The Emotional Cost of People-Pleasing

Posted on May 26, 2026 by Alisa Hafkin

What’s the difference between being generous and being a people-pleaser? The distinction can be nuanced and difficult to discern. Usually, however, a person’s emotional health is a strong indicator of whether the tendency to people-please comes from a healthy or unhealthy source. If you are dealing with any kind of anxiety, fear, or overwhelm in your life, you’ll likely need some help developing boundaries so that you can continue your generosity from a healthier space.

Defining people-pleasing

Wouldn’t the world be a better place if everyone tried to care more about others than about themselves? Absolutely! But a spirit of generosity must not come at personal expense. There are always going to be people who are in need, important causes to volunteer for, and friends who need help. All of us should care enough to provide necessary support in any of these ways.

So if these are all good actions, what are some warning signs that something is wrong?

  • Feeling internally compelled to help
  • Feeling guilty if you say “no”
  • Feeling anxious, exhausted, or overwhelmed
  • Putting aside the needs of your spouse, children, or close family in order to help someone else or to do volunteer work
  • Ignoring your own physical, emotional, financial, or familial needs to help someone else
  • Agreeing with something or someone just to avoid conflict
  • Allowing yourself to be a doormat for others
  • Wanting the approval of others
  • Defining your own self-worth by how much you do for others
  • Trying to be agreeable all the time; never asserting oneself
  • Avoiding saying anything unpleasant, to the point of making “little white lies”
  • Feeling like a “martyr” and letting people know how much you are giving up for them

A few specific examples may include:

  • Loaning money or helping someone buy a big-ticket item because “they need it” or “it will make her happy,” when you can’t really afford it, or giving small amounts of money repeatedly until it causes you financial problems
  • Always saying yes when people ask you to do something, large or small: finishing up a job at work so someone else can leave early but you stay later; babysitting a child so that the mother can go out, even though you had plans
  • Taking on additional tasks at a volunteer organization, which cut into family time, because there’s “no one else who will step up to do it”

Notice that in all these examples, it isn’t just the kind or generous act that is in question; it is what effect it has on you and your family. And once people know that you will say “yes,” you will be asked more and more often. Without healthy boundaries, you will continue to feel pushed in an unhealthy direction.

Motivations behind people-pleasing

As a psychotherapist in New York City, I can tell you that there are almost as many reasons for people-pleasing as there are people themselves. Our emotions and behaviors are, to a large extent, formed by our life experiences. However, what may cause people-pleasing in one person may have no effect on another.

When I work with a client, we work together to review and evaluate past experiences that may have led to the root causes of people-pleasing, which may include:

  • Low self-esteem or insecurity
  • Fear of loss
  • Fear of conflict
  • The feeling that you need to earn other people’s love
  • The belief that your value is dependent upon what others think of you
  • The desire to control the thoughts and feelings of others (possibly unconsciously)

Anything could have caused these feelings to develop in you. Maybe you grew up in a high-conflict household and tried to be the peacemaker, which earned the approval of certain family members. Or maybe one of your siblings was unhealthy and got the lion’s share of the attention. You found yourself often forgotten, or you did more to help around the house because of the family crisis. Maybe you were bullied and developed a habit of passivism to avoid further conflict. Or maybe you grew up in a great family where service was part of the atmosphere, but you never developed healthy boundaries.

Whatever the cause, we can find solutions to help you redefine how you serve others in a healthier way.

Making healthy changes

Your internal motivations are what make the difference between a generous, caring person and a people-pleaser. Your feelings of anxiety, overwhelm, worrying about what people think of you, inability to say “no,” and other unhealthy tendencies are signs that your good works and generous actions are not coming from the right interior motivations and are actually hurting you.

Let’s work together to redefine your thought patterns, heal some of those wounds, and help you develop healthy boundaries so that you can continue to help others without hurting yourself or those who depend on you. If you live in the New York City area, feel free to reach out to me to see how I can help.

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Depressed Because You Feel Left Behind

Posted on May 26, 2026 by Alisa Hafkin

You had big plans, and maybe some of them were successful at first, but now your life feels stuck. You created timelines and expectations for yourself that aren’t being met, and you feel like your peers are moving ahead while you’re being left behind. You’re anxious about aging and not making progress. You feel pressure from family and friends, and generalized anxiety is turning into depression.

As a psychotherapist in New York City, I see that pattern all the time. New York is the city that never sleeps. It’s a place that, by its reputation, can make or break you. As the song goes, “If I can make it there, I’ll make it anywhere!”

Unrealistic Expectations

But it doesn’t have to be that way. When we construct unrealistic expectations and develop unhealthy belief systems – about ourselves, the place where we live, what our friends and family are thinking – we set ourselves up for anxiety, depression, and eventually a feeling of failure, even if objectively we are very successful. How we view ourselves and the events in our lives determines how we feel about them and sometimes how well we perform. It’s critical to redefine, recreate, and re-envision ourselves and our lives.

Most people internalize beliefs about success from their childhood experiences and their family culture. Oftentimes, these are positive influences that may be taken too far. For instance, your father started his own business, worked hard, and became successful, supporting his family very comfortably. You want to do the same, but you have put upon yourself the added pressure, perhaps, that you need to “make Dad proud” or “prove yourself” to your family. These are the kinds of unhealthy expectations that may only take a few sessions to review and reframe so that you can move forward successfully, with a peaceful persepctive.

But perhaps you had negative experiences in the past: growing up in poverty, making a mistake in your career that caused you to lose a promotion, or low self-esteem from childhood bullying. There are myriad past events, large or small, that could be causing you to pressure yourself in unhealthy ways or that may actually be undermining your success.

Using Therapy to Move Forward

As a psychotherapist, I utilize psychodynamic and cognitive behavioral therapies. These practices enable me to provide a safe and secure environment that fosters self-awareness and the motivation necessary to make a change.

Psychodynamic therapy is a deep and sensitive exploration of problems and issues affecting your life in order to understand your unique history of thoughts, relationships, and behavioral patterns. Uncovering the origins of behaviors and emotions leads to the potential to resolve them in a safe environment and an ability to make more conscious rather than reactive choices.

Cognitive behavioral therapy offers a concrete approach to uncovering automatic thoughts that lead to specific behaviors. By becoming aware of your thoughts, you gain insight into how and why choices are made in life. Some techniques include relaxation exercises, mindfulness homework, positive thinking, self-talk practices, and journaling, all of which help you positively retrain automatic reactions and thoughts.

In my first session with a client, I encourage the client to share freely, guiding them with expert questions that help me determine the best approach. With the help of these therapies, I will help you find the underlying beliefs that may be causing your depression and your unfulfilled expectations, develop methods and habits of thought to overcome these feelings, and then work with you to redefine where you are now and where you want to be, chart a realistic growth plan, and reconstruct your timeline to help you reach your goals. If you’re in the New York City area, reach out to see how I can help you.

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The Guilt of Relaxing

Posted on April 21, 2026 by Alisa Hafkin

Do you ever feel guilty when you relax? You’re not alone. It’s extremely common for highly effective people to feel guilty if they slow down, go on vacation, or even sit and relax for an hour. But why? Is it just because you like being busy, or is there some deeper reason that’s making it hard for you to appreciate leisure time?

This is a very complex question that could have many different answers and first let’s understand that guilt implies that you have done something wrong. As a psychotherapist in New York City, I have had many clients who equated relaxation with laziness or “wasting time.” But relaxation is absolutely not a waste of time. It is necessary for your mental, emotional, and physical health.

The first thing I do with my clients who feel this guilt is to help them evaluate what is causing this false perception of relaxation. Then I help them reframe their thinking so that they can relax and actually enjoy themselves while doing it.

Why you can’t relax

There could be a number of reasons that contribute to your guilt about relaxing. Some are positive, some negative, and some neutral. Most of us have a combination of reasons. See how many of these may be contributing to your guilt:

  • Your mind is overactive or anxious: If you struggle with intrusive or negative thoughts, staying busy could be your way of keeping them at bay.
  • You see hard work as a virtue: Certainly, hard work is a wonderful thing! We should all be committed to doing our best at whatever we are doing. If you came from a family or culture that idealizes hard work and the results that can come from it, then you may have a hard time relaxing.
  • You identify yourself with your productivity or your job: You may feel like your job or your success defines you. This may actually come from a place of low self-esteem, not recognizing that you have value beyond your work.
  • You may be concerned about losing your job or being able to pay your bills: This can be a very real concern, and it can prevent you from spending time with those for whom you are working so hard to make ends meet.
  • You like to see results: The benefits of relaxation are mostly abstract and come with time. By contrast, work is measurable, tangible, and offers immediate gratification. There’s nothing more satisfying than checking something off the to-do list or getting that bonus for beating the numbers for the month!
  • You compare yourself to the success of others: People in your life or people you see online have what you want, and you feel like you need to keep pushing so that you, too, can reach that level. Conversely, you may have grown up with an example of someone who did not work hard and therefore did poorly in life, and you do not want that person’s fate.

This is not, of course, an exhaustive list, but you may see yourself to some degree in several of these scenarios. There are a few things you can do to break this connection between rest and guilt.

The benefits of relaxation

First of all, you need to know the benefits of relaxation. In fact, knowing these benefits will help you see that you’re actually “doing something” while relaxing: you’re making yourself more productive in the long run! That’s not actually the point; leisure has value in itself, but it is a nice benefit for those who love to always accomplish something.

By relaxing regularly, your body is able to get out of the “fight or flight” merry-go-round that modern American culture has pushed us onto. This leads to a staggering number of physical, mental, and emotional benefits:

  • Healing of the nervous system
  • Improved mental health
  • Better emotional regulation and balance
  • Clearer thinking, improved decision-making
  • Improved creativity and problem-solving
  • Improved focus, concentration, and memory
  • Better sleep, less fatigue
  • Improved relationships
  • Improved digestion
  • Increased blood flow and oxygen by relaxation of the arteries
  • Possible reduced inflammation
  • Possible decreased blood pressure and risk of stroke or heart attack

Once you know the benefits of relaxation, you see that you aren’t “doing nothing” when you relax. You are doing something critically important.

Claiming the benefits of relaxation

Being a productive person is a good thing. You don’t have to stop “being productive” to relax. But you may have to address some deep-seated lies first, if they are driving your guilt. Working with a counselor could help define them. If you’re in the NYC area, reach out to me for help. In the meantime, try a few of these ideas:

  • Acknowledge that you deserve to relax. You’ve certainly earned it.
  • If you’re the kind of person who lives by the calendar, be sure to schedule in your relaxation every day, with some longer breaks (a few days off) from time to time.
  • Step away from your desk or computer frequently. Learn some relaxation or mindfulness techniques that only take a few minutes and that you can do hourly or at least several times during the work day to keep you relaxed while being productive.
  • Turn off the phone and the computer in the evening, and tell people your new available hours.
  • Plan time with friends or family, and stick with it. If you plan to sit down with your spouse at 8 pm every day, or you plan to play catch with the kids on Saturday after lunch, you won’t want to disappoint them, so you’ll make the time to relax with them.
  • Find a fun hobby that may be active, so you feel like you’re “doing something” when you’re actually relaxing. That could be biking, baking, painting, or playing an instrument. The goal is to choose something that you won’t be judging yourself on. There are extra benefits for doing something with friends or family, but some alone time is also valuable.

These are just a few ideas that can help you learn to relax. It’s hardly productive to feel guilty about relaxation when the benefits of relaxing are so clear. If you have trouble applying these tips but you’re ready to learn the fine art of leisure, give me a call to see how I can help.

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Anxiety of High Achievers

Posted on April 21, 2026 by Alisa Hafkin

As a high achiever, you drive yourself to succeed, and you usually do succeed. But you may also experience anxiety associated with that success. You want peace of mind, but you don’t want to give up everything to find it. The good news is, you don’t have to.

Unhealthy behaviors

In my experience, it is very common for high achievers to ruminate on worst-case scenarios, evaluating every little thing that could possibly go wrong. They minimize praise and fixate on constructive criticism. They compare themselves unfavorably with others, always expecting better of themselves, and not sufficiently acknowledging their accomplishments.

You might have thought you would be happy when you reached a certain milestone, moving up the ladder of success. But you now feel isolated from co-workers and friends who may not have reached that level or who now feel awkward with (or even jealous of) your new authority. You may also find you need support in a new position, but are afraid to ask for help and appear weak or underqualified.

Some of these unhealthy mental behaviors stem from low self-esteem that may be driving you to succeed. Others may simply arise from not knowing how to navigate your new reality. Either way, you need to resolve these feelings in order to continue to function well and be happy.

Type A personalities

The term “type A personality” is often used to describe a person who is self-driven and always busy. It’s fine to be type A, but it is not fine to have anxiety. The correlation of anxiety with functionality is a bell curve. Those who have no anxiety generally also have very little self-motivation and often very little functionality; they could be the couch potatoes in your life. Those who have too much anxiety are on the other end of the bell curve, unable to function.

The top of the curve is where the healthy type A personalities reside: just enough anxiety to stay on their toes while still being highly functional. They do not experience negative side effects from their anxiety. It does not affect their work, their personal lives, or their overall happiness. It’s considered “healthy anxiety.”

Therapy can help

Where would you place yourself on that bell curve? If you are experiencing any of the negative effects of anxiety, talk to a professional counselor who can help you evaluate the root causes of your anxiety and guide you to reframe your thinking. If you live in the NYC area, reach out to me to see how I can help.

Together, we’ll review what your main concerns are, what triggers you, and what steps need to be taken to create healthy thought patterns. My orientation is in psychodynamic and cognitive behavior therapies, which provide me with a wide range of tools to help you find solutions for your unique situation.

We do not function in a vacuum; we are the sum of our own life stories. These stories have their beautiful parts and their dark sides. By looking at both positive and negative, we can work together to craft a future that builds on your past, healing old wounds, and building up all that is good, so that you can move forward with greater joy and deeper connection to the important people in your life. Give me a call to see how I can help.

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Postpartum Anxiety

Posted on April 9, 2026 by Alisa Hafkin

You’ve just had a baby, and everyone is so excited for you, but you feel like this wonderful time is nothing but stress. You’re expected to host guests and well-wishers who want to see the baby and congratulate you, but you’re exhausted, worried, tense, and moody. You wonder, “What’s wrong with me?”

Nothing is really wrong with you. Your reactions are common and understandable. Postpartum anxiety (PPA) can occur any time within the first year after having a baby, but usually begins within days or weeks of the delivery, and can occur no matter how many children you have had.

As an experienced psychotherapist in New York City who has also worked as a postpartum doula, I have helped many new mothers recover their sense of calm and balance after childbirth.

Baby blues, postpartum anxiety, and depression

A new mother’s emotions can be a bit volatile shortly after having a baby. This is mostly caused by hormonal changes, disruption in normal sleep cycles, family life, and concern for the baby. It can begin a few days after delivery and last a couple of weeks. These feelings generally resolve on their own, as you settle into parenthood and your hormones calm down.

However, if these symptoms seem extreme or if they persist, you may be experiencing anxiety, which strikes about 17% of mothers postpartum. Factors that increase the risk of PPA include:

  • Previous history of anxiety, PTSD, or abuse
  • Limited social or familial support
  • Preterm birth or difficult delivery
  • Poor health habits, both physical and mental
  • Low sense of self-esteem or capability
  • Difficulty nursing or concern because the baby needs to take formula

Symptoms of PPA are not unlike general anxiety but tend to be focused on the baby or parenthood. These may include:

  • Physical symptoms such as rapid heart rate, loss of appetite, shortness of breath, trouble sitting still, or muscle tension
  • Disruption of sleep beyond the need to feed or care for the baby at night; getting up to constantly check that the baby is breathing; jumping at every sound
  • Racing thoughts (especially worse-case scenarios); forgetfulness; irritability or tearfulness; unable to relax; feeling fearful; obsessive thoughts
  • Excessive caution; being controlling or not trusting anyone else with the baby; avoiding certain people or places beyond healthy precautions

Sometimes these feelings can bloom into postpartum depression (PPD), so it’s important to address your symptoms as soon as possible to avoid this possibility. PPD differs from PPA in degree and also in thoughts of hopelessness or worthlessness; overwhelming fatigue; excessive mood swings, anger, or weepiness; inability to think clearly; and even thoughts of harming yourself or your child.

Getting help quickly

Turn to your partner and talk out your feelings to get support during this time of transition. You need help so that you can get the sleep you need, and you need someone to make healthy meals for you so that you maintain your own health. If you have family or friends whom you trust, turn to them for emotional support and share the caregiving.

As a psychotherapist who started as a postpartum doula, I understand what you’re going through. We can work on grounding skills so that you can develop the confidence and peace that you need to trust that your baby will be fine and that you can be the mother that you want to be.

Interestingly, 11% of partners can also experience PPA, so you may want to get counseling together. Your partner can learn techniques to help and support you while getting the help he/she may need for themselves. Find an experienced postpartum counselor near you so that you can address your feelings as soon as possible. If you’re in the New York City area, call to see how I can help.

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Why Saying “Just Relax” Is Not Emotionally Healthy

Posted on April 9, 2026 by AHafkin

Whether you say this to yourself or you hear it from your spouse, friend, or colleague, being told to “just relax” or “just let it go” doesn’t work and isn’t healthy. While it might be true that you need to relax or let go, it’s not that easy. You need to address your main issue—you are stressed, and you want help.  

Yes, you can learn to relax, let it go, and get over it. But the keyword is “learn.” As a psychotherapist in New York City, I regularly help my clients learn powerful tools that don’t just “manage” stress but can actually help to reduce it. We can work together to calm your nervous system, get you through stressful situations, and manage future stress successfully.

First steps

Evaluate what causes you to feel stressed or anxious. What are your triggers? Do they involve specific situations? Individuals? Levels of busyness? Do they come on when you are low on sleep or haven’t exercised in a while?

Sometimes the answer is fairly obvious: “Whenever I don’t get enough sleep or miss my workout, I get really stressed.” This is easy to fix. But if it were that obvious, you probably would have fixed it. So it likely goes deeper.

If you get overwhelmed and stressed when you have too many things going on at once, and you’re just too busy, the answer may be to learn how to politely say no.

But if you evaluate yourself and can’t find an obvious solution, or if the solution is obvious but you can’t really change it (for instance, an extremely stressful work environment or trouble balancing work and family life), then you need to develop strategies to ease your stress and anxiety.

Helpful strategies

We should always look first to lifestyle fixes: nutritious food, healthy sleep, and regular exercise. Involving your family in these steps deepens the family bond and helps everyone be less stressed and healthier together! Walking the dog with your spouse or going to the park to jog with the kids can be a wonderful bonding time and an emotional lift.

Beyond basic self-care, there are many very helpful strategies for de-stressing, but different methods work better for different people. We can work together to see which works for you. Some possible strategies include:

  • Mindfulness: There are many techniques, and I work with my patients to determine which mindfulness techniques work best for them.
  • Movement that calms: Again, there are many techniques. We can find something you enjoy that helps you relax.
  • 60-second reset: There is strong science behind a breathing technique that calms the brain and slows the nervous system reaction to anxiety in just 60 seconds. Here are the steps: Relax your shoulders and get comfortable; breathe in through the nose for four seconds; hold it for four seconds; release the air slowly through your mouth for six seconds; repeat four times.
  • Laughing and smiling: You literally trigger “happy hormones” when you smile and laugh. Get a joke book, tell someone your favorite joke, or watch a funny movie.
  • Doing a hobby you love: Pick something soothing, not something that you will criticize yourself over. For instance, if you try to draw or paint a portrait and it doesn’t look like the person, and that would bother you, don’t pick that hobby.

In our discussions, we will also explore the possibility of a deeper cause for your anxious response to these stimuli. Sometimes, a past event keeps rehearsing subconsciously in your head. For instance, if traffic makes you very anxious, was there a traffic accident in your past that involved you or a loved one, that may still be affecting you? If you are fearful of losing your job if you don’t perform to perfection, is there an event in your past that is creating this fear?

The stress management techniques may be all you need to balance your emotions and overcome anxious moments. But if there is an underlying issue that causes your anxiety, we can explore that together. With deeper underlying causes, there are no quick fixes, since they’ve been there for a while. But together we can create a safe space for you to explore what causes the stress and how to deal with it long before you are in a prolonged state of anxiety. If you’re in the NYC area, contact me to see how I can help you.

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Apps Don’t Help Your Relationship Issues

Posted on March 17, 2026 by Alisa Hafkin

Lots of relationship apps have been developed in recent years that claim to help couples connect and bond. These apps offer suggestions for date nights, send daily relationship questions, or help couples understand each other’s emotional needs. 

I applaud every attempt to help couples engage in meaningful dialogue and grow in understanding of each other’s emotional needs. But an app can’t help deep-seated issues that may be causing conflict in your relationship.

When relationship apps can be useful

I have found that these types of apps do have some value. They help couples get to know each other at the beginning of relationships. This can help them determine if they are actually compatible. The apps are also helpful in stable, long-term relationships when a couple wants to renew their focus on each other, as the busyness of life can often distract partners from one another. I think an app is a great idea for helping these healthy relationships become stronger. There are many different kinds of apps with different focuses. If you want to try one, look at several to see which one suits your needs.

When it’s time to seek professional help

Nonetheless, if you and your spouse have been struggling in some area, don’t depend on an app to fix it. If an issue is just beginning to crop up, nip it in the bud. Reach out to an experienced marriage counselor who can help determine if the problem is a communication style difference or a difference in emotional needs. A counselor can help you pick up on each other’s emotional signals and adjust your communication styles so that the other one hears and understands what you’re trying to say (and vice versa, of course). With this knowledge, you may be able to use apps effectively and continue to strengthen your relationship over time.

Couples who are dealing with more extreme issues such as infidelity or infertility need the safe and supportive environment that a couples therapist can provide. The breakdown that extreme issues cause, can often trigger intense responses in a relationship and this is when couples therapy can help.

The value of doing the work together

I applaud and honor couples who are willing to work together to overcome problems for the sake of their love and the commitment they made toward each other. We all benefit from having someone to walk through life with and help us through our rough spots. When you have a partner who is willing to do that for you, life is a little easier. Recognizing what a gift such a person is in your life, will help you both see the value in working hard to keep your relationship strong.

Feel free to try a few relationship apps. But if you need more help, reach out to a good marriage therapist. If you’re in the NYC area, give me a call to see how I can help you.

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Dealing with Anger

Posted on March 17, 2026 by Alisa Hafkin

We often hear of people having “anger issues.” But anger is considered a secondary emotion, generally caused by a primary emotion that is under the surface. The “anger iceberg” can hide deep-seated emotions that can extend as far back as early childhood. 

If you have unreasonable anger or “anger issues” that you just haven’t been able to overcome even though you’ve tried, it is probably because you’re trying to address the symptom rather than the real cause. If you fly off the handle because the cap is left off the toothpaste, or if you find yourself being irritable with your co-workers, spouse, or children beyond what the situation warrants, you may need to look deeply into what other emotions you may be hiding. 

Here in NYC, emotions can naturally run high with the stress of navigating daily life. Managing your career, family, and self-care usually comes with a certain amount of hustle and stress. I work with clients to find underlying causes of the issues that brings them to my office. We can work together to develope tools that can help you slow down and take stock of how you are feeling so that you can assess all aspects of your life.  

Physiology of anger

Anger is an evolutionary defense mechanism. When something triggers anger in us, our heart rate increases, blood rushes to our extremities, and we have a rush of energy, making us ready to fight to defend ourselves and our loved ones. We are ready for rigorous action to protect ourselves! The problem is that most of us don’t face physical danger that requires us to fight. Our perceived danger is emotional or relational, so a different approach needs to be exercised. Learning that approach is critical to overcoming a tendency to anger.

Say no to “anger management”

As a psychotherapist, I don’t help people “manage” their anger. I help them find out what underlying emotions are being masked by the anger. The anger may be hiding feelings such as fear, humiliation, hurt, rejection, loss, frustration, and sorrow. Many of these emotions leave one feeling raw, exposed, and vulnerable. Anger protects us from the vulnerability of these painful emotions. Anger is safer. It also often pushes people away from us, protecting us from more pain.

Most people don’t realize they are doing this. Most people don’t really want to fly off the handle so easily. But subconsciously, anger is the lesser of two evils.

For example, a woman who carries a deep-seated fear of loss since childhood due to abandonment by a parent may consciously want a good relationship as an adult, but anger keeps damaging every relationship she has. Subconsciously, she may be protecting herself from being hurt again. By uncovering the origins of her behaviors and emotions, we can resolve them in a safe environment and work to develop alternative, healthier behaviors and emotional responses to triggers.

If you find yourself struggling to overcome anger, consider the possibility that something else deeper may be going on. A professional therapist can help you find the root causes and work with you to overcome them. If you’re in the NYC area, give me a call to see how I can help you.

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The Emotional Toll of Infertility

Posted on February 6, 2026 by Alisa Hafkin

Infertility can be heartbreaking and emotionally exhausting. Although men and women cope differently with infertility, both feel the emotional impact. Couples should turn to each other for support in order to ease the emotional toll and maintain mental health as they address their fertility challenges.

Infertility treatments—medical procedures, appointments, and medications—can be physically exhausting, draining time and energy from a couple. But the strain on your relationship and your mental health can be just as challenging. It’s important to be aware of the signs of such strain so that you and your partner can avert any escalation of these problems and get the help you need to deal with them.

Red flags

Watch for signs that your mental, emotional, or relational health is suffering and needs attention. For instance, infertility almost invariably attacks self-esteem and leads to the blame game. You may feel defective, inadequate, or like a failure. You may blame yourself or your partner.

Do you ever find yourself thinking, “What’s wrong with me?” “What did I do to my body to cause this?” and even worse, “What did I do wrong to deserve this?” Do you ever think these things about your spouse? Guard against this negative self-talk and these false messages!

Infertility can cause feelings of jealousy towards those who easily conceive or already have children. It can cause social anxiety, making you feel like withdrawing from social situations where you will see children or where people may ask about why you don’t have any children.

You may experience anger or resentment at unsolicited advice or thoughtless words. You may have emotional swings such as bursting into tears and then feeling unreasonable anger or complete lethargy and disinterest.

These are all examples of the emotional toll of infertility, and they should not be ignored. Your relationship with your spouse and any children you have requires you to be mentally healthy and resilient. But what can you do?

Getting help

If your mental health, marriage, work, or relationships are suffering from your struggles with infertility, please know that it doesn’t have to be that way. Find a mental health professional who specializes in treating couples dealing with fertility issues.

Even before reaching out to a professional, your first step should be practicing some self-love. If you’re engaging in negative self-talk, ask yourself, “Would I talk that way to my best friend?” No, of course not! So begin to talk to yourself internally the way you would talk to someone you love who needs support. Then turn to your spouse and offer him or her the same loving support. This is an important first step on the path to healing.

The good news is that addressing mental health issues can improve the chance of getting pregnant. Several studies on the effect of cognitive behavioral therapy (CBT) on couples dealing with fertility have measured both a decrease in anxiety, depression, and anger as well as an increase in fertility rates. A year-long follow-up among participants found a viable pregnancy rate of 55% for the CBT group and 20% for the control group. CBT is one of the methods that I use to help my clients. Couples counseling during IVF treatments has also demonstrated lower cases of anxiety and depression and higher pregnancy rates.

I encourage you to find a psychotherapist near you who specializes in infertility counseling in order to get the help you need. If you are in the NYC area, contact me today to see how I can help you.

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When Anxiety Is Not Just Nervousness

Posted on February 6, 2026 by Alisa Hafkin

Whether you were about to talk in public, take an exam, or say “I do,” you’ve probably experienced the racing heart, sweaty palms, and shaking that go with nervousness. We all have at some point. But how is that different from anxiety? And when do you need help to address it?

Nervousness

Nervousness and nervous energy are associated with a particular event and are temporary, lasting for moments, hours, days, or even weeks, but ending with the culmination of the event. You might be nervous for weeks approaching your wedding day or defending your dissertation for your PhD. But afterward, you take a deep sigh and can relax.

Nervousness can be very uncomfortable—in the moment, the symptoms might even be stronger than general anxiety. Some people with severe nervousness might even faint or feel nauseous. You can lessen severe nervousness with a few helpful techniques:

  • Put things into perspective. Most things we become very nervous about are not that critical.
  • Use your nervous energy to prepare or even over-prepare for the event. This preparation can help to lessen the nervousness, as you become more confident that all will go well.
  • Visualize success. Picture yourself over and over doing everything just right. See yourself giving a great speech—you may even want to imagine tripping up on a few words and laughing about it with the audience. This humanizes the audience in your mind and decreases the fear of mistakes.
  • Use positive self-talk, telling yourself over and over that everything will be fine, silencing the negative self-talk.
  • Right before the event, take deep, controlled breaths and strike a “power pose”—shoulders back, head up, hands on hips. Remind yourself, “I got this!” then go do it.

Anxiety

Anxiety is not as easy to fix as nervousness. Anxiety is defined as an ongoing feeling of fear, dread, or indecision, not connected with a particular upcoming event. You may or may not know what is causing your anxiety, and in fact, there may be more reasons than you can identify. For this reason, general anxiety can be a challenge to overcome. But it can definitely be lessened with some help from an experienced counselor. 

Signs of general anxiety:

  • Constant feeling of stress
  • Uncontrolled worry, ruminating
  • Feelings of dread, but unable to define what you dread
  • Chronic indecision, difficulty starting or finishing tasks, procrastination
  • Doing little tasks but avoiding the big ones
  • Inability to concentrate, racing thoughts
  • Expectation that something will go wrong
  • Moodiness or agitation
  • Digestive problems, tension headaches
  • Poor sleep, feeling “tired but wired”
  • Panic attacks

These feelings can be absolutely exhausting, because unlike nervousness, they never go away. 

Managing anxiety

If you have mild anxiety, some of the same techniques used in overcoming nervousness can be used to defeat anxiety. For mild to moderate anxiety, try these additional strategies:

  • Improve your diet. There is an undeniable connection between how our brain works and the nourishment we give it. Some evidence suggests that gut health and mental health are closely connected, and an unhealthy gut is unable to absorb the nutrients your brain needs for optimum function. Eliminate processed foods and eat healthy foods as much as possible. Avoid alcohol, excess sugar, and carbohydrates.
  • Exercise, especially outside. A brisk walk in the sunshine and nature is as effective as medication for mild to moderate depression and anxiety. Our bodies are designed to be outside. Our brains need sunshine, and our souls need nature. Listening to birds, feeling the breeze, and soaking in vitamin D from the sun is fundamentally healing.
  • Improve your sleep patterns by turning off screens at least an hour before bedtime. Evaluate what kind of content you consume and consider that it may be one of the sources of your anxiety. Eliminate all content that does not build up your mental health.
  • Keep a gratitude journal. Focusing on the positive can completely rewire how we think and can dramatically improve our mood.
  • Smile. Smiling triggers the brain to release mood-boosting neurotransmitters and can actually lower your stress level, even if it feels insincere at first, and even if no one sees you smiling. Of course, if people see you smile, they smile back, which has many other positive benefits!
  • Practice mindfulness. There are many different techniques, and I work with my patients to discover which mindfulness techniques work best for them.

In my practice, I’ve found that these strategies can profoundly benefit people struggling with anxiety. But some people need more help. As a psychotherapist oriented towards psychodynamic and cognitive behavioral therapy, I work with clients to find the underlying causes of the issues that have caused so much stress.

If you have been experiencing anxiety for an extended period of time or have severe anxiety, there may be deep-seated causes that are best addressed with a psychotherapist, who can help you discover those causes and resolve them. Find an experienced therapist near you, and if you are in the NYC area, contact me to see how I can help.

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