My Spouse Has ADHD, and I Feel Like I Am Parenting My Spouse

Posted on June 5, 2025 by Alisa Hafkin

When we think of ADHD, we usually think of children. However, studies show that, while symptoms may decrease in adulthood, only 15-35% of children with ADHD completely outgrow the full disorder. So if you have a spouse with ADHD symptoms, you are not alone.

In any committed relationship, each person loves the other for who he or she is – both strengths and weaknesses, virtues and flaws.  But over time, some personality traits can begin to rub the wrong way. This can be even more true when one spouse has ADHD. In such cases, couples counseling and cognitive behavioral therapy (CBT) can be very effective.

ADHD symptoms

People with ADHD exhibit difficulty with “executive function” and self-regulation, which help the brain manage information, make decisions, and plan ahead. This difficulty can vary in degree, but some symptoms may include:

  • Forgetfulness, distractedness or hyperfocus, and inability to complete tasks
  • Interrupting conversations or abruptly changing subjects
  • Not listening or forgetting what was just said
  • Difficulty concentrating
  • Compulsive behavior or dysregulated emotions
  • Difficulty seeing other points of view
  • Hyperactivity or lack of motivation

Sometimes depression and anxiety can include some of these behaviors. Therefore, a mental health professional should properly evaluate your spouse to determine the root of the issue. In my counseling practice in New York City, I have found that once we determine the underlying issue, a proper treatment plan can be developed. We can greatly improve or even resolve many issues.

How your spouse’s ADHD affects you

If your spouse is showing symptoms of ADHD, you may feel like you’re parenting your spouse, doing many things for him or her, taking on a heavier load of household chores and responsibilities, and always having to follow up to make sure your spouse has done his/her part.

This can leave you feeling physically and emotionally exhausted, lonely, unappreciated, and even resentful. You may begin to forget why you fell in love with your spouse and begin to overlook all the wonderful traits that your spouse still has, because you’re overwhelmed by the ADHD traits that are making your life more difficult.

You may find yourself doing most things for your spouse, like making appointments and constantly reminding him/her about them, paying the bills, finishing chores your spouse was supposed to do, and even talking to your spouse like a parent to a child.

This can lead to unintended consequences for your spouse, including learned helplessness, becoming dependent on you to do everything, and forgetting or not developing necessary skills every adult should have. In addition, your spouse, who is an adult, may begin to develop resentment towards you, realizing that you’re treating or talking to him/her like a child. This can lead to marital conflict.

What we can do together

An ADHD-affected marriage has the same challenges as any marriage: learning proper communication skills, creating boundaries, defining expectations, learning how to focus on the good, and growing together rather than apart. When the main difficulty is ADHD, I often suggest couples therapy as well as therapy for the ADHD-affected partner to help him or her develop different behavioral patterns and thought processes. This can benefit the non-affected spouse as well, particularly if the problem has been going on for a while and that partner has developed a set of negative thoughts and reactions that need to be unlearned. But couples therapy is always an important part of the healing process.

As you learn better communication methods, discover or rediscover your own unique strengths, and remember what you love in each other, you will strengthen your marriage, put healthy strategies into place, and be able to look forward together with hope and joy.

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In Survival Mode? Let’s Talk!

Posted on June 5, 2025 by Alisa Hafkin

Stress seems to be the norm in our modern world, but it is possible to learn techniques to help you cope. Chronic stress threatens your mental and physical health. In our modern, stressful world, people need to learn how to manage and de-escalate stress and live a more peaceful life. Some people are able to do this effectively by reading a book or following good advice from a friend, but in my years of practice as a psychotherapist in New York City, I have found that the most long-lasting and life-changing results occur when a person spends a little time working with a therapist.

What stress does to you

Your stress may be caused by interpersonal issues, such as marital problems, concern for your children, difficult people at work, or an elderly parent needing frequent care. Your job may be stressful by nature, such as with medical personnel or other first responders. Or you may have past experiences that keep being triggered. Whatever the cause, the body responds the same way.

During an acute stress situation, such as a near-collision on the road, your body reacts immediately to keep you safe. Your hypothalamus in the brain prompts the adrenal glands to release the hormones adrenaline and cortisol. They make your heart beat faster and blood pressure rise, and they surge energy to your body to react quickly – the “fight or flight” response. When the danger has passed, all things should return to normal, physiologically. But if you are in a continual state of stress, the hormones and organs involved do not get to calm down, causing a cascade of problems throughout your body.

Physical responses may include:

  • Cardiovascular problems, including chest pain, racing heart, palpitations, high blood pressure
  • Digestive system problems, such as irritable bowel, weight gain or loss, and ulcers
  • Clenching the jaw or grinding teeth, body aches
  • Headaches, migraines, dizziness, shaking
  • Weakened immune system, including arthritis, fibromyalgia, and rashes
  • Reproductive system issues, such as frequent infections, irregular periods, infertility, and loss of libido
  • Sleep problems, which can include both extremes: exhaustion due to lack of sleep, as well as low energy leading to excessive sleep

Psychological and behavioral responses may include:

  • Anxiety
  • Irritability
  • Depression
  • Panic attacks
  • Addiction, or other compulsive behaviors
  • Eating disorders
  • Brain fog or poor memory

What a therapist can do for you

Overcoming stress requires a multi-pronged approach. In my practice, I utilize both psychodynamic therapy as well as cognitive behavioral therapy, as I deem necessary, upon discussing with my clients their particular needs.

Psychodynamic therapy is a deep and sensitive exploration of problems and issues that may affect your behaviors, usually starting in one’s childhood or youth. The process helps demystify the reasons behind why you do what you do, why you react the way you react. This can be a truly freeing experience for clients as they finally begin to see how they can take control of their thoughts and master their own responses.

Cognitive therapy is a more concrete approach. I work with my clients to identify automatic thoughts and develop techniques to rewire unhealthy, habitual thoughts and behaviors through self-talk practices and journaling, relaxation and mindfulness techniques, and positive thinking and self-affirming statements. Some people may start here, while others may benefit from psychodynamic therapy first.

As the therapy work progresses and new outlooks become possible, the patient and I work together to form new life habits, including exercise, healthy food choices, fostering healthy friendships, and developing outside interests that bring joy.

As patients progress from a state of constant stress and a feeling of helplessness to a more enhanced state of confidence, they gain more control over their thoughts and behaviors, and hope for the future. If you’re in the NYC area, contact me for an evaluation to see how I can help you.

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Bullied in Childhood?

Posted on May 20, 2025 by Alisa Hafkin

Bullied as a child? You’re not alone. Many people share your experience. One longitudinal study following more than 1,200 children into adulthood found that about a third of the children experienced bullying. Many of the victims of bullying carried the effects of the experience into their adult years.

Here in my NYC office, I help clients process bullying that they experienced and build the strength to move forward. The experience of childhood bullying can range in intensity, as can the long-term effects. However, it does not always follow that the worst experiences caused the worst problems. We are all different, and we have other life experiences that can ease or exacerbate the wounds of childhood. The good news is that adult survivors of childhood bullying can find the help they need to break free from the effects of these adverse childhood experiences.

Effects of childhood bullying

When children experience bullying, they internalize negative messages about themselves at a very tender age. The presence of other supportive and loving people in their lives can mitigate the negative messaging. However, depending upon their personalities and other life experiences, these negative messages may become embedded long-term and result in health issues and emotional behaviors rooted in these now-subconscious beliefs.

Some health problems that may be rooted in bullying include anxiety, depression, low self-esteem, eating disorders, headaches and migraines, insomnia, poor stress management among others.

People who have been bullied sometimes develop a deep sensitivity towards the sufferings of others. This may be a result of remembering their own feelings from childhood. Others can experience a sense of detachment from their own feelings, perhaps because they felt no one cared about them, or perhaps to protect themselves from more hurt.

Some adult survivors of bullying become disconnected and isolated, not trusting people. Others feel a tremendous need to be liked and to be accepted by others.

Some develop a submissive, passive personality, while others are hypervigilant, ready to defend themselves aggressively (verbally or physically) against any perceived insult or injury.

These behaviors find their roots in a feeling of powerlessness and low self-esteem, messages that the bullies ingrained into your head in childhood. These messages need to be rewired, and these lies need to be dispelled. Doing so will improve your emotional and physical health, improve your relationships, and relieve you from the weight of your childhood trauma.

Becoming free from childhood bullying

Some adult survivors of bullying continue to experience the bullying with the mind and heart of their inner child. In therapy, we work to help you reexamine your past experiences with the mind and heart of an adult. In therapy, we explore your unique history and the various experiences that have impacted your life. This will help you understand the connection between past experiences and your own emotional and physiological responses today.

When you are able to review your childhood experiences, recognize the hurting child who is still experiencing them, and reevaluate them from an adult perspective, you will begin to be able to let go of the grieving and powerless child’s perspective and replace it with the perspective of a healthy adult.

Bullying is a statement on the bully, not on you. As a child, you could not understand that, but as an adult, you can. Allowing the bully to continue to hurt you means they still have power over you, even after all these years. They may be old and lazy now, they may be in prison, or they may have turned into a great person who regrets being mean as a child. Whatever their fate, they have no right to hold power over you anymore.

How therapy can help

Once you begin to uncover your automatic thoughts by recognizing their roots, you can begin to reclaim control over your own emotions, thoughts, reactions, and triggers by rewiring them in healthy ways. This is where cognitive behavioral therapy can be very helpful.

There are a variety of techniques that can help you positively retrain your automatic thoughts and reactions. We will customize them to what works best for you. These include relaxation exercises, mindfulness homework, self-talk practices, positive thinking, and journaling, to name a few.

Reframing your core beliefs about yourself based on the reality of your self-worth will help you change old habits of thought, develop a healthy self-love, and build self-confidence. On this strong foundation, you can strengthen relationships and empower yourself to navigate your future towards success and inner peace. Find a good therapist near you to help you reach your true potential. If you’re in the NYC area, reach out to me to see how I can help.

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App Therapy – Can AI Be a Good Therapist?

Posted on May 20, 2025 by Alisa Hafkin

Technology that interacts with humans, such as Artificial Intelligence (AI), is developing at an accelerating rate, causing many people to wonder – or worry – that it may replace many jobs currently held by humans. What could happen to the economy when robots and AI replace human workers? This is a very real concern, and it may be surprisingly near. But can AI replace a good therapist? Can a computer program provide effective counseling? I don’t think so.

We are each so very different. Our life experiences, current environment, and personalities are so complex that there could be a seemingly infinite combination of inputs that have created your personality, your set of needs, your strengths, and your weaknesses. No machine is as complex as the human brain or the human soul. It takes another human being to understand, provide compassion, and help someone heal and blossom.

What technology can do

Technology is undoubtedly helpful in some ways. Individuals can find AI services, apps, or online resources that can help them in their first steps of emotional healing or stress reduction. Just as some people find significant relief from mild-to-moderate symptoms through the help of a support group, either in person or online, some people may find helpful suggestions or life-hacks that give them exactly what they need to improve their issues through AI. I encourage people to look into some phone apps or AI-driven services that help in areas such as:

  • Mindfulness
  • Sleep improvement
  • Stress relief
  • Positive thinking
  • Meditation or relaxation
  • Lifestyle changes (better eating habits, quitting smoking, etc.)

Some of these apps and services use AI to fine-tune your experience, customizing the app to your particular needs. These can be very helpful, alone or as a support to traditional therapy. But while there are also apps that attempt to provide depression help and talk therapy, I strongly urge people with serious problems not to depend on these apps for relief. You need an experienced therapist to help with more serious mental health concerns, trauma, or long-term struggles.

What technology can’t do

AI cannot pick up on the nuances of your unique situation that a sensitive, experienced therapist can. An app can’t provide the empathy and compassion that you need when addressing deep-seated issues. Technology can’t provide the human interaction that we have evolved to need in order to thrive. In fact, many therapists and counselors, including myself, have dealt with an increasing number of clients whose modest mental or emotional health issues have become amplified into much more serious conditions due to the isolating effect of the internet, smartphones, and social media.

Science is only just beginning to research the effects that cell-phone use and the internet have had on our mental health, as well as on our physical health and the cognitive health of young people. Both the online content and the hardware itself, along with the energy that it puts out, are being implicated in sudden declines in our mental and physical health, especially in the young. These are very serious concerns.

Additionally, some concerns have been raised by the Federal Trade Commission (FTC) and other government officials regarding the privacy of health information and compliance with HIPAA laws. Even if your health data is not shared, there is the added concern that your contact information could be.

These are just a few of the concerns that I have about AI therapy apps and other online therapy options. Some of my clients utilize apps to help them apply lifestyle changes that we discuss in therapy – for instance, using a positive thinking app or a gratitude app. I am personally thankful that such tools exist to help my patients apply what we have discussed in therapy, thus speeding their recovery. But I cannot recommend replacing a good therapist with an app. I am very concerned that people who are in great need of counseling will go too long without the help they need, worsening their condition.

If you feel you need help addressing issues such as anxiety, depression, trauma, relationship issues or other emotional or mental health concerns, please find a good counselor near you who is an expert in the issues that you are experiencing. If you’re in the New York City area, please reach out to see how I can help you.

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When You Need a New Therapist

Posted on April 3, 2025 by Alisa Hafkin

As a psychotherapist in New York City, I help individuals, couples, and those struggling with infertility with their psychological or emotional challenges. My orientation is in both cognitive behavioral and psychodynamic practices, which help foster a safe and secure environment while my clients develop self-awareness and the motivation to make changes. I have found that these methods are successful for many people. But there is more to a good therapist than his or her expertise and methods. In order for you to experience the most benefit from your therapy, you need the right fit of the therapist’s skills, your particular needs, and how you work together. 

Signs that the therapist is right for you

In a nutshell, your therapist is right for you if you feel comfortable and you are seeing improvement. Of course, it often takes a little while to see noticeable improvement. However, after a few sessions, some progress should be taking place, if not in feeling better then at least in starting to understand what is behind the issues that are fueling your emotional or mental distress. 

Some signs that you and your therapist are a good match are:

  • You feel comfortable being fully honest with your therapist
  • You feel fully accepted, not judged
  • The challenges that your therapist may suggest to you, even though difficult, seem to make sense and are appropriate
  • The goals of the suggestions or challenges are explained, not dictated without being clarified
  • Your therapist is not giving excessive advice but rather is helping to guide you in finding the root causes and helping you find your own answers and develop helpful strategies
  • You are seeing improvement or can see how the process will soon lead to improvement 

These are all good signs that your therapist is a good fit for you in your healing and growth process. 

Signs that it’s time for a change

When you begin with a new therapist, allow for a brief breaking-in period as you come to understand each other. Your therapist can use this time to evaluate what methods may help you best. You likely came to your first session with questions and expectations. Hopefully, your therapist took time to interview you, get a foundational understanding of you and what you may need, and explain to you his or her methods. If you did not take these steps at the beginning, you might quickly discover that your therapist is not a good fit.

Sometimes, even if you’ve been working with a therapist for a while and all has gone well, a time may come to make a change. Some signs that it may be time to find another therapist may be:

  • You feel dissatisfied or discouraged, or you consistently leave therapy sessions feeling worse
  • You feel misunderstood, bored, unchallenged, or “not being heard”
  • You don’t see any improvement at all, or perhaps you did see improvement before but things have stalled
  • Your personalities don’t “click” or you don’t feel comfortable or safe
  • Your therapist is doing too much talking or is sharing too much personal information
  • Your therapist is telling you what to do, rather than guiding you to find the answers yourself so that the change comes from within
  • You are becoming too dependent on the therapist, feeling like you can’t live without him or her
  • The therapist does not have the expertise you need
  • What worked before doesn’t work now since you have progressed and your therapist doesn’t have a broad enough “toolbox” to find the right tool to help you in this next phase 

If you are only just beginning to feel like things aren’t working, speak up. Advocate for yourself. Let your therapist know how you’re feeling and give him or her a chance to make adjustments. There is much to be said for maintaining a long-standing relationship with someone who has helped you up until now. However, sometimes it is just time to move on.

How to make a switch

A good therapist can tell when a client is not benefitting from his or her help. At that time, they should recommend a switch. But sometimes you need to take the initiative. 

Unless you feel unsafe with the counselor, don’t just cancel future appointments and go elsewhere. Tell your therapist that you feel like you have reached an end to how he or she can help you and now you would like to explore other avenues. Thank them for the work they have done up to now (even if it was just a few sessions). It is reasonable to say “I just don’t think it’s a good fit” or “I want to look into a different approach.” A good therapist will understand and encourage you in your next phase. 

If you are looking for a new therapist and you are in the New York City area, give me a call. I spend time in the first session getting to know my clients and helping them know me so that we can make sure it’s a good fit from the start.

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Taking a Workday Break Outside for Your Physical and Mental Health

Posted on April 3, 2025 by Alisa Hafkin

More and more evidence is showing that going outside, even if just for a short time, is tremendously beneficial, not only to our physical health but to our mental health as well. As a psychotherapist in New York City, I often encourage my clients to include outside exercise, or even just being out in the sunlight, as part of their regimen for healing and well-being. 

I think most of us realize that getting regular exercise is beneficial to one’s physical health. Our bodies were not designed to sit all the time. What many of us forget, however, is that our bodies and minds are interconnected. Any steps we take to improve our physical health will improve our mental health, and the reverse is also true. Fortunately, being outside helps both body and mind simultaneously.

Just as we were not made to sit for most of our waking hours, we were not made to be inside. We need to be out in the sun for our bodies to produce vitamin D, a critical chemical that impacts many functions in our bodies.

The benefits of sunshine to your mental health

Sunlight can improve mood by increasing the production of serotonin, often called “the feel-good chemical.” A boost in serotonin can decrease symptoms of depression and anxiety. It can treat seasonal affective disorder (SAD), a form of depression that often occurs with decreased sunlight in the winter.

If you have trouble sleeping, this may be a sign that you need more sunlight. Sunlight affects your body’s internal clock; light tells the body to wake up. Too much light at night can confuse the body about when to sleep. Natural light regulates melatonin, which in turn regulates sleep. Disrupted sleep patterns can also negatively affect mental health. This is another reason why getting out into the sun is so important.

Vitamin D is necessary to help our bodies absorb other nutrients, such as calcium and phosphorus, which in turn are necessary for strong bones and teeth. Vitamin D is a critical component in supporting our immune system and helping us fight illness. It can also help stimulate the production of nitric oxide, which can widen blood vessels, lower blood pressure, and potentially decrease the risk of heart attacks and stroke.

It doesn’t take a lot of sunlight to start noticing a difference. Exposing yourself to direct sunlight on your arms and face for even 15 minutes a few times a week is sometimes enough for people to see their mood improve. It’s important to be outside, in that glass can filter out some of the beneficial rays that your body needs. Sunblock also filters out critical components of sunlight that create vitamin D, therefore, take your sun exposure in small enough doses so as not to burn and damage your skin. If you expect to be out for a while or at a beach or other very sunny location, use sunscreen liberally.

The benefits of nature to your mental health

More and more science is demonstrating that being in nature has additional benefits beyond sunshine and fresh air. The benefits from sunshine are magnified and expanded when we experience nature. Allow yourself to enjoy the green, the sound of the birds and squirrels, and the feel of the breeze. Interacting with nature enables you to take in the benefits that nature provides.

For instance, if you are walking in one of the many parks we have in NYC with headphones on, listening to a podcast without noticing the nature around you, you may get sunlight and exercise, but you won’t experience the added benefits of the natural environment. It would be the equivalent of walking along a busy street – good, but not as good as exposing yourself to all that nature encompasses.

One study demonstrated the benefits of this by comparing a group that walked along a busy road and a group that walked in a grassland scattered with trees. While both experienced the same physiological benefits, brain scans showed that the group that was in nature had a significant decrease in the activity of the part of the brain responsible for ruminating and negative emotions. Nature really makes a difference!

The deepening of connections with people

As you take your brief break from the office, consider inviting someone along. Make sure it is someone with whom you can have a positive conversation, or who will be okay with spending time walking in silence. Silence allows us to experience nature with all our senses. It is also an underutilized way to deepen a relationship when experiencing something together. So choose someone who is not going to gossip or talk about office politics. Feel free to suggest this to your walking companion as a guideline: no negative talk, and let’s enjoy nature in silence part of the time. I bet you’ll find others who want this as much as you do!

If you can take an outside break in the middle of the day, even just a few times a week, you will find yourself returning to the office refreshed, your general mood improved, and possibly sleeping better. If you’re in the NYC area and would like to learn more about how to add a nature walk to your regular schedule, or if you feel you need some help with stress, anxiety, depression, or other mental or emotional health issues, please feel free to reach out to me.

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Postpartum Depression

Posted on February 20, 2025 by Alisa Hafkin

Postpartum depression (PPD) can occur any time within the first year after having a baby but usually begins within days or weeks after delivery. It is estimated that one in nine new mothers will experience some degree of PPD, regardless of age or number of children. Many factors can lead to PPD. If you are experiencing symptoms of depression, it’s important to review and address all possible causes. As an experienced psychotherapist in New York City who has also worked as a postpartum doula, I have helped many new mothers identify the difference between baby blues and postpartum depression.

Signs of PPD

Most women experience a variety of emotions after having a baby. There’s great joy, but there’s also a little worry – wanting to be a good mother, making sure the baby is all right, wondering how you’ll function with little sleep, concerns about juggling other responsibilities. These are all normal thoughts. But for some women, these normal concerns can feel more intense and can cause anxiety. Emotions can get out of hand and you may want to feel overjoyed but you find yourself feeling sad, angry, and/or depressed, leaving you with little energy or motivation. You might feel as though you aren’t able to care for the baby or that you can’t connect with the baby.

Do not dismiss these feelings as “baby blues” and don’t let anyone else tell you that you’re overreacting or that “this, too, shall pass.” Only by addressing your feelings will they pass. Sometimes the feelings may be so severe that you can’t address them yourself; you need your spouse or family to help you.

PPD can range in intensity from mild to severe and usually last more than three weeks postpartum. Common signs that you may be experiencing PPD include:

  • Excessive or severe mood swings, anger, sadness
  • Feelings of worthlessness or failure
  • Inability to bond with your baby
  • Withdrawal from friends, family, and activities you love
  • Thoughts of harming yourself or your baby
  • Excessive sleepiness or an inability to sleep that cannot be attributed to childcare
  • Overwhelming fatigue or lethargy
  • Inability to think clearly or as well as before
  • Fear and doubt of your abilities as a mother

Possible causes of PPD

Causes of PPD can include biological factors, personal history, lifestyle, stress, and personal situations. Each should be examined so that your PPD can be quickly addressed and treated. Some causes include:

  • A history of depression or mental illness
  • Hormonal imbalance, especially if there is a previous history
  • Brain chemistry changes due to hormones and nutrition
  • Poor diet or consuming food or beverages that your body responds to negatively
  • Stress
  • Lack of emotional or financial support
  • Lack of help with the baby
  • Complications in childbirth
  • Lifestyle changes brought about by adding a baby to the family
  • Genetic disposition with a family history of PPD

Finding help for PPD

In my current practice, I help couples through the challenging first few weeks (or months, as needed) after a baby is brought home. I work with both mother and father to circumvent possible triggers in the environment that can lead to PPD. In this way, we are sometimes able to prevent it from occurring or reverse it when it shows up. 

It’s not a matter of just discussing your feelings. It’s important to set up the necessary support that the new mother needs. Historically, new mothers had the help of a wider community, experienced mothers giving them advice and taking charge when the mother needed to rest. Unfortunately, few families have that type of supportive environment in our modern society. Developing a support community or interacting with support groups can make a world of difference, helping to ease the anxiety of new mothers.

Fathers also often need emotional support, though they are less likely to recognize the need or ask for help. This is why it is important to work with both mother and father to help set the family up for success from the earliest days of the baby’s life.

 A multi-pronged approach

My approach, then, is multi-pronged. Evaluation of one’s feelings leads to a deeper exploration of causes. When actionable causes are discovered, such as stress, past traumas, or lack of support, we seek solutions together to address those causes. When there is a history of depression, therapy may lead to deeper healing. 

It may also be necessary to engage the help of a medical doctor or nutritionist to address any biological factors that are causing the symptoms of PPD. Concurrent with addressing the biological and nutritional issues, we can work to establish lifestyle changes that will further ease the depression. For instance, we may develop a plan for a family member or friend to take charge of the baby at a certain time of the day to allow the mother or father to nap, split the family chores or demands of other children, and create a sleep and exercise schedule that offers more rejuvenation.

All possible solutions are evaluated and implemented when dealing with depression, including PPD, since there are many possible factors. If you’re experiencing postpartum depression, or if you have not yet given birth and you are already feeling stress or anxiety, don’t try to deal with it alone. Talk to your partner, your loved ones, and your doctor about what you’re experiencing. Don’t let anyone dismiss it. You deserve to experience joy and health as you bring a new baby into the world. Find a counselor or therapist in your area experienced with postpartum depression. If you are in the NYC area, reach out to see how I can help you.

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Mental Health and Your Pregnancy

Posted on February 20, 2025 by Alisa Hafkin

When you are pregnant, the decisions you make affect both you and your baby. Since our bodies are integrated systems, pregnancy causes changes to your entire body, including your mental health. Your emotions, stress reactions, and relationships can all be affected by the hormonal and nutritional demands of your body as you nurture your unborn child. 

It’s important to be aware of these changes so you can know how to respond and maintain a healthy body, mind, relationship, work environment and a healthy baby. Life at times, can be stressful so it is important during pregnancy to finds ways to manage that stress. There are many physical and emotional stressors that can affect the health of the mother, the couple, and the child including the after effects of infertility treatment, medical issues during pregnancy, decreased mobility, lack of sleep, work demands, among others.

Basic health practices

Of course, taking good care of yourself is even more important when you’re pregnant. However, it can also be more challenging. We should always strive to get plenty of rest, exercise, and eat nutritious foods, but this can be harder during pregnancy. You may find yourself more tired or struggling with insomnia, experiencing nausea or cravings, and not feeling up to exercising. Talk to your obstetrician about these issues, and make sure to consider all options including natural remedies. Low iron can be one of the causes of exhaustion during pregnancy. Cravings can be a sign that you may be missing some vitamins or minerals. Speak to your doctor about all your health concerns and work together to find ways to make your pregnancy as healthy as possible for you and your baby.

Mental health practices

Emotional swings and weepiness are common effects of hormonal changes during pregnancy. Being aware of this and having an honest discussion with your partner and others you see often such as co-workers and friends should help to avoid any hurt feelings or damage to relationships. It may even strengthen your bonds, as your loved ones and friends will be much more sympathetic and will probably look for ways to lessen your stress.

Stress, though often caused by hormonal changes, is also a very real part of most pregnancies. You may have concerns about how growing the family may strain finances. You may have a small home or apartment and wonder how you will accommodate a child (or an additional child). If your marriage is already strained, the pregnancy is unexpected, or you are not really excited about being pregnant, then these stressors can negatively effect your mental health during the pregnancy.

Common emotional or mental health issues during pregnancy include:

  • Depression
  • Anxiety
  • Fear and worry
  • Panic attacks
  • Feelings of inadequacy
  • Loss of motivation
  • Loss of libido
  • Mood swings and irritability

Getting help if you need it

It’s important not to go through these emotional struggles alone. Certainly, talk to your medical team to make sure you are physically healthy and your hormones and vitamins/minerals are in a healthy range. A marriage counselor, one who is experienced in working with couples through the challenges of pregnancy, can play an important role in keeping you mentally and emotionally healthy while simultaneously strengthening your relationship with your partner. 

Sometimes events have unintended consequences. A welcomed pregnancy may cause strain on a healthy marriage; an unexpected pregnancy may, with some counseling, help heal a strained marriage. Either way, don’t allow the arrival of a new baby to cause your mental health or your relationships to deteriorate.

It is important to be in as calm a state of mind as possible when the baby arrives because caring for a newborn can be an even greater strain. For over seven years I was a postpartum doula, visiting couples in their homes, listening, and counseling both mothers and fathers through the challenges and joys of first-time parenting.

If you feel like you need some help managing the challenges of pregnancy and even those first few weeks after birth, I encourage you to find the help of a licensed counselor who is trained in helping couples through the strain of pregnancy and caring for a newborn. If you are in the New York City area, please give me a call to see how I can help. Sometimes, just a few sessions can give you the insights and strategies you need for a healthy, happy marriage, pregnancy, and baby.

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How Is 2025 Going for You?

Posted on February 6, 2025 by Alisa Hafkin

Are you feeling stuck already, and the new year has just begun? Are you struggling to stick to your resolutions? Does thinking about the year ahead make you feel discouraged? 

The new year can be exciting for some people. For others, it can feel like they’re facing another year of more of the same. An important skill for all of us to learn is recognizing and silencing the negative voice within us that holds us down. Negative self-talk is always counterproductive, even if you think it’s based on some truth (“I never finish my resolutions” or “I can never get ahead, as hard as I try” or “I just can’t find Mr. Right”). 

Sometimes past experiences, trauma, or hard times drag you down. This can make it very difficult to make necessary changes in your life. And sometimes, you just need a little help making realistic goals and knowing how to follow through.

Why resolutions fail

Making resolutions is a sign of hope, so if you’ve made them, good for you! If you haven’t, because you are discouraged that they haven’t worked before, I can share a few possible reasons why they were previously unsuccessful. This knowledge often helps people make better goals.

  • Unrealistic – Sometimes we see the big picture and make the goal too large without dividing it into bite-sized pieces to chip away at the big goal a little at a time throughout the year. And sometimes we just make too many goals.
  •  Lack of planning – If you don’t create actionable steps that can lead to final success, your goal will likely not be accomplished.
  • Not adjusting habits or routines – People are often unwilling to make changes that will help them implement their new goals – for instance, you want to curtail your drinking but you won’t stop going to your favorite bar after work.
  • No support– You don’t have a support group encouraging you in your resolutions.
  • External factors – Unexpected events or pressures over which you have little control may intervene. 

Except for external factors, we do have control over these other obstacles, but sometimes it’s hard to feel as though we are in the driver’s seat. If you want 2025 to be your best year yet and the beginning of even better years ahead, a little guidance from an experienced counselor can make all the difference. If you’re in the New York City area, give me a call to see how I can help. 

How to increase your chances of reaching your goals

The list of reasons for failure can give us hints of how to succeed. A few practical points may help you make successful resolutions this year. 

Examine your reasons for making resolutions. Are you making resolutions because of what other people think about you, because of low self-esteem, or because of a higher reason? For instance, if you want to lose 30 pounds, is it because people have teased you about your weight, because you think you’re unattractive, or because you want to maximize your health? Only the last reason is a strong enough “why” to lead to success. The other reasons are based on fear or self-loathing. In these cases, whether you lose weight or not, you will feel like a failure. 

If you lose 15 pounds and feel a lot better, you’ll still feel like a failure because your goal was off. That negative self-opinion will likely cause you to gain the weight back. Resolutions need to come from a place of strength within, and a true conviction for the good, not out of fear or negativity.

Make a few clear, actionable resolutions with a well-developed plan of action. Write out the steps you plan to take with time frames that will help you meet your goal. Track your goals in a journal, listing your successes and setbacks and what you learned from them. Adjust as needed.

If you’re trying to lose weight, list changes in diet and exercise that should help you toward your goal. Choose one unhealthy food a month to eliminate except for special occasions. For instance, allow yourself pizza once a month instead of once a week. Decide if you need to join a gym or change your commute to work. Consider parking at the farthest end of the parking lot or getting off at an earlier train stop so you walk every day. Simple life changes are the most enduring. Track your weight. If weight loss stalls, that’s ok, it usually does. If you start to gain again, find out why and make changes. Record the improvements that you feel in your health – not being so out of breath when you climb stairs or walk the dog, for instance. 

Find partners to support your resolution. Tell your friends and family about your goals and tell them how you want them to cheer you on. They don’t need to ask how you’re doing. You also don’t want them to shame you when you eat a donut. However, you want to be able to share your successes and talk out your struggles with them so they can give you moral support.

Reward yourself. When you’ve succeeded in your goal, reward yourself! You don’t need to get it done in a year. In fact, you might get close to your goal and be happy with that outcome. Whatever and whenever you succeed, reward yourself. Sticking with our example, buy a special outfit, get professional pictures taken, or take your support group out for a special, healthy dinner. 

Getting help to succeed

This is all great advice, but sometimes it’s really hard to implement it. And sometimes, a person just feels too “down” to take the necessary first steps. If this sounds like you, it could be that you’re actually experiencing “unrealized depression.”

Whether you are experiencing unrealized depression, dealing with past trauma or self-esteem issues, or you just need motivation and accountability, I’m here. If you’re in the NYC area, let’s talk about your goals and how we can help you attain them.

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Are We Heading for Divorce?

Posted on February 6, 2025 by Alisa Hafkin

You’re fighting all the time – or worse, you’re not communicating at all. Has there has been a breach of trust or a loss of respect? You wonder if it’s possible to save your marriage, or if it’s even worth trying. You wonder if you are headed for divorce.

In my experience as a marriage counselor in New York City, I would say “yes, it’s worth trying.” You have committed yourself to each other and that commitment means something. You got married because you loved each other. You’ve built a world together, maybe with children, shared friends, shared property, shared experiences. It’s worth trying to save all that. It’s worth trying because you want to be able to look back and say to yourself, “I tried everything I could to make it work”.

How can an appointment with me help? 

In my couples therapy sessions, we will explore the unique patterns that you and your spouse engage in. We’ll work to uncover hidden motivations and develop new methods of communication. We will examine what is wrong in your relationship and what is right, your strengths and weaknesses, communication styles, and each one’s goals and priorities, among other important topics. 

Renowned marriage researcher, Dr. John Gottman, discovered four patterns that he called “the four horsemen of the apocalypse” because they forewarned marital problems. They are criticism, contempt, defensiveness, and stonewalling (the silent treatment). In my experience as a counselor, I have seen many of those same patterns in troubled marriages. The good news is that many couples are able to find ways to modify these habits to create more functional and beneficial outcomes.

Most problems in marriage stem from patterns of thought that we have developed over time, usually from experiences in our early years. You don’t have to have experienced serious trauma in order to carry “baggage.” It could even be a positive life experience that is at odds with your spouse. For instance, if you grew up in a very neat, orderly home, sloppiness may drive you nuts. This may cause you to lose respect for your spouse, thinking he or she is a “slob.” This is a form of contempt. Maybe you were criticized a lot when you were younger and now any perceived criticism from your spouse results in an angry, defensive response. 

These are the kinds of underlying causes that we can bring to light. In my experience, once a person knows why he or she is behaving in such a way, the person is empowered to behave differently. Being aware of what you are doing enables you to make conscious rather than reactive choices in your relationship.

In my practice, I focus on psychodynamic therapy and cognitive behavioral therapy. When necessary, I draw those disciplines into my couples counseling sessions. Psychodynamic therapy focuses on a deep understanding of your unique history of thoughts, relationships, and behavior patterns to help gain insight into how or why you behave as you do. Cognitive behavioral therapy is a more concrete approach, helping a person to make changes in one’s life through positive thinking and self-talk, mindfulness, and other practical approaches. Both of these aspects can be well-suited to finding the underlying causes of disagreements and developing new, healthy relationship patterns to heal your marriage.

If you’re in the New York City area and would like to explore how to begin healing your marriage, reach out to me. You don’t have to be on the verge of divorce. In fact, the sooner you start working on your marriage the better. If you want to strengthen your marriage, therapy may be able to help.

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