Some relationships need to end. 

Years ago, I treated a woman whose husband was deliberately trying to drive her toward suicide while attempting to extract money from her family. What struck me was not only the cruelty of his behavior, but his complete lack of empathy or remorse for the harm he was causing. Leaving him was necessary, and the woman is now happily remarried.

Most troubled relationships look nothing like that. They involve disappointment, resentment, misunderstanding, conflicting needs, old wounds, and people who have never learned how to reconcile after hurting one another. In more than 20 years of clinical practice, that extreme case remains the only time I directly recommended divorce.

Mental-health professionals have become remarkably good at helping clients identify unhealthy relationships. We have a sophisticated vocabulary for boundaries, trauma, toxicity, narcissism, gaslighting, and emotional safety. But I worry that we are far less effective at helping people navigate difficult but meaningful connections.

There is an irony here. Psychotherapy itself is predicated upon the healing power of human connection, yet therapists can be surprisingly quick to undervalue relationships outside the therapy room. Furthermore, relationships themselves teach basic psychological capacities such as regulating emotions, tolerating disappointment, and negotiating differences—skills which therapy is supposed to cultivate.

Too often, we mistake relational distress for relational dysfunction. Wall Street Journal columnist Elizabeth Bernstein recently highlighted this eloquently. She reported on therapists who encouraged adult children to go “no contact” with their parents, often after surprisingly little effort to mend ruptures. In a survey of roughly 7,000 estranged parents, one-third believed their adult child’s therapist had influenced or even recommended the decision to cut ties. That should give us pause.

The issue extends well beyond parents and children. Similar patterns appear in marriages and among siblings, friendships, and other close bonds. Therapists have become too quick to support ending difficult relationships instead of helping people develop the skills to repair them.

In reality, walking away from another person often solves one problem while creating others. Increasingly, my practice sees clients who have ended relationships that took a lifetime to build. The immediate conflict may be gone, but so is the connection. Many become lonelier and less equipped to navigate conflict, disappointment, and repair elsewhere.

Tragically, many who end contact with loved ones also become more distressed in the long run, since close relationships are a foundation of mental health. Maintaining social connection is a form of “fitness” that requires ongoing cultivation. Even when strained or difficult, human bonds provide belonging, support, identity, and resilience. That may matter more now than ever, as many meaningful in-person social interactions are dwindling in the face of digital alternatives.

I learned this lesson the hard way about 15 years ago.

A woman came in because she was deeply concerned about her husband, who had obsessive-compulsive disorder. We eventually got him into treatment. He worked hard, completed difficult exposure therapy exercises, and improved considerably. By the standards I had been trained to use, the treatment was successful. But their marriage was not. His wife remained deeply unhappy, and their connection deteriorated. Eventually he lost most of his hard-fought progress, and she fell into clinical depression. Looking back, I can see the mistake clearly: we treated the patient and his symptoms, but not the relationship itself.

This reflects something larger about how mental-health care is generally structured. Our system is overwhelmingly individualistic. Diagnostics assign disorders to individuals, and insurance reimbursement follows an identified patient and his or her diagnosis. Even family psychotherapy is typically covered only when it is being used to treat an individual’s mental health. That model may make sense in other areas of medicine, such as orthopedics where a fracture occurs within one body. Mental health is fundamentally different. A great deal of flourishing and suffering happens between people, not just within them, because human beings are relational beings.

A second structural problem is that mental healthcare increasingly pathologizes ordinary negative emotions. That can backfire. Excessive focus on distress tends to amplify it. As an anxiety specialist, I know this pattern well. Avoidance may bring immediate relief, but over time it reinforces fear and reduces our capacity to tolerate discomfort. 

Effective treatment does the opposite: it helps people face distress so they become more capable to withstand adversity, not less. Applied to relationships, this becomes especially critical because even the healthiest connections generate some strain. Loving spouses disappoint us, supportive parents fail us, close friends misunderstand us, and even terrific children create enormous stress. If stress itself is taken as evidence that a relationship is unhealthy, the normal difficulties of human interaction begin to look pathological.

Therefore, therapy should do more than help people identify what’s wrong with their relationships. It should build our capacity to sustain connection and repair ruptures: to tolerate disappointment, take responsibility for our own contribution to tensions, set limits without reflexively severing ties, and accept what another person may never be able to give us.

These skills matter beyond any single relationship. Learning how to reconnect with a spouse can make us better caregivers. Learning how to accept a parent’s limitations can change how we relate to our friends, work colleagues, and children. Working through difficult interactions can both preserve meaningful connections and strengthen our ability to navigate other ones.

Mel Robbins captured this idea in accessible language through her book, The Let Them Theory. Her core insight is simple: stop trying to control other people. Let them disappoint you, disagree with you, and make choices you don’t like. Then decide how you want to respond.

That message matters because a great deal of interpersonal conflict comes from trying to force others to change. We want parents to be more emotionally available, spouses to react differently, siblings to finally understand us, and adult children to make choices we approve of. Sometimes change is possible and can be requested directly upon the foundation of a loving connection. But sometimes the wiser move is to stop demanding that another person change as a condition of staying in contact with them.

Unfortunately, some of my academic and clinical colleagues have dismissed this approach. I think they are missing something critical. Leaving is sometimes necessary, but far more often the harder and healthier work is learning how to stay connected to imperfect people without surrendering ourselves, or trying to control them.

Human beings need relationships. Relationships require skills. Therapy should help us build them.

Six months into the war between the United States and Iran, President Donald Trump has turned to economic warfare to force the country into submission and threatened an “Economic D-Day” against Iran. This new American strategy was spelled out by Treasury Secretary Scott Bessent earlier this week: a campaign of U.S. sanctions against countries and financial institutions that do business with Iran or help it evade sanctions. 

The proposed new sanctions go beyond oil exports to target digital assets, gold, and the aviation sectors that help finance the Iranian economy. Bessent described it as a campaign to “collapse every last option for Iran.” Making all this work depends on whether the U.S. can convince Iran’s most important trade partners to cut out the Islamic Republic. China, which buys around 80% of Iran’s seaborne crude oil, has already pushed back, warning that it will “take all necessary measures” to protect its interests should it be targeted by U.S. sanctions. Beijing's response casts doubt on whether Washington’s new gambit can deliver results.

If the aim, as stated, is to deal an economic blow to Iran, the fact is that the country is already under severe strain. A U.S. naval blockade has constrained oil exports, the primary source of revenue for Iran. Ordinary Iranians are facing greater economic pressure as their purchasing power is eroding: food inflation reached 128% year-on-year in July and families are cutting back on meat and other items. The dollar value of the minimum wage has fallen from about $105 to $86 since late March as the rial has weakened significantly. On Monday, Iranian currency fell to a record low of 2.02 million rials to the dollar.

So what is the goal of Bessent’s announcement? Simply put, acknowledging the reality—even if the administration won’t state it in these terms—of avoiding a further, major military campaign as the conflict drags on. For their part, Iran’s leaders have dismissed the threat of intensified economic warfare, insisting the new punitive economic measures would fail. “It is the same movie they keep playing over and over again,” remarked Iran’s foreign minister, Abbas Araghchi.

Does this mean nothing will change with the American announcement? Put another way, are we likely to see a continuation of the current state of neither war nor peace, with Iran prolonging things until it can secure a favorable deal to end the conflict? Tehran, it is true, has powerful reasons to avoid another major military escalation. A new round of fighting could deepen the damage to Iran’s energy, transport and industrial infrastructure—much of it still under repair from earlier hostilities— and would also complicate reconstruction by further straining state finances, disrupting imports and exposing an already weakened economy to another cycle of destruction.

Yet American economic saber-rattling could alter this calculus. After all, on Aug. 10, Iran’s Supreme Leader Mojtaba Khamenei appointed Brigadier General Ahmad Vahidi, a hardliner with significant experience in intelligence and operational positions, as the commander of the Islamic Revolutionary Guard Corps (IRGC), instructing him to strengthen capabilities for “powerful offensive operations against the enemy.” That language was echoed on Aug. 22 by Mohsen Rezaei, who was recently appointed secretary of the Supreme National Security Council, the top national security body of Iran. In an interview Rezaei spoke of Tehran going to introduce “changes in the conduct of the war” and bring “new capabilities” into play. He also warned that Iran had so far targeted only U.S. military bases but could begin striking American economic interests if Washington intensified its economic campaign. 

Tick tock, tick tock

If Iran is pondering a possible escalation in the military conflict, the Trump Administration appears to be betting that time may yield what bombs have so far failed to. The naval blockade in the Strait of Hormuz  remains in place, secondary sanctions are being tightened, and pressure is being increased on countries and financial networks that have allowed Tehran to circumvent previous restrictions. On Aug. 19, the United Arab Emirates, which has been a traditional financial gateway for Iran, suspended financial and commercial transactions with the country, a decision that is bound to hurt the Iranian economy.

Iran has declared the Strait of Hormuz closed, but oil has continued to move through the waterway, which is 29 nautical miles wide at its narrowest point. The U.S. military has established a protected route along the southern side of the strait, close to the shore of Oman. The Gulf states have experimented with ship-to-ship transfers and other means of moving crude around Iranian restrictions. Saudi Arabia and the United Arab Emirates have been working intensively to reduce their dependence on the strait, building pipelines and investing in storage facilities to transport their oil by other routes.

Precise estimates of oil passing through the strait are not available, but the volume seems to be somewhere between a quarter and half of the prewar flow of 20 million barrels a day. Oil prices remain elevated, hovering around $90 a barrel, but they are still far below the levels Tehran might have expected from an effective and sustained closure. Tehran had hoped that continued disruption in Hormuz would eventually make the economic costs of the confrontation intolerable for Washington and force Trump back toward compromise. Instead, the U.S. increasingly appears to believe that it can keep enough oil moving while allowing the blockade and sanctions to steadily increase the pressure on Iran.

For Iran, that creates a very different calculation. The longer the current situation continues, the greater the strain on an economy already struggling with shortages, inflation and restrictions on trade. Iranian officials are increasingly speaking of the domestic consequences. First Vice President Mohammad Reza Aref has spoken of the danger of economic discontent turning into social instability; the speaker of Parliament, Mohammad Bagher Ghalibaf, has warned that measures such as raising gasoline prices could provide an opening for renewed unrest. President Masoud Pezeshkian has acknowledged that the blockade has restricted the country’s ability to import essential goods, including fuel.

Thus, Tehran is finding it increasingly harder to sustain the condition of “no war, no peace.”

A renewed war would impose enormous costs on Iran, but its leaders might ask a different question: will those costs be greater after months of economic pressure, declining revenues and continued military containment?  If the answer is yes, then waiting ceases to be a strategy of restraint and begins to look like gradual erosion of power and strength. And they could consider escalation as a means of breaking the deadlock before Iran’s position deteriorates further.

From retaliation to initiative

Economic pressure is not the only reason Iran may be more willing to take risks. Tehran’s own understanding of deterrence has also changed over the course of the war. For years, Iranian leaders portrayed military action as retaliatory: Iran would absorb an attack, then impose costs on the aggressor. The experience of the past two years has increasingly called that logic into question. From Tehran’s perspective, repeated attempts to contain escalation did not prevent Israel and the United States from expanding their attacks.

The strategic reassessment is now visible in Iran’s military leadership and practice. After appointing Vahidi as the commander of the IRGC, Khamenei instructed him to pursue “maximum deterrence” while preparing the force for “powerful offensive operations.” The wording is significant. Offensive action is increasingly being conceived as a path to restoring deterrence. Iran has already offered a glimpse of what this could mean in practice. On Jul. 28, the IRGC launched ballistic missiles at a U.S. military base in Jordan, at a time when Trump had paused American strikes to give diplomacy more time.

In a departure from the past, the strike was not a response to an American attack. U.S. Central Command described it as an attempted surprise attack, and Washington subsequently resumed its strikes against Iran. The sequence suggested that Tehran was becoming more willing to initiate military action when it believed doing so could alter the strategic equation, rather than waiting to retaliate. Iranian leaders may also feel they have more room to act than Washington or Israel expected. Despite the enormous damage inflicted on Iran’s military-industrial infrastructure, recent satellite imagery and Israeli assessments indicate that Tehran has been restoring missile bases, production facilities, ports and other military infrastructure at a surprisingly rapid pace.

Iran has not recovered from the war, and its leaders have not become indifferent to the risks of another military confrontation. Yet capability and willingness do interact. The more Tehran believes it can regenerate the military tools damaged during the war, the less compelling a strategy of absorbing economic pressure becomes. The emerging emphasis on proactive military action and sense of military regeneration could establish a lower threshold for Iranian military escalation than Washington assumes.

If Iran considers the current balance as unsustainable, its escalation would have to differ from what it has already tried. Tehran is already attacking commercial shipping, contesting passage through Hormuz and relying on the Houthis to keep pressure on maritime traffic in the Red Sea. Intensifying those actions may raise costs, but it is unlikely to change Washington’s calculation of moving significant volumes of oil through the southern part of the strait.

Iran could resume attacks on U.S. bases, radar systems, and other facilities that support maritime surveillance and command-and-control systems that help protect and coordinate shipping through the Strait. More  dangerous still, it could attempt to strike U.S. naval vessels directly. Iran is believed to possess anti-ship missiles that, at least on paper, can threaten American warships operating in and around the Persian Gulf. The harder problem is locating and tracking moving targets with sufficient precision, why is why better intelligence, including potentially from partners such as Russia or China, could become an important variable.

So far, Tehran has generally had strong reasons to avoid inflicting large numbers of American casualties, which could trigger a much larger U.S. campaign against Iran’s military and civilian infrastructure. But that restraint depends on Iranian leaders continuing to believe that avoiding such a confrontation leaves them better off. If they conclude instead that prolonged blockade and economic pressure are steadily worsening their position, the threshold for taking that risk could fall. Tehran has already warned that major U.S. attacks on Iranian energy or civilian infrastructure would be met with strikes against comparable infrastructure across the region, potentially widening the confrontation well beyond Hormuz.

This is also why diplomacy remains the least costly way out for both sides. Washington may believe that time and economic pressure are improving its bargaining position; Tehran may increasingly believe that the same process is closing its window for action. That is a particularly dangerous combination. 

The memorandum of understanding reached earlier in the conflict is imperfect and each side accuses the other of violating it, but it still provides an existing framework for sequencing de-escalation, maritime arrangements, sanctions relief, and further negotiations. Reviving it would require concessions from both Washington and Tehran. The alternative is to allow each side’s strategy to reinforce the other’s worst assumptions until escalation begins to look less like a choice than an inevitability.