to provide care and not cause further pain. This secure attachment can promote disclosure.

If caregivers were unpredictable or created fear in response to mistakes, disclosure can trigger an internal conflict of wanting help but fearing more harm could be done.  Or if they grew up being ignored or made to feel small, they may expect that they can’t depend on others to help and they have to do things on their own. These unhealthy attachments can discourage disclosure.

Trust

Trust is built slowly and broken quickly.  When someone is repeatedly reminded that they are safe, trust is built. But if they feel like a person in their life is dismissive it can undo trust and reinforce secrecy.

Sharing typically happens when a person has trust that their pain will be taken seriously, they won’t be shamed, their choices and independence will be respected and what they disclose will not be used against them in any way now or in the future.

Previous Reactions

If a person has responded negatively or made the individual feel unsupported in the past, it can play a role in how open they are in the future.

Past responses that can discourage sharing in the future are judging, minimizing the significance of the behavior by telling them “it’s not that bad”, trying to control them by monitoring them and directing their actions, or betraying their confidence and telling others private info they have shared. 

Any of these examples signals to the person that making the disclosure leads to danger, so secrecy becomes a way to protect themselves.

Being found out can feel very threatening and, to the individual, seem worse than the actual behavior.  This is because the behavior is protecting them by regulating their overwhelming emotions.  If that way to regulate is taken away, nothing feels reliable anymore and that’s scary.

They may realize that the behaviors are a threat but it is known, predictable and within their control.  

How Therapy Builds Trust Without Forcing Disclosure

A therapist prioritizes relationship before behavior and developing a relationship takes time and requires trust. 

“How to treat eating disorders in therapy depends on the person going through the experience and their individual history and journey. In that sense, the best therapy for eating disorders is the kind that’s going to help someone best address their physical, mental, and emotional needs.” (Clerkin, Bridget. “Therapy for Eating Disorders.” Within Health. https://withinhealth.com/learn/articles/eating-disorder-therapy)

A therapist understands that safety comes before change.  So in the beginning, there is a focus on understanding what the eating disorder is doing for the person. They do not react with alarm, but with a desire to learn what is going on and to help.  Ultimately, they convey that to the person that they are more important than their symptoms. 

Respect for autonomy is key in therapy because a loss of control is a fear that people with eating disorders have.  So they ask permission before diving into sensitive topics and give them choices in the therapeutic process.  

They allow the individual to move at their own pace and don’t force compliance or readiness.  There is no pressure to disclose information on a certain timeline, they share what they feel comfortable sharing, when they feel comfortable sharing it.

During the process the therapist leads with clear transparency and maintains consent. They explain the treatment approach, what the expectations are, and work to make sure nothing feels hidden or sudden. 

 

As mentioned before, secrecy is a symptom of an eating disorder and it is used to protect self, not manipulate others.  If you are struggling with an eating disorder and you are ready to step out of the secrecy and get help, contact us, we are here for you. Nikki Eby, MFT, ATR, one of our therapists on staff has expertise in supporting clients with eating disorders. 

 

 

 

Why Eating Disorders Are Really About Emotional Regulation

Why Eating Disorders Are Really About Emotional Regulation

Most people think that eating disorders are about food, weight or appearance, but that’s not the core issue. They are really about how a person experiences, manages, and survives intense internal feelings, or emotional regulation. Let’s dive a little deeper into what that means. What 

The Invisible Emotional Labor of Women in Their 30s and 40s (and Why You’re So Tired)

The Invisible Emotional Labor of Women in Their 30s and 40s (and Why You’re So Tired)

The emotional labor of women in their 30s and 40s can go unseen by everyone, even the women themselves.  It can be exhausting and cover a range of things, so let’s talk about it. What emotional labor really is When lots of responsibilities collide, like 

When Everyone Else Seems to Get Pregnant Easily: Managing Comparison, Fear, and the Unknown

When Everyone Else Seems to Get Pregnant Easily: Managing Comparison, Fear, and the Unknown

If you are struggling with infertility or pregnancy related challenges, watching others get pregnant quickly can be a tough terrain to navigate.  There is no right or wrong way to feel, but sometimes negative feelings can take over and that’s normal. Let’s talk about why this happens.

The emotional impact of others’ pregnancy announcements

The emotions you have when someone else announces their pregnancy, while you are struggling to get pregnant, can be complex.  They can range from happiness to sadness, frustration, envy, to thinking you are not deserving or worthy of being a parent.

Seeing others experience the joy of sharing that they are expecting can make your reality of not experiencing this yet feel more real.  When it is something that you are longing for this is a disappointing reminder of your situation and it hurts. So even if you are happy for them, you can still feel sad.

Sometimes your sadness can turn into frustration and be internalized as self-blame, because you can’t understand how it is so easy for others but difficult for you.  This can lead to anger, not only at the situation but towards people who don’t really understand how you are struggling.

“Grief, the process in coming to terms with not conceiving as we wanted to, nor often at the time we wanted to, includes anger. We may also be angry about the time spent thinking about fertility and money spent too.” (Sainsbury, Tracey. “Caring for your mental health when trying to conceive.” Fertility Network UK. https://fertilitynetworkuk.org/caring-for-your-mental-health-when-trying-to-conceive)

As you long for the experience of being able to share your own pregnancy announcement, you may become envious of those who are able to easily get pregnant. It’s not that you don’t care for these people and want the best for them, it’s just hard to see them enter the journey with ease.

Unless that is someone else that you are close to that has gone through it before, or is currently going through it, struggling to get pregnant can make you feel alone.  Although people in your life may be supportive, it’s hard for them to relate to what you are feeling and that can be isolating.

The psychology of “why not me?”

People who are struggling with infertility or challenges in conceiving commonly experience feelings of unfairness, frustration, or that they are personally inadequate.  

When someone thinks “Why not me?” it’s because as humans we have this inherent sense of fairness. We think it’s only fair that good things should happen to good people, and that if you have done everything “right”, you should be rewarded with the thing you desire.  When it’s not happening but others seemingly get pregnant effortlessly, this reinforces a feeling of being singled out. 

“When we perceive unfairness, the brain activates emotional centers tied to social pain, which is why unfairness can feel personally hurtful, even when it doesn’t directly affect us.” (Jhutty, Dr. Saira. “Coping with Jealousy During Infertility: A Psychiatrist’s Guide to Healing.” June 4, 2025. https://www.cofertility.com/family-learn/coping-with-jealousy-during-infertility-a-psychiatrists-guide-to-healing)

So you think “Why not me?” because there is a sense that you somehow don’t deserve the same outcome.  

As humans, we compare ourselves to others, especially in situations that are significant. Socially, we evaluate ourselves relative to other people, especially when we are determining how we are doing in life.

Being able to conceive and have children may be tied to your sense of identity, self-worth, and life goals. If you can’t, it can feel like a failure to fulfill your role or purpose.

Healthy ways to support yourself during this season

It’s important to recognize that all of these feelings that you are experiencing are valid.  It’s okay to feel hurt when you see someone else celebrating and you are not a bad person for having these emotions.

Setting boundaries is key.  This can include taking a break from social media, opting out of attending baby showers if it feels too difficult, and politely declining to engage in conversations about pregnancy, parenting, etc.  This is not rude, it is self-care because protecting your mental health is essential.

It’s also very healthy to talk to someone you trust like a close friend or your partner.  Expressing your feelings is helpful to release the weight of carrying them alone. Some find comfort in connecting with others who are currenting experiencing the same thing or have in the past through support groups or online communities.  

“Say the things you’re scared to say out loud. Cry. Laugh. Rant about your partner’s terrible timing. Connection is one of the most powerful tools for protecting your mental health and feeling less alone in this weird limbo.”

(“Trying to conceive? 12 tips to keep your mental health intact.” Calm.com. April 10, 2025. https://www.calm.com/blog/trying-to-conceive-mental-health)

Sometimes it’s easier to talk with a therapist because it gives you an outside perspective and they are trained to help you process your emotions and work with people walking this same path. 

 

When it comes to managing this very challenging time, remember to be kind to yourself. You may not be on the path you thought you would be on and that’s okay, the struggle is not a reflection of your self-worth. Each person has a different story so focus on your journey and try not to compare yourself to others.

If you need help or support navigating what you are going through, contact us, we are here for you.

 

 


 

 

When Big Feelings Show Up as Anxiety or Anger: Understanding Emotional Overload in Tweens

When Big Feelings Show Up as Anxiety or Anger: Understanding Emotional Overload in Tweens

As a parent, you might notice a lot more irritability, defiance, or meltdowns with your tween, which can be really disruptive. In dealing with that disruption, and everything that triggers for everyone else in your house, it’s hard to remember that those mood swings and