Therapy terms, in plain language.

A behavioral therapy that focuses on accepting difficult thoughts and feelings rather than fighting them, while moving toward what matters most to you.

ACT is part of the third-wave behavioral therapies, alongside DBT and mindfulness-based approaches. The core move is psychological flexibility — noticing what shows up internally without being run by it, then choosing actions aligned with your values. ACT works well for anxiety, depression, chronic pain, and the broader experience of feeling stuck in repeated patterns.

Source: Association for Contextual Behavioral Science · Related on this site: Anxiety therapy

The conscious or unconscious work of hiding ADHD symptoms — often through over-preparation, perfectionism, or social mimicry — usually to avoid judgment or rejection.

Masking is exhausting because it runs constantly in the background. Many adults, especially women and people of color, get diagnosed with ADHD late in life specifically because their masking was effective enough to fool teachers, employers, and even their own clinicians. The cost shows up as burnout, identity confusion, and the feeling of working twice as hard for the same results.

Related on this site: Adult ADHD: what late diagnosis actually looks like

Therapy that explicitly supports a client's identity — sexual orientation, gender, neurodivergence, faith, cultural background — rather than treating it as the problem to fix.

Affirming care is a stance, not a single technique. The clinician brings actual training and ongoing learning around the identity in question, not just openness. The opposite — non-affirming care — can include conversion therapy, pathologizing identity, or quietly steering a client toward a different identity than their own. In California, conversion therapy on minors is illegal under SB 1172.

Related on this site: LGBTQ+ affirmative therapy

An attachment style characterized by a strong drive for closeness paired with chronic worry about whether the connection is secure.

Anxious attachment usually develops in childhood when a caregiver was inconsistently available — sometimes warmly responsive, sometimes not, in ways that didn't track to the child's behavior. The adult version often shows up as protest behavior in relationships: pushing for closeness, scanning for signs of distance, escalating during conflict to force resolution. It's a pattern, not a personality, and it's modifiable.

Related on this site: Couples therapy

A repeating couples pattern where one partner pursues closeness while the other withdraws, with each move triggering more of the other.

The cycle isn't anyone's fault — it's a system that catches both people. The anxious partner reads the avoidant partner's pull-back as abandonment and pursues harder. The avoidant partner reads the pursuit as overwhelming and pulls back further. Couples therapy that names the cycle directly, and works with both halves at once, is what unhooks it.

Related on this site: Couples therapy

Patterns of how people connect, seek closeness, and respond to distress in relationships, originally identified in research by John Bowlby and Mary Ainsworth.

The four commonly named styles in adult attachment research are secure, anxious, avoidant, and disorganized (sometimes called fearful-avoidant). Styles aren't fixed traits — they shift with context, partner, and intentional work. Understanding your own and your partner's style is often the first move that makes couples therapy productive instead of just venting.

Source: The Attachment Project — research overview

An attachment style characterized by self-reliance, discomfort with emotional dependence, and a tendency to pull back when intimacy intensifies.

Avoidant attachment usually develops when a child's bids for closeness were consistently met with distance, criticism, or impatience. The adult version often shows up as needing space during conflict, deactivating emotionally when the relationship gets serious, or feeling crowded by a partner's needs. The work isn't to become anxiously attached — it's to develop secure enough capacity to stay present with closeness when it shows up.

Related on this site: Navigating relationships with avoidant partners

A focus and self-regulation strategy where being in the presence of another person — in person, on video, or in parallel via audio — makes it easier to start, stay with, or complete a task.

Body doubling is widely used in ADHD communities to externalize accountability and work around executive function bottlenecks. The mechanism isn't pressure or judgment; it's nervous-system coregulation and a low-stakes social anchor that helps attention land. Apps like Focusmate, study-with-me streams, and ADHD coaching groups formalize what neurodivergent people have long done in libraries and coffee shops.

Related on this site: ADHD therapy

A specific syndrome of emotional exhaustion, cynicism, and reduced sense of effectiveness — usually arising from chronic workplace stress, but increasingly recognized in caregiving and parenting.

Burnout was first described by psychologist Christina Maslach and was added to the WHO's ICD-11 as an occupational phenomenon in 2019. It isn't depression, though it overlaps. The hallmark is the depletion-cynicism-ineffectiveness triad, and recovery typically requires actual structural changes (workload, control, meaning) rather than just rest.

Source: WHO — burnout classification · Related on this site: Mental health at work

A short-term, structured therapy that identifies the thought patterns driving distress and works to change them, alongside behavioral experiments that test those patterns against reality.

CBT is one of the most-researched psychotherapies, with strong evidence for anxiety, depression, OCD, PTSD, and a range of other conditions. The core move is examining automatic thoughts that fuel emotional reactions — not replacing them with positive thinking, but with more accurate thinking. It's often time-limited (8–20 sessions) and goal-directed.

Source: American Psychological Association — CBT for PTSD · Related on this site: CBT and sex therapy

The ability to tell a clear, integrated story about your own life — including difficult or traumatic parts — that holds together rather than fragmenting under examination.

The concept comes from Daniel Siegel's work on attachment and adult development. Research using the Adult Attachment Interview shows that the strongest predictor of secure attachment in your own children isn't whether you had a happy childhood, but whether you can tell a coherent story about whatever childhood you had. Trauma therapy is partly the work of building that coherence — turning fragments and gaps into a narrative that can be held without overwhelming the person telling it.

A trauma response stemming from prolonged, repeated trauma — often relational and starting in childhood — characterized by emotion regulation difficulty, negative self-concept, and difficulty in close relationships, on top of standard PTSD symptoms.

C-PTSD was added to the WHO's ICD-11 in 2019 as a distinct diagnosis from PTSD. It tends to require longer treatment than acute PTSD because the trauma shaped early development rather than disrupting an already-formed self. EMDR, IFS, and somatic therapies are common evidence-based approaches; the work usually unfolds in phases (stabilization, processing, integration) rather than linearly.

Related on this site: Trauma therapy

A pattern where sexual thoughts or behaviors feel out of control, cause significant distress, and persist despite negative consequences. Recognized in the WHO's ICD-11 as Compulsive Sexual Behavior Disorder; not formally listed in the DSM-5.

The clinical literature has largely moved away from the term 'sex addiction,' which AASECT does not endorse, because the addiction model imports assumptions that don't match what the research shows. Compulsive sexual behavior is a real clinical presentation, and treating it well requires distinguishing it from religious or cultural shame about sex, from non-monogamy or kink that's working for the person, and from a partner's distress about sexual behavior the client doesn't actually want to change.

Related on this site: Sex therapy

The nervous-system process where one person's calm or activation influences another's — the way two regulated nervous systems can settle a dysregulated third, or escalate each other when both are activated.

Coregulation is foundational in attachment, parenting, and couples work. Babies coregulate with caregivers; couples coregulate during conflict or fail to; therapists coregulate with clients in session. Polyvagal theory frames it as the way our autonomic nervous systems read other nervous systems and respond. It's why a calm partner sometimes makes a stressed partner more stressed — coregulation only works when both nervous systems perceive safety.

Therapy with both partners present, focused on the relationship as the client rather than either individual.

Modern evidence-based couples therapies include the Gottman Method, EFT (Emotionally Focused Therapy), and Discernment Counseling for stay-or-go conversations. Couples therapy isn't a referee match or 50/50 negotiation — it's structured work on the patterns that keep showing up between two people. The therapist's job is to make the dynamic visible enough that both partners can choose differently.

Related on this site: Couples therapy

A skills-based therapy combining cognitive-behavioral techniques with mindfulness, originally developed by Marsha Linehan for borderline personality disorder and now used broadly for emotion regulation and self-harm.

DBT teaches four skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. It's often delivered in a structured format with individual therapy plus skills group, and has strong research support for chronic suicidality, self-harm, eating disorders, and emotion dysregulation. The dialectic is the central insight: accepting yourself as you are AND working to change.

Source: Behavioral Tech — DBT overview

A short-term, structured approach (typically 1–5 sessions) for couples where one partner is leaning out and the other wants to stay — designed to help both partners reach clarity before committing to a direction.

Discernment counseling was developed by Bill Doherty at the University of Minnesota. The goal isn't to save the marriage; the goal is clarity. Couples leave with one of three outcomes: continue as-is, divorce, or commit to six months of intensive couples therapy. It's the right tool when traditional couples therapy isn't working because one partner has already half-left.

Related on this site: Discernment counseling

A model of sexual response, popularized by Emily Nagoski, that frames desire as the balance between sexual accelerators (what turns you on) and sexual brakes (what turns you off) — both of which are individually unique and contextually variable.

The dual control model replaces the older linear arousal-desire-orgasm model with something more accurate: most people don't have constant accelerators or brakes; they respond to context. Sex therapy using this frame focuses less on increasing accelerators and more on identifying and reducing brakes — stress, distraction, body image, relationship friction, unprocessed history.

Source: Emily Nagoski — Come As You Are · Related on this site: Sex therapy

A research-supported phenomenon where adults who had insecure childhood attachment develop secure attachment patterns later in life through corrective relational experiences and intentional inner work.

Earned secure attachment is hopeful evidence that attachment isn't destiny. It typically develops through some combination of long-term therapy, a securely-attached partner or close friend, or significant insight work that lets someone tell a coherent narrative of their own history. The defining feature isn't a perfect childhood — it's the capacity to make sense of an imperfect one.

An attachment-based couples therapy developed by Sue Johnson, focused on identifying the negative emotional cycle in a relationship and helping partners create new, secure patterns of connection.

EFT has some of the strongest outcome research in couples therapy, with around 70–75% of couples moving from distress to recovery in randomized trials. The work moves through three stages: de-escalating the cycle, restructuring interactions to allow vulnerability and responsiveness, and consolidating new patterns. It works particularly well for couples stuck in the anxious-avoidant cycle.

Source: International Centre for Excellence in EFT · Related on this site: EFT (Emotionally Focused Therapy)

An evidence-based trauma therapy that uses bilateral stimulation — typically guided eye movements, taps, or sounds — to help the brain reprocess traumatic memories so they're integrated rather than stuck.

EMDR was developed by Francine Shapiro in 1987 and is now considered a first-line treatment for PTSD by the WHO, APA, and Department of Veterans Affairs. Sessions move through eight phases, with the reprocessing phase being the work most people associate with EMDR. It often works in fewer sessions than traditional talk therapy for trauma, particularly for single-event traumas, though complex trauma typically needs longer.

Source: EMDR International Association · Related on this site: EMDR therapy

An umbrella term for relationship structures where all partners knowingly and willingly engage in romantic, sexual, or emotional connections with more than one person.

ENM includes polyamory, open relationships, swinging, and relationship anarchy, among other configurations. The defining feature is consent and transparency — distinguishing ENM from cheating. Research from Amy Moors, Terri Conley, and others suggests ENM relationships show comparable satisfaction, attachment, and functioning to monogamous relationships. ENM-affirming therapy means a clinician treats the structure of your relationship as neutral and works the patterns inside it.

Related on this site: LGBTQ+ affirmative therapy

A trauma response — the fourth one, alongside fight, flight, and freeze — characterized by appeasing or merging with a perceived threat as a way to stay safe.

Fawning was named by Pete Walker in his work on complex PTSD. It looks like agreeableness, peacekeeping, or accommodation, but the root is threat detection rather than kindness. Fawning often develops in childhoods where conflict, anger, or unhappiness in a caregiver was dangerous to be around. Recognizing fawning is usually the first step toward recovering access to your own preferences.

Related on this site: Fawning isn't kindness

A specific manipulation tactic where one person systematically undermines another's perception of reality — denying events, dismissing emotions, or rewriting history — until the target doubts their own judgment.

The term comes from the 1944 film Gaslight. Gaslighting is a pattern, not a single statement, and it's a hallmark of psychologically abusive relationships. It's worth noting that the word is now used loosely in pop culture for any disagreement; clinically, it specifically requires the systematic, intentional erosion of someone's ability to trust their own perception.

A research-based couples therapy developed by John and Julie Gottman, drawing on four decades of observational research on what differentiates happy couples from unhappy ones.

The Gottman Method gives couples tools for managing conflict, building friendship, and creating shared meaning. Core concepts include the Four Horsemen (criticism, contempt, defensiveness, stonewalling), bids for connection, and the Sound Relationship House. It's strongest as a structured, skills-based approach for couples who want concrete tools alongside the emotional work.

Source: Gottman Institute — research overview · Related on this site: Gottman Method

An informal term for chronic anxiety that hides behind achievement, productivity, and the appearance of having it all together — often missed by clinicians because the person looks fine on paper.

High-functioning anxiety isn't a formal DSM diagnosis. It usually overlaps with generalized anxiety disorder, perfectionism, or trauma-driven over-functioning. The hallmark is a high external success rate paired with internal exhaustion, sleep problems, irritability, and persistent rumination — often paired with the feeling that slowing down is dangerous.

Related on this site: What is high-functioning anxiety?

A therapy developed by Richard Schwartz that frames the mind as containing distinct parts — protectors, exiles, managers, firefighters — alongside a core Self that has the capacity to lead all of them.

IFS is a non-pathologizing model: every part has a positive intent, even the parts that look destructive. The work is to build relationship between the Self and each part rather than getting rid of any of them. IFS is increasingly used alongside EMDR and somatic work for complex trauma, and it's gentler than many trauma approaches because the protective parts get attended to first.

Source: IFS Institute · Related on this site: Trauma therapy

A clinical stance that treats kink, BDSM, and fetish interests as healthy, consensual variations of human sexuality rather than pathology — and brings actual training to working with kink-identified clients.

Kink-affirming therapy is distinct from kink-tolerant therapy. Tolerant means a clinician won't moralize about it; affirming means they understand the structures (negotiation, aftercare, scene dynamics, power exchange in long-term relationships) well enough to work with them clinically when they show up. The Kink Clinical Practice Guidelines from the Alternative Sexualities Health Research Alliance is the closest thing to a formal standard.

Related on this site: Sex therapy

The practice of paying attention to the present moment, on purpose, without judgment — a foundational skill in many modern therapies and a stand-alone clinical intervention with strong evidence for anxiety, depression, and chronic pain.

Modern mindfulness in clinical settings traces back to Jon Kabat-Zinn's MBSR (Mindfulness-Based Stress Reduction) protocol developed in 1979. It's not relaxation, religion, or emptying the mind — it's attentional training. Most therapeutic uses involve short daily practice (5–20 minutes) and structured exercises during sessions.

Related on this site: Mindfulness techniques and sex therapy

A Gottman concept describing the state in a distressed relationship where neutral or even positive partner behavior gets perceived as negative — a global negative filter that takes hold once conflict has gone on long enough.

The opposite is positive sentiment override, where partners give each other the benefit of the doubt by default. Negative sentiment override is one of the strongest predictors that a couple is heading toward separation in the Gottmans' research, because it changes how every interaction lands — even genuine repair attempts get read as manipulation or insincerity. Couples therapy in this state isn't just about communication skills; it's about rebuilding enough goodwill that repair attempts can be received again.

Source: Gottman Institute — research overview · Related on this site: Gottman Method

In Internal Family Systems, a part is a distinct inner sub-personality with its own perspective, feelings, memories, and motivations — every person has many parts, and each one carries positive intent, even the parts that look destructive.

IFS sorts parts into three broad roles: managers (who try to keep daily life running and prevent harm), firefighters (who jump in when difficult feelings break through, often with intense or impulsive responses), and exiles (the vulnerable, often younger parts that hold pain and have been locked away for protection). The work of IFS isn't to eliminate any part — it's to help each one unburden the extreme role it's been carrying so the Self can lead.

Source: IFS Institute · Related on this site: Trauma therapy

A form of ethical non-monogamy involving multiple loving relationships, with the knowledge and consent of everyone involved.

Polyamory differs from open relationships (which are usually a couple structure with outside sexual partners) in centering emotional and romantic connection across multiple partners, not just sexual access. Configurations vary widely — hierarchical (primary plus secondaries), non-hierarchical, kitchen-table, parallel — and the structure that works for any given polycule depends on the people in it. Research from Amy Moors and others shows comparable relationship satisfaction and attachment health in polyamorous and monogamous relationships when consent and communication are present.

Related on this site: LGBTQ+ affirmative therapy

A polyamorous community term for the state of having reached your emotional, time, or logistical capacity for romantic partners — not closed to non-monogamy, but not currently looking to add new connections.

Polysaturation is the polyamorous answer to 'are you open?' — yes, the structure is open; no, the bandwidth is not. Naming the limit honestly tends to protect existing relationships from overextension and prospective new connections from being underserved. The term is community-coined rather than clinical, but it shows up often in ENM-affirming therapy because saturation patterns track closely with relationship distress and time-management strain.

Related on this site: LGBTQ+ affirmative therapy

A framework developed by Stephen Porges describing how the autonomic nervous system organizes social engagement, fight-or-flight, and shutdown responses through different branches of the vagus nerve.

Polyvagal theory is influential in trauma therapy because it gives clinicians and clients a shared language for nervous system states — ventral vagal (safe and social), sympathetic (fight or flight), and dorsal vagal (freeze/shutdown). Some details of the theory are debated in neuroscience, but the clinical applications — particularly around co-regulation and safety — have been widely adopted.

Any action either partner takes during conflict to de-escalate, soften, or reset the interaction — a joke, an apology, a touch, naming what's happening, asking to start over.

Repair attempts are one of the strongest research-backed predictors of long-term relationship success. The Gottmans' research found that the difference between Masters and Disasters of relationships isn't whether they fight or how often they fight — it's whether their repair attempts land. Building a couple's capacity to make and receive repair attempts is one of the most useful pieces of work in couples therapy.

Source: Gottman Institute — research overview · Related on this site: Couples therapy

An intense, often physically painful emotional response to perceived rejection, criticism, or failure — most commonly described in adults with ADHD, though not formally part of the DSM.

RSD was clinically described by William Dodson and is now widely recognized in the ADHD community. The internal experience is often disproportionate to the external trigger — minutes of anguish over a slightly delayed text reply. It tends to drive both perfectionism (avoid the pain by never failing) and avoidance (avoid the situations that might trigger it). Treatment typically combines ADHD-affirming therapy, sometimes medication, and skills for catching and naming the cascade as it begins.

Related on this site: Rejection sensitivity in ADHD relationships

An IFS term for the state of being grounded in your core Self — calm, curious, compassionate, courageous — rather than blended with a part that's running the show.

Richard Schwartz identified eight qualities of Self that emerge when no part is dominant: calmness, curiosity, compassion, confidence, courage, clarity, creativity, and connectedness (the '8 Cs'). Being Self-led doesn't mean parts go away — it means they trust the Self to take the lead. Therapy in the IFS model is largely the work of helping parts step back enough that Self-leadership becomes possible, then letting Self lead the unburdening of the parts that have been carrying the most.

Source: IFS Institute · Related on this site: Trauma therapy

A foundational sex therapy technique developed by Masters and Johnson in the 1960s — a structured series of touch exercises that progressively rebuild physical and emotional intimacy by deliberately removing performance pressure.

Sensate focus typically begins with non-sexual touch, attention to sensation rather than outcome, and a clear agreement about what's on and off the table at each stage. The exercises are done at home, never in session. It remains one of the most evidence-based interventions in sex therapy, particularly for couples dealing with desire discrepancy, performance anxiety, or post-trauma reintegration.

Related on this site: Sex therapy

A body-based trauma therapy developed by Pat Ogden that integrates cognitive, emotional, and somatic processing — particularly attentive to how trauma is stored in posture, movement, and habitual body patterns.

Sensorimotor Psychotherapy is built on attachment theory, neuroscience, and trauma research. It's structured in three phases: stabilization (resourcing the nervous system), processing (working with traumatic memory through the body), and integration. It overlaps with somatic experiencing in working bottom-up rather than top-down, with particular attention to the way movement and posture carry trauma history.

Related on this site: Trauma therapy

A specialized form of psychotherapy that addresses sexual concerns — desire, pleasure, pain, performance, disconnect — with a clinician specifically trained to treat sex as a normal, healthy part of human experience.

Sex therapy is talk therapy, not anything physical with the therapist. Common concerns include low or mismatched desire, erectile or arousal difficulty, painful intercourse, performance anxiety, sexual trauma recovery, and questions of identity, kink, or non-monogamy. The most rigorous certification is through AASECT, though many excellent sex therapists work without it. California allows any licensed therapist to do sex therapy; the differentiator is specialty training, not licensure.

Related on this site: Sex therapy

A reduced therapy fee offered to clients who can't afford a clinician's standard rate — set either by income, by hardship, or by negotiation at the consult.

Sliding-scale spots in California vary by therapist; some advertise them, many don't. The cleanest way to ask is at the free consult: name that the standard rate isn't in your budget and ask whether sliding scale is possible. Worst case, the therapist refers you to someone whose rates fit; best case, they make it work. Open Path Collective is a network specifically built around sliding-scale rates of $30–$80 per session.

Related on this site: How much does therapy cost in California?

A form of polyamory where the practitioner doesn't seek or maintain a primary or hierarchical partnership — by intention rather than circumstance.

Solo polyamory is distinct from being single between relationships. The person is in ongoing, often multiple, romantic and sexual relationships, but doesn't share a household, finances, or hierarchical priority with any one partner. The structure is sometimes a relief from earlier merger-based relationships and sometimes about preserving autonomy as a long-term value. The work in therapy often centers on processing cultural pressure toward escalation (move-in, marry, merge) and being clear about preferences rather than apologizing for them.

A body-based trauma therapy developed by Peter Levine that works with the felt sense — internal body sensation — to discharge trapped traumatic activation from the nervous system.

Somatic Experiencing is one of the foundational somatic trauma therapies and influenced both sensorimotor psychotherapy and modern trauma-informed care broadly. Levine's central insight came from observing wild animals: prey animals who survive a near-death encounter shake, breathe, and discharge — and don't develop chronic trauma. Humans, with cortical capacity to override that discharge, often carry the activation. SE works to allow the discharge to complete, gradually and titrated, so the nervous system can settle.

Source: Somatic Experiencing International · Related on this site: Trauma therapy

One of the Gottmans' Four Horsemen — a conflict response where one partner shuts down, withdraws, or stops engaging entirely, often as a way of self-protecting against feeling overwhelmed.

Stonewalling isn't always intentional unkindness. The body usually goes into physiological flooding before the shutdown — heart rate over 100, cortisol spike, cognitive narrowing — and the withdrawal is the nervous system's attempt to recover. The Gottman repair for stonewalling is a structured 20-minute break with explicit return time, used proactively before flooding becomes total.

Related on this site: Gottman Method

The delivery of clinical services via secure video, phone, or messaging — for therapy, the dominant mode in California since 2020 and now the default for most private-practice clinicians.

California law allows licensed therapists to see any client physically located in California, regardless of where the therapist is. Outcome research consistently shows telehealth psychotherapy is comparable in effectiveness to in-person work for most concerns. The right platform is HIPAA-compliant with a signed BAA — Zoom for Healthcare, SimplePractice, Doxy.me, and Google Meet (under Google Workspace BAA) are common.

Related on this site: Online therapy

A clinical stance that recognizes how widespread trauma is, builds safety into the therapy environment, and avoids practices that can re-traumatize clients — without requiring trauma to be the focus of the work.

Trauma-informed care is broader than trauma therapy itself. It shapes how a clinician asks questions, paces sessions, holds power dynamics, and responds to dysregulation. SAMHSA's framework names six principles: safety, trustworthiness, peer support, collaboration, empowerment, and cultural awareness. Trauma-informed isn't the same as trauma-trained — the first is a stance, the second is specific clinical training.

Source: SAMHSA — concept of trauma and trauma-informed approach

Stimuli — sights, sounds, smells, conversations, situations — that activate a trauma response by reminding the nervous system of past unresolved experience.

The word has been diluted in pop culture to mean any uncomfortable reminder. Clinically, a trigger produces a disproportionate physiological response — racing heart, dissociation, flashback, panic — because the nervous system reads the present as the past. Treating triggers means processing the underlying memory (often through EMDR, IFS, or somatic work) rather than avoiding the trigger forever.

A concept developed by Dan Siegel describing the zone of nervous system arousal where you can think, feel, and connect at the same time — outside that window, you're either hyperaroused (panic, rage, flooding) or hypoaroused (numb, dissociated, shut down).

Trauma narrows the window. Healing is partly about widening it — increasing the range of stress your nervous system can hold while staying connected to yourself and others. Most modern trauma therapies (EMDR, IFS, somatic experiencing, sensorimotor) explicitly work with the window, pacing the work to keep clients in it as much as possible.

Related on this site: Trauma therapy