We talk a lot about Melani and her “We Do Not Care Anymore” Movement—and yes, we love her! She truly gets it. But this doesn’t necessarily have to mean “letting yourself go.” Sometimes, it’s simply about expressing yourself authentically and reserving your energy for what truly matters to you—by choice, not by default.

For decades, the struggles of perimenopause and menopause—insomnia, hot flashes, brain fog, and mood swings—were often endured quietly, with women suffering in isolation. Today, thanks to Melani Sanders, founder of the We Do Not Care Club (WDNC) on social media, millions of women have a vibrant space to voice their experiences, share relatable challenges, and celebrate the humor and honesty of midlife transitions.

If you spend any time on Instagram, and your algorithm allows, you’ve met Melani. Melani has created a movement that resonates deeply with women navigating midlife, capturing the humor, courage, and liberation that come with embracing authenticity. Known for her distinctive style—often spotted with multiple pairs of readers dangling from her body—she embodies playfulness alongside wisdom, reminding women that self-expression and confidence can coexist at any stage of life. Her work celebrates emotional honesty, boundary-setting, and self-alignment, offering a voice that many women feel mirrors their own inner experience. Beyond trendiness, Melani provides a supportive, validating framework for women to reclaim energy, make intentional choices, and approach life with clarity and confidence.

Are you a woman in NYC navigating the challenges of perimenopause and menopause? Hormonal changes during this transitional stage can bring mood swings, anxiety, fatigue, and heightened stress to the surface. At Holistic Therapy, EMDR & Wellness NYC, I specialize in supporting women through perimenopause with talk therapy support, education,somatic therapy, mindfulness, and other supportive holistic approaches that help manage emotional shifts, release tension, and regain balance.

Perimenopause and menopause can bring major emotional and cognitive shifts that may leave you wondering, “What’s happening to me?”If you’re experiencing mood swings, anxiety, or brain fog, you’re not alone. These symptoms are common and are linked to natural hormonal changes that affect the brain and the body. Mental health challenges during menopause are often overlooked, even though this transitional period can bring increased symptoms of anxiety, depression, mood swings, and struggles with alcohol or substance use. Women with pre-existing conditions such as schizophrenia or bipolar disorder may find their symptoms intensifying during perimenopause and menopause.

Midlife therapy isn’t about symptom management—it’s about reintegration. At my Holistic Psychotherapy & Wellness practice, I combine psychotherapy, EMDR, somatic, and attachment-based work, and mind-body coaching to help women reinhabit themselves—body, mind, and spirit.

“It feels like I’m running on a different operating system than I used to.”

If you’re a woman somewhere in your forties, fifties—or even sixties—you may have noticed that the ground beneath your life has started to tremble in subtle, disorienting ways. Your mind doesn’t feel as sharp. Your skin feels dry and thin, your sleep unsteady. You love your partner, but your libido has disappeared. You find yourself looking at your reflection, wondering where the old “you” has gone. And perhaps, for the first time in a long time, you feel… fragile. Not in the weak sense of the word, but in the way that things feel closer to the surface. The emotions. The memories. The longing. The grief for what used to feel easy.

As a psychotherapist in New York City and midlife coach supporting women through perimenopause and menopause, I see this every day. Women who are strong, intuitive, successful—and utterly bewildered by how unfamiliar their inner world feels. This time of life is not just hormonal. It’s existential. It’s spiritual. It’s about identity, power, and the question that begins to echo through everything:

"Who am I now, and how can i rewrite the script for myself?

These days, everyone seems to be talking about trauma bonds, and while the term has become part of pop-psychology vocabulary, the lived reality is far more complex than a viral headline. A trauma bond isn’t just an emotional attachment to someone who’s hurt you; it’s a physiological tether formed through cycles of fear and intermittent reward. In therapy, we move beyond labels to understand what’s actually happening in your nervous system—why breaking free can feel impossible, and how healing that bond requires compassion, safety, and time.

If you’ve ever left a toxic or emotionally abusive relationship and found yourself missing the person who hurt you, you’re not alone—and you’re not broken. You may feel confused by your own emotions, ashamed that you still care, or angry that part of you longs for their approval. But this reaction isn’t weakness—it’s wiring. Trauma bonds are powerful, involuntary connections formed through cycles of affection, fear, and uncertainty. They’re psychological and physiological—woven into the body’s stress response and attachment system. Understanding how trauma bonds form is the first step in breaking free—not just from a person, but from the emotional conditioning that keeps you tied to pain.

Why success doesn’t silence suffering—and how therapy can help

In my work as a trauma-informed psychotherapist and integrative coach, I support a wide range of clients from all walks of life—each one navigating their own complex emotional landscape. A portion of my practice is dedicated to supporting ultra-high-net-worth individuals and public figures navigating complex emotional landscapes, while I also reserve space for clients seeking low-fee services—because healing should be accessible, and every story matters.

Success looks different for everyone. Whether you’re leading a company, raising a family, building a creative career, or simply trying to hold it all together, the pressures of modern life can take an invisible toll. Emotional suffering doesn’t discriminate—and neither does the need for support. While this post explores the often-overlooked struggles of high achievers and high-net-worth individuals, the themes are universal: disconnection, burnout, performance pressure, and the quiet longing for more meaning, more peace, more you. This post speaks specifically to those who appear to be thriving on the outside, yet feel adrift, anxious, or unfulfilled within. My hope is that, wherever you find yourself, you’ll see reflections of your own experience here—and feel less alone.

In my work with driven, high-functioning individuals who’ve built extraordinary lives—yet quietly wonder why it still doesn’t feel like enough, there are some common themes…

From the outside, they have it all. The accolades, the assets, the lifestyle. High-achieving professionals and ultra-successful individuals often appear untouchable—leading with confidence, accumulating wealth, juggling influence and ambition with practiced ease. But behind closed doors, many quietly endure a different reality: the emotional toll of success, the pressure of public scrutiny, and the silent burden of expectation.

At my private psychotherapy and coaching practice serving clients in New York, Montana, and worldwide via telehealth, I work with high-net-worth individuals, executives, creatives, and public figures who carry invisible stressors beneath their polished exterior. Despite outward accomplishments, these clients often struggle with complex emotional challenges that are easily overlooked or misunderstood—even by those closest to them.

Becoming a mother in New York City is often idealized as a joyful milestone—but for many high-achieving women, the postpartum experience is layered with exhaustion, emotional overwhelm, and a deep sense of disorientation. You may look like you’re managing on the outside, but inside you’re navigating mood swings, persistent sadness, irritability, and a loss of connection to yourself. Insomnia, intrusive thoughts, and the pressure to “bounce back” can make even the simplest moments feel unmanageable. Postpartum depression is not a personal failure—it’s a physiological and emotional response that deserves expert, compassionate care.

At Holistic Therapy & Wellness New York, my boutique psychotherapy practice in Manhattan, I work closely with women facing postpartum depression, perinatal anxiety, and other hormone-related mental health challenges. Using a trauma-informed blend of EMDR, somatic therapy, and mind-body psychotherapy, I help you process the emotional toll of new motherhood, regulate your nervous system, and gently reconnect with a sense of stability, clarity, and self-worth. For many clients, therapy becomes a vital sanctuary—a place to speak honestly, feel supported, and heal without judgment.

In addition to emotional support, I provide holistic care integration, including referrals for functional medicine, hormonal assessments, and wellness practitioners when needed. Whether you're a new mother battling insomnia and emotional fatigue, or a professional woman experiencing the destabilizing effects of hormonal shifts, you don’t have to figure this out alone. With the right therapeutic support, healing is possible—and you can begin to feel like yourself again.

Why High-Functioning Anxiety Is So Common in New York City

In a metropolis where 5 AM workouts, 14-hour workdays, and perfectly curated feeds feel “normal,” it’s easy to miss the warning signs of chronic stress. High-functioning anxiety allows you to perform while you’re quietly:

• Replaying every conversation in your head

• Feeling guilty the moment you slow down

• Taking on more responsibility to prove your worth

• Living with jaw tension, migraines, or gut issues

• Worrying you’ll drop a ball—then working harder to keep them all in the air

Because productivity never falters, colleagues and friends rarely see the cost: brittle nerves, stalled joy, and a body that’s always running on adrenaline.

What Exactly Is High-Functioning Anxiety?

High-functioning anxiety isn’t an official DSM diagnosis; it’s a lived experience that blends Generalized Anxiety Disorder, perfectionism, and people-pleasing. Externally you appear:

• Capable, collected, and always on time

• Hyper-organized and detail-oriented

• Socially poised—hosting, leading, mentoring

Internally, you may feel:

• A near-constant “buzz” of worry or dread

• Panic when your calendar isn’t maxed out

• Fear of being exposed as an imposter

• Exhaustion that no amount of sleep fixes

Left unaddressed, the pattern can lead to burnout, hormone imbalance, relationship conflicts, and stress-related illness.

Why Traditional Self-Help Tips Fall Short

Generic advice—“just meditate,” “say no,” “take a spa day”—rarely works for women whose identity and livelihood depend on high performance. Sustainable change requires:

1. Nervous-System Recalibration that lowers the body’s baseline stress signal

2. Trauma & Attachment Healing to rewrite the deeper message that worth equals output

3. Lifestyle Re-Design that protects ambition and honors rest

That’s where integrative, trauma-informed psychotherapy can be life-changing.

Perimenopause is a profound biological transition that marks the beginning of the end of a woman’s reproductive years. While many associate this phase with hot flashes and irregular periods, far less attention is given to the complex emotional and mental health changes that can arise as the many body-wide systems are impacted by hormone depletion. Typically high-functioning, already overwhelmed New York City women are caught off guard. For many, perimenopause is not just a hormonal shift but a neurological and psychological one, capable of reshaping how they think, feel, and relate to themselves and others.

My mental health is tanking—what’s happening to me?

So many women have no idea what is happening to them during perimenopause. They feel emotionally off-balance, disconnected, or unlike themselves—and often, they’re met with confusion or dismissal. Their doctors may be undereducated about the emotional and neurological dimensions of hormonal changes, or tell them they’re "too young" for hormone therapy. Many are left feeling brushed aside or undersupported. Compounding this is the reality that most mental health professionals receive little to no formal training on how hormonal transitions impact emotional well-being. This lack of awareness can leave women misdiagnosed, misunderstood, and unsure where to turn. In my Manhattan-based boutique psychotherapy practice, I regularly hear from high-functioning, high-achieving women who have been struggling in silence, unaware that their mental health challenges are rooted in hormonal change. Therapy that integrates an understanding of these transitions can be a game-changer—offering validation, regulation, and real tools for relief.

In the throes of a panic attack, it can feel utterly indistinguishable from dying. Your heart pounds like it's about to give out, your chest tightens, your breath comes in shallow gasps—or disappears altogether—and your vision may narrow as a wave of dizziness and unreality crashes over you. The terror is primal, total, and convincing: something is deeply wrong.Many people rush to the ER certain they're having a heart attack, only to be told their body is responding to fear, not failure. But in that moment, logic vanishes. Panic hijacks your nervous system and convinces you this is the end. And yet—every time—it passes. You survive. The work of healing begins by understanding that what you’re experiencing isn’t madness or weakness, but your body sounding an alarm that something needs care, attention, and repair.

Katrina was driving across the Williamsburg Bridge—just another part of her daily New York City commute—when it happened. Out of nowhere, her heart pounded, her vision blurred, and a crushing wave of dread swept over her. Trapped in traffic high above the East River, she felt like she couldn’t breathe—convinced she was going to lose control or pass out behind the wheel. Though the panic subsided, everything changed after that moment.

Now, she avoids the bridge altogether, rerouting through side streets, canceling meetings in Brooklyn, and meticulously planning every trip to prevent another episode. This is the hidden reality of panic disorder for many high-functioning New Yorkers: one terrifying event followed by a life increasingly shaped by fear, avoidance, and the haunting question—what if it happens again?

What Is Panic Disorder?

Panic disorder is a complex anxiety condition marked by sudden and repeated panic attacks—intense surges of fear that peak within minutes and trigger distressing physical symptoms such as a racing heart, dizziness, chest pain, shortness of breath, and a feeling of detachment from reality. Many individuals report feeling as though they’re dying or “going crazy.” Unlike general anxiety, panic disorder includes a persistent worry about future attacks, which often leads to avoidant behaviors. For New Yorkers, this can mean steering clear of subways, elevators, bridges, high-rise buildings, or crowded events—shrinking one's world in a city where independence and mobility are everything.

If so, you are likely to have your share of questions about how to identify, manage, escape from, and avoid future entanglements with narcissistic people. As a psychotherapist from New York City, I work with couples and individuals who present with many symptoms of narcissistic abuse or describe patterns of emotional abuse in their primary relationships. It’s not just men, women can also have narcissistic traits or NPD. Oftentimes, a member of a couple will complain that their partner is a narcissist when actually, they also have these traits. It can make the work of therapy challenging. For anyone involved with a narcissist, it's heartbreaking to realize that years, and even decades, have been spent under the rule of a tyrannical parent or partner. Parents, bosses, and partners with narcissistic personality disorder or strong traits have the potential to powerfully and negatively impact your physical and emotional health and wellbeing.

You may be traumatized, numb, and shut down from years of experiences with family members. You may also find yourself repeating this pattern in your current relationships by seeking out narcissistic partners. And so the neurotic dance of repetition compulsion begins. You're now wondering why you are questioning if you are the "crazy and confused" one in your relationship. Reality test: narcissists and psychopaths exhibit crazy-making behaviors. Narcissists project a lot—they come fully loaded with accusations and criticisms. What's crazy-making is that most of what the narcissist claims YOU are doing is exactly what THEY are doing. A seasoned therapist can support your personal growth and help you develop high-level skills for dealing with the narcissist in your life. 

EMDR Therapy, also known as Eye Movement Desensitization and Reprocessing, is a popular form of healing, powerful healing. As people become more comfortable talking about their mental health concerns, we see more people discussing EMDR, especially celebrities. What is EMDR? When something terrible happens to us, it is stored in our brain and nervous system in a different way than our everyday experiences. Memories and sensations show up when we are least expecting it, just like that, your day has been hijacked. EMDR therapy helps to make the memory less disturbing.

Research reveals that EMDR is a powerful therapeutic approach for resolving symptoms of PTSD and for processing trauma and negative experiences. EMDR has been extensively researched and is recognized as effective by organizations such as the American Psychiatric Association and the World Health Organization for treating PTSD. Many individuals experience significant symptom reduction and improvement in their overall well-being after undergoing EMDR therapy.

You’ve just learned the couple next door are swingers. You’re intrigued—curious even. Maybe you’ve had conversations with your partner about what it might be like to open your relationship. Maybe you’re quietly wondering: Could this work for us?

In my New York City couples therapy practice, I regularly work with individuals and couples exploring alternative relationship styles—including ethical non-monogamy, polyamory, and swinging. These conversations are becoming more common as couples seek to redefine what intimacy, commitment, and love look like—on their own terms.

Before diving into an open relationship, it’s essential to understand what non-monogamy entails and whether it’s right for your unique relationship dynamic.

What Is an Alternative Relationship?

Alternative relationships refer to romantic and sexual partnerships that fall outside traditional monogamy. These include:

• Consensual Non-Monogamy (CNM): A broad term for any relationship structure involving multiple partners with the full knowledge and consent of everyone involved.

• Swinging: Typically involves couples engaging in recreational or social sex with other individuals or couples, often in group settings.

• Polyamory: Involves forming multiple emotionally and/or sexually intimate relationships, where love is shared and nurtured with more than one partner.

• Open Relationships: A primary couple allows for sexual experiences outside the relationship, often with boundaries in place.

• Relationship Anarchy: Emphasizes freedom from traditional relationship labels, hierarchy, and rules. Every relationship is self-defined.

At Holistic Therapy & Wellness NY, I help couples navigate open relationship dynamics, clarify boundaries, and strengthen communication—whether they’re just curious or already exploring non-monogamy.

Struggling with addiction or substance abuse/misuse is a common reason people reach out for therapy. Addiction is a disease that affects a person's brain and behavior and typically leads to an inability to control the use of a substance or behavior which always has consequences. When you are addicted, you may continue using the drug, device or behavior despite the harm it causes to your work, relationships and emotional and physical health.

What is addiction and substance abuse? Substance abuse disorder is a complex brain disease that causes you to compulsively seek out and use alcohol, drugs and addictive behaviors despite dangerous and harmful consequences. Substance abuse disorder and addiction causes distorted thoughts, behaviors, and body function. There is a genetic component

Substance abuse and addiction causes symptoms and behaviors including:

• Feeling a need or urge to use the substance or engage in the behavior regularly

• Needing more and more of the substance or behavior to feel the effects

• Time spent ensuring that you have a steady supply of the substance or spending money you don’t have on the substance or behavior

• Failing to meet your personal and professional obligations and responsibilities

• Experiencing withdrawal symptoms

• You feel a worsening of your cognition, with impaired decision-making and memory

• You may do things you would not normally do or later regret acquiring the substance

CBT techniques are very helpful tools to be used in therapy, coaching and useful when applied to everyday life situations. What follows are some of the most common CBT techniques that I use with my therapy and coaching clients. 

Journaling—This technique gathers information and data about habitual thoughts, emotions and moods. Included in journal entries can be: time of day, the source or trigger, the intensity of the feeling state and the response or action taken. You can add more helpful and adaptive coping responses that might be considered in the future.

Catastrophizing—This tendency is to go immediately to an irrational thought that something is far worse than it actually is. Catastrophizing generally takes two different forms: making a catastrophe out of a current situation or a future situation. Step one is to identify when your are doing this. Next, use your smartphone or journal to write the thoughts down throughout the day and add a corrective statement to counteract the negative belief. 

“Giving Up My Anxiety Will Negatively Impact My Success.” Is This You?

Like most New Yorkers, your days are busy with work, family and trying to find a way to manage and balance it all. With all that striving and the many tasks to complete, who has time to think about stress reduction or connecting with a therapist to help you manage your anxiety and mood symptoms. You may even wonder who you’d be without your drive—and your anxiety! Take away the anxiety and you’d potentially lose your edge.

You may not even consider your striving to be an anxiety response. As a therapist, we see this a lot. You haven’t crashed yet, and we would like to help you have an even better quality of life. If you haven’t yet crashed, how can you tell if your level of stress and anxiety is normal? Skillful therapy can help you recognize how your stress, anxiety and unconscious beliefs are behind your super-charged drive. If you spend any time on instagram, you’ve likely heard of high-functioning depression, as well as high-functioning anxiety.

Traumatic experiences change the brain. Some changes are meant to protect from future negative experiences. Just as trauma changes the brain, it is possible to heal the brain. Trauma symptoms that live in the nervous system do not have to hold you in its grip forever. As you continue to think, talk, re-tell and act on your experience(s), you reinforce your attachment to what happened, as well as your brain’s wiring and connection, and this serves to maintain your symptoms as you loop on the upsetting memory and trauma responses. As a New York City based Psychotherapist, I work with individuals who have experienced trauma and would like to heal and improve their lives.

The brain and body is designed to heal. We now know that the brain has an amazing capacity to heal by creating new neural pathways. This process is called neuroplasticity. When people are finally able to regain control over their thoughts, behaviors, responses and lives, the brain's limbic system,

Holistic Psychotherapy is beneficial for people of all ages, and it’s never too late to begin developing healthier lifestyle habits. No matter your age, mental health issues can interfere with your wellbeing throughout your lifespan. Individuals and couples enter therapy with a unique set of challenges and goals. As a holistic psychotherapist with a private practice in NYC, I specialize in helping older adolescents, adults and couples who experience struggle in their day to day lives. My focus is to help you uncover the root cause of your struggle in psychotherapy, as holistic psychotherapists believe that this is the best path forward to support your mental health recovery. Let me explain the many ways therapy can help make your life better.

Psychotherapy offers the opportunity for an individual to better understand and change patterns of behavior, feelings, and relationships that are getting in the way of your functioning. Psychotherapy offers the opportunity for an individual to understand and change patterns of behavior, feelings, and relationships that are getting in the way of higher-functioning. Good therapy can enable you to have richer, fuller and more meaningful life experiences.

What Does Holistic Psychotherapy Do?

I just finished reading “Women Have Been Mislead About Menopause” in the New York Times. As a licensed psychotherapist with a private practice in New York City, this is one of the best articles that I have read about menopause in a very long time. Because as a psychotherapist, I see women who are menopausal, or soon to be, suffering from impactful mental health symptoms related to these hormonal changes. Of course women have other life events that may coexist with any hormonal changes, and that’s why it’s important to let a professional help you sort things out, and this can inform your counseling and wellness plan. Because, when your hormones are all over the place, unbalanced or deficient, it also makes it harder to cope with the usual demands of life. I have had my own personal experience with hormonal changes and failing ovaries, and my own ongoing journey has opened my eyes and informed my psychotherapy practice.

Did I learn about mental health and hormones in graduate school? Absolutely not. And this means that patients seeking counseling help are likely not receiving education and comprehensive care from their psychiatrists, psychologists and other mental health professionals who should be knowledgable about the impact of hormonal changes and mental health.

According to the article, about 85 percent of women experience menopausal symptoms. Rebecca Thurston, a professor of psychiatry at the University of Pittsburgh who studies menopause, believes that, in general, “menopausal women have been underserved — an oversight that she considers one of the great blind spots of medicine. It suggests that we have a high cultural tolerance for women’s suffering,” Thurston says. “It’s not regarded as important. Women’s symptoms are often minimized or dismissed; they are told it’s “just a natural part of aging” and they will have to learn to “deal with it.”

Wise Mind is a highly-effective core skill used Dialectical Behavior Therapy (DBT). According to DBT, we have three states of mind: reasonable mind, emotion mind, and wise mind. Wise mind is thought of as the balance or integration of the reasonable and the emotion mind. Reasonable mind is the rational part of you, just-the-facts, thinking state of mind where you are ruled by logic. When you find yourself governed by emotion mind, your emotions are in control. You tend to be led by strong feelings and desires. Both states have their value and provide important information, but it’s easy to become stuck in one state of mind, being either cut-off from emotions or controlled by emotions. That is where wise mind becomes an important ally in your goal to have a more balanced life and state of mind.

In dialectical behavior therapy (DBT), the goal is to have wise mind available to you in situations where you are pulled to an extreme state or polarization. Wise mind is the integration or intersection of the reasonable mind and the emotion mind. Put another way, wise mind is your intuition or inner wisdom. It’s the state where you are wisely able to balance between the cool detachment of reason, and the wild current of emotion mind. Incorporating this wise mind DBT practice allows you to find balance between inaction and the active state of doing. Practicing wise mind allows you to engage in your life with awareness, with the goal of mindful presence.

We are all born with unique attributes and qualities. If we are fortunate enough to have optimal circumstances and nurturance along the way, we develop into secure adults. Adults with secure attachment and relational capacity are able to have meaningful experiences and relationships. They feel safe in the world and with others. Secure individuals are free to thrive.

As it turns out, most of us have had more adversity than is helpful. While some adversity makes us strong (we develop skill and resilience), too much adversity threatens to overwhelm us. It interferes with growth, because we are unable to feel safe, explore the world and develop adaptive coping strategies. Reduced capacity to cope naturally leads to anxiety, depression, addictions, compulsions, eating disorders and other troubling symptoms. When symptoms and poor coping takes over, our ability to establish healthy relationships, maintain those relationships and function well in the world is diminished. Sometimes we are fortunate enough to make an important connection to begin the healing process. The therapeutic relationship is one way to begin to heal.

Mental health seems to be experiencing a time of less stigma and greater awareness. People seem to feel safe sharing their mental health struggles on social media. The pandemic certainly led to an increase in loneliness, isolation, anxiety and terror, which led many to seek therapy and counseling, sometimes for the first time. This exploration to find a therapist also led to a great deal of confusion. With so many potential therapists and different therapeutic orientations, the big question becomes, “what’s the right type of therapy for me?”

Many want a quick fix as they enter therapy. Of course, short-term models that offer skill building and concrete interventions have their place. The problem with this strategy is that it rarely moves the needle when it comes to true healing.