By Galen E. Cole, PhD, MPH, LPC -- Published for galencole.com/blog I’m not here to change your vote or tell you the news is fake. I’m here because anger plus a 24-hour feed is running your nervous system. We can respect your convictions and still ask whether this is a good use of the years you actually have. That is the whole argument. Not apathy. Not “touch grass” as a slogan. Stewardship of attention. You can care about the country and still let doomscrolling, headline str

By Galen E. Cole, PhD, MPH, LPC -- Published for galencole.com/blog A person can understand a problem and still live inside it. That is not a mystery of willpower. It is what happens when we treat change as one conversation instead of four. Most people arrive with insight already in hand. They can name the pattern. They can quote the damage. They can describe the life they want with surprising precision. Then they go home and repeat the week they just described. The missing p

By Galen E. Cole, PhD, MPH, LPC -- Published for galencole.com/blog When I led the Health Communications Branch at CDC's Office on Smoking and Health, it often felt like we were at war with the tobacco companies for the health of people across the globe. The industry had vast resources, sophisticated messaging, and decades of normalized harm on its side. Our side had science, persistence, multi-layered strategies, and an unwillingness to quit until the damage was contained. W

By Galen E. Cole, PhD, MPH, LPC -- Published for galencole.com/blog Stress is not the enemy. Unmanaged stress is. Your nervous system was built to handle short bursts of challenge. The problem begins when the activation never fully turns off—when the same thoughts keep looping, sleep gets fragmented, the body stays braced, and the mind starts treating ordinary life like a series of threats. Over time this pattern quietly erodes mood, focus, relationships, and physical health.

The January 2023 deaths of three young children in Duxbury, Massachusetts, continue to force an uncomfortable conversation about psychiatric prescribing. Court records show that Lindsay Clancy was prescribed approximately thirteen different psychiatric medications in the four months leading up to the tragedy. The list included sertraline (Zoloft), fluoxetine (Prozac), mirtazapine (Remeron), trazodone, amitriptyline, quetiapine (Seroquel), lamotrigine (Lamictal), lorazepam (At

“The greatest weapon against stress is our ability to choose one thought over another.” — attributed to William James In my earlier post We Feel What We Focus On, I wrote that our focus determines our feelings. What we dwell on becomes our emotional reality. That truth sits at the center of everything I teach in trauma-informed mindful cognitive behavioral therapy (TI-MCBT). You cannot think negative and feel positive at the same time—it is impossible. The thoughts you allow

Most psychiatry for depression and anxiety still centers on prescribing medications—primarily selective serotonin re-uptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) as first-line options. Other categories commonly used for anxiety include benzodiazepines (typically short-term due to dependence risk), buspirone, pregabalin in some guidelines, beta-blockers for performance or situational anxiety, and occasionally tricyclic antidepressants or o

"To people-please or not to people-please, that is the question—and the answer!" People-pleasing often masquerades as kindness, empathy, or being “easy to get along with.” On the surface it looks like love or social intelligence. In reality, chronic people-pleasing is a pattern of prioritizing others’ approval, comfort, and expectations at the consistent expense of one’s own needs, values, boundaries, and authenticity. It is not the same as healthy generosity or flexible coop

Acute trauma—whether from a sports injury, accident, violence, medical crisis, or other sudden overwhelming event—doesn’t just leave emotional scars. It disrupts memory consolidation, autonomic regulation, and neural circuitry during a critical window of heightened neuroplasticity. For many people, the days and weeks right after exposure represent the best opportunity to prevent those disruptions from hardening into chronic PTSD, anxiety, depression, and long-term functional

I recently listened to a well-known psychiatrist speak about self-esteem. He stressed, with conviction, the importance of loving ourselves. He was right — as far as he went. Then he stopped! He never answered the next and more important question: Then what? Loving yourself is essential. It creates the internal permission to stop the constant war against your own existence. Without that baseline acceptance, change feels like self-punishment. But acceptance alone is not the des

You do not experience life as it is. You experience the life you focus on! That simple truth is one of the most powerful and evidence-based principles in psychology. Whatever you consistently give your attention to becomes the emotional weather system of your inner world. Focus on threat, lack, past failures, or what you can’t control, and your nervous system responds with anxiety, resentment, or helplessness. Focus on what is workable, meaningful, or possible right now, and

In my practice I regularly sit with people who describe relationships that feel impossible to leave—and equally impossible to stay in. The pattern is familiar: intense connection, rupture, reconciliation, hope, disappointment, and the cycle repeating. These "on-again, off-again" relationships often produce profound emotional pain, confusion, and a sense of being trapped. Many clients say some version of “I know it’s not good for me, but I can’t seem to walk away.” A central c

Why You Need a Plan to Change (And Why Science Proves It) “If you do what you’ve always done, you’ll get what you’ve always gotten.” — Tony Robbins That line is not motivational fluff. It is a scientific observation. In my years as a behavioral scientist at the CDC, we lived by a simple rule: if you want to change a behavior, you must first identify what is driving it and then deliberately intervene on those drivers. Without a plan, you are guessing. Guessing produces the sam

Most of us spend years (sometimes decades) trying to rewrite, deny, or endlessly analyze the painful chapters of our story. We treat the past like a problem that still needs solving instead of a fact that already happened. Trauma, adversity, rejection, betrayal, failure—these experiences are real. They shaped us. Pretending they didn’t, or waiting until they somehow feel “resolved” before we move, keeps us stuck in the same emotional loops. The shift that changes everything i

We’ve all seen it—the alluring promise of quick fixes, secret shortcuts, and “manifestation” hacks that claim success is just a thought away. Magical thinking whispers that if you just believe hard enough, the universe will deliver. But real life, real change, and real achievement tell a different story. Hard work, paired with persistent action, beats magical thinking every single time. One of the most famous quotes on mindset comes from Henry Ford: “Whether you think you can

“All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison.” — Paracelsus (16th century) This foundational principle from toxicology remains profoundly relevant today, particularly when considering cannabis and its primary psychoactive component, delta-9-tetrahydrocannabinol (THC). While cannabis has legitimate therapeutic applications for certain conditions in controlled medical contexts, the evidence is clear: too much THC —

Most couples who come to therapy feel overwhelmed by the sheer number of problems in their relationship. Criticism, defensiveness, withdrawal, escalation, score-keeping, and years of unresolved hurts can make the entire marriage feel broken. When partners try to fix everything at once, hope fades quickly. Effort collapses under the weight of too many moving parts. One of the most reliable ways I have found to restore hope is to stop trying to overhaul the whole relationship a

Most couples who come to therapy with kids don’t start by saying, “We need better parenting skills.” They start by describing how the other person is the problem. He’s too soft. She’s too harsh. He undermines me. She never backs me up. The kids play us against each other. What often gets lost in that cycle is the one thing both parents usually still care about deeply: raising healthy, capable children with character. One of the most reliable ways I’ve found to help couples ge

Scroll social media for a few minutes and you will be told that change is simple. Just “manifest,” follow a short morning routine, or apply some influencer’s five-step formula. If those effortless approaches actually produced lasting results, I would have packaged them long ago, charged premium rates, and moved on. As a psychotherapist who has worked with thousands of individuals and couples, I can state the reality that most online advice avoids: lasting change is hard. It r

In over four decades as a licensed professional counselor, public health researcher, and brain health specialist, I’ve witnessed the real value — and the very real limits — of psychiatric medications. For people in acute crisis, they can blunt unbearable symptoms, stabilize dangerous situations, and literally save lives. That role must be respected. But medication is not healing. A pill does not rewire neural pathways, restore autonomic regulation, rebuild purpose, or undo th