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What to Do When Someone Gives You the Silent Treatment

26 August 2026 at 22:33
—Photo-Illustration by TIME (Source Image: Hans Neleman—Getty Images)

There’s a healthy way to take a break during conflict. Asking for space—and specifying when the conversation will resume—can protect a relationship by giving both people time to calm down. 

The silent treatment does the opposite. Withdrawing without explanation or a plan to reconnect just creates a new conflict, leaving the person on the receiving end scrambling to figure out what went wrong.

Yet not everyone who goes quiet is trying to inflict pain. Some people shut down because they’re overwhelmed and genuinely incapable of having a productive conversation. We asked experts how to figure out what’s behind the silent treatment—and what to do when someone stops speaking to you.

First, figure out what kind of silence you’re dealing with

A healthy cooling-off period and the silent treatment can look identical from the outside, says Rachel Needle, a psychologist in West Palm Beach, Fla. Both involve someone stepping away from a conversation. What changes the meaning of that silence is whether the person explains what's happening and offers some reassurance that the conversation isn't over. Most of all, it's whether they say when they'll be back.

Someone who’s emotionally flooded might say: “I need a little time to calm down before we keep talking. Can we pick this up tonight?” Doing so gives the silence a purpose and an endpoint, Needle says. If the person needs more time when the agreed-upon hour rolls around, they can say so and suggest another time. 

That communication sends an important message, says Enid Wilson, a licensed marriage and family therapist in Sacramento: “I’m still in this relationship. I’m just taking a pause on this conversation because I need to take care of myself.” Walking away or refusing to respond leaves the other person wondering whether the conversation—or even the relationship—is over. The best version also comes with a timeframe.

People withdraw for all kinds of reasons. They might be afraid they’ll say something they regret or have learned to protect themselves by shutting down. Some people simply haven’t learned how to sit with difficult emotions or repair a disagreement, Needle says, so “silence really becomes a way to escape the discomfort, rather than having to deal with it and move through it.”

In other cases, silence is leverage. It creates uncertainty and pressures the recipient to apologize or back down. Sometimes that strategy is conscious, Needle says, and sometimes it isn't. Whatever's motivating the withdrawal, the impact on the other person can be similar. "It creates anxiety, rejection, uncertainty, and a sense of being shut out," she says.

Because it’s impossible to climb inside someone else’s head, focus on what can be observed. Did they say they needed space? Did they give some indication of when they’d return? Did they follow through—or at least check in to ask for more time? Then ask whether this is a rare rupture, or the way every disagreement ends.

Context matters, too. There's no universal number of hours that transforms a delayed response into the silent treatment. If two friends usually exchange a couple emails a month, a week of quiet probably doesn't mean much. If a partner who texts throughout the day suddenly disappears in the middle of a tense conversation, it might. Texting also strips out tone of voice and facial expression, the signals that make intent easier to interpret. "You just miss so many cues when you're not talking either on the phone or in person," Wilson says. That's why she encourages moving difficult conversations out of the text thread.

Send one clear message—and then stop chasing

When someone abruptly goes quiet, the goal is to respond without escalating the conflict while staying grounded in your own needs, Needle says. Start by calmly naming what you've observed: "I noticed that you've gone quiet. I want to understand what's going on, but I also don't want to push you if you need some space."

If the silence is unfolding over text, Wilson suggests a question instead of an accusation: "It seems like now isn't a good time to talk. Can we set a time for later tonight or sometime this week?" That gives the person room to respond while making it clear that disappearing indefinitely doesn't work for you.

Then resist the urge to send six more messages. "One of the biggest mistakes that people make is reacting to the anxiety that the silence is creating, instead of responding to the situation itself," Needle says. That anxiety might inspire repeated calls and demands to talk right now. It might inspire apologies for things you don't believe you did. Some people abandon their own needs simply to get the other person talking again; others retaliate with silence of their own.

Those reactions are understandable, but none are especially useful. Chasing might briefly relieve your distress if the person responds. But “in some cases, it can actually unintentionally reinforce an unhealthy dynamic by teaching both people that silence is what finally gets a response,” Needle says. Returning the silent treatment, meanwhile, only complicates a problem already caused by a lack of communication.

These dynamics can easily become a pursue-withdraw cycle, Wilson says. One person experiences conflict as an urgent threat to the relationship and needs to resolve it immediately. The other copes by detaching or shutting down. The more the first person calls and texts, the more conflict the withdrawer perceives—and the farther away they retreat. "If that person is conflict-avoidant, you're creating more conflict," Wilson says. "So they're going to avoid it."

The way out is to step out of the cycle, at least temporarily. That means tolerating the discomfort of not getting an immediate response, and directing all that nervous energy somewhere else. "The best and healthiest response is usually just the least reactive one," Needle says. After expressing your willingness to talk and asking when the person can reconnect, shift your attention toward what you can control. "Go for a walk, call a friend that you trust, journal, engage in another grounding activity," she suggests, rather than staring at your phone and rehearsing apologies. Doing so helps ensure the other person's silence doesn't determine when you're allowed to feel OK again.

When things are calm, make a plan for next time

When communication resumes, you might be so relieved that you simply pretend nothing happened. But unless the pattern itself is addressed, the next disagreement might end the same way.

Needle suggests leading with curiosity: “Can you help me understand what was happening for you when you needed to step away?” Once you’ve listened, describe the impact without claiming to know the person’s intent: “When I didn’t hear from you and didn’t know whether we would talk again, I felt anxious and disconnected. I’m OK with taking space during conflict, but I need to know we’ll come back to it.”

Then decide together what a future timeout will look like. Avigail Lev, a clinical psychologist in San Francisco, encourages couples to agree in advance on how either person will signal that they need a break, roughly how long it will last, what they’ll do to calm down, and who will restart the conversation. If the person needs longer, they should still check in at the agreed-upon time and provide a new endpoint. Some couples and families even choose a code word that means the conversation is pausing, Wilson says—not that the relationship is disappearing.

It's also a good idea to set a boundary. Wilson likes to think of boundaries not as walls that block people out, but as roads that show them how to stay connected: "You can be here with me, but you can't just go off-roading everywhere." A boundary does more than ask the other person to stop going silent. It clarifies what communication you require in a relationship, and what you'll do if that need repeatedly goes unmet.

One episode of withdrawal isn’t enough to judge an entire relationship, Needle says. What matters is the pattern: Does the behavior change after it’s addressed? Are both people willing to repair the rupture? Or does restoring contact always require one person to get quieter and stop raising concerns? 

If the silence continues despite repeated conversations—or leaves you feeling controlled and perpetually on edge—it might be time to seek professional help or reconsider the relationship. Healthy relationships make room for people to calm down, Needle says. They don’t leave one person indefinitely responsible for managing all the uncertainty that someone else’s silence creates.

What the Lindsay Clancy trial reveals about a broken postpartum mental health system

Lindsay Clancy's murder trial hasn't just dominated headlines for its tragic story and true crime fascination. For many, it has prompted a groundswell of recognition and outrage around the barriers women face when seeking care, the lack of research on postpartum mental health conditions and little education for providers.

Taylor Swift Revealed Her Coping Mantra. Here’s How to Find Yours

26 August 2026 at 20:36
—Matt Winkelmeyer—Getty Images

Taylor Swift already told us she can do it with a broken heart. That might be due to grit, stamina—or a little psychological trick called a coping mantra.

When she feels stressed by her circumstances, “I go through several processes and coping mechanisms,” Swift revealed in August during the Icon Sessions, a conversation presented by the Recording Academy’s Songwriters & Composers Wing. “And one of them is saying, ‘You chose this. You chose this every day. You could have opted out of this any day before it got unmanageably big.’ And I decided not to because I love it that much.”

Even if you don’t have plans to perform in stadiums worldwide, you might recognize the peculiar frustration of being trapped by something you chose—whether that’s the job you once desperately wanted, the committee you volunteered to lead, or the dinner party you insisted on hosting. “Where people tend to get really distressed is when they feel powerless, or like something's being put upon you—you're just sort of stuck in an achy feeling,” says Jill Stoddard, a clinical psychologist in Newburyport, Mass. “But if you remind yourself, ‘Wait a minute, this is actually a choice I made, and choices do come with difficult consequences, but I'm in charge here’—that empowers you to move forward.”

Enter the coping mantra: a short, deliberate phrase you can reach for when your brain starts sprinting toward the worst-case scenario. Stress leaves little room for nuance, says Dr. Jasmine Sawhne, a psychiatrist in Los Angeles. When your body is in fight-or-flight mode, you’re not going to reason your way out of it. A mantra gives your overloaded brain something simple to grab onto—and buys you a beat to choose what to do next. Here’s how to find one that actually helps.

Make your brain an offer it can believe

“Everything will be OK” is a lovely thought. It’s also a promise about a future you can’t see—which means your anxious brain might reject it before you finish the sentence.

From a cognitive behavioral therapy perspective, predicting that everything will work out is a form of fortune-telling, says Alison McKleroy, a San Francisco therapist and author of The Self-Compassion Journal. The same goes for affirmations like “I am confident.” If you feel unsure, your brain isn’t going to buy it. You can say it 1,000 times, McKleroy says, and still not believe a word of it.

Instead of predicting a rosy outcome or forcing a new personality, a useful mantra can state a choice that’s within your control. Swift’s is essentially: I’m choosing to keep doing this, difficult parts and all. “It’s a decision you’re making out loud,” McKleroy says.

Stoddard takes a slightly different—but equally reality-based—approach. When she’s crushed by too much to do and too little time, she tells herself, “I’ll get it done. I always do.” It works because in her case, it’s true. “I wouldn’t have a PhD in psychology if I didn’t always get it done,” she says.

If you’re someone who does not, in fact, always get it done, that phrase may not be for you. This isn’t an exercise in “blowing sunshine” at yourself, Stoddard says. The best mantra is simple, specific, memorable—and true.

Figure out what your brain forgets under pressure

Rather than reflecting on which situations stress you out, try a sharper question: “What do I need to remind myself when I get uncomfortable?” suggests Joanna Hardis, a Cleveland-based therapist and author of Just Do Nothing: A Paradoxical Guide to Getting Out of Your Way.

In other words, don’t choose a generic mantra for “stress.” Identify your brain’s favorite way of making stress worse, then find a phrase that interrupts it. If you tend to predict disaster, McKleroy suggests: “I can’t know that yet” or “I don’t have a crystal ball.”

Sawhne’s stress takes a different form: She tries to solve everything at once. She runs a bicoastal psychiatry practice and has two children under 5, and she often catches herself mentally juggling five problems at the same time. Her mantra—“I don’t have to solve everything right now”—reminds her that urgency and importance aren’t the same thing. She doesn’t need the entire day, week, or situation figured out; she needs to identify what requires her attention first.

McKleroy, meanwhile, likes to over-research, add more information, and complicate projects past the point of usefulness. So she tells herself: “Let it be simple.”

“Things are usually naturally simple,” she says. “I just add stuff to it.”

Keep it short enough to say in one breath

Cap a coping mantra at about four words. When stress hits, “we just don’t have a lot of cognitive bandwidth,” Sawhne says, so you need a few words you can pull “out of your back pocket” as soon as your nervous system fires.

Shorter also means fewer words to obsess over. “Perfectionists are going to overthink it,” Hardis says. “You just want something that’s short enough that you can remember that’s going to orient you.” Her own mantra—“Discomfort, not danger”—passes the one-breath test with room to spare.

Use it to keep going while the feeling is still there

Nearly two decades ago, Hardis underwent exposure therapy for an intense fear of flying. When the plane hit turbulence, she would tell herself: “This may suck, but I can handle it.”

She still uses that mantra. During rough turbulence on a recent flight home from visiting her daughter, “I found myself saying it,” she recalls. In the past, she would have stared out the window, listened for every ominous noise, and asked a flight attendant if the plane was OK. This time, she calmly repeated her mantra and kept reading. “It helped me get through the flight and do what I knew I needed to do,” she says.

The fear was still there; it simply didn’t dictate her next move. “The goal in anxiety treatment isn’t to make the feeling go away,” Hardis says. It’s to help you decide what to do while the feeling is still there.

Borrow one—and make it sound like you

There are no bonus points for originality here. Anna Elton, a licensed marriage and family therapist in Palm Beach, Fla., and author of The Formula of Desire, uses “just keep swimming.” She borrowed it from Finding Nemo, which she watched with her kids. “That’s why it’s easy to remember,” she says. She also turns to “If it were easy, everyone would do it” when a project proves harder than expected. Her most exuberant mantra is a call-and-response: “Who is awesome? I’m awesome.” “I do it all the time,” she says. 

Once you settle on a potential mantra, say it out loud. Does it sound like something you’d actually tell yourself—or something embroidered on a throw pillow you’d try to hide? McKleroy recommends trying slightly different versions until one lands. “Brave” and “courageous” might look interchangeable on paper, for example, but one could feel much more natural coming out of your mouth.

You’ll know you’re getting close when the words produce even a small shift. The right phrase might bring “a little hit of relief,” McKleroy says, or make a spiral lose some of its momentum. If your brain instantly rejects it, change a word or scale it down. “Let it be simple,” for example, might become “Let it be simpler.”

Once you find one that works, practice it before you need it. Stoddard encourages clients to try new coping tools during low-stakes moments, when their emotions are relatively mellow. Call your mantra to mind when you’re running five minutes late, opening a mildly stressful email, or sitting down to a task you’ve been avoiding. Otherwise, summoning an unfamiliar phrase in the middle of a crisis will be “an uphill battle,” she says.

Put it where the problem lives

Years ago, when McKleroy was trying to stop procrastinating, she hung “Do it now” in big letters above her kitchen sink. “That was my command,” she says. “Just do the dishes.” After enough repetition, “do it now” stopped being a mantra and became a habit, and now she rarely procrastinates.

These days, “Let it be simple” hangs above her desk—prime territory for over-researching and adding just one more thing. McKleroy calls this “keeping it in existence,” or displaying the reminder exactly where you’ll need it.

That might mean taping your mantra to your computer monitor, writing it on the bathroom mirror, turning it into your phone lock screen, or putting it on the front of your journal. “If you’re really anxious, your mind’s not going to remember—it’s going to go blank,” Hardis says. A visual cue ensures the words are waiting for you when you need them.

Your reminder doesn’t even have to be made of words: McKleroy suggests drawing a circle on a stone and carrying it in your pocket or leaving it on the bathroom counter. To her, the circle represents simplicity. “A circle on a rock would be enough,” she says, to remind her to “let it be simple.” You could similarly choose a meaningful color, shape, or object. And—since this entire exercise began with Swift—you could even spell yours out on a friendship bracelet. 

Meta reaches $17 billion settlement with states in landmark trial over teen social media addiction

Meta has agreed to pay $17 billion and add stronger child-safety measures to its Facebook and Instagram platforms to end a landmark trial over teen social media addiction and settle claims filed by 47 states, state attorneys general announced Wednesday.

What’s driving Sweden’s startup boom, from Lovable to Legora 

26 August 2026 at 19:00
Vibe-coding darling Lovable just raised $400 million at a $13.3 billion valuation, roughly doubling its worth in eight months. But Lovable isn’t the only Stockholm startup putting up huge numbers lately — legal AI company Legora and health tech startup Neko Health are right there with it.  On this episode of TechCrunch’s Equity podcast, Dominic-Madori Davis is joined by Sophia Bendz, a partner at Cherry Ventures and longtime fixture of Europe’s startup […]

Is Toilet Paper Bad For You? Here’s What Experts Say

26 August 2026 at 17:41
—Photo-Illustration by TIME (Source Image: Pakin Songmor—Getty Images)

Toilet paper has become a hot topic online. You don’t have to look hard to find videos of health-conscious influencers warning about supposedly harmful ingredients in toilet paper. But how concerned should you be?

Not very, most experts agree. But some also say that TP is worth examining more closely.

Concerning chemicals

Studies have found some concerning chemicals in toilet paper. A 2023 study looking for per- and polyfluoroalkyl substances (PFAS) in toilet paper found them in 21 brands from around the world. Also known as “forever chemicals,” PFAS exposure has been linked to reproductive issues in women, developmental delays in kids, an increased risk of some cancers, and more. A 2019 study in Ghana found “elevated levels” of phthalates, which are endocrine disruptors that may cause developmental and reproductive harm, in toilet paper. That research also found polycyclic aromatic hydrocarbons (PAHs), which are associated with cancer, and semi-volatile chlorinated organic compounds, which have also been connected to cancer and reproductive harm, in toilet paper.

Some research cautions against toilet paper made from recycled paper because it could be made with discarded newspapers or recycled cash-register receipts, which can contaminate the product with BPA, a substance linked to reproductive issues, cardiovascular disease, and more.

There have also been concerns over toilet paper that is bleached, as bleaching can create dioxins, and concerns over toilet paper that includes formaldehyde, a carcinogen.

The ingredients in toilet paper, which manufacturers aren’t required to disclose, are potentially concerning because the skin on the genitalia and anus is thinner and more absorbent than other skin on the body, says Dr. Julia Saylors, an oncologist and integrative medicine physician based in Charleston, South Carolina. 

While skin is known to absorb chemicals, including PFAS, genital and anal areas are made of mucosal surfaces, a type of thin, moist, and more sensitive skin that leads to the interior of the body. This skin is more absorbent than the surfaces on our arms and legs, says Saylors.

“It is well known that applying a medication to the vaginal mucosa results in a substantially higher absorption if the same medication is applied to the skin,” Saylors says. “Therefore, any potentially harmful chemical is best to avoid in that area.”

And while Saylors says that toilet paper probably isn’t a person’s highest exposure to toxins—food packaging, cleaning products, and textiles are more significant sources—she says that any changes we can make to reduce toxin exposure are potentially helpful. 

Toilet paper does not pose a major risk

How toilet paper interacts with people’s skin in these areas and their overall health is not well studied. But the research that has been done suggests that toilet paper does not pose significant health risks, experts agree.

Dr. Amar Rewari, chief of radiation oncology at Luminis Health in Maryland, notes that PFAS and some other industrial chemicals are under study for possible long-term health effects, “but the levels typically found in consumer products like toilet paper are very small and not clearly linked to cancer.”

“Many of these chemicals, including PFAS, phthalates, BPA, and trace dioxins, can be found in small amounts throughout modern life,” he adds. “The highest exposures usually come from what we eat, drink, or breathe over time, not from brief skin contact with toilet paper.”

While BPA may be found in recycled paper, “the levels of BPA detected are generally low, and the clinical significance of these findings remains uncertain,” he says.

Bleaching, likewise, is not a huge concern, and modern processes don’t pose a significant cancer risk, he says.

“The concerns people sometimes hear about chlorine-bleached paper products largely stem from older manufacturing methods that used elemental chlorine. Today, most toilet paper is produced using elemental chlorine-free (ECF) bleaching, which relies on chlorine dioxide instead of chlorine gas. This process dramatically reduces the formation of dioxins and other potentially harmful byproducts and is widely accepted as the standard in modern paper manufacturing,” Rewari says. “The amount of residual chemicals in finished products is extremely low.”

Dr. Alok A. Khorana, professor of medicine in the department of hematology and medical oncology at Case Western Reserve University, agrees that toilet paper probably isn’t a major cause of exposure to toxins. “Exposure to environmental toxins through toilet paper is likely much smaller than those we’re exposed to in food and water, which has a more direct route into our system,” he says. Still, he says exposure to toxins through toilet paper is "worth investigating further.”

“There are several potentially harmful substances present, such as PFAS, and it's worth understanding whether exposure to these is carcinogenic in any way,” Khorana explains. 

He adds that we don’t have many studies yet, likely because concerns over toilet paper are relatively new—plus, Khorana notes it may be difficult for researchers to find people in the U.S. who don’t use toilet paper to compare to those who do. “Studies become challenging to conduct when the candidate risk factor is as prevalent as toilet paper use,” he says.

“I don’t think people need to avoid conventional toilet paper altogether,” Rewari says. “Most people will use conventional toilet paper throughout their lives without any problems.”

Still, he advises patients to choose products with fewer unnecessary additives when possible. “Fragrances, lotions, and dyes don’t improve hygiene, and they may increase the risk of irritation in susceptible individuals. For most people, a simple, unscented, dye-free toilet paper is a reasonable choice.”

An unexpected issue with toilet tissue

Chemicals in toilet paper can present other issues, says Dr. Hannah Kopelman, a dermatologist based in New York City. She says the paper product comes up in her practice more often than one might expect.

“I’ve had patients come in with itching and irritation, which they thought was a yeast infection or eczema flare, only to discover that the culprit was their toilet paper,” Kopelman says. “Most people assume all toilet paper is the same, but the reality is that some formulations can cause problems.”

“When they switch to plain, unbleached, fragrance-free options, the irritation usually clears quickly,” she says.

Dr. Meagan W. Shepherd, an allergist and immunologist based in Barboursville, West Virginia, says people are often surprised to learn how commonly allergens are found in toilet paper, noting that both traditional paper and flushable wipes can cause irritation.

“Wet varieties such as flushable wipes often have preservatives like methylchloroisothiazolinone and methylisothiozolinone, which together account for about 10% of contact allergen sensitizations in North America,” says Shepherd. Dry varieties, on the other hand, are more likely to include added fragrances or dyes, which can act as irritants or allergic triggers, she says.

“I frequently see patients with severe vulvar rashes caused by hidden chemicals,” she adds.

Shepherd also says that if people are struggling to find toilet paper they can tolerate, she recommends skipping recycled paper. “It can be rougher than regular varieties, leading to irritation,” she says. “Plus, trace amounts of various allergens found in the original paper product sources could still be present and potentially cause a reaction in those who are sensitized.”

Shepherd also cautions against recycled toilet paper—as well as anything marketed as “ultra soft.” “While meant to soothe, these products may contain softening agents such as lanolin, as well as fragrances, dyes, preservatives, and adhesives,” she says. “These can be irritating for some people and can cause unpleasant symptoms like itching, redness, and contact dermatitis.”

Kopelman adds that looking for words including “unscented,” “dye-free,” or “chlorine-free” on the packaging is more important than the base material.

“On its own, toilet paper is unlikely to be a major source of chemical exposure,” says Kopelman. “But for those with sensitive skin, choosing products without unnecessary chemicals in toilet paper is a simple way to avoid skin irritation.”

Is the food at the farmers market safer?

26 August 2026 at 16:00
Still image from a video showing produce in containers, with a caption reading "Local farms = safer food?"

What we eat and where it comes from is a critical part of human health. According to a 2025 survey, 59 percent of Americans think it’s important to know where their food comes from, and 54 percent prioritize food that is consistently available locally. And one of the best places to get that locally sourced food? Farmers markets. 

The US has more than 8,700 farmers markets, where roughly 40,000 farmers sell their products. Recently, the markets have been getting a bit more attention thanks to a series of high-profile food recalls. Americans’ confidence in the safety of their food is being tested, and buying direct from your local farm could be the answer. 

Some produce travels hundreds or thousands of miles from where it’s grown to where it’s sold, passing through processing, storage, and distribution facilities. One advantage of a small local farm is the direct journey the produce takes from the field to the customer. But how does a small family farm business compete with major grocery stores for customers, and what’s behind their sales pitch for safer and fresher food? We drove out to Camarillo, California, to a small family farm to find out. 

Read more about food sources and food safety:

This video is presented by Verizon Business. Verizon Business doesn’t have a say in our editorial decisions, but they help make videos like this one possible.

The lifesaving case for CPR dummies with breasts

26 August 2026 at 14:30

Every once in a while, I feel the urge to shout “women are not small men!” at inanimate objects. Today, that object is the flat-chested plastic torso typically used for CPR training. 

Breasts, it turns out, are really the bane of every woman’s existence — the back pain, the boob jail, the running. But here’s a new one: In a public cardiac arrest, they may be the reason nobody helps you.

Two years ago, an analysis of over 300,000 cardiac arrests showed that women are 14 percent less likely than men to receive CPR from a stranger if they have a cardiac arrest in public. Bystanders tend to be more hesitant and feel less comfortable providing CPR or using external defibrillator paddles, called AEDs, on people with breasts. Experts have time and again pointed, in part, to the fact that nearly everyone learns to perform CPR using the traditional, flat-chested dummies called “manikins,” which overwhelmingly represent the male anatomy. If the first time a stranger has to perform CPR on someone with breasts is in the middle of a high-stakes emergency — what else would you expect? 

For the last 20 years, not only has the survival rate for out-of-hospital cardiac arrests been around 10 percent, but also the chances of the victim surviving decrease by 10 percent every minute that interventions like CPR are not performed. It makes it all the more harrowing that women are not receiving the care they need when they experience cardiac arrests — especially in places where they are surrounded by people. 

Whether it is manikins used for CPR training, crash tests or medical care in combat, the default stand-in for what is “human” has long been male. 

But recently, researchers, advocates and governing bodies like the American Heart Association and European Resuscitation Council are pushing for better representation in CPR training and education. Increases in simulation-based research on the use of representative manikins, like ones that accurately represent female anatomy, are changing how people train to respond to cardiac arrest — and simultaneously exposing bigger gender gaps in design that systematically exclude women from experiencing the same level of safety and care as men. 

One size doesn’t fit all

The first CPR manikin was developed in 1960 by the Norwegian toy manufacturer Laerdal. The manikin, called Resusci Anne, which had the anatomy of a prepubescent teen, was ironically modeled off an unnamed girl who was thought to have drowned in the river Seine in Paris. Laerdal famously wanted a female face on the manikin since he thought men might hesitate to practice mouth-to-mouth resuscitation on a male manikin. It’s not surprising that women trainees didn’t factor into the equation at all back in the 1960s — they weren’t even included in clinical trials yet — but the norm of designing with the comfort of men at the forefront continues to this day. 

Since then, Resusci Anne has been reengineered many times over, and today’s manikins are surprisingly high-tech and interactive. However, as of 2022, about 95 percent of manikins on the market from mainstream manufacturers were still flat-chested and androgynous. 

Key takeaways

  • Women are less likely than men to receive CPR from a stranger in the event of a public cardiac arrest. 
  • Research indicates that this is because people feel uncomfortable and hesitant to touch or expose women in order to perform CPR, in case it is misconstrued as inappropriate. They also worry about injuring them in the process. 
  • Experts believe that such dangerous hesitation could be reduced by using resuscitation manikins that have female secondary sex characteristics, like breasts, during CPR training.
  • This is difficult to execute because anatomically accurate female manikins are not widely available for purchase or widely adopted; 95 percent of manikins on the market are flat-chested and androgynous.
  • The conversation surrounding the design disparity in CPR training is also exposing similar flaws in other fields like vehicular crash-testing or combat medicine, where female dummies are largely excluded from mainstream testing and training protocols.  

So why does this matter?

In the past, research has hinted at three main reasons why bystanders don’t immediately rush to the aid of a woman in cardiac arrest. One, they are hesitant to expose or touch her in any way that could be misconstrued as inappropriate and are worried about sexual assault allegations after the fact. Two, they don’t want to accidentally hurt them, perceiving them as generally more fragile than the average man. And three — perhaps saddest of all: bystanders often don’t recognize that a woman is in cardiac arrest if, say, she collapses in public, misattributing it as overreacting, simply fainting or faking it. 

CPR training with female manikins would go a long way in teaching people to be comfortable with the female form.  

In one study, people at MassCPR — the free CPR certification program offered by Massachusetts Institute of Technology for the MIT community — were trained using standard manikins,  as well as a few which were retrofitted with a mold resembling breasts. At the end of the certification, participants who practiced on the manikin with breasts reported greater comfort performing CPR on women. 

If there was widespread adoption of manikins that looked and felt different, this could ultimately become the norm. 

It’s really only in the past five years or so that research on this disparity has sped up, offering some evidence for the need for more representative manikins. Even then, widespread adoption of female manikins is hindered by commercial availability of anatomically correct models and the cost of switching existing CPR training programs over to using them.   

Closing the design (gender) gap

There are two main ways to go about increasing the availability of female manikins: Either you retrofit existing standard manikins with breasts or you design completely new ones. 

When Christoph Veigl and colleagues at the Medical University of Vienna surveyed 133 training organizations across 43 countries from six continents, they found that of more than 5,000 manikins in use, only a fifth of organizations owned a female one. While that number is still low, adoption is triple what it was four years ago. The researchers acknowledge that just the availability of female manikins is not necessarily an indication of how much they are used in training — about a quarter of the organizations were also employing makeshift adaptations, like placing a bra on standard manikins, to simulate training on women. 

Dr. Pooja Nawathe, a resuscitation science researcher and pediatric critical care clinician at Cedars-Sinai Hospital, chose to focus her research on gender disparity in resuscitation for a specific reason. 

“Skin color is about implicit biases, but female breast tissue, which is a normal physical characteristic, is about the actual science of this,” she said, speaking about variations in care during cardiac arrests. “Are we teaching how to place the pads on the breast tissue?”  

She also stresses the importance of gathering good, granular data on how CPR performance changes when people are exposed to diverse populations.     

CPR manikins are just one example of the gender gap in design: Across fields like crash testing, the “human” body has long been modeled on men.

CPR manikins are just one example of the gender gap in design: Across fields like crash testing, the “human” body has long been modeled on men. But that’s starting to change, too. Last year, the National Highway Traffic Safety Administration (NHTSA) released the design details for THOR-05F, the first detailed female crash-test dummy.

Before this, the standard female crash-test dummy was a model called the Hybrid III 5th percentile female dummy — literally just a scaled-down version of the Hybrid III 50th percentile male dummy that represents the average male body dimensions. But the THOR-05F — every woman’s dream name, I’m sure — is a much more anatomically accurate female dummy, and includes a female pelvis, breasts, and a flexible spine. 

THOR-05F has arrived just as new research by the NHTSA affirmed the need for better crash-testing on women. Although the gap in vehicular accident fatality rates between the sexes has narrowed significantly in newer car models, women continue to experience a higher injury rate compared to men in multiple different types of vehicular accidents. The hope is that testing with the THOR-05F will provide a better understanding of this trend and help engineer safer vehicles and regulations for women.

Women are not small men!

Women are often referred to as the “invisible sex,” and the lack of female manikins really brings that to the forefront. It’s not like the manufacturers or policymakers intentionally excluded women from this area — they simply ignored them, accepting an androgynous body as the standard with an unchallenged assumption that what applies to it will undoubtedly apply to women too. 

In 2019, Joan Creative, the New York-based ad agency, launched the Womanikin, a universal attachment for CPR manikins, in partnership with United State of Women, a now-shuttered organization focused on gender equity. Launched during National CPR Week, the Womanikin is a neoprene vest with silicone breasts that can be zipped onto any standard manikin. Built as an awareness campaign, they open-sourced the design for the breasted vest and helped spark a broader conversation about the CPR gender gap. But we don’t have any detailed information about its success or adoption. 

More recently, other manufacturers like Prestan have come out with newly designed female manikins that can be purchased as is. They also sell “replacement female skin” that retrofits any existing Prestan adult manikins. Notably, these are now available on the American Red Cross store, increasing visibility for female manikins.

The fact that women account for 50 percent of the world’s population and yet have to mold themselves to standards not designed for them in the first place is atrocious. Not only is it frustrating to live in a world not built for you, but in cases like CPR training, the gender gap can quite literally be fatal. This is true whether it is for motor vehicle crash-test dummies or those used to train battlefield medics — another field where women injured in battle have a higher fatality rate than their counterparts.

The basic idea is that repeated exposure to female bodily characteristics during training or testing can significantly alleviate discomfort that causes dangerous hesitation. If people had more practice administering CPR to models that looked more feminine, they wouldn’t be thrown off by breasts, would understand how to cut away clothing like bras if needed, and learn how to efficiently place the pads of the external defibrillator on a female body. 

CPR techniques remain largely the same irrespective of sex. Chest compressions are performed on the sternum, which is the flat bone running down the center of your chest. For women, it lies between the breasts, so there are some additional considerations. That is what representation in training manikins is meant to address — not new skills, but familiarity. 

Ultimately, it really comes down to not feeling awkward about putting your hand in between two breasts, if it means you save a life.

Mpox is back – and in new countries. How can this outbreak be contained?

The public health emergencies in 2022 and 2024 saw the virus reported in 145 countries, but in the new cases children appear particularly affected

A fresh outbreak of mpox in Guinea Bissau – the country’s first – means the virus formerly known as monkey pox is back in the headlines. So what has changed?

Since 2022, there have been almost 190,000 lab-confirmed cases of mpox reported worldwide in 145 countries. Before then, outbreaks of mpox tended to be relatively small and in a handful of African countries, where the viral infection was known to be endemic.

Continue reading...

© Photograph: Tchandrou Nitanga/AFP/Getty Images

© Photograph: Tchandrou Nitanga/AFP/Getty Images

© Photograph: Tchandrou Nitanga/AFP/Getty Images

A look at the devastating impact of USAID cuts in rural Afghanistan

It's been 18 months since the Trump administration made cuts to foreign aid. One of the countries hardest-hit is Afghanistan. The five years since the U.S. withdrawal have been grim for the people there, and Refugees International attributes over 160 deaths during the last 18 months to cuts in aid. Special correspondent Leila Molana-Allen and videographer Eric O'Connor report.

Two People Have Died of Measles in Pennsylvania

25 August 2026 at 22:27
—Peter Dazeley—Getty Images

Two people in Pennsylvania have died from measles, marking the first reported deaths from the disease in the U.S. this year. 

The Pennsylvania Department of Health said on Tuesday, Aug. 25, that the two people who died were unvaccinated and lived in Lancaster County, the epicenter of a statewide measles outbreak that has sickened hundreds. 

No additional information has been released about the two people who died. State health officials said the deaths are the first measles-associated fatalities in Pennsylvania in 35 years.

“Because measles was largely eliminated in the [state] for more than three decades, people are not familiar with this disease and don’t fully understand the potential severity of the illness,” said Dr. Debra Bogen, Pennsylvania’s health secretary, in a statement.

More than 2,700 measles cases have been reported in the U.S. this year—the highest number of cases since the disease was considered eliminated in the country in 2000. In just the past two years, the U.S. has recorded more measles cases than it did from 2000 through 2024 combined.

Measles is a highly contagious viral disease that can cause high fever, a tell-tale rash, cough, and other symptoms. The disease can be mild for some, but about one in four people sickened with measles is hospitalized. Young children, pregnant women, and the elderly are among those who are at risk of more severe disease.

No specific treatment for measles exists. The measles vaccine—delivered as a combination measles, mumps, and rubella (MMR) shot series—is 97% effective at preventing the disease and lowers the risk of complications if someone is infected. 

“As a physician, I want to make sure that people understand that the MMR vaccine is safe and provides the best protection we have against measles,” said Bogen.

Within communities, a vaccination rate of above 95% is considered ideal for robust herd immunity against measles. The national MMR vaccination rate among kindergarteners surpassed 95% in the 2019-2020 school year, but it has been declining ever since, according to U.S. Centers for Disease Control and Prevention data. In 2025-2026, MMR vaccination coverage was just 92.4% nationally, and about 93% in Pennsylvania. In Lancaster County, home of the largest Amish settlement in the country, the vaccination rate was under 88%. An estimated 25% of the Amish population in Lancaster County is vaccinated against measles, according to the Association of Immunization Managers, an organization of state and local immunization officials. 

Vaccination rates began notably declining in the U.S. during the COVID pandemic and have continued dropping amid increasing anti-vaccine rhetoric and policy under the Trump Administration. On Aug. 10, President Donald Trump signed an executive order that called for U.S. children to receive fewer vaccines and ordered the MMR vaccine to be split into three separate shots, despite a lack of scientific evidence to back the changes.

“Together, there could be a possibility they’re quite lethal,” Trump said of the combined shot, which has been in use for more than 50 years and has a strong safety and efficacy record.   

Doctors and vaccine scientists said Trump’s executive order and comments were unscientific and misleading. "As measles cases reach a 35-year high in the U.S. and with cold and flu season quickly approaching, [the] executive order on vaccines is not only disheartening but dangerous,” Dr. Andrew Racine, president of the American Academy of Pediatrics (AAP), said in a statement at the time. 

The CDC and the American Academy of Pediatrics recommend that all children get two doses of the MMR vaccine, starting with the first dose at 12 through 15 months of age. 

An additional early dose of the vaccine can also be given to children aged 6 to 11 months under some circumstances, says Dr. Elizabeth Murray, a pediatric emergency medicine physician in Rochester, N.Y. “With the ongoing measles outbreak, make sure your children are immunized. If your child is under age 1, talk to your doctor. Depending on how much measles is circulating where you live, your doctor may recommend an earlier dose,” she says. 

The CDC also advises adults who haven’t been immunized against measles or who are unsure about their vaccination status to get the vaccine. The agency recommends that people who were vaccinated before 1968 with an older version of the shot get at least one dose of the vaccine in use now, which is more effective. 

For people fully vaccinated after 1968, however, there is no need to get a booster, the CDC says, as two doses of the vaccine should offer adequate, lifelong protection

Football is dangerous. Parents are finally steering their kids away from it.

25 August 2026 at 21:00
Two football players collide

When the NFL season kicks off next month, millions of Americans will gather around their televisions to watch athletes of comic book proportions crash into each other at breathtaking speeds. Inevitably, those players’ heads will smash into each other, leaving them dazed on the field. And according to a major new study, these repeated head-on collisions may eventually lead to a degenerative brain disease for many — if not most — of the players long after they’ve left the field.

For years now, America has been reckoning with the tension between its love for football and the growing evidence of its dangers. Those concerns can be boiled down to three letters: CTE, or chronic traumatic encephalopathy, which is the progressive brain disease that can lead to dementia, depression, suicide, and other serious mental health problems.

One major question over the past 20 years has been: Exactly how often does playing football lead to CTE? What are the risks for peewee players versus pros? How quickly does the brain deteriorate once the disease takes hold? And new research, published this week in BMJ, has provided us with some staggering answers. After analyzing the death records for hundreds of former NFL players, the co-authors concluded that at least 25 percent of the former players who died between 2016 and 2021 had CTE at the time of their death. 

And the actual prevalence could be much higher, but more players’ brains would have to be given over to scientists for a CTE assessment for us to know for sure. Because among the 338 players whose brains were donated and studied, the CTE rate was an astonishing 93 percent. The question is, according to the researchers: Is that percentage skewed because the players exhibiting CTE symptoms were more likely to offer up their brain for research? Or, as the authors suggest is possible, is the real CTE rate closer to 90 percent? Only further research will be able to tell us, but even the latest estimate — one in four — is cause for concern.

It’s a stark reminder of football’s risks, delivered right on the cusp of a new season for pro, college, and high school teams around the country. And according to the Aspen Institute’s annual State of Play report, there are signs that the game’s future may actually be at risk. 

More and more American parents are steering their kids away from tackle football. How long can an elite league like the NFL last when the pool of players is getting smaller and smaller — at the same time the scientific evidence of its dangers is becoming clearer and clearer?

The youth football pipeline is drying up

Despite the latest research, the NFL is going to be fine in the short term. Professional football is the biggest TV show in the country: Last year, 83 of the top 100 rated TV shows were NFL games, up from 72 in 2024. The next Super Bowl will almost certainly attract more than 100 million viewers and end up the single most-watched TV program in the US for the whole year. Football is one thing that transcends politics in an increasingly polarized America.

But with each new piece of evidence about the physical and mental costs of playing football, football’s long-term dominance looks less and less certain. Already, if you dig into the trend lines for youth participation, they reveal a real threat to the sport’s future.

Let’s start with the good news for football enthusiasts: Flag football has become more and more popular among kids, supported by investments and promotion by the NFL itself and expert consensus that it’s much safer than tackle, especially when it comes to head injuries. According to the Aspen Institute’s State of Play survey, flag football participation among kids ages 6 to 12 grew by 13.6 percent from 2019 to 2024, while tackle football play dropped 7 percent among the same age group over that time.

But it’s participation among the next age group that may be most revealing. According to the Aspen Institute, tackle football participation rates among Americans ages 13 to 17 — the prime age for middle school and high school teams — decreased 9 percent from 2019 to 2024. It has even fallen behind tennis among the teenage cohort. Many of the tweens who play flag football may never strap on a helmet to play tackle.

Even if fewer kids play tackle football year over year, the sport may still subsist on its promises of upward mobility for people who come from poorer backgrounds. With the recent introduction of compensation for college players, elite athletes can make millions of dollars in income before they even reach the NFL. It may be no surprise, then, that the young people still playing tackle football are more likely to be lower-income and live in conservative states. 

Another study found that Black and Hispanic parents, who on average earn less money than their white counterparts, are more likely to see football as a path to college scholarship or even a professional career; the Washington Post reported in 2023 that the proportion of white players at the college level is falling while the percentage of Black players is rising. Football players are often thought of as modern gladiators: participants disproportionately from lower classes aspiring to riches and glory in a violent game for the viewing pleasure of the general public. That’s becoming more and more true as we learn more about its dangers. 

As the annual hoopla around the NFL kickoff makes clear, football’s cultural dominance remains unrivaled among professional sports. But this new study has left even me, a lifelong football fan, wondering how much longer it can, and should, last.

What Hanging from a Bar for 30 Seconds Can Do for Your Body

25 August 2026 at 18:24
—NickyLloyd––Getty Images

Most people leave the monkey bars behind with childhood. Yet hanging from a bar—right-side up, don’t worry—may be one youthful habit worth picking back up, especially if you spend your days hunched over your desk and phone. (Guilty.)

“We look at kids on a playground—what are they doing?” says Australian physiotherapist Daniel Vadnal, owner of FitnessFAQs, who posts instructive videos on Instagram and YouTube. “They don’t need to be told to hang. They just intuitively do it.”

A few years ago, Vadnal persuaded his grandmother, now 93, to try a supported hang. That means gripping a bar overhead with straight arms but keeping your feet planted on the floor, rather than dangling your entire body weight. She was skeptical: She hadn’t even raised her arms fully overhead since she was a kid. But after just 30 seconds, she felt taller and looser—and found it easier to reach her kitchen cabinets.

Here’s what hanging can do for your body, how to keep your feet planted while you build strength, and why just 30 seconds is long enough. 

It gives your upper body a stretch

At its simplest, hanging means gripping a secure overhead pull-up bar—the kind that can be installed in a doorway—with straight arms while supporting some or all of your body weight. You remain right-side up: Your hands are above your head, and your feet point toward the floor or remain planted on it. Hanging upside down, known as inversion, is an entirely different exercise. “It’s fairly simple, but it’s not easy,” says Hazel Anderson, a physical therapist and faculty member at the University of St. Augustine for Health Sciences in Austin.

Whether your feet stay planted for support or lift off the floor, there are two ways to position your upper body. “The passive hang is, as the name suggests, just relaxed,” Vadnal says. “You’re letting nature, gravity, your body do whatever it wants.” Your shoulders move toward your ears, creating a stretch through the shoulders, arms, and trunk.

An active hang requires more effort. “You want to think of trying to bring your shoulder blades down away from your ears,” Vadnal says. That engages the muscles around the shoulders and back, creating more stability. Your elbows remain straight—and your feet can remain planted or off the floor—in either type of hang.

Vadnal considers passive and active hangs opposite ends of a spectrum. A passive hang still requires enough muscle effort to remain safely attached to the bar; an active one involves “really making a concerted effort” to hold yourself in position. He recommends choosing the amount of engagement that feels most comfortable for your body.

Reaching overhead may feel especially satisfying after all those hours slumped over your desk. Hanging “stretches all the tight muscles that we tend to have through the pecs, through the triceps on the back of the arms, as well as the lats,” Vadnal says. You’ll likely find it leaves you feeling a little taller—and less scrunched up through the shoulders.

That doesn’t mean 30 seconds on a bar will permanently correct your posture or treat back or shoulder pain; those claims haven’t been established in strong clinical trials. But hanging moves your upper body into a position it might not visit very often, which helps explain why people often step down feeling looser.

It makes your grip work

A hang might look passive, but your hands and forearms are busy keeping you attached to the bar. “First and foremost, it supports grip endurance,” Anderson says. “It’s helping with grip strength, but more with the endurance of being able to hold on to the bar.”

That endurance is useful for everything from carrying groceries to working toward a pull-up. “The hands, fingers, and forearms serve as a link to our back,” Vadnal says. Strengthening that link helps prepare you to support—and eventually pull—your body weight.

Research on short, recreational hangs is limited, and most studies involve climbers. In a small 2026 study, 11 climbers hung on until their grip gave out. As they got tired, their shoulders and other upper-body muscles increasingly pitched in to keep them on the bar.

Another randomized trial found that when experienced climbers hung by their fingers for eight weeks, with progressively more weight attached to the body, some measures of grip strength improved. The study involved extra weight and a climbing hold—not beginners attempting a relaxed 30-second hang—but it supports the idea that regularly asking your hands to hold you up can make them better at the job.

Grip strength is also widely used as a marker of overall health. “We do know that grip strength is correlated with longevity,” Vadnal says. In a study of nearly 140,000 adults across 17 countries, weaker grip was associated with a higher risk of death and cardiovascular disease.

That doesn’t mean hanging longer will make you live longer, Vadnal adds. Think of it as one useful signal—not a path to immortality.

Your feet can stay on the floor

Beginners don’t need to hover heroically above the ground. When you’re starting out, the bar is—quite literally—low. “I love the addition of a little step stool or platform,” Anderson says. Hold the bar with both hands, bend your knees slightly, and keep enough weight in your feet that the stretch feels manageable. You can gradually allow your arms to support more of you as you become comfortable.

“You definitely don’t need to jump straight to 30-second hangs all at once,” Anderson says. She recommends starting with a 10-second supported hang and repeating it three to five times, resting briefly between attempts. From there, work toward the 30-second goal. Vadnal likes three 30-second sets, but only after choosing a variation easy enough to complete with control.

Begin with your hands about shoulder-width apart. “That’s most comfortable for pretty much everyone,” Vadnal says, though you can move your hands wider or narrower based on what feels best. Wrap your thumbs underneath the bar to make your grip more secure.

If the typical overhand position bothers your shoulders, try a neutral grip, with your palms facing each other. Many gyms have parallel handles that allow for it, and gymnastics rings will rotate to accommodate your joints. Vadnal calls it “probably the most friendly position for the shoulders.”

Decide whether a passive or slightly more active hang feels better, and don’t worry about matching someone else’s position. Forcing your shoulders farther overhead than they can comfortably go may leave them sore or irritated, Vadnal says. Let your range of motion improve gradually instead.

Most importantly, remember to breathe. Anderson advises using “slow, controlled breaths” and making sure you’re not holding your air in, whether you’re a beginner or an expert. It’s easy to get so focused on staying on the bar that your whole body clenches up; a few steady breaths can help you relax into the hang.

“Don’t chase the clock,” Anderson says. If your form changes or you can no longer control the hang, put your feet down, rest, and try again.

Know when to let go

Hanging should feel like work—not like you’re about to injure yourself. “We should feel a stretching sensation; we should feel fatigued,” Vadnal says. “We shouldn’t feel pain.” Put your feet down if you experience sharp or persistent pain, numbness, tingling, or weakness.

Those symptoms are signs to stop, not to push through. Talk to a doctor or a physical therapist before trying again. Some people should seek guidance before they ever reach for the bar: Anderson recommends medical clearance for anyone who recently had shoulder surgery or an injury involving the neck, shoulders, elbows, wrists, or trunk. The same applies to people with shoulder instability, pain when reaching overhead, cardiovascular concerns, or uncontrolled high blood pressure. 

Osteoporosis doesn’t automatically make hanging off-limits. But because a fall could have more serious consequences, Anderson says, it’s particularly important to keep your feet supported and get personalized guidance.

Anderson recommends practicing two or three times a week on nonconsecutive days, which allows the muscles to recover. There’s no need to progress from zero hanging to auditioning for Cirque du Soleil. Add time or body weight gradually, and take a day off if your hands, forearms, or shoulders remain unusually sore.

If you like hanging, Vadnal suggests keeping a bar somewhere you’ll regularly see it, like in your laundry room. “It’s like daily hygiene,” he says. “You brush your teeth; hanging is a good thing, too.”

How to Break Up With Your Therapist Without Ghosting Them

25 August 2026 at 16:48
Elizaveta Starkova—Getty Images

Your therapist has probably encouraged you to have difficult conversations, advocate for your needs, and resist the urge to avoid things that make you anxious. That’s all well and good—until, one day, the difficult conversation is with them.

If therapy doesn’t feel useful anymore, or if you’ve realized that you and your therapist simply aren’t the right match, it can be tempting to outsource the breakup to the cancel-appointment button. Yet unless there’s an ethical, boundary, or safety concern, experts say it’s usually worth having a conversation with your therapist before ending the relationship. It might improve the therapy. It might also help you find someone better suited to you, or simply allow you to leave without feeling guilty about ghosting the person who knows exactly why you tend to ghost people.

Speaking up could also save you from having to begin the search from scratch. “Your therapist could be the gateway to your next great therapist,” says Ryan Culkin, a licensed professional counselor and chief counselor officer at Thriveworks, which provides therapy and psychiatry services. They might be able to adjust their approach—or recommend someone who would suit you better.

Even if you already know you’re finished, breaking the news doesn’t require a dramatic confrontation or an elaborate defense. Here’s how to decide whether it’s time to call it quits—and how to do it painlessly.

Figure out what kind of discomfort you’re feeling

Good therapy isn’t necessarily easy. “Sometimes therapy can be really uncomfortable, but it can be incredibly productive,” says Eli Kraiem, a clinical psychologist in New York. A therapist might challenge an assumption you’re attached to, point out a pattern you’d rather not see, or encourage you to do something that scares you. Feeling unsettled after a session doesn’t mean it went badly.

Michael G. Wetter, a clinical psychologist in Los Angeles, prefers this question: “What is the discomfort accomplishing?” Productive discomfort generally leads to insight, reflection, behavioral change, or progress toward goals you and your therapist have agreed on, he says. If it’s a poor fit, you might notice you leave therapy feeling misunderstood or have the same conversation week after week without much meaningful movement.

Juliann Siwicki, a licensed clinical professional counselor in Vero Beach, Fla., thinks about it this way: “Are you uncomfortable because you’re talking about something hard? Or because you feel like you’re having coffee with someone and not getting help? Those are two different things.”

You should be able to name what you're working toward—a pattern you're trying to break, a decision you're stuck on, a reaction you'd like to change—and to notice how much airtime your therapist is taking up. "A therapist can share something about themselves if it helps the client," Siwicki says. "It becomes too much when the client is spending the session listening to the therapist's stories, or feels like they need to take care of the therapist."

Kamran Eshtehardi, a clinical psychologist in Pasadena, Calif., has heard the far end of that spectrum. One client described a previous therapist who "thought it would be helpful to tell me about when they cheated on their wife"—including that his wife left him, and that he later saw an escort. "And I'm like, ‘What? Like, a therapist told you?’" Eshtehardi says. "Those are major red flags."

What was once a good fit can also change over time. A therapist who helped you through a crisis might not be right for your next stage. "A great therapist might not be great for you," Culkin says. "It's kind of like dating—you're not going to get it right the first time every time."

Even finding that “the therapist gets on your nerves” doesn’t necessarily mean you should quit, says Eshtehardi. A rupture doesn’t mean the therapy has “rotted on the vine,” he says, and progress sometimes develops “underneath the surface” before reaching a tipping point. But if you’ve explained what you need and nothing changes—or there’s no sense of progress—your frustration deserves attention.

Serious boundary violations, unethical behavior, or anything that makes you feel unsafe are different. You don’t need to attempt a repair before leaving, nor do you owe the therapist another session.

Say what isn’t working

If you’re open to continuing with your therapist, with the appropriate changes, describe what you’ve noticed and need—without turning the conversation into a performance review.

Try: “Our sessions have started to feel conversational, and I need more structure, feedback, and therapeutic insight. Can we talk about that?” Or: “I’m not sure what I’m working toward. Could we revisit my goals?” Culkin suggests language as straightforward as: “That didn’t land with me,” “I want to try something different,” or “I really liked when you did this.”

Eshtehardi recalls a client telling him that the usual sympathetic responses—“I’m so sorry to hear that” or “That must have been so hard”—didn’t work for them. “I just want to get stuff on the table and say, ‘OK, what’s going on here? How do we work with this?’” the client told him. That feedback helped Eshtehardi calibrate his approach. “I’m not saying it’s necessarily the client’s job to help train the therapist,” he says, but clients can explain what they’re looking for and how they prefer to work.

If you know you’re ready to leave 

Sometimes you’re not interested in recalibrating the relationship—you’ve already decided to end it. In that case, the goal isn’t to persuade your therapist that you have a good enough reason to go. It’s simply to communicate your decision in whatever way feels most manageable. 

You don’t have to deliver the news face-to-face. A call, email, or text is fine: “I don’t want therapy and the therapeutic relationship to be another source of anxiety for my clients,” Eshtehardi says. For someone accustomed to conflict or pushback, sending “I’m sorry, this isn’t working for me” and receiving a calm response can itself be therapeutic. You might realize, he says, that “maybe there’s a way to connect with people that doesn’t feel like I’m always doing the wrong thing.”

Eshtehardi also encourages clients who feel guilty to view the conversation as an opportunity to “practice trusting that someone else is going to be OK,” and trusting themselves to make the right decision. Your therapist’s response will provide useful information. A therapist who responds with openness and a willingness to adjust is giving you one kind of information; defensiveness or guilt-tripping gives you another. If the therapist acts wounded, Eshtehardi thinks of it as a “double whammy.” It might hurt, but it also “confirms that you’ve made the correct decision to stop therapy.”

You don’t need to build a case for your decision. “When it comes to trying to find the right fit, I don’t think clients should have to worry about having to justify their perspective,” Eshtehardi says. He suggests keeping the message simple: “I don’t think it’s the right fit. I’d like to stop sessions, and I really appreciate your time. Thank you.”

And try not to assume you’ve devastated them. Therapists are trained to handle patients leaving, Kraiem says. If yours can’t tolerate it, “then there’s a problem with the therapist, not with the patients.”

Make the transition easier on yourself

If you need consistent support, try to line up a new therapist before leaving your current one. Ask your therapist if they can recommend someone with a different style or specialty.

Before booking, confirm the new therapist accepts your insurance. “There’s nothing worse than getting through that first session” only to discover they don’t, Culkin says. You can also ask how they structure sessions, establish goals, and respond when a client disagrees. Be candid about what helped the first time around, what didn’t, and what’s important to you this time. Culkin encourages therapists to ask what clients appreciated about past providers and what they wish had been different. “Those are gold answers,” he says.

It’s not mandatory, but Kraiem recommends a wrap-up session, if you’re comfortable: “Let’s have one session to reflect on the experiences, process how you’ve improved, how you’ve grown through therapy, and maybe areas that still need improvement,” he says. 

Ask the practices about transferring relevant records. You’ll typically sign an authorization specifying what can be shared. Whether you want a direct handoff depends on why you’re leaving, Eshtehardi says. If you felt misunderstood, the former therapist’s perspective could “muddy the waters,” and you might prefer a clean start. If your therapist is referring you to someone with more specialized expertise, a conversation could help them get up to speed more quickly. In that case, Eshtehardi tells clients, “I’ll tell you everything I tell them so you know what they know.”

Finally, cancel future appointments and settle outstanding balances or other loose ends. Eshtehardi suggests asking: “Are there any last things we need to do?” If medication is part of your care, coordinate with your prescribing clinician about refills.

Changing therapists isn’t proof that treatment failed. Sometimes successful therapy means repairing a strained relationship. Other times, it means recognizing that the relationship has run its course—and using the difficult-conversation skills you’ve practiced to say so.

WATCH LIVE: Psychologist hired by prosecutors testifies Lindsay Clancy was criminally responsible for killing her 3 children

25 August 2026 at 16:27
Kirk Heilbrun told jurors that he didn't believe Clancy's claim that she hallucinated a voice telling her to kill her children, who ranged from 8 months to 5 years old. He said he instead believed she took their lives so they wouldn't "suffer" after she killed herself.

WATCH: Forensic psychologist testifies that Lindsay Clancy has bipolar disorder

Kirk Heilbrun, who examined Clancy over three days this year, said he struggled to reach a diagnosis of bipolar 2 disorder "because of all the diagnoses in the records and all the symptoms that she experienced."

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