Many of Flourish Psychology’s patients live lives where discretion is critical and time is minimal. CEOs, content creators, doctors, attorneys, and more – these are individuals who are often tasked with work day and night, or find themselves with a busy personal and professional life where it is extraordinarily challenging to manage their mental health.
It is for these individuals that we created our exclusive mental health services. These are mental health services with significantly more availability, using a retainer model similar to the legal field that makes it possible to access mental health services on your schedule, personalized to you.
You can learn about our exclusive mental health services here.
On a surface level, it should already be easy to recognize why having your own individual therapist that is available more often when you need us most is valuable. You have access to a therapist when:
You’re in the middle of some type of crisis.
You have some rare but available free time.
You need someone to trust with your emotions or ideas.
Exclusive services allow you to have a therapist that is essentially on call, and while that doesn’t necessarily mean 100% availability, it does mean that you’re on a few coordinating steps away from someone at all times.
But this level of accessibility and higher level of care also has secondary benefits as well. It means that you have:
The knowledge that you are NEVER alone. With someone you can contact at any time whose role and expertise it is to help you, you will never feel like you’re taking on these challenges and emotional burdens by yourself.
Someone that knows you deeply – deeper than even traditional therapy. Exclusive services often mean that we can meet more often and connect much longer than traditional therapy typically allows.
A therapist unburdened by topic. Often, when you work with a therapist on a more limited basis, we have to keep the focus on the topic of need (for example, anxiety). With our concierge therapy services, this is no longer the case, as there is plenty of opportunity to talk about any emotions of challenges of note to you.
It is also simply a more catering level of care as well. We are professional therapists, and our role is your mental health, but concierge therapy allows for more services, more often, on more topics than traditional weekly or biweekly therapy allows, and that means that you have a therapist that is here to help you at every step.
If this type of therapy is right for your needs, please reach out to us today. We’d love to see if there is a fit or recommend options depending on what your needs may be.
We’re not getting enough sleep. Most of us are sleep deprived, and rarely, if ever, get a full night’s sleep more than one day in a row.
There are many issues that lead to these difficulties, and addressing them can take time as we determine why they’re occurring and work individually with how to solve them. Yet some of the potential causes of sleep difficulties, including racing thoughts, metal to due lists, and emotional residue from the day can interfere with the onset and quality of sleep.
Sleep hygiene practices are, at least theoretically, designed to address this. By giving yourself a habit/routine to help you fall asleep, you should be able to calm your mind and ease off easier than if you simply go straight to bed with your phone in your hands.
But, of course, sleep is more complicated than that, and there are plenty of times when our brains stay highly active and we have too much on our minds to relax.
Why the Brain Struggles to Transition to Sleep
Before examining journaling, it’s important to understand why sleep onset is disrupted. One of the most well-documented factors is heightened cognitive arousal – essentially, excessive mental activity in the pre-sleep period. This can include:
Persistent planning or problem-solving thoughts
Unresolved emotional tension from daytime experiences
Anticipatory anxiety about the following day
New ideas you want to remember or to-dos that you would like to prioritize
Research shows that these thought patterns correlate with activity in the default mode network (DMN), a neural system associated with self-referential thinking. High DMN activity at bedtime is associated with longer sleep onset latency and lighter sleep cycles.
Because journaling externalizes internal dialogue, it has the potential to reduce DMN activity and shift the brain toward a state more conducive to sleep.
The Power of Sleep Journaling
In these situations, you may want to consider keeping a sleep journal next to your bed.
Sleep journals are, essentially, journals where you can write down anything and everything that is on your mind when you are trying to go to sleep at night. It doesn’t necessarily matter what you write down, and you never need to force yourself to write down anything if you’re feeling tired (it differs from a gratitude journal in this way, as those types of journals are designed to be completed daily).
Rather, it’s a place for you to put your thoughts on paper in order to get them out of your head.
Journaling at night can reduce mental overactivity and create psychological closure that supports sleep onset. This practice is not simply about venting thoughts onto paper. The type of journaling, the structure, and even the timing all contribute to how journaling interacts with the brain’s sleep-regulating systems.
What Happens When You Journal Before Bed
Journaling operates at the intersection of cognitive restructuring and emotional regulation. Several peer-reviewed studies have found that the right form of journaling can measurably affect key variables tied to sleep, including sleep latency (how long it takes to fall asleep) and overall sleep quality. For example:
A 2018 study published in Journal of Experimental Psychology found that individuals who wrote out specific tasks they needed to complete the next day fell asleep significantly faster than those who journaled about completed tasks.
Another study published in Behavioral Sleep Medicine showed that expressive writing – where individuals write about their thoughts and feelings – reduced symptoms of sleep-onset insomnia in people with anxiety.
Keep in mind these are examples of *different* benefits. The first study looked at something called “cognitive offloading” where moving thoughts out of your mind (your working memory) and onto paper basically tells your brain “don’t worry, you can’t forget, it’s written down on paper” which frees up additional resources and helps the brain disengage from active processing.
The second study showed that writing out our emotions and feelings is a form of processing. Anxieties and stresses often occur when emotions feel unresolved, or when they’re bouncing around in mind without being fully processed. Writing out these emotions help us process them, allowing us to have some closure and, eventually, sleep.
Remember, these thoughts may not all be stressful. Imagine you’re someone that loves writing, and – when you’re supposed to go to sleep – you have this great idea for a story. Your mind can’t relax if you’re worried that you may forget the idea. If you write it down, your brain knows you can’t forget it, and you can hopefully relax better and ease yourself into sleep.
Addressing Sleep for Mental Health
Sleep may not be directly responsible for the entirety of our mental health, but it becomes extraordinarily difficult to cope with stress and address our psychological challenges if we’re not also prioritizing sleep. Journaling may not solve all your issues, but if an active mind is keeping you awake, consider taking out a journal and testing out those benefits.
In the mental health world, the term “obsessions” has a very different meaning than it does in casual conversation. In casual conversation, “obsessions” are things you want or desire. They’re things you’re happy to think about often, or things that you like to do.
In the mental health world, “obsessions” are very different. They are typically thoughts that you *do not want* that “intrude” your mind over and over again. Most of the time, these thoughts also cause distress, as they’re often on topics and subjects that a person finds upsetting.
One of the challenges of obtrusive thoughts is how hard they are to control. The more you try to push them away, the more they come back. This is actually by design. Our brain is, in some ways, specifically designed to make sure that the more you try to stop a thought, the more often the thought will occur.
Why Can’t We Stop Intrusive Thoughts?
Psychological studies have shown that it takes a lot of mental energy to avoid thinking about something. So much energy, in fact, that your brain needs to remind you of it in order to remember not to think about it. There are different terms for this, but one of the most popular is called the “Pink Elephant Problem.”
What is the Pink Elephant Problem?
The Pink Elephant Problem is a study that shows that if you tell half a group of people to think about a pink elephant, and half a group of people not to think about a pink elephant, the group told not to think about it ends up thinking about it more than the other group. It takes so much energy to avoid thinking about a topic, that you end up thinking about it more.
What Does the Pink Elephant Problem Have to Do With OCD?
Imagine you have an intrusive thought that causes you distress. Because it causes you so much stress and anxiety, you try to push it away. You try your best not to think about it. Suddenly, you’re running into the pink elephant problem. Your brain spends so much energy trying not to think about it that it ends up thinking about it more and more often.
How Do You Break This Cycle?
Part of overcoming these intrusive thoughts is breaking this cycle and making it so that you *can* forget. To do that, you have to actually embrace the thought. Remind yourself that your intrusive thoughts do not define you. Remind yourself that pushing the thought away does not work. You may even want to think about the thought on purpose in order to make it something that you no longer obsess on.
Is That All There is To It?
No, addressing OCD does take a lot more energy and effort. You may have to address the initial causes of the obsessions, the compulsions, what causes you the most distress, and even forgiving yourself for your thoughts. Those all take time and energy, and benefit from working with a therapist.
But if you stop attempting to push down those thoughts, accept that you have them, and focus on moving forward, then the thoughts not only should occur less – they should also cause less distress when they do occur.
Ready for OCD Help?
If you are someone that struggles with obsessive compulsive disorder or intrusive thoughts, reach out to a therapist today. Through therapy, you can gain more understanding of the cause of these thoughts and develop cognitive tools to help you control them. Contact us today to learn more.
Parenting has always been hard. What’s different now is the volume and intensity of everything that surrounds it. Social media delivers an endless stream of worst-case scenarios — missing children, exploitation, tragedy, comparison — directly into the palm of your hand. The political environment around schools has become a source of genuine stress for families across the ideological spectrum. The cost of raising children in New York City is relentless. And then there are the everyday challenges that don’t make headlines but accumulate quietly: the developmental concerns, the behavioral struggles, the sleepless nights, the constant sense that you should be doing more or doing it differently.
Anxiety is a reasonable response to all of that. The problem is that parental anxiety doesn’t stay contained. It touches everything — the way you show up for your child, the quality of your relationship with your partner, your ability to be present in the moments that actually matter. And when it goes unaddressed long enough, it stops being a reasonable response to difficult circumstances and starts being a condition that shapes your life in ways you didn’t choose.
You don’t have to be in crisis to deserve support. If anxiety is affecting how you parent — or how you experience parenthood — that’s enough of a reason to talk to someone.
Why Parental Anxiety Deserves Specific Attention
There’s a tendency to normalize parental anxiety in a way that actually does parents a disservice. Of course you’re worried — you’re a parent. Of course you’re stressed — this is hard. Those statements are true, and they also miss the point. The fact that anxiety is common among parents doesn’t mean it’s inevitable, doesn’t mean it’s harmless, and doesn’t mean you have to manage it alone.
Anxiety affects the nervous system in ways that have real consequences for how you parent, even when you’re trying your hardest to show up well. A dysregulated nervous system doesn’t turn off when you walk in the door from work. It affects your patience, your reactivity, your ability to be genuinely present rather than physically present while mentally somewhere else. It affects how you read your child’s behavior and how you respond to it. Over time, these effects accumulate.
Research on parental mental health consistently shows that a parent’s emotional state is one of the strongest predictors of a child’s emotional development. That’s not a guilt trip — it’s a reason to take your own mental health as seriously as you take your child’s.
What Parental Anxiety Can Look Like
Parental anxiety doesn’t always look like panic or obvious distress. It often shows up in subtler patterns that are easy to mistake for conscientiousness, protectiveness, or simply caring a lot.
Some of the most common ways it manifests include:
Hypervigilance Around Safety — A persistent, exhausting alertness to potential dangers that goes beyond normal parental caution. Difficulty letting children take age-appropriate risks. Intrusive thoughts about what could go wrong.
Overcontrol and Difficulty Stepping Back — Managing every aspect of a child’s environment, schedule, or social life in ways that come from anxiety rather than intentional parenting. Struggling to tolerate uncertainty about outcomes you can’t control.
Emotional Reactivity — Responding to normal childhood behavior — tantrums, defiance, sibling conflict — with a level of distress that feels disproportionate but is difficult to regulate in the moment.
Constant Comparison and Self-Doubt — Measuring your parenting against other parents, against what you read online, against some imagined standard you’re never quite meeting. A persistent sense that you’re falling short even when the evidence doesn’t support it.
Difficulty Being Present — Going through the motions of parenting while mentally rehearsing future worries, replaying past mistakes, or managing internal distress that makes genuine presence difficult.
Physical Symptoms — Insomnia, tension, fatigue, and somatic complaints that don’t have a clear medical explanation but track closely with the stress of parenting.
Recognizing these patterns in yourself is not a sign of failure. It’s information — and it’s the kind of information that therapy is well-positioned to help you work with.
How Parental Anxiety Affects Children
One of the more difficult realities of parental anxiety is that children are exquisitely attuned to their parents’ emotional states. Long before they have language for what they’re sensing, children pick up on the nervous system signals of the adults who care for them. A parent who is chronically anxious, even if they’re managing it skillfully on the surface, communicates something to a child’s developing nervous system about what the world is like and how safe it is.
This isn’t about blame. Anxious parents don’t make their children anxious through bad intentions or inadequate effort — they do it through the normal mechanisms of human attachment and co-regulation. It’s also something that can change when the parent gets support.
Anxiety treatment that helps a parent regulate their own nervous system more effectively produces ripple effects in the family. Children whose parents become calmer, more present, and more regulated tend to become calmer and more regulated themselves. The work you do on your own mental health is some of the most direct investment you can make in your child’s.
What Underlies Parental Anxiety
For many parents, the anxiety they experience isn’t entirely new. It’s connected to experiences that long predate their children — patterns from their own childhood, their relationship with their parents, early experiences that shaped what they believe about safety, worthiness, and what it means to be enough.
Becoming a parent activates those older layers in ways that can be surprising and disorienting. Holding a newborn for the first time, watching a child struggle, navigating a difficult developmental stage — these experiences can surface fears and feelings that seem out of proportion to the present moment because they’re not entirely about the present moment. They’re about everything that came before it.
Trauma and attachment history play a significant role in parental anxiety for many people. Parents who experienced inconsistent care, emotional unavailability, or frightening experiences in their own childhood often find that parenthood brings those experiences closer to the surface — not because something is wrong with them, but because the attachment relationship with a child activates the same neurological systems that were shaped by their own early attachment experiences.
EMDR and other trauma-informed approaches can address this layer of parental anxiety in ways that insight-focused therapy alone sometimes can’t — working directly with how early experiences are stored and how they’re being activated in the present.
Postpartum depression and anxiety are also worth naming specifically. The transition into parenthood, particularly after a first child, is one of the most significant neurological and psychological transitions a person experiences. Anxiety and depression in the postpartum period are common, frequently undertreated, and respond well to therapy when they’re addressed rather than pushed through.
What Therapy for Anxious Parents Addresses
Therapy for parental anxiety at Flourish Psychology is individualized to what’s actually driving the anxiety and how it’s showing up in your specific life and family. There is no single script — what the work looks like depends on who you are, what your history is, and what your goals are.
That said, several areas come up consistently in work with anxious parents:
The Anxiety Itself — Developing a more workable relationship with anxious thoughts and the physiological state that accompanies them, using approaches like CBT, ACT, and somatic therapy to build genuine regulation rather than just symptom management.
The Underlying Patterns — Examining where the anxiety comes from, what it’s protecting, and what early experiences may be shaping current responses in ways that are no longer useful.
The Parent-Child Relationship — How anxiety is affecting the way you show up for your child and what shifts in your own regulation produce in the relationship.
The Relationship with Your Partner — Parental anxiety puts real pressure on couples. How anxiety-driven behavior patterns affect the partnership, and how to address the relational dimension alongside the individual one.
Guilt, Shame, and the Inner Critic — Many anxious parents carry a significant burden of self-judgment alongside the anxiety itself. The voice that says you’re not doing enough, you’re doing it wrong, your child deserves a better parent. Therapy addresses that layer directly, not as a secondary concern but as a central part of the work.
Identity and Loss — Parenthood changes who you are, sometimes in ways that feel disorienting. The loss of previous versions of yourself, previous freedoms, previous relationships to your own time and body — these are real and deserve space, not dismissal.
The goal is not to produce anxiety-free parenting. That’s not realistic, and it’s not the point. The goal is to help you parent from a more grounded, regulated, and intentional place — so that the anxiety that’s present doesn’t determine the quality of your experience or the quality of your relationship with your child.
You Deserve to Be Present for This
Childhood moves fast. The stages that feel endless in the middle of them — the sleepless infant months, the tantrum years, the complicated adolescence — become memories before you fully realize they’ve passed. Anxiety robs you of presence in those moments. It keeps you in your head, in the future, in the worst-case scenario, rather than in the room with your child.
Getting support for parental anxiety isn’t indulgent and it isn’t selfish. It’s one of the most practical things you can do for your family. The parent who does their own work shows up differently — not perfectly, but more fully.
We talk about anxiety as though it is always a debilitating disorder – one that people struggle with *immensely*. Certainly, some people do have anxiety that makes it difficult to function, unable to leave the house or experience a happy and productive life.
But for others, anxiety is not a debilitating condition. It is a manageable one. Their anxiety affects their life, but it doesn’t control them, and so a person with anxiety can still manage relationships, work, parent, and perform normal tasks.
The thing is, that itself can be a problem.
When a person has this type of anxiety, they may be hesitant to treat it. Why see a therapist when you are still married, or you still work, or you have friends that you see regularly?
Yet, we know a few things to be true:
Everyone deserves to live their best, happiest life, and that is often not possible when a person has anxiety.
Someone that has more manageable anxiety now may not have manageable anxiety later. Untreated anxiety is at risk for getting worse over time.
Anxiety may seem manageable because your life seems normal, but if you didn’t have anxiety, your life would be very different.
Individuals with this type of anxiety are sometimes referred to as having “high functioning” anxiety or being “high functioning.”
High functioning anxiety is not a clinical diagnosis, but rather a term used to describe individuals who appear outwardly successful, organized, and composed, while internally experiencing persistent worry, self-doubt, and emotional distress. These individuals often meet personal, academic, or professional expectations while privately struggling with anxiety symptoms that are either unrecognized or dismissed due to their high level of daily functioning.
This form of anxiety can be difficult to detect because it doesn’t disrupt responsibilities in obvious ways. In fact, it can drive people to be more detail-oriented, more dependable, or more productive. But beneath the surface, the emotional toll can be significant.
How High Functioning Anxiety Differs from Other Anxiety Presentations
Typically, a person that is high functioning with anxiety are still touched by the condition. Generalized anxiety disorder, for example, causes people to feel anxious more generally, without necessary a specific fear or issue. At work, they may feel anxious about meetings, but they’re still *at work* and doing their job, and to others they may just appear a bit more shy, or their heartbeat goes up a lot but they are otherwise able to manage their experiences. When dating, they may have more fears about “screwing up” a date, but they may otherwise be able to go on dates and just feel high stress and high anxiety throughout the time – possibly overthinking later.
Yet even though they’re functioning, they’re still being affected by their anxiety. They may, for example, be less likely to ask for a raise at work. Or they may be less likely to act confident on a date. Or they may be overly worried about their child running into a street. Their anxiety still touches everything they do in some form.
Compensatory Behaviors
Some people with high functioning anxiety go a step further. Unlike generalized anxiety disorder (GAD), which may interfere visibly with day-to-day functioning, high functioning anxiety may be marked by compensatory behaviors that mask internal distress. People with high functioning anxiety may manage their anxiety through over-preparation, perfectionism, and rigid routines – behaviors that may be socially rewarded but are mentally and emotionally draining.
They are often described as:
Responsible
Ambitious
Reliable
Detail-focused
Self-motivated
But internally, they may also feel:
Constantly worried or tense
Afraid of failure or disapproval
Overwhelmed by routine decisions
Exhausted from overthinking or over-planning
Anxious even during rest or downtime
While the outward appearance may suggest control and capability, internal symptoms often include:
Racing thoughts or chronic overthinking
Difficulty relaxing or feeling “off duty”
Irritability or restlessness, especially when unproductive
Fear of disappointing others or being judged
Over-scheduling or trouble saying no to requests
Perfectionism and fear of making mistakes
Sleep disturbances, especially trouble falling asleep due to mental activity
Physical symptoms such as muscle tension, headaches, or gastrointestinal discomfort
These symptoms may not be severe enough to stop the person from functioning, but they can contribute to long-term stress, burnout, or emotional fatigue.
Why It Often Goes Unnoticed
High functioning anxiety often goes unrecognized for several reasons:
The behaviors it drives – such as punctuality, attention to detail, and overachievement – are socially reinforced.
The person may not describe their experience as “anxiety” because they are not having panic attacks or visibly falling apart.
Friends, family, and coworkers may see them as capable or calm, unaware of the internal pressure they are constantly managing.
In many cases, individuals don’t seek help because they believe their anxiety is simply part of their personality. They’re used to it. And because their life feels fairly normal, at least in the eyes of society, then they do not feel like they are in need of additional help.
Risks of Leaving High Functioning Anxiety Unaddressed
When high functioning anxiety goes unrecognized or untreated, it can lead to long-term complications such as:
Chronic stress or burnout
Increased risk of depression
Relationship strain due to emotional unavailability or irritability
Avoidance of rest or difficulty enjoying downtime
Difficulty adjusting to failure, change, or reduced productivity
Even if your anxiety feels manageable, it does not need to be. Your life will often feel more fulfilling and energizing when your anxiety is under control.
Treatment and Support
Even when anxiety does not appear to interfere with work or responsibilities, it is still valid and treatable. High functioning anxiety responds well to several approaches:
Cognitive Behavioral Therapy (CBT) to challenge perfectionistic or anxious thought patterns
Mindfulness-based practices to promote rest and present-moment awareness
Behavioral techniques to reduce compulsive planning or avoidance
Medication in some cases, for generalized symptoms that don’t respond to therapy alone
Stress reduction strategies to support sustainable routines without over-reliance on anxiety as a motivator
Support from a therapist can help individuals develop healthier ways to manage pressure without sacrificing well-being.
Get Therapy for Anxiety Today
Having high functioning anxiety means living with a constant undercurrent of fear or worry, even when everything appears to be in order. It often looks like success from the outside but feels like survival on the inside.
Awareness is the first step toward change. With the right support, individuals can learn to function not from fear, but from a place of clarity and balance – still achieving, but with far less cost to their emotional and physical health.
For more information, reach out to Flourish Psychology, today.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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