Earlier today, San Antonio Spurs center Victor Wembanyama sat down for an interview with journalist Maxime Aubin and said something that cut through the noise in a way that sports quotes rarely do.
Speaking about his own mental health, Wembanyama said, as a response to people calling him “soft” for caring about his feelings: “I refuse to carry the burden of having to hide my emotions.”
For a 21-year-old athlete operating under one of the most intense spotlights in professional sports, that’s a striking statement. It’s also, as it turns out, one of the most psychologically sound positions a person can take.
The pressure to hide emotions is not unique to professional athletes. It is one of the most pervasive and quietly damaging expectations in modern life — embedded in workplaces, families, relationships, and the internal narratives most people carry about what it means to be functional, professional, or strong. The cost of meeting that expectation, day after day, is significant in ways that psychology has been documenting for decades.
Emotional Suppression and its Effects on Mental Health
Emotional suppression is the deliberate inhibition of emotional expression. It’s different from emotional regulation, which involves managing how emotions are experienced and expressed in constructive ways. Suppression is something more blunt: the active effort to prevent an emotion from being visible, and often from being fully felt.
Most people engage in some degree of emotional suppression regularly:
The tears held back in a meeting.
The anger swallowed before it reaches the surface.
The grief set aside because there isn’t time for it right now.
In small doses and appropriate contexts, this is a normal part of navigating social life. The problem is that for many people, suppression isn’t a tool used selectively — it’s a chronic operating mode that runs in the background of everything.
The difference matters enormously. Momentary suppression in a specific context has different effects than sustained, habitual suppression across all areas of life, and the research on what habitual suppression does to a person is consistent and problematic.
What Happens in the Body
Emotions are not purely psychological events. They are physiological ones. When an emotion arises, it triggers a cascade of activity in the nervous system — changes in heart rate, cortisol levels, muscle tension, breathing pattern, and neurological activation. The body is preparing to respond to whatever the emotion is signaling.
When that emotion is suppressed rather than expressed or processed, the physiological response doesn’t simply disappear. It continues. The activation persists even when the outward expression is shut down. Several decades of research have demonstrated that suppressing emotional expression actually increases physiological arousal rather than reducing it — the opposite of what most people intuitively expect.
James Gross at Stanford, one of the leading researchers on emotion regulation, has documented this pattern extensively. In studies where participants were asked to suppress their emotional reactions while watching distressing or emotionally evocative material, physiological measures showed sustained or elevated activation compared to participants who were allowed to express naturally. The suppression worked at the behavioral level — people looked calm — but the body told a different story.
Over time, that sustained physiological activation takes a toll. Chronic emotional suppression has been associated with elevated blood pressure, dysregulated cortisol patterns, weakened immune function, and increased cardiovascular risk.
The body was not designed to maintain an ongoing gap between what is experienced internally and what is expressed externally. Sustaining that gap requires effort, and that effort has a biological cost.
What Happens in the Mind
The psychological costs of chronic suppression are equally well-documented and perhaps more immediately recognizable in daily life.
One of the most consistent findings in the research is that suppression doesn’t reduce the intensity of an emotion — it amplifies it. The act of trying not to feel something, or not to show it, tends to make the emotion more intrusive rather than less. This is sometimes called the rebound effect, and it mirrors what most people have experienced: the harder you try not to think about something, the more it occupies your attention.
Suppression also consumes cognitive resources. When a significant portion of mental bandwidth is dedicated to monitoring and inhibiting emotional expression, less is available for other cognitive tasks — memory, attention, decision-making, social engagement. Studies have found that people who are actively suppressing an emotion perform worse on memory tasks and have more difficulty processing information during conversations. The effort of hiding is quietly taking up space that would otherwise be available for thinking.
There is also a relational dimension that is often underappreciated. Emotional suppression doesn’t just affect the person doing it — it affects the people around them. Research on social interactions consistently finds that suppression in one person creates discomfort and disconnection in their conversation partner, even when the partner can’t articulate why. People are more attuned to incongruence between expressed and experienced emotion than they consciously realize.
Relationships built around significant emotional suppression tend to feel superficial or unsatisfying to both parties, even when neither person fully understands what’s missing.
The Culture of Suppression
Emotional suppression doesn’t develop in a vacuum. It is learned, rewarded, and reinforced by specific cultural and social environments. Several forces consistently produce habitual suppressors.
The most well-documented is gender socialization. Men in most Western cultures are socialized from childhood to suppress a broad range of emotions, particularly those associated with vulnerability — sadness, fear, uncertainty, hurt. The messages are pervasive and start early: don’t cry, toughen up, hold it together. What gets rewarded is stoicism. What gets punished is emotional visibility. The result is a significant proportion of adult men who have spent decades developing highly efficient suppression mechanisms and have little practice with the alternative.
Women face a different but equally constraining version. The emotions deemed acceptable for women to express are often narrow — warmth, enthusiasm, gratitude — while anger, frustration, ambition, and certain forms of distress are met with social penalties. The policing looks different, but the outcome is similar: a learned orientation toward hiding specific emotional states.
Workplace culture adds another layer. Most professional environments implicitly or explicitly reward emotional suppression. Composure under pressure is admired. Emotional reactivity is stigmatized. Over years of professional life, the suppression habits developed at work can generalize to all other contexts, producing people who are no longer sure how to turn them off when they leave the office — or whether they want to.
High achievers are particularly vulnerable to this pattern. The same drive, discipline, and performance orientation that produces professional success can also produce a rigid relationship with emotional experience — emotions become things to be managed, controlled, optimized, or set aside in service of performance. The idea that an emotion might simply need to be felt, rather than used or processed into something productive, can feel almost foreign.
What Suppression Is Often Confused With
One of the reasons emotional suppression persists so reliably is that it gets confused with qualities that are genuinely valuable — self-control, professionalism, resilience, strength. These conflations are worth examining carefully because they shape how people think about their own emotional lives.
Self-control is the ability to choose how to respond to an impulse or emotion. It is a skill, and a valuable one. Suppression is the blanket inhibition of emotional experience or expression regardless of context. They are not the same thing. A person with genuine self-control can feel an emotion fully and choose how and when to express it. A habitual suppressor cannot access that choice because the emotion is blocked before it fully registers.
Resilience is the capacity to recover from adversity. Research on resilience consistently finds that emotional processing — the ability to experience, acknowledge, and work through difficult feelings — is central to it. Suppression and resilience are essentially opposites. The people who recover most effectively from difficulty are not the ones who feel the least. They are the ones who can tolerate what they feel and move through it.
Professionalism is context-specific appropriateness. Choosing not to express every emotion in every setting is a normal part of social functioning. It becomes problematic when the professional setting bleeds into all other contexts, leaving no space where genuine emotional experience is permitted.
The distinction Wembanyama was drawing is essentially this last one. He wasn’t refusing to exercise judgment about when and how to express emotion. He was refusing to carry the ongoing burden of hiding — the chronic, effortful maintenance of a gap between inner experience and outer expression. That is a psychologically meaningful distinction, even if it rarely gets named as clearly as he named it.
What Emotional Expression Requires
If suppression is the problem, expression is not simply the solution — at least not in the form of unregulated emotional discharge. The research makes clear that venting, ruminating, or amplifying emotional experience without any processing element doesn’t produce relief. What produces relief is something more specific: the ability to acknowledge an emotion, experience it without being overwhelmed by it, and move through it in a way that allows for integration rather than just discharge.
This is a skill set, and it is one that many people were never taught. Families that modeled suppression don’t produce adults who know how to do this naturally. Neither do schools, workplaces, or the broader cultural environments described above. For a significant number of people, learning to relate differently to their own emotional experience — to stop hiding and start processing — is something that requires deliberate effort and often support.
Therapy provides exactly that kind of support. Several modalities have particularly strong evidence for helping people work with emotional experience in healthier ways:
Somatic therapy works directly with the body’s experience of emotion, helping people develop awareness of and tolerance for the physiological dimension of emotional states that suppression keeps out of reach.
EMDR addresses the stored emotional material from past experiences that often drives chronic suppression in the present.
DBT builds the specific skills of emotional awareness, tolerance, and regulation that habitual suppressors typically haven’t developed.
ACT works to change the relationship to emotional experience itself — shifting from avoidance and control to acceptance and flexibility.
What all of these approaches share is a recognition that the goal is not to feel less. It is to develop a more workable relationship with what is already being felt — one that doesn’t require the chronic expenditure of energy that suppression demands.
The Burden Wembanyama Was Describing
The word he used was burden. Not habit, not strategy, not tendency. Burden — something carried, something that requires effort to sustain, something with weight.
That framing is accurate. Emotional suppression is effortful. It consumes resources. It has costs that accumulate over time in the body, in relationships, in the quality of a person’s inner life. The people who carry it longest often don’t recognize how heavy it’s become until something disrupts the pattern — a loss, a health crisis, a relationship that finally creates enough safety to put it down — and they feel, sometimes for the first time in years, what it’s like to not be carrying it.
The burden can be set down. That process isn’t always simple, and for many people it doesn’t happen without support. But it is possible, and the research on what happens when people do it — the improvements in physical health, the deepening of relationships, the increase in psychological flexibility and resilience — suggests that it’s one of the more consequential changes a person can make.
If you recognize yourself in what’s described here — if chronic suppression is something you’ve been carrying for a long time without naming it — Flourish Psychology offers therapy in Brooklyn and throughout New York City for anxiety, depression, trauma, and the kind of deeper work that addresses what’s underneath the surface. Call 917-737-9475 or reach out through the contact page to get started.
Panic attacks don’t make sense to the people experiencing them. Your heart races, your chest tightens, you can’t catch your breath, and your body floods with terror — all while you’re doing something completely ordinary like sitting at your desk, shopping for groceries, or watching TV.
There’s no tiger chasing you. No obvious threat. You don’t feel under stress. Nothing happening that should trigger this level of physical alarm. Yet your body is responding as if you’re in mortal danger.
For people who experience panic attacks, this disconnect between their physical response and the actual situation is confusing, and in some cases actually creates fear. There’s no clear reason this occurs – nothing that feels like it can easily be explained by mental health – so something *must* be wrong physically. Your doctors have to be missing something. Something must be wrong with you.
But polyvagal theory offers a different explanation — one that helps panic attacks make sense. With polyvagal theory, your body isn’t malfunctioning or overreacting. Your nervous system is doing exactly what it’s designed to do when it perceives threat, even when that perception doesn’t match the reality you’re consciously aware of.
What Happens During a Panic Attack
A panic attack is your sympathetic nervous system activating at maximum intensity. Within seconds, your body shifts into an extreme fight-or-flight response.
Your heart rate spikes. Your breathing becomes rapid and shallow. Your muscles tense. Blood flow redirects away from your digestive system and toward your large muscle groups. Your pupils dilate. You start sweating. You might feel dizzy, nauseous, or lightheaded. You may even have chest pains and a pounding heart.
These physical symptoms aren’t random. They’re your body preparing to fight or run from a life-threatening situation. Your heart races to pump more oxygen to your muscles. Your breathing quickens to take in more air. Your muscles tense to ready for action.
The problem is that there’s nothing to fight or run from, which makes you intensely aware of how you’re feeling in a way you would likely not be if you were being chased by a predator. The threat your nervous system detected isn’t there. Your body is reacting to something, but it’s not always clear what.
Why Panic Attacks Happen Without Obvious Triggers
Panic attacks can – and often do occur – when a person is under severe stress. But they don’t always. Panic attacks often occur when there’s no external stressor, no obvious trigger, and nothing you can point to as the “reason” you’re panicking.
People with panic attacks don’t always have high-stress lives. You might have a stable job, good relationships, and no major life crisis happening. You’re not constantly anxious about specific things. Your life might actually be going well. Then suddenly, out of nowhere, your body floods with panic.
This is where polyvagal theory provides clarity. Your nervous system doesn’t just respond to external threats. It also responds to *internal cues* — sensations in your body, changes in your heart rate, shifts in your breathing, or even subtle changes in your blood sugar or hydration.
Your nervous system is constantly scanning for signs of danger through a process called neuroception. This happens below conscious awareness. You don’t decide whether something is threatening. Your nervous system makes that determination automatically based on cues it picks up from your body and environment.
Sometimes your nervous system misinterprets those cues. A normal increase in heart rate from climbing stairs gets interpreted as the beginning of a threat response, which triggers more activation, which increases your heart rate further, which your nervous system reads as confirmation that something is wrong. Within seconds, you’re in a full panic attack.
Other times, panic attacks are triggered by sensations that your nervous system associates with past danger — even when there’s no current threat. If you once had a panic attack in a specific situation, your nervous system learned to associate that situation (or anything similar to it) with danger. The next time you encounter something even vaguely reminiscent of that situation, your nervous system might activate before you’re consciously aware of any connection.
The Role of Interoception in Panic
Interoception is your awareness of internal body sensations — your heartbeat, your breathing, hunger, thirst, the feeling of your muscles tensing or relaxing. For most people, these sensations stay in the background. You notice them when they become intense, but otherwise they don’t demand much attention.
People who experience panic attacks often have heightened interoception. You’re more aware of subtle changes in your body than most people. A slight increase in heart rate, a small shift in breathing, a flutter in your chest — sensations that others might not even notice can be very apparent to you.
This heightened awareness isn’t a bad thing in itself. But when your nervous system is primed to detect threat, those subtle body sensations can trigger panic. Your nervous system interprets normal bodily fluctuations as signs of danger and responds accordingly.
The panic attack then creates more intense physical sensations — racing heart, difficulty breathing, chest tightness. These sensations confirm to your nervous system that something is wrong, which intensifies the panic response. You’re trapped in a feedback loop where your body’s alarm system is responding to the alarm itself.
Why Understanding This Matters
When you understand that panic attacks are your nervous system responding to perceived threat — not evidence that something is medically wrong with you or that you’re losing control — the experience changes.
Panic attacks are terrifying. The physical sensations are intense and genuinely frightening. But they’re not dangerous. Your body is doing what it’s designed to do when it believes you’re in danger. The sympathetic activation that creates those symptoms is the same activation that would help you survive an actual threat.
The symptoms feel unbearable, but they’re time-limited. Your nervous system can’t sustain that level of activation indefinitely. Even without intervention, panic attacks typically peak within 10 minutes and begin to subside. Your body physically can’t maintain fight-or-flight at maximum intensity for extended periods.
This doesn’t make the experience less frightening in the moment. But it does mean that panic attacks, while intensely uncomfortable, are not dangerous. You’re not having a heart attack. You’re not dying. You’re not losing your mind. Your nervous system is overreacting to perceived threat.
How Polyvagal-Informed Treatment Helps
Traditional approaches to panic disorder often focus on challenging catastrophic thoughts or gradually exposing yourself to feared situations. Those approaches can be helpful, but they don’t address the underlying nervous system dysregulation that creates panic attacks.
Polyvagal-informed therapy works directly with your nervous system. Instead of just challenging your thoughts about panic, you learn to recognize when your nervous system is shifting toward sympathetic activation and how to interrupt that process before it escalates into a full panic attack.
This involves learning to notice subtle cues that your nervous system is activating. You might feel your heart rate increase slightly, your breathing shift, your muscles begin to tense. These early signs of activation happen before the panic attack fully develops. When you can recognize them, you have a window of opportunity to intervene.
Interventions might include breathing techniques that activate your ventral vagal system and signal safety to your nervous system. Slow, deep breathing — specifically extending your exhale — stimulates the vagus nerve and shifts your nervous system out of fight-or-flight.
You might use grounding techniques that help you orient to your current environment rather than getting caught in the internal experience of panic. Noticing specific details around you — the texture of fabric, the temperature of the air, sounds in the room — can help your nervous system recognize that you’re in a safe place rather than experiencing an actual threat.
Movement can also help discharge the sympathetic activation. During a panic attack, your body is flooded with energy meant for fighting or running. Gentle movement — walking, stretching, shaking out your arms and legs — can help release some of that activation.
Over time, you also work on helping your nervous system feel safer overall. Chronic stress, poor sleep, irregular eating, or ongoing relationship difficulties can keep your nervous system in a heightened state where it’s more likely to trigger panic in response to minor cues. Addressing these foundational issues reduces your overall nervous system activation.
What This Means for Treatment
Effective treatment for panic attacks needs to address the nervous system, not just thoughts or behaviors. Cognitive behavioral therapy can help you understand that panic attacks aren’t dangerous and challenge catastrophic interpretations of symptoms. That’s valuable.
But you also need tools for working directly with your nervous system. This might include somatic approaches that help you recognize and respond to body sensations without triggering panic. It might involve vagal toning exercises that strengthen your ventral vagal system’s ability to regulate sympathetic activation.
For some people, understanding the polyvagal framework itself is therapeutic. When you know that panic attacks are your nervous system responding to perceived threat — not evidence of a medical emergency or sign that you’re losing control — the fear of the panic attack itself decreases. That fear often maintains the cycle of panic, so reducing it can break the pattern.
Therapy also addresses any underlying trauma or chronic stress that might be keeping your nervous system in a heightened state. Trauma therapy can help resolve experiences that sensitized your nervous system to threat. Stress reduction strategies can help lower your baseline activation.
Getting Support
If you’re experiencing panic attacks, working with a therapist who understands nervous system regulation can make a significant difference. Panic attacks are treatable. You don’t have to live with the constant fear that another attack might happen at any moment.
At Flourish Psychology, our therapists integrate polyvagal principles into treatment for panic disorder and anxiety. We work with you to understand what’s happening in your nervous system and develop practical tools for managing activation before it escalates into panic.
We offer therapy in Brooklyn and online therapy throughout New York. We work with individuals experiencing panic attacks, anxiety disorders, trauma, and other challenges that involve nervous system dysregulation.
Contact Flourish Psychology at 917-737-9475 or through our contact page to learn more about treatment options. Panic attacks might not make sense when they’re happening, but with the right support and tools, you can learn to work with your nervous system rather than feeling controlled by it.
Depression can have many symptoms and take many forms. But one of the more common symptoms may not feel like a mental health symptom at all. Depression affects sleep, often in complex, biological ways.
Some people with depression struggle to fall asleep or wake up multiple times during the night. But for others, the problem is the opposite — they sleep constantly. Twelve hours, fourteen hours, sometimes more. They wake up exhausted, go through the day in a fog, and collapse back into bed as soon as possible.
If you’re sleeping excessively and still feeling drained, it may be a symptom of depression. Depression can fundamentally change how your body regulates sleep, and while some parts of it are directly related to thoughts and feelings, others are related to the way that depression rewires and affects hormones in the brain.
How Depression Affects Sleep Regulation
Depression doesn’t just make you feel sad or hopeless. It disrupts the biological systems that control sleep, energy, and alertness.
Your brain relies on neurotransmitters like serotonin, dopamine, and norepinephrine to regulate mood, motivation, and wakefulness. Depression typically involves imbalances in these chemicals, which means the systems that keep you alert and energized during the day aren’t functioning properly. When these neurotransmitters are depleted or dysregulated, your brain struggles to maintain normal wakefulness, and sleep becomes the default state.
Depression also affects your circadian rhythm — the internal clock that tells your body when to sleep and when to wake up. When this rhythm is disrupted, you can feel tired all the time regardless of how much you sleep. Your body loses the ability to distinguish between rest time and active time, so exhaustion becomes constant.
The result is hypersomnia, which is the clinical term for excessive sleeping. People with hypersomnia sleep far more than the typical seven to nine hours but wake up feeling just as tired as when they went to bed. The sleep isn’t restorative because the underlying brain chemistry issues remain unresolved.
Depression and Fatigue
Depression causes profound physical and mental fatigue that goes beyond ordinary tiredness. Everything feels harder — getting out of bed, making decisions, holding conversations, even basic tasks like showering or eating. This overwhelming exhaustion makes sleep feel like the only relief available.
Part of this fatigue comes from the mental and emotional work depression creates. Your brain is constantly processing negative thoughts, managing feelings of worthlessness or hopelessness, and fighting against the weight of despair. That takes enormous energy, even if you’re not consciously aware of it. By the end of the day — or even by mid-morning — your brain is depleted, and sleep becomes the easiest escape.
Depression also reduces motivation and interest in activities that would normally energize you. When nothing feels rewarding or enjoyable, there’s no reason to stay awake. Sleep becomes preferable to facing another day where everything feels pointless.
For some people, excessive sleep also functions as avoidance. When you’re asleep, you’re not dealing with the pain, the negative thoughts, or the overwhelming sense that nothing will get better. Sleep offers a temporary reprieve from the emotional burden of depression, which makes it incredibly appealing even when you’ve already slept for hours.
Why Some People Sleep More While Others Sleep Less
Not everyone with depression experiences hypersomnia. Some people develop insomnia instead, lying awake for hours unable to shut off their racing thoughts or falling asleep only to wake up repeatedly throughout the night.
The type of depression you have can influence which sleep pattern emerges. People with atypical depression — a subtype characterized by mood reactivity, increased appetite, and sensitivity to rejection — are more likely to experience hypersomnia. Those with melancholic depression, which involves a persistent inability to feel pleasure and early morning waking, tend toward insomnia instead.
Your brain chemistry, stress levels, and individual physiology also play a role. Some people’s bodies respond to depression by shutting down and conserving energy, leading to excessive sleep. Others experience heightened anxiety or rumination that keeps them awake despite their exhaustion.
Treatment Options for Depression-Related Hypersomnia
If depression is causing you to sleep excessively, treatment needs to address both the depression and the sleep disturbance.
Therapy — particularly Cognitive Behavioral Therapy (CBT) — helps identify and challenge the negative thought patterns that fuel depression and the behaviors that reinforce excessive sleep. CBT for insomnia can be adapted to address hypersomnia by focusing on sleep restriction, activity scheduling, and gradual reintroduction of structure and routine.
Light therapy can help reset your circadian rhythm, especially if you’re sleeping through daylight hours. Regular exposure to bright light in the morning signals your brain that it’s time to be awake and alert, which can gradually restore a more normal sleep-wake cycle.
Establishing a consistent sleep schedule — even when you don’t feel like it — helps retrain your body’s internal clock. Going to bed and waking up at the same time every day, limiting naps, and creating boundaries around sleep can gradually reduce hypersomnia.
Another option is exercise. Physical activity, though difficult when depression saps your energy, can improve both mood and sleep quality. Even short walks or gentle movement can help regulate your sleep cycle and boost the neurotransmitters that depression depletes.
Getting Help for Depression and Sleep Problems
If you’re sleeping excessively and feeling trapped in a cycle of exhaustion and depression, reaching out for professional support can help you break that pattern. Depression-related hypersomnia responds well to treatment, but it requires addressing the underlying depression rather than just trying to force yourself to sleep less.
Flourish Psychology’s therapists in Brooklyn specialize in treating depression and understand how sleep disturbances complicate recovery. We use evidence-based approaches like CBT and other modalities to help you regain control over your sleep, your energy, and your life.
You can reach Flourish Psychology at 917-737-9475 to schedule a consultation, or connect through the website to learn more about services and availability.
Do You Mentally Prepare for Conversations That Haven’t Happened?
You’re lying in bed at 11 PM, trying to fall asleep, when your brain decides it’s the perfect time to rehearse tomorrow’s conversation with your boss. You run through what you’ll say, how they’ll respond, what you’ll say back. You plan for every possible objection, every dismissive comment, every worst-case scenario.
Or maybe you’re in the shower, mentally replaying a text message you sent three hours ago, crafting better versions of what you should have said. You imagine the other person’s reaction, prepare your defense, plan your follow-up.
This mental rehearsal – this constant preparation for conversations, confrontations, and scenarios that may never happen – is one of the most common patterns therapists see in people struggling with anxiety, and while it feels productive, like you’re getting ready for something important, it’s actually keeping you stuck in a cycle of worry and stress.
What Is Mental Rehearsal?
Mental rehearsal is when you repeatedly imagine future conversations, events, or confrontations in your mind. You script out what you’ll say, anticipate how others will respond, and plan your reactions to their responses. Sometimes you’re rehearsing something that’s actually scheduled to happen. Other times, you’re preparing for conflicts or conversations that exist only in your imagination.
This pattern shows up in different ways for different people. Some people mentally rehearse difficult conversations with partners, preparing for fights that haven’t started. Others rehearse work presentations over and over, imagining every question that could be asked. Some people rehearse explanations or defenses for situations that haven’t even occurred yet.
The problem is that mental rehearsal rarely stops at one run-through. You rehearse the conversation, then you revise it. You think of a better response, so you run through it again. You imagine a new objection, so you prepare for that too. Before you know it, you’ve spent 30 minutes or an hour mentally preparing for a conversation that might take five minutes – or might not happen at all.
Why Your Brain Does This
Mental rehearsal isn’t random. Your brain has a reason for doing this, even if it’s not helping you.
It Feels Like Control — When you’re anxious about something, your brain looks for ways to manage that anxiety. Mental rehearsal creates the illusion of control. If you can anticipate every possible response, plan every counterargument, you feel more prepared. The problem is that real conversations don’t follow scripts, and the more you rehearse, the more anxious you become about deviating from your mental plan.
It’s Avoidance In Disguise — Mental rehearsal can be a way to avoid actually dealing with uncomfortable situations. As long as you’re “preparing,” you don’t have to take action. You can tell yourself you’re being productive when you’re actually procrastinating or avoiding the real issue.
Every time you mentally rehearse a difficult conversation, you’re reinforcing the idea that the conversation is something to fear. Your brain doesn’t distinguish between imagined threats and real ones, so rehearsing a confrontation triggers the same stress response as actually having it. The more you rehearse, the more anxious you become about the real thing.
When you’re constantly running through future scenarios in your mind, you’re not fully engaged in what’s happening right now. You miss conversations happening in front of you because you’re too busy preparing for ones that haven’t happened yet.
How CBT Addresses Mental Rehearsal
Cognitive Behavioral Therapy offers specific, practical tools to interrupt this pattern and help you respond differently when your brain wants to start rehearsing.
Identifying The Pattern — The first step in CBT is recognizing when you’re doing this. Many people rehearse conversations so automatically that they don’t even realize it’s happening. CBT helps you become aware of the pattern – noticing when your mind shifts from the present moment to mentally preparing for future scenarios.
Examining The Thoughts — Once you recognize the pattern, CBT helps you look at the thoughts driving it. What are you afraid will happen if you don’t rehearse? What do you think you’re accomplishing by going through the conversation in your mind? Often, you’ll find that the mental rehearsal is based on assumptions that aren’t accurate.
Challenging Cognitive Distortions — Mental rehearsal is often fueled by cognitive distortions – thinking errors that make situations seem worse than they are. Common distortions include catastrophizing (assuming the worst possible outcome), mind reading (assuming you know what the other person will say or think), and fortune telling (predicting negative outcomes with certainty). CBT helps you identify these distortions and challenge them with more balanced, realistic thoughts.
Testing Your Predictions — One of the most effective CBT techniques is behavioral experiments – testing whether your predictions actually come true. If you’re mentally rehearsing a conversation because you’re convinced it will go badly, CBT encourages you to have the conversation without all the preparation and see what actually happens. Often, you’ll find that your predictions were wrong, and the conversation went differently than you imagined.
Developing Tolerance For Uncertainty — Mental rehearsal is often driven by a need for certainty and control. CBT helps you build tolerance for not knowing exactly how a conversation will go, for being unprepared in the moment, for trusting yourself to respond appropriately without a script. This is uncomfortable at first, but it’s useful for breaking the rehearsal pattern.
These CBT techniques give you tools to interrupt the mental rehearsal loop and redirect your attention to the present moment. Over time, you learn to trust yourself in real conversations without needing to prepare for every possible outcome.
What This Looks Like in Practice
In CBT sessions, addressing mental rehearsal might look like this:
You come to therapy reporting that you spent two hours last night mentally preparing for a conversation with your partner about household responsibilities. Your therapist helps you identify the thoughts driving the rehearsal – maybe you’re afraid your partner will get defensive, or you’re worried you won’t be able to articulate your needs clearly.
Together, you examine whether those fears are based in reality or distorted thinking. Your therapist might ask whether past conversations have actually gone the way you predicted, or whether your partner has shown the ability to hear your concerns without becoming defensive.
Then you work on an alternative approach. Instead of rehearsing the conversation, you might practice grounding techniques to stay present. You might identify the core point you want to make and trust yourself to communicate it without a script. You might even intentionally have the conversation without any preparation and observe what happens.
This process doesn’t happen all at once. Breaking the mental rehearsal habit takes time and repeated practice. But with consistent work, you start to notice the pattern earlier, challenge it more effectively, and trust yourself more in real-time conversations.
When to Seek Support
Mental rehearsal becomes a problem when it’s taking up significant time, interfering with your sleep or daily activities, increasing your anxiety rather than reducing it, or preventing you from being present in your actual relationships and interactions.
If you find yourself spending hours mentally preparing for conversations, replaying interactions over and over in your mind, or feeling more anxious despite all your preparation, it might be time to work with a therapist who specializes in CBT.
At Flourish Psychology, our therapists use evidence-based CBT techniques to help clients break free from patterns like mental rehearsal and develop healthier ways of managing anxiety and uncertainty. If you’re ready to stop spending so much mental energy preparing for conversations that haven’t happened and start being more present in your actual life, we can help.
Call (917) 737-9475 or fill out our from to schedule an appointment with one of our NYC therapists who specializes in Cognitive Behavioral Therapy.
There are so many joys a person can experience in life, but many of those same joys also come with stresses. For example, you may be happy to see your kids’ smiling faces when you pick them up from school (joy) but to get them, you have to rush and wait in a long line to pick them up (stresses).
Many people have a level of stress (arousal) that they can tolerate where it won’t interfere with their functioning. They can handle stresses, difficulties, noises/sounds, and more while still being mentally present, feeling all their emotions, and otherwise able to stay emotionally regulated.
One term for this is the “Window of Tolerance” – the amount of space someone has that allows for psychological comfort and flexibility. It’s not necessarily about happiness, but it is about being able to function despite what’s going on around them.
Those with mental health challenges, however, typically have a much smaller window of tolerance. Stresses and difficulties end up putting them above or below the window:
Above the Window – This is called the “hyperarousal” zone. It is more common for people with anxiety. It is where their bodies react with excess energy, like nervousness and agitation, when the stresses do not fit into their window of tolerance.
Below the Window – This is known as the “hypoarousal” zone. It is more common in those with depression. It is where a person’s response to issues not fitting in their window is to shut down, become numb, and give up.
Note: Admittedly, one of the limitations of the “Window of Tolerance” analogy is that it doesn’t explain why some people go “above the window” and some people go “below” other than an individual’s mental health. But the window of tolerance itself does help beneficially describe what a person can handle, and why it differs from one person to the next.
The Shrinking Window of Tolerance with Depression
When a person has depression, they have a smaller window of tolerance. That means that there are fewer things that they can handle before their window becomes full and overwhelmed. For example, a light criticism from a coworker becomes a head on collision, because their window is full and nothing else can fit through before it spills out below the window.
But why does this window shrink?
Low Battery – Depression is exhausting, so a person with depression often has a low battery that is less capable of handling multiple tasks before being depleted.
High Threat Systems – Those with both depression and anxiety have a higher than active threat detector, which misinterprets neutral or only mild threats as more significant threats.
Minimal Backup – When your mental health is functioning, you have mechanisms in place to keep you “in your window.” Not so with chronic stress and depression, where the systems that usually calm us, like neurotransmitters, are not able to do their job.
The smaller the window, the less a person feels like they can handle. So our role as therapists is to try to get the window bigger.
How Do We Increase the Size of the Window of Tolerance?
Improving the size of the Window of Tolerance is something we do indirectly in therapy, by teaching coping tools and stress reduction mechanisms that allow us to stay grounded, present, and reduce negative critical thoughts.
If you feel like you may be struggling with a smaller window of tolerance and want help addressing your depression, please reach out to Flourish Psychology, today.
We often talk about social anxiety by referring to its effects on relationships. Yet, what make social anxiety so challenging and so problematic is that it affects us even when we are not engaging in social activities. Like other forms of anxiety, social anxiety is ongoing and constant, and it is in our best interests to make sure that we are addressing this anxiety so that we can improve not only our social life, but the rest of our decision making as well.
The Ways Social Anxiety Shapes Decision Making
Remember, social anxiety is always there. It does not just appear when you’re in a party or a meeting. It, like most forms of anxiety, touches everything that you do.
That means that it can also guide choices that you make throughout the day. It affects decisions you make about work, school, dating, marriage, and much more.
Many people living with social anxiety make decisions based on fear of judgment rather than personal preference or practical benefit. This can influence everything from small routines to major life paths.
Avoiding Opportunities – A person with social anxiety may decline a job interview, pass on a promotion, or avoid signing up for a class because they anticipate embarrassment or fear not meeting expectations. These choices limit personal growth.
Over-Preparation and Perfectionism – Decisions can become slowed by the need to prepare excessively. Writing an email, submitting work, or even posting online may require multiple drafts because of concern about how others might perceive mistakes.
Choosing Convenience Over Preference – Something as simple as deciding where to shop or which restaurant to order from may be shaped by which option feels less likely to involve social stress, even if it is not the person’s preferred choice.
Difficulty Saying “No” – Fear of disappointing others or being seen negatively can lead to agreeing to commitments that do not align with personal goals or comfort.
Withdrawing from Conflict – When facing disagreements, the decision may be to avoid confrontation entirely, even at the expense of personal needs or fairness.
Trouble Analyzing Others – Negative self talk may cause people to misunderstand social media posts, texts, and more, as they assume that other people do not see the world the way they do, leading to worse decisions.
Any decision that is fueled by anxiety is one that may not be right for the person experiencing it. Instead of going through life in such a way that they’re able to make decisions that benefit them, they may be choosing things not just based on the anxiety itself, but on the way it shapes their opinions.
The Ongoing Effects of Social Phobia
Another factor to consider is the way that social anxiety reinforces its own behaviors. When you make small decisions in the moment based on your social anxiety, you create patterns that reinforce avoidance behaviors and problematic thinking.
This both:
Causes you to have more social anxiety and allow it to control you further.
Leads to situations where you’re in a job, relationship, or something else you do not want, leading to more unhappiness and, ultimately, more anxiety about life.
This is one reason why social anxiety is never limited to social experiences. When you have social anxiety, it quietly influences everyday decisions, leaving less space for spontaneity, growth, or authenticity.
Moving Toward Healthier Decision Making
Addressing social anxiety means more than reducing fear in social events. It involves building awareness of how anxiety guides decisions and working to shift the decision-making process back toward personal goals rather than avoidance.
Even if you feel like your social anxiety is manageable – maybe you have a few close friends, or you’re in a good relationship, or you’ve accepted this anxiety as a part of yourself – it’s always touching the decisions you make and the behaviors you do.
Treat social anxiety instead. You’ll find that you’re happier and more fulfilled when your anxiety is in your control.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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