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  • Home
    • About Us
    • Insurance And Appointments
    • Contact Form
    • Privacy Policies
  • Therapy Services
    • Trauma Therapy
    • Anxiety Therapy
    • Depression Therapy
    • Individual Therapy
    • Child and Teen Therapy
    • Young Adults Therapy
    • Couples Therapy
    • Family Therapy
    • Eating Disorders and Body Image
    • Faith Based Counseling
    • EMDR Therapy
    • Online Therapy in Texas
    • View All Therapy Services
  • Meet Our Counselors
    • Aimee Rhodes
    • Bella Nieto
    • Daniella Reyes
    • Christine Barnes
    • Elizabeth Oldham
    • Jazzmine Kelly
    • Jessica Shultz
    • Julie Ramsey
    • Karen Rodriguez
    • Kendra Moreno
    • Mia Zamora
    • Shakelia McKenzie, CIT
    • Staci Makela-Kerr
    • Swathi Weaver, LPC-S
  • Support Groups
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Mental Health Resources & Therapy Insights

Support, Insight & Practical Tools for Emotional Wellness

Explore trauma-informed articles, anxiety support, parenting resources, EMDR education, grief guidance, relationship insights, and mental health tools designed to help you feel more informed, supported, and connected in everyday life.

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July 27th, 2026

7/27/2026

 

Embracing the Fear of Change

By Kendra Moreno, LPC

Change is one of life's greatest certainties, yet it often feels overwhelming. Whether you're starting a new job, ending a relationship with someone you still love, relocating across the country, or stepping into an unfamiliar season of life, change can stir up fear, grief, and a lot of self-doubt. Even positive changes can bring unexpected anxiety because they require us to leave behind what is familiar.

Many people struggle with questions like, Did I make the right decision? What if I fail? What if I regret this? These thoughts are completely normal and can lead to decision paralysis. Our brains are wired to seek safety and predictability, making the unknown feel threatening—even when it holds opportunities for growth.

Adult navigating uncertainty and change during a major life transition

Why Can Change Feel So Scary?

There is a biological reason uncertainty can feel uncomfortable. Fear is part of the brain's built-in threat-detection system. When something feels uncertain or potentially dangerous, the brain can activate physiological responses designed to prepare us to respond.

That can happen even when the "threat" isn't physical danger. A major decision, unfamiliar environment, new relationship dynamic, career change, or uncertain future can be enough to put the nervous system on alert.

Your Brain Detects Uncertainty

The amygdala helps detect potential threats, while other areas of the brain use memory, context, and reasoning to determine whether something is actually dangerous.

Your Body Prepares

Fear can increase heart rate, breathing, muscle tension, alertness, and other physical responses associated with the body's fight-or-flight system.

The Unknown Leaves Gaps

When we cannot predict what will happen next, anxious thoughts may attempt to fill in those gaps—often by imagining what could go wrong.

Feeling afraid of change does not automatically mean the change is wrong. Sometimes fear simply means you are stepping beyond what is familiar.

Moving Forward When Change Feels Uncomfortable

While there is no quick fix for the discomfort of change, there are healthy ways to navigate it. First, give yourself permission to grieve what you're leaving behind while remaining open to what lies ahead. Maintain applicable routines that provide stability, lean on trusted friends and family, practice mindfulness, and remind yourself that uncomfortable emotions are valid but temporary. Most importantly, avoid letting fear control your decisions. Courage isn't the absence of fear—it's choosing to move forward despite it.

Courage Does Not Require You to Stop Feeling Afraid

We sometimes imagine courage as complete confidence: knowing exactly what to do and moving forward without hesitation.

In real life, courage often looks much less dramatic. It can mean taking an important step while fear is still present.

Research examining courage and fear suggests that people can continue approaching something meaningful even while experiencing fear. The importance we attach to an action can also influence our willingness to move toward it.

Ask What Matters, Not Just What Feels Safe

When anxiety starts making decisions for you, try asking:

  • What am I afraid might happen?
  • What evidence tells me this outcome is certain?
  • What would I choose if fear were not making the decision?
  • What matters most to me in this situation?
  • Which choice moves me toward the life I want to build?

Why Avoiding Change Can Make Fear Stronger

When something makes us anxious, avoidance can feel incredibly appealing. We postpone the conversation. We don't submit the application. We stay in the familiar situation. We tell ourselves we'll make the decision when we feel more confident.

Avoidance often works in the short term because anxiety decreases when we move away from whatever frightened us. The problem is that our brain may learn an unintended lesson: I escaped, so that situation must have been dangerous.

Over time, this can reinforce fear and make the situation feel even harder to approach.

Fear Appears

A decision, conversation, transition, or unfamiliar situation triggers anxiety.

You Avoid It

You postpone, withdraw, seek repeated reassurance, or return to what feels familiar.

Anxiety Drops

You experience immediate relief, which makes avoidance feel effective.

Fear Returns

The next time you face the situation, your brain may interpret it as something that still needs to be escaped.

You Don't Have to Face Everything at Once

Moving toward change does not mean forcing yourself into the most frightening situation imaginable. In anxiety treatment, feared situations are often approached gradually so people have opportunities to discover that anxiety can be tolerated and that feared outcomes are not always as likely—or as catastrophic—as they feel.

Make the Next Step Smaller

Instead of asking, "How am I going to handle all of this?" identify the smallest useful step you can take next.

  • Research the opportunity before making a final decision.
  • Write down your questions before an important conversation.
  • Tour the new neighborhood before moving.
  • Update your résumé before applying for a new job.
  • Talk through your concerns with someone you trust.
  • Give yourself permission to make one decision at a time.

When Fear of Change Shows Up in Your Mind and Body

When change becomes especially distressing, it can affect both your mind and body. You may notice racing thoughts, difficulty sleeping, changes in appetite, increased irritability, fatigue, trouble concentrating, or a constant feeling of being "on edge." Some people even experience physical symptoms such as headaches, muscle tension, stomach discomfort, or a racing heart. These reactions do not mean you are weak, incapable, or that you shouldn't follow through with that change; they are common stress responses as your nervous system works to adjust to uncertainty. Acknowledging these symptoms with self-compassion, rather than self-criticism, is an important first step toward peace and acceptance.

Racing Thoughts

Replaying decisions, imagining worst-case scenarios, or repeatedly questioning whether you've made the right choice.

Sleep Changes

Difficulty falling asleep, waking frequently, or feeling unable to mentally switch off.

Physical Anxiety

A racing heart, muscle tension, stomach discomfort, headaches, shakiness, or feeling on edge.

Fatigue

Constant decision-making and heightened alertness can leave you feeling mentally and physically depleted.

Difficulty Concentrating

Anxiety can make it harder to focus on work, conversations, responsibilities, or everyday decisions.

Irritability

When your nervous system is already working overtime, everyday frustrations may feel harder to tolerate.

How to Ground Yourself During a Major Life Change

Keep Some Things Predictable

Maintain routines that still work for you, such as regular meals, movement, sleep routines, or a familiar morning ritual.

Stay Connected

Talk with people who can listen without immediately telling you what decision you should make.

Focus on What You Can Control

Separate the decisions you can make today from outcomes you cannot predict or control.

Allow Adjustment Time

A new situation can feel unfamiliar before it feels comfortable. Adjustment does not have to happen immediately.

Make Room for Mixed Feelings

You can feel excited and scared, relieved and sad, hopeful and uncertain at the same time.

Take the Next Step

When the entire transition feels overwhelming, focus on the next manageable action rather than solving the whole future.

You can miss what you're leaving behind and still believe that moving forward is right for you.

When Fear of Change Starts Interfering With Daily Life

If feelings of anxiety, sadness, or overwhelm begin interfering with your daily life, seeking support from a mental health professional can make a meaningful difference. Therapy provides a safe, nonjudgmental space to process emotions, develop healthy coping strategies, and build confidence through life's transitions. You don't have to navigate change alone. Sometimes, reaching out for help is the first step toward discovering that the life waiting on the other side of change is stronger, healthier, and more fulfilling than you ever imagined.

Facing a Major Life Change?

Counseling can help you understand what is underneath the fear, work through uncertainty, challenge anxious thought patterns, and develop tools for navigating the transition ahead.

Transform & Renew Counseling offers therapy in San Antonio and secure online therapy throughout Texas.

Schedule Your First Session

Frequently Asked Questions About Fear of Change

Change introduces uncertainty, and the brain often responds to uncertainty as a potential threat. Even positive changes can trigger anxiety because they involve unfamiliar situations, new decisions, and the loss of routines or circumstances that once felt predictable.

Yes. Starting a new job, moving, beginning a relationship, graduating, becoming a parent, or reaching another meaningful milestone can bring excitement and anxiety at the same time. Feeling nervous does not necessarily mean you made the wrong decision.

It can. Avoidance may reduce anxiety temporarily, but repeatedly avoiding feared situations can reinforce the belief that they are dangerous or unmanageable. Gradually approaching difficult situations can help build confidence and reduce fear over time.

Helpful strategies can include maintaining familiar routines, focusing on what you can control, breaking large decisions into smaller steps, practicing mindfulness, talking with trusted people, and allowing yourself time to adjust emotionally.

Fear can sometimes alert us to genuine risks, but anxiety can also make uncertain outcomes feel more dangerous than they are. It may help to look at the available evidence, identify the specific risk you are worried about, and consider whether fear is helping you make a thoughtful decision or preventing you from moving toward something important.

Anxiety during a major transition may include racing thoughts, difficulty sleeping, irritability, fatigue, trouble concentrating, changes in appetite, muscle tension, headaches, stomach discomfort, a racing heart, or feeling constantly on edge.

Therapy may be helpful when fear, anxiety, sadness, or overwhelm begins interfering with work, relationships, sleep, decision-making, or daily functioning. Counseling can help you understand what is driving the fear, develop coping strategies, and navigate the transition with greater confidence.

July 22nd, 2026

7/22/2026

 

Are You Part of the Sandwich Generation? Hint: It Is Not About Food

By Staci Makela-Kerr, MS, LPC Associate

Adult balancing caregiving responsibilities for children and aging parents

You have probably heard of Baby Boomers, Generation X, Millennials, and Generation Z. But have you heard of the sandwich generation?

Despite the name, this is not the generation that grew up eating peanut butter and jelly sandwiches and later made friends with GLP-1 medications.

The sandwich generation includes adults who are raising or financially supporting their own children while also helping care for aging parents. They are “sandwiched” between the needs of two generations, often while managing careers, relationships, household responsibilities, and their own health.

That can mean taking a teenager to school in the morning, calling a parent’s doctor during lunch, helping a college graduate with rent, picking up prescriptions after work, and somehow remembering that you also need to eat dinner.

“When everyone depends on you, it can become easy to forget that you are also someone who needs care.”

What Is the Sandwich Generation?

The sandwich generation is not one specific birth cohort. It describes a caregiving role that is especially common during middle adulthood.

Some people are raising young children while helping an aging parent. Others are supporting an adult child who is still financially dependent while coordinating medical appointments, transportation, finances, or daily care for an older relative.

The support is not always hands-on. It may be emotional, financial, logistical, or all three.

Supporting Children

You may be raising young children, parenting teenagers, or helping an adult child with housing, education, childcare, or financial stability.

Helping Aging Parents

Support may include transportation, household tasks, medical coordination, financial decisions, emotional support, or direct caregiving.

Managing Your Own Life

At the same time, you may be working, maintaining relationships, managing a home, preparing for retirement, and trying to protect your own health.

Why Are More Adults Feeling Sandwiched?

There is no single reason more adults find themselves supporting multiple generations. Several social, medical, and economic changes have combined to extend caregiving responsibilities.

People Are Living Longer

Medical advances, preventive care, improved living conditions, and better treatment of chronic illnesses have helped many adults live longer. Longer lives can also mean longer periods of support, care coordination, or assistance with daily needs.

Families Are Starting Later

Many adults are having children later because of education, career goals, finances, fertility treatment, or personal choice. As a result, some are still actively parenting when their own parents begin needing more help.

Adult Children Need Support Longer

High housing costs, education expenses, uncertain employment, and other financial pressures may delay independence or lead adult children to return home.

Retirement Income May Be Limited

Older adults may face rising costs for medication, housing, food, transportation, and healthcare while living on fixed or limited incomes.

Care Is More Complex

Families may be coordinating multiple specialists, medications, insurance plans, safety concerns, and decisions about independent living or long-term care.

Families Are Often Spread Out

When relatives live in different cities or states, caregiving tasks may fall heavily on the person who lives closest or has the most flexible schedule.

The Emotional Weight of Caring for Two Generations

Being needed can feel meaningful. Many people genuinely want to support their children and parents.

But caregiving can also be exhausting, expensive, and emotionally complicated.

You may love your family deeply and still feel frustrated. You may feel grateful that your parent is alive and simultaneously grieve the changes you are witnessing. You may want to help your adult child while worrying that the support is preventing independence.

Opposing emotions can exist at the same time.

Constant Time Pressure

There may never seem to be enough time for work, caregiving, parenting, relationships, rest, and basic household responsibilities.

Caregiver Exhaustion

Long periods of emotional and practical responsibility can lead to fatigue, irritability, sleep disruption, and difficulty concentrating.

Anticipatory Grief

Watching a parent’s health or independence change can create sadness, fear, dread, and grief before a death or major loss occurs.

Guilt

You may feel guilty when helping one person means disappointing another—or when you take time for yourself.

Family Conflict

Siblings and relatives may disagree about finances, medical decisions, caregiving responsibilities, or what an aging parent truly needs.

Feeling Like You Are Failing

When the demands exceed the hours available, it can feel as though you are not being a good enough parent, child, partner, employee, or caregiver.

“You can love your family, feel honored to help, and still admit that caregiving is difficult.”

When the Parent-Child Roles Begin to Change

It can be difficult to remain someone’s child while also becoming the person who reminds them about medication, questions whether they should still drive, or discusses whether they can safely live alone.

A well-meaning adult child may sound controlling to an aging parent who has made independent decisions for decades. Meanwhile, the adult child may feel frightened, responsible, and unsure how to help without taking over.

This role reversal can create tension on both sides.

Preserve Choice Whenever Possible

Unless there is an immediate safety issue, include your parent in decisions rather than making every decision for them.

  • Ask what type of help they are comfortable receiving.
  • Offer choices instead of giving orders.
  • Discuss concerns before a crisis occurs.
  • Respect the tasks they are still able to manage.
  • Focus on safety without unnecessarily removing independence.

Three Skills That Can Protect Your Sanity

There may not be a perfect way to balance every responsibility. But boundaries, communication, and thoughtful planning can reduce confusion and help responsibilities feel more manageable.

1. Set Boundaries Before You Reach Your Limit

A boundary is the line that identifies what you can reasonably provide and where your limits begin.

It may mean learning to say no when you have always said yes. It may mean deciding that you cannot answer every call immediately, attend every appointment, solve every financial problem, or serve as the only person responsible for care.

A boundary can sound like:

“I Can Help With This Part”

“I can take you to the appointment, but I cannot miss work to stay for the full afternoon.”

“I Need Advance Notice”

“I want to help, but I need you to tell me about appointments before the day of the visit.”

“I Cannot Be the Only Helper”

“I can coordinate the schedule, but we need other family members to share transportation and errands.”

“That Is Not Something I Can Pay For”

“I care about what is happening, but I cannot take on that expense without putting my own household at risk.”

“I Need Time to Think”

“I am not able to answer right now. Let me look at my schedule and get back to you.”

“I Love You, and I Need Rest”

“I am not available this evening. I need time to take care of myself so I can continue helping.”

Boundaries are not punishment. They are a way of keeping support sustainable.

2. Communicate Clearly and Directly

You cannot expect people to respect boundaries they do not know exist.

Having a thoughtful conversation is the first step. Let family members know what you can do, what you cannot do, and where additional help is needed.

Somewhere along the way, you may have learned that doing everything alone means you are strong, capable, or good. But asking for help can also be an act of strength.

Make the Request Specific

Instead of saying, “I need more help,” try assigning a clear task:

  • “Can you take Mom to her appointment next Thursday?”
  • “Can you call Dad twice a week to check on his medications?”
  • “Can you handle grocery delivery this month?”
  • “Can you stay with the kids Saturday so I can rest?”
  • “Can we divide these expenses instead of one person paying for everything?”

People may be willing to help but unsure what is needed. Specific requests make it easier for others to participate.

3. Plan Before a Crisis Forces the Conversation

Planning does not create a medical emergency, financial problem, or loss of independence. It simply gives the family a starting point if circumstances change.

If your parents do not currently need much help, this may be the best time to ask what they would want in the future.

Important Documents

Discuss where legal, financial, insurance, medical, and advance-care documents are stored.

Healthcare Wishes

Ask who should communicate with medical providers and what type of care your parent would want if they could not speak for themselves.

Transportation

Talk about what would happen if driving became unsafe and what alternatives might feel acceptable.

Living Arrangements

Explore preferences for staying at home, receiving in-home support, moving closer to family, or considering assisted living.

Financial Planning

Discuss recurring expenses, available resources, insurance coverage, and who can access accounts when necessary.

Division of Responsibilities

Identify what siblings, relatives, adult children, friends, neighbors, or professionals can realistically contribute.

Look for Ways Family Members Can Help One Another

Not every responsibility has to flow through the person in the middle.

Perhaps your parent can help your teenager practice driving, share family stories, or assist with homework. An adult child living at home may be able to run errands, prepare meals, troubleshoot technology, or spend time with a grandparent.

These arrangements should not place inappropriate caregiving responsibility on children, but there may be safe and meaningful ways for family members to support one another.

“Sometimes the best plan is not doing more. It is helping the family share what already needs to be done.”

Self-Care Is Not Another Task to Perform Perfectly

Self-care does not always mean a spa day, a weekend away, or several uninterrupted hours. Those things can be wonderful, but they may not be realistic during an intense caregiving season.

Sometimes self-care is smaller and more practical.

Protect Basic Rest

Create a realistic bedtime, share overnight responsibilities when possible, and talk with a healthcare provider if stress is consistently disrupting sleep.

Meet Physical Needs

Eat regularly, drink water, attend your own medical appointments, and take prescribed medications.

Schedule Recovery Time

Place short periods of rest on the calendar instead of waiting for free time to magically appear.

Stay Connected

Speak honestly with a friend, partner, support group, faith community, or therapist about what you are carrying.

Move Your Body

A short walk, stretching, or a few minutes outdoors can help release tension and create a mental pause.

Allow Yourself to Stop

Not every problem must be solved today. Pausing is not abandoning your family.

Signs You May Be Experiencing Caregiver Burnout

Caregiver stress can build gradually. Because you are focused on everyone else, you may not notice how depleted you have become.

Pay Attention if You Notice:

  • Persistent exhaustion that does not improve with rest.
  • Irritability, anger, or resentment that feels difficult to control.
  • Withdrawal from friends, hobbies, or relationships.
  • Difficulty sleeping or sleeping much more than usual.
  • Frequent headaches, tension, stomach problems, or other stress symptoms.
  • Feeling hopeless, trapped, numb, or constantly overwhelmed.
  • Using alcohol, food, medication, or other behaviors to cope.
  • Feeling as though no amount of effort is ever enough.

These signs do not mean that you do not love your family. They may mean that your current level of responsibility is not sustainable without additional support.

When Therapy Can Help

Therapy can provide space to talk openly about emotions that caregivers often feel ashamed to admit, including anger, resentment, guilt, fear, grief, and relief.

Counseling may help you:

Set Realistic Boundaries

Clarify what you can provide without sacrificing your health, relationships, or financial stability.

Prepare for Difficult Conversations

Practice discussing driving, finances, healthcare, living arrangements, and shared responsibilities.

Process Grief

Make room for anticipatory grief, changing family roles, and the loss of how relationships used to be.

Work Through Guilt

Challenge the belief that resting, saying no, or asking for help makes you selfish or uncaring.

Solve Problems Collaboratively

Break overwhelming responsibilities into smaller decisions and identify support that may already be available.

Reconnect With Yourself

Remember that you are more than a parent, employee, partner, adult child, and caregiver.

You Are Allowed to Be Part of the Care Plan

If any of this sounds familiar, you may be part of the sandwich generation.

Perhaps your parents still live independently but are finding certain tasks more difficult. Maybe you have a teenager at home who does not drive, an adult child struggling to find stable work, or a parent who has decided it is time to stop driving.

Learning to set boundaries can feel uncomfortable. Communicating differently may feel like learning a new language. Asking for help may challenge everything you were taught about strength and responsibility.

But you do not have to disappear inside your caregiving roles.

Your needs matter. Your health matters. Your relationships matter. Your rest matters.

“You can say, ‘I love you, and I need to care for myself too.’ Both parts of that sentence can be true.”

Feeling Overwhelmed by Caregiving Responsibilities?

Transform & Renew Counseling provides compassionate support for caregiver stress, grief, anxiety, family transitions, burnout, and changing roles in middle and later adulthood. Sessions are available in San Antonio and through secure telehealth across Texas.

Schedule Your First Session

Frequently Asked Questions About the Sandwich Generation

The sandwich generation refers to adults who are supporting children while also helping care for aging parents or older relatives. The support may be emotional, financial, practical, medical, or a combination of several responsibilities.

Common signs include persistent exhaustion, irritability, sleep problems, guilt, resentment, difficulty concentrating, relationship strain, physical tension, and feeling as though no amount of effort is ever enough.

Start by identifying what you can realistically provide, then communicate those limits clearly and specifically. Boundaries may involve asking for advance notice, sharing responsibilities, limiting financial support, protecting rest time, or explaining that you cannot be the only person providing care.

Families can divide responsibilities by assigning specific tasks such as transportation, grocery delivery, medication check-ins, appointment coordination, household help, or financial contributions. Clear requests are often more effective than asking generally for more help.

Helpful topics include healthcare wishes, transportation, finances, important documents, living arrangements, emergency contacts, and who will manage different responsibilities if needs increase. Planning early can reduce confusion and conflict later.

Yes. Caregivers can love their family and still experience resentment, grief, anger, guilt, or exhaustion. These feelings do not mean you are uncaring. They may be signs that the current level of responsibility is not sustainable without more support.

Yes. Therapy can help caregivers set boundaries, prepare for difficult family conversations, process grief, reduce guilt, manage anxiety, and create a more sustainable plan for balancing caregiving with their own health and relationships.

July 14th, 2026

7/14/2026

 

Why You Don’t Feel Good Enough: Understanding Low Self-Esteem and Your Inner Critic

By Mia Zamora, LPC Associate

Woman reflecting on low self-esteem and negative self-talk

One of the most common concerns I see among the clients I work with is low self-esteem. Many people enter therapy believing they simply “don’t like themselves” or that they need to become more confident.

Confidence can certainly be part of self-esteem, but self-esteem runs much deeper than how capable or outgoing you feel in a particular moment. It includes the beliefs you carry about who you are, what you deserve, and whether you believe you are enough.

These beliefs usually do not appear overnight. They are often learned gradually through our experiences, relationships, and the messages we receive from the people around us.

“You are not your inner critic. You are not your negative self-talk. Those thoughts may have been with you for a long time, but they do not define who you are.”

What Is Self-Esteem?

Self-esteem is the overall way you evaluate your own worth and value. It affects more than whether you feel confident walking into a room or completing a difficult task.

Your self-esteem can influence how you respond to mistakes, what you tolerate in relationships, whether you advocate for your needs, and how you interpret challenges.

Self-Worth

The belief that you have value even when you are imperfect, struggling, or unable to meet every expectation.

Relationships

Self-esteem can affect the treatment you accept from others and how comfortable you feel expressing your needs.

Boundaries

Believing your needs matter can make it easier to say no, protect your time, and recognize unhealthy dynamics.

Resilience

A healthier sense of self can help you recover from setbacks without viewing one difficult moment as proof that you are a failure.

Decision-Making

Self-esteem influences whether you trust yourself to make choices that reflect your needs, values, and goals.

Emotional Health

Low self-esteem can reinforce anxiety, shame, perfectionism, depression, and chronic self-doubt.

How Do Core Beliefs Shape Self-Esteem?

Many of the beliefs we carry about ourselves are what therapists refer to as core beliefs. These are deeply rooted assumptions we develop about ourselves, other people, and the world around us.

Core beliefs often begin forming in childhood and continue to be reinforced throughout adolescence and adulthood. They may come from parents or caregivers, siblings, coaches, peers, romantic relationships, social expectations, or repeated life experiences.

Sometimes these messages are communicated directly through criticism, rejection, bullying, or unrealistic expectations. Other times, they are much more subtle.

Maybe you learned that you had to perform well to receive praise. Perhaps your emotions were dismissed, leaving you with the impression that your feelings did not matter. You may have received attention mainly when you were helpful, successful, attractive, agreeable, or productive.

Over time, these experiences can shape how you begin to see yourself.

Where Does Low Self-Esteem Come From?

Childhood Experiences

Frequent criticism, inconsistent care, emotional invalidation, or feeling overlooked can shape early beliefs about worth.

Critical Relationships

Messages from controlling, dismissive, or emotionally harmful relationships may eventually become part of your internal voice.

Achievement-Based Worth

You may learn that you are valuable only when you succeed, perform, produce, or make other people proud.

Social Comparison

Repeatedly comparing your appearance, relationships, career, or progress to others can reinforce feelings of inadequacy.

Emotional Neglect

When emotions are ignored or minimized, you may begin believing your needs are inconvenient or unimportant.

Trauma or Bullying

Painful experiences can lead to beliefs such as “I am unsafe,” “I am unlovable,” or “Something is wrong with me.”

Meet Your Inner Critic

One thing I often ask clients to do is pause and become curious about their inner critic. We all have one to some degree.

Rather than immediately trying to silence it, I encourage people to first get to know it.

Listen With Curiosity

Take a moment and notice what your inner critic is saying.

  • Does it tell you that you are not good enough?
  • Does it predict that you will fail?
  • Does it warn that you will disappoint everyone around you?
  • Does it insist that you should have done more or handled something differently?
  • Does it criticize your appearance, productivity, emotions, or relationships?
  • When does this voice become the loudest?

These questions may feel uncomfortable, but they can also create valuable awareness.

Is the Inner Critic Really Your Voice?

Many clients assume the inner critic is their own voice. They believe these thoughts represent who they truly are.

But as we begin exploring where these thoughts originated, we often discover something different.

More often than not, negative self-talk contains internalized messages that were repeated so many times they began to feel like facts. The critic may sound like a demanding parent, an unhealthy relationship, a former teacher, societal expectations, or years of comparing yourself to everyone else.

Eventually, those outside messages become internalized. Without realizing it, you may begin speaking to yourself the way others once spoke to you.

“Instead of automatically believing, ‘I am not enough,’ begin asking, ‘Where did I learn that I wasn’t enough?’”

Your Thoughts Are Learned Patterns, Not Automatic Facts

That small shift can change the way you relate to negative thoughts. It moves you from accepting them as truth to recognizing that they may be learned patterns of thinking.

Long-held beliefs can feel factual even when they are based on old experiences, assumptions, or distorted interpretations. Learning to identify and question them is an important part of building healthier self-esteem.

Trigger

A mistake, conflict, rejection, comparison, criticism, or unfamiliar challenge occurs.

Automatic Thought

Your mind responds quickly with a thought such as, “I always ruin everything.”

Core Belief

The thought connects to a deeper belief such as, “I am incapable,” “I am unlovable,” or “I am not enough.”

Emotion

You may experience shame, anxiety, sadness, embarrassment, anger, or hopelessness.

Behavior

You may withdraw, over-apologize, people-please, avoid trying, or work excessively to prove your worth.

Reinforcement

The behavior prevents new experiences from challenging the original belief, allowing the cycle to continue.

Externalizing Low Self-Esteem

In therapy, we sometimes refer to this shift as externalizing the problem.

Rather than viewing low self-esteem as a permanent part of your personality, you begin seeing it as something that developed through experiences and patterns. Because it was learned over time, it can also be examined, challenged, and changed over time.

You are not the problem. The pattern is the problem.

Common Signs of Low Self-Esteem

Constant Self-Criticism

You focus heavily on mistakes while minimizing your effort, progress, and positive qualities.

People-Pleasing

You prioritize other people’s comfort because disagreement or disapproval feels threatening.

Difficulty Accepting Praise

Compliments may feel uncomfortable, exaggerated, or impossible to believe.

Fear of Failure

You may avoid new opportunities because mistakes feel like evidence that you are inadequate.

Constant Comparison

You measure your worth against other people’s appearance, success, relationships, or progress.

Perfectionism

You hold yourself to rigid standards and struggle to feel satisfied even when you accomplish something meaningful.

Difficulty Setting Boundaries

You may fear that expressing your limits will make others angry, disappointed, or likely to leave.

Chronic Self-Doubt

You second-guess your choices and rely heavily on reassurance from other people.

When Worth Becomes Conditional

Somewhere along the way, many people learned that their worth was based on achievement, appearance, productivity, or meeting other people’s expectations.

When those expectations are not met, the inner critic becomes louder and reinforces the belief that something is wrong with you.

This can create a painful cycle:

The Conditional-Worth Cycle

  • You set an unrealistic standard.
  • You work hard to prove your value.
  • You feel temporary relief when you succeed.
  • The standard moves higher or changes.
  • You criticize yourself when you cannot maintain it.
  • The belief that you are not enough becomes stronger.

Healing self-esteem is not about becoming perfect or eliminating every negative thought. It is about building a different relationship with yourself.

Why Self-Compassion Matters

Self-compassion is something I discuss with many clients because it can feel unfamiliar. For some people, showing kindness toward themselves feels uncomfortable or even undeserved.

They worry that if they stop criticizing themselves, they will become lazy, complacent, or stop growing.

In reality, self-compassion does not mean avoiding responsibility or pretending mistakes do not matter. It means responding to difficulty with honesty, patience, and care instead of shame.

Research suggests that self-esteem and self-compassion can work together as protective factors for mental health. Self-compassion may also help people respond to setbacks without making their entire worth dependent on success or approval.

Inner Critic Versus Self-Compassion

Inner Critic

“I’m a failure.”

Self-Compassionate Response

“I made a mistake, but one mistake does not define who I am.”

Inner Critic

“I’m not good enough.”

Self-Compassionate Response

“I am still learning, and my worth is not dependent on being perfect.”

Inner Critic

“I should be further along by now.”

Self-Compassionate Response

“Growth does not happen on one universal timeline.”

Inner Critic

“Everyone else is doing better than me.”

Self-Compassionate Response

“I am comparing my full experience to a limited view of someone else’s life.”

Inner Critic

“If I stop pushing myself, I’ll become lazy.”

Self-Compassionate Response

“I can hold myself accountable without treating myself cruelly.”

Five Ways to Begin Strengthening Self-Esteem

1. Notice the Inner Critic

Pay attention to when it appears, what it says, and which situations make it louder.

2. Examine the Evidence

Ask whether the thought is supported by facts or shaped by fear, assumptions, or an old belief.

3. Practice Self-Compassion

Respond to yourself with the same patience and care you would offer someone you love.

4. Recognize Progress

Notice effort, learning, consistency, and growth rather than measuring yourself only by perfect outcomes.

5. Seek Support

Therapy can help you understand where negative beliefs began and practice healthier ways of responding to yourself.

A Reflection Exercise for Your Inner Critic

Pause and Write

Choose one negative thought that frequently appears and reflect on the following:

  • What happened immediately before the thought appeared?
  • What exactly did the inner critic say?
  • What emotion did the thought create?
  • Who or what does this voice remind you of?
  • What evidence supports the thought?
  • What evidence does not support it?
  • What would you say to a close friend in the same situation?
  • What would a more accurate and compassionate response sound like?

How Therapy Can Help With Low Self-Esteem

Therapy does not aim to turn you into someone different. It can help you understand the experiences that shaped your self-image and identify patterns that continue to reinforce self-doubt.

Depending on your needs, counseling may help you:

Identify Core Beliefs

Recognize the deeply rooted assumptions influencing your thoughts, feelings, and choices.

Challenge Distorted Thinking

Learn to recognize all-or-nothing thinking, negative filtering, emotional reasoning, and harsh self-labeling.

Build Healthy Boundaries

Practice expressing needs and limits without automatically assuming you are selfish or difficult.

Develop Self-Compassion

Create a more supportive internal response to mistakes, rejection, stress, and disappointment.

Strengthen Identity

Explore who you are beyond achievement, appearance, productivity, and other people’s expectations.

Practice New Patterns

Take gradual steps toward healthier relationships, goals, decisions, and ways of treating yourself.

You Have Always Been Worthy

At the end of the day, you deserve to extend yourself the same love, care, patience, and grace that you so freely give to the people around you.

Therapy does not aim to make you someone different. It helps you uncover the version of yourself that may have been buried beneath years of self-doubt, unrealistic expectations, and critical self-talk.

My hope is that, over time, your own voice becomes louder than your inner critic—and that voice begins reminding you of something you have deserved to hear all along:

“You have always been worthy.”

Ready to Build a Healthier Relationship With Yourself?

Transform & Renew Counseling provides compassionate therapy for low self-esteem, anxiety, depression, trauma, perfectionism, relationship concerns, and negative self-talk in San Antonio and through secure telehealth across Texas.

Schedule Your First Session

Frequently Asked Questions About Low Self-Esteem

Low self-esteem can develop through criticism, bullying, emotional neglect, unhealthy relationships, trauma, social comparison, perfectionism, or learning that your worth depends on achievement, appearance, or other people’s approval. It is usually shaped over time rather than caused by one single experience.

Yes. Therapy can help you identify the core beliefs and past experiences that shaped your self-image, challenge negative self-talk, build healthier boundaries, practice self-compassion, and develop a more balanced sense of worth.

Confidence usually refers to how capable you feel in a specific situation, such as speaking in public or learning a new skill. Self-esteem is broader and relates to your overall sense of worth and value as a person.

The first step is noticing the thought without automatically accepting it as true. From there, you can examine the evidence, identify where the message may have originated, and replace it with a response that is more accurate, balanced, and compassionate.

Self-compassion means responding to your own pain, mistakes, and limitations with honesty, patience, and care. It does not mean avoiding responsibility. It means holding yourself accountable without using shame or cruelty as motivation.

Yes. Childhood experiences can strongly influence the beliefs you develop about your worth, safety, abilities, and relationships. Criticism, emotional invalidation, inconsistent care, unrealistic expectations, or feeling valued only for achievement can contribute to low self-esteem later in life.

There is no single timeline. Improving self-esteem usually involves gradually recognizing old patterns, practicing new responses, building healthier relationships, and developing self-compassion. Progress often happens over time rather than all at once.

July 06th, 2026

7/6/2026

 

Why Many Black Americans Don't Seek Therapy: Breaking the Stigma Around Mental Health in the Black Community

By Jazzmine Kelly, MA, LPC Associate
Supervised by Dr. Aimee Rhodes, Ed.D., MS, LPC-S, CCTP

Black mental health therapist supporting culturally responsive counseling

If you grew up in a Black household like I did, chances are mental health wasn't something your family openly discussed.

We talked about working hard. We talked about being strong. We talked about making it through difficult seasons. But conversations about anxiety, depression, trauma, burnout, or therapy? Those were much harder to find.

For much of my childhood, mental health simply wasn't part of the conversation. It wasn't until I became an adult that my own family started openly acknowledging that our emotional well-being matters just as much as our physical health.

As a Black therapist, I've realized this experience is incredibly common. Many of my clients share similar stories of growing up believing they had to "push through," "pray about it," or simply keep moving.

The truth is, mental health has always mattered. We're just finally giving ourselves permission to talk about it.

"Strength and vulnerability can exist together. Seeking support does not erase resilience—it honors it."

Mental Health in the Black Community: The Numbers Tell a Story

Black Americans experience anxiety, depression, trauma, grief, chronic stress, and burnout like anyone else. But research consistently shows that Black adults are less likely to receive mental health treatment compared to White adults, even when care is needed.

This gap is not about Black communities caring less about mental health. It is connected to stigma, access barriers, cost, historical mistrust of healthcare systems, discrimination, and difficulty finding culturally responsive providers.

Did You Know?

Mental health stigma can be especially powerful when emotional struggles are seen as weakness, private family matters, or something that should only be handled through personal strength or faith. These beliefs often come from survival, but they can also keep people from getting support.

Why Is Therapy Underutilized in the Black Community?

One of the most common questions people ask is, "Why don't more Black people go to therapy?"

The answer is complex because there isn't just one reason.

Mental health services have historically been underutilized by many Black individuals due to a combination of stigma, limited access to care, financial barriers, historical mistrust of healthcare systems, and a lack of culturally responsive providers.

Many of us were raised believing emotional struggles were something to overcome privately rather than something worthy of professional support.

"Stay Strong"

Strength was often taught as the ability to keep going, even when we were hurting.

"You'll Get Over It"

Pain was sometimes minimized because previous generations survived without space to process it.

"Pray About It"

Faith can be deeply meaningful, but prayer and therapy do not have to compete with one another.

"Don't Tell People Your Business"

Privacy was often used as protection, but silence can also keep wounds hidden.

"What Happens Here Stays Here"

Family loyalty matters, but healing sometimes requires safe support outside the family system.

These phrases often came from places of love and resilience. Our parents and grandparents survived incredibly difficult circumstances, often without access to mental health care themselves. They taught us the coping skills they knew.

But surviving is not the same as healing.

Mental Health Stigma Doesn't Mean People Don't Care

Mental health stigma is often misunderstood. It does not mean families do not care about emotional pain. More often, stigma develops when generations of people have had to survive adversity without access to emotional support, safety, or culturally responsive care.

For many Black families, being strong was not just a personality trait. It was a survival strategy.

But strength can look different now. Strength can include rest. Strength can include asking for help. Strength can include naming what hurts instead of pretending everything is fine.

How Untreated Stress Can Show Up

When anxiety, depression, grief, trauma, and chronic stress go untreated, they rarely disappear. Instead, they often show up in our bodies, relationships, work, and daily functioning.

Burnout

Feeling emotionally drained, unmotivated, or unable to keep carrying everything.

Sleep Problems

Difficulty falling asleep, staying asleep, or feeling rested even after sleeping.

Irritability

Feeling easily triggered, short-tempered, overwhelmed, or emotionally reactive.

Panic & Anxiety

Racing thoughts, tightness in the chest, fear, dread, or feeling constantly on edge.

Relationship Conflict

Unprocessed pain can affect communication, trust, boundaries, and connection.

Emotional Numbness

Sometimes the mind protects itself by shutting down feelings altogether.

Barriers to Mental Health Care for Black Americans

Stigma is only one piece of the puzzle. Many Black individuals and families also face practical barriers when trying to access therapy.

Historically, Black communities have experienced significant disparities in healthcare access. Families may encounter financial hardship, limited insurance coverage, fewer nearby mental health providers, transportation challenges, childcare barriers, or work schedules that make regular appointments difficult.

Mental Health Care Is Healthcare

When you're focused on paying bills, supporting your family, or working multiple jobs, therapy can feel like a luxury. But mental health care is not a luxury. It is healthcare.

Just like we visit a physician when our bodies need attention, we deserve support when our emotional health is struggling.

Historical Mistrust of Healthcare Systems

For many Black Americans, mistrust of healthcare systems did not appear out of nowhere. It is connected to generations of medical racism, discrimination, unethical treatment, misdiagnosis, and unequal access to quality care.

Even today, many Black clients worry about whether they will be believed, respected, understood, or unfairly judged when seeking medical or mental health support.

That history matters. It is one reason culturally responsive care is so important.

Why Representation Matters in Therapy

One question I hear often is, "Does it matter if my therapist looks like me?"

The answer is different for everyone.

Some people do not have a preference, while others specifically seek a Black therapist or therapist of color because they want someone who understands parts of their lived experience without needing extensive explanation.

Representation matters because culture shapes how we experience the world.

Family Dynamics

Culture can shape family roles, expectations, communication, privacy, and responsibility.

Faith & Spirituality

Religion and spirituality may be central to coping, identity, and decision-making.

Code-Switching

Many Black clients navigate different versions of themselves at work, school, church, and home.

Racial Stress

Discrimination, microaggressions, and racial trauma can affect emotional well-being.

Identity

Therapy can be a space to explore identity, belonging, pressure, and self-worth.

Cultural Humility

A culturally responsive therapist does not assume. They listen, learn, and honor context.

As a Black therapist, I know how validating it can feel when clients do not have to explain concepts like code-switching, racial stress, generational expectations, or the pressure of constantly having to be "strong."

That does not mean therapists from different backgrounds cannot provide excellent care—they absolutely can. But having more diversity within the mental health profession gives clients more opportunities to find someone they naturally connect with.

Therapy Is More Than Treating Mental Illness

Many people think therapy is only for individuals experiencing severe depression or a mental health crisis.

That simply is not true.

Therapy can help you build tools, understand patterns, improve relationships, process pain, and create a healthier way of living.

Anxiety & Stress

Learn practical tools to manage racing thoughts, worry, and overwhelm.

Relationships

Improve communication, boundaries, emotional honesty, and connection.

Burnout

Understand exhaustion, over-functioning, people-pleasing, and the need for rest.

Grief & Loss

Process sadness, anger, complicated grief, and life after loss.

Trauma Healing

Work through painful experiences in a safe, paced, supportive environment.

Self-Understanding

Explore your patterns, values, needs, identity, and emotional responses.

You do not need to wait until everything falls apart before asking for support.

What to Expect From Your First Therapy Session

If therapy feels unfamiliar, it is normal to feel nervous before your first session.

A first therapy session is not about being judged, criticized, or forced to share everything at once. It is usually a conversation where your therapist gets to know you, what brings you in, what you have been carrying, and what you would like support with.

Your First Session May Include:

  • Talking about what led you to therapy.
  • Sharing symptoms, stressors, or concerns at your own pace.
  • Discussing your goals for counseling.
  • Learning about confidentiality and the therapy process.
  • Asking questions about your therapist's approach.
  • Beginning to create a plan for support.

You do not have to have all the right words. You do not have to know exactly what you need. You just have to start somewhere.

"You don't have to earn the right to receive help. You don't have to wait until you're in crisis. You are allowed to be supported now."

Breaking Generational Cycles Starts With One Conversation

One of the most rewarding parts of being a therapist is watching clients become cycle breakers.

They are teaching their children emotional vocabulary. They are modeling healthy boundaries. They are learning that asking for help is not weakness. They are showing future generations that healing deserves a seat at the table.

Every conversation about mental health helps reduce stigma.

Every therapy appointment helps normalize emotional wellness.

Every person who chooses healing makes it easier for someone else to do the same.

You Deserve Support

If you have been considering therapy but wondering whether your struggles are "bad enough," I want you to know this:

You do not have to earn the right to receive help.

You do not have to wait until you are in crisis.

You do not have to carry every burden by yourself simply because previous generations had to.

Seeking therapy does not mean you are weak. It does not mean you have failed. It does not mean you are abandoning your family's resilience.

It means you are choosing healing alongside strength.

As a Black therapist, I believe our communities deserve access to compassionate, culturally responsive mental health care. We deserve spaces where we feel heard, understood, and supported—not only during life's hardest moments, but throughout our journey toward growth.

Healing is not just about surviving. It is about creating a life where you can truly thrive.

Ready to Start Therapy?

Transform & Renew Counseling offers compassionate, culturally responsive therapy for children, teens, adults, couples, and families in San Antonio and across Texas through telehealth.

Schedule Your First Session

Frequently Asked Questions About Black Mental Health and Therapy

Many Black Americans delay or avoid therapy because of stigma, cost, limited access, historical mistrust of healthcare systems, lack of culturally responsive providers, and messages about staying strong or keeping family matters private.

Mental health stigma can be common in many communities, including Black communities. For some families, emotional struggles may be viewed as weakness, private family business, or something that should be handled through faith or personal strength alone.

Yes. Therapy is not only for crisis situations. Counseling can help with anxiety, stress, boundaries, grief, trauma, burnout, relationships, life transitions, self-esteem, and better understanding yourself.

It depends on the person. Some clients feel more comfortable with a therapist who shares or understands aspects of their cultural background. Others prioritize therapy style, specialty, personality, or availability. A culturally responsive therapist should approach your lived experience with respect, humility, and curiosity.

You can look for therapists who mention cultural humility, racial identity, racial stress, multicultural counseling, or culturally responsive therapy in their profile. It can also help to ask directly about their experience working with your concerns and cultural background.

    Authors

    Elizabeth Oldham is an LPC-S and co-founder of Transform & Renew, PLLC.  She specializes in co-dependency, anxiety and OCD, depression and mood disorders. 

    Aimee Rhodes,  Doctorate in Education, Global Training and Development and LPC-S is a cofounder of Transform & Renew, PLLC. She specializes in mood disorders, relationship trauma and grief. 

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