7 Touchy Topics Everyone Discusses in Therapy—& What to Do If You’re Dealing Too
Are we getting more anxious…or are we just getting better at talking about it? That was the question I raised to several mental health experts who were unanimous in their answers: It’s a bit of both, and whatever it is you’re dealing with, therapists have heard it all.
“I think our vocabulary certainly has entered the mainstream to use [specific] words like depression and anxiety [when describing what we’re feeling],” explains Dr. Blair Steel, PsyD, a licensed clinical psychologist at the Carrara Treatment, Wellness & Spa residential rehab facility in Los Angeles. “We now know that mental health is not mental illness.”
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It’s no wonder: “So many things have happened in the last several years, and I’m not just talking about COVID, I’m talking about people communicating primarily through social media,” says Dr. Patrice Le Goy, PhD, LFT, a psychologist and licensed marriage and family therapist based in Los Angeles. “We’ve just lost so many of our skills of how to just talk to a person on the street, like, ‘Oh, they’re gonna think I’m weird.’ I think people are more anxious about everyday interactions.” While a bit of anxiety from time to time is normal, it can reach a point where it becomes difficult to manage on your own.
Services like BetterHelp—an online therapy platform that matches users to one of their 30,000 licensed therapists in less than 48 hours—can be a valuable resource to guiding you through these tough periods. As isolating as your worries may feel in the beginning, they’re more common than you realize.
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Comparison
The lives of social media stars can feel unattainable and when we wonder, “Why doesn’t my life look like that?” that can cause a huge amount of anxiety.
While we’re legally considered adults at 18 in most parts of the world, our brains are still in a “rewiring” phase until about 25, sometimes even later. As Dr. Le Goy notes, young people are constantly “comparing themselves with a fictionalized image,” and “when you’re exposed to all of that, particularly when you don’t have that nuance about what’s reality, I think it’s really damaging.”
She says that the best thing to do is to set boundaries for yourself. “I think sometimes people think of ‘boundaries’ as a bad word, where you’re shutting other people out. And that’s not really the idea, the idea is to figure out what you need to feel safe,” and giving yourself a time restriction on social media can really help prevent sending you into a spiral. “Like, ‘I’m not going to follow this person anymore because I don’t feel good,’ or ‘I’m not going to go on this site anymore.’”
Dr. Steel echoes this sentiment. “If we’re doing something that more times than not makes us feel some sort of negative experience, reducing that will certainly help,” she said. “Setting some basic parameters around social media usage, trying to do things outside of the house, a hobby, or joining some sort of group that’ll keep you around people that share similar interests [is a good place to start].”
Jealousy
Adjacent to the burden of comparison are complicated feelings of jealousy. As our friends hit certain milestones in life, sometimes it can feel like we’re being left behind.
“There are lots of conversations around jealousy that feel very difficult for people to talk about in their personal relationships,” says Dr. Harden Bradford. She gives the example of when one friend gets pregnant while another experiences fertility struggles, and there’s a sense of guilt from the friend who wants to be happy for their friend but also feels resentment. Accepting that “two things can be true at once,” can be a helpful thought exercise.
Similar to overcoming the burden of comparison, Dr. Steel suggests that “if we’re doing something that more times than not makes us feel some sort of negative experience, reducing that will certainly help.” In the simplest of terms, she says a great first step is to “put down the phone” and/or unfollow the people that don’t bring you joy, she says.
Relationship Status
Single and don’t want to be? It’s easy to start picking yourself apart, as if it’s you—your looks, your personality, your continuing love for Glee playlists, whatever—as the reason you’re not in a relationship.
But as famed psychotherapist Esther Perel once said, singledom is a choice. “We tend to think of being single as a matter of being alone rather than a matter of choosing the types of relationships we want to be in—including the relationship we have with ourselves.”
Still, if you’re feeling like you’re in the 31 percent of Americans who haven’t met or feel like they can’t meet someone, remind yourself that a) you definitely can, and b) there are definite pros to going it solo.
“A lot of us really want to be in a relationship with others, but in the short term, I would say find happiness and joy in life and in the current relationships you have, whether that’s with family, or friends or colleagues,” suggests Georgia Grace, a certified sex coach and host of the University of New South Wales Sexual Wellbeing Series. “Orienting to that kind of joy in life is also really useful because dating can be really challenging.”
All this said, it’s totally natural to want a relationship. “There’s a lot of conversation around the dating pool, like, ‘Where do I even find people who I am compatible with people who are interested in me?’ So, I think that there is some angst about that,” says Dr. Joy Harden Bradford. “The other side of the conversation is people exploring what it means to be single, and how to have cool, happy single lives.”
To overcome this, “I typically suggest attending events and participating in activities that interest you,” she says. “[This] often leads to meeting people who are also interested in these things. This opens up options for meeting new people who could become a part of your community.”
Grace agrees. “I always like to ask people, ‘It sounds like you want to be in a relationship, but how willing are you to actually do something that’s vulnerable? Because going on dates is exhausting. You can feel really vulnerable, it can feel really nerve-wracking, and as a result, people may not do it. And that’s cool. I think it’s really important that we celebrate not going on dates if you don’t want to or if it feels like too much. But we need to make friends with the idea of being vulnerable.”
Sex (or lack thereof)
Sex is so, well, everywhere…but ironically, many people don’t think they can bring it up with their therapist, says Dr. Harden Bradford. “It’s important for people to know with therapists, many of us are trained in sex conversations,” she says. “If you’re experiencing difficulty with sexual function, or if you have any thoughts around exploring sexuality, those things are totally appropriate and OK to talk with your therapist about.”
Desire discrepancy is among the main reasons couples (and individuals in a relationship) seek therapy—in fact, one study showed that 80 percent of couples experience this in some way. There are a range of causes: Changes in lifestyle, or in the aging process. Or it may be that the relationship has changed or you’re working through something, stress, or sexual confidence. Desire is a dynamic thing, says sex coach Georgia Grace. “Often, what we need to do is look at the different ways of experiencing desire,” she explains. “And sometimes what people will identify is that, “I actually don’t have low desire, it’s just that I am more responsive in my desire, and you’re more spontaneous in your desire.”
She continues: “When we can understand these different design types, we can give people more choice, around choice and awareness around how to kind of navigate this, if they are wanting to have more sex, then we’ll also look at what we call their brakes and accelerators,” she says. “Often talking about it, naming it, creating a plan together is a great step.”
Her number one tip is to take the pressure of sex and “bring in some smaller, more accessible moments of intimacy or pleasure, like hooking up on the couch or on the outbreak, having a shower together instead, telling each other how attractive they look or how much they want to touch them and bringing back that kind of flirtatious nature so that it makes so that it feels easier to be sexual in different kinds of contexts.”
Existential causes
Many therapists have seen an increase in climate change anxiety, otherwise known as eco-anxiety or climate doom. According to a study published in The Lancet in 2021, which polled 10,000 people across 10 countries, 59 percent of young people between 16 and 25 years old reported feeling very or extremely worried about climate change.
“In the last three or four years, there has been a rise in anxiety related to what we call existential causes of concern,” explains Dr. Joy Harden Bradford, PhD, a licensed clinical psychologist in Atlanta, host of the podcast Therapy for Black Girls, and the author of Sisterhood Heals. Examples include worrying about climate change and what can be done about it. “Definitely things related to the pandemic and questions of, ‘How do I keep myself safe? How do I keep my family safe? What does all of this mean?’”
Dr. Sanam Hafeez, a New York-based neuropsychologist and Director of Comprehend the Mind, says that “engaging with climate change can be emotionally challenging so it’s important to prioritize self-care to maintain your mental well-being,” offering solutions like “spending time in nature, practicing mindfulness and meditation, exercising, or engaging in hobbies that bring you joy and relaxation.”
She continues, “Focus on the aspects within your control. Make sustainable choices in your daily life, such as reducing energy consumption, adopting eco-friendly habits, supporting local and sustainable businesses, and advocating for climate-friendly policies.”
Burnout
While life is seemingly “back to normal” since COVID, many therapists believe we still haven’t fully recovered from the trauma of the global pandemic.
“I don’t think that we have been able to stop, as a world, to mark the grief related to all the people involved in the pandemic, all the experiences that were lost, all the things that were shaken up,” observes Dr. Harden Bradford. “That’s something else that people should normalize and know that if they are feeling that way, they are not the only one, because I think the majority of the country is feeling that way.”
How does this relate to general feelings of burnout? “While delaying trauma itself may not directly lead to burnout, it can contribute to the development or exacerbation of burnout symptoms,” explains Dr. Hafeez.
Indeed, while the mind-body connection is frequently overlooked, burnout (as well as other forms of mental distress) can manifest physically. This can show up in higher-than-normal levels of stress hormones, such as cortisol, adrenaline, epinephrine, and norepinephrine. It also can cause insomnia, physical exhaustion, head and stomach aches, changes in appetite, and nausea, for example.
Recognizing the signs is a great first step, says Mimi Winsberg, M.D., co-founder and chief medical officer of Brightside, an online therapy and medication management program. “A normal routine of meals, exercise, work, time with loved ones, and getting fresh air each day will help sustain a sense of control,” she notes—putting you on the path to reducing feelings of burnout.
The future of work
Yes, we’re burnt at work—but we also still need jobs! Unlike the Boomers, who would spend 30 to 40 years in the same job or same industry, it’s just not the same for younger generations, who are worrying about job security and experiencing layoffs at a far more frequent clip. Gen Zers entering the workplace face a volatile job market where even “entry-level” positions ask for experience. Which brings us to this issue: How do I get a job that requires experience when no one will hire me to give me the experience?
When you’ve applied for 80 roles on LinkedIn and gotten 80 form-letter rejections, Dr. Hafeez wants you to remember this: “The job market is dynamic, and new opportunities may arise.”
“See challenges as opportunities for personal and professional development and continuously seek to acquire new skills and knowledge that can enhance your employability,” she continues.
How do you do that? Keep up with industry trends, technological advancements, and the evolving job market, she advises. In other words, be ready to be at the right place, right time. “Stay informed about the skills and qualifications that are in demand. This knowledge can help you adapt and prepare for future employment opportunities,” she explains.
Also keep front of mind that we’re in a gig economy right now. While self-work can be daunting at times, recognizing that you’re not alone in these hurdles can be a great comfort. And when you need help, ask for it—this isn’t a sign of weakness, it’s a strength.
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