These are genuinely different things, and the distinction matters clinically. OCD is not an anxiety disorder in the way it is often treated — it is a cycle, and the approaches that help general anxiety can actually make OCD worse. My work with OCD starts with understanding exactly how that cycle works for you, before we ever talk about how to interrupt it. If you have been through anxiety-focused therapy and felt like something was still being missed, that is worth exploring.

Yes. Many people with OCD don't recognize it as OCD because the content of their thoughts feels too specific, too private, or too far from the stereotypes. OCD attaches to what matters most to you — relationships, identity, values, safety — and it often looks nothing like counting or hand-washing. If you are living with intrusive thoughts, private rituals, or a cycle of temporary relief followed by the thoughts returning, it is worth a conversation.

It is, and it is some of the work I find most important. The intersection of hormonal change, shifting identity, grief, and the resurfacing of things that never had adequate space is real, significant, and consistently undertreated. Many women in this stage of life have spent decades being reliable for everyone around them and arrive here not in crisis, but carrying more than they should be carrying alone. That is a legitimate and serious place to start.

Yes, and it is one of the things I feel most strongly about. The psychological dimensions of perimenopause and menopause — the anxiety, the low mood, the rage, the grief, the sense that your mind no longer feels like your own — are real, significant, and routinely dismissed. A ten-minute appointment with a checklist is not equipped to hold what this experience actually involves. Therapy is not a replacement for medical care, but it is often the only space where the full weight of what you are going through gets named honestly and taken seriously. If you have been leaving appointments feeling minimized, you are not imagining it.

Nothing is wrong with you. What you are describing is one of the most common and least talked-about experiences I work with. When the structure of caregiving lifts — whether because children have grown, a relationship has changed, or simply because life has shifted — the nervous system finally has room to surface what it has been holding. The grief, the disorientation, the question of who you are outside of what you do for others — these are not signs that you are falling apart. They are signs that something real is asking for attention, probably for the first time in a long time.

Nope. And we want to be clear about that, because it matters.

AI scribe tools are everywhere right now — in doctors' offices, in legal practices, and increasingly in therapy rooms. They promise efficiency. What they don't come with, yet, is a clear answer to what happens to the recording of your session once the software has it.

For us, that's a non-starter. The conversations you have in therapy are some of the most private you'll ever have. They belong in the room with your therapist — not on a server somewhere, not in a training dataset, not in a vendor's privacy policy that quietly updated last Tuesday.

So at Eterna, the only intelligence in the room is the human kind.