Both Sides of the Couch

Send us Fan MailIn this episode, I explain why I don’t offer free consultation calls and why that decision is grounded in ethics, safety, and respect for therapeutic labor. I unpack the myth of the “quick 15-minute call,” why it almost always turns into unpaid therapy adjacent work, and the very real risks of engaging in clinical conversations without informed consent.I talk openly about mandated reporting concerns, client safety, sexual harassment in the therapy room, and why structure and intake paperwork aren’t cold or rigid; they’re protective. I also challenge the idea that something being “standard practice” makes it ethical, especially in a profession where unpaid emotional labor (particularly from women) is deeply normalized.This episode is a candid look at boundaries, burnout, transparency, chronic illness, and why the intake session is the consultation just done ethically, thoroughly, and with consent.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari reflects on a small, ordinary moment that sparked a much bigger realization about imbalance in relationships. Through the lens of a therapist, a chronically ill person, and a friend who often gives more than she receives, she explores what it feels like to be emotionally capable yet quietly unsupported.Kari unpacks how emotional competence is frequently mistaken for self-sufficiency, how chronic illness causes support to fade over time, and how helpers often become invisible in their own relationships. Drawing from personal experiences with grief, friendship, and long-term illness, she names a pattern many people feel but struggle to articulate: being strong doesn’t mean not needing care.This episode is for chronically ill listeners who feel forgotten, therapists and helpers who are quietly overgiving, and well-intentioned friends who care deeply but aren’t sure how to show up. With compassion rather than blame, Kari offers validation, insight, and gentle reframes for building more attuned, sustainable relationships.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan Mail In this mini episode, Kari shares a funny moment about an HSA statement that turns into a reflection on invisible labor, chronic illness, and why some parts of life are hard to explain even to the people who love us. For information on health savings accounts, check out these links:https://www.healthcare.gov/glossary/health-savings-account-hsa/https://www.healthcare.gov/high-deductible-health-plan/Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn Episode 13, Kari explores a deeply familiar tension for people living with chronic illness: being told “don’t overdo it.” While often well-intentioned, Kari explains how this phrase can feel controlling, dismissive, and painful, especially for people who already live with constant limitation and loss.This episode is not about ignoring consequences or denying the reality of chronic illness. Instead, Kari centers choice and autonomy, emphasizing that chronically ill adults still have the right to decide how they use their bodies, even when those choices come with a cost. She challenges the idea that risk assessment belongs only to healthcare providers or loved ones, pointing out that everyone, ill or not, makes daily decisions that balance effort, desire, and consequence.Kari distinguishes between denial and intentional choice. Denial looks like ignoring limits and warning signs; intentional choice means understanding the risks, planning for them, and deciding that an experience, connection, or moment of normalcy is worth the recovery that may follow. She shares personal examples, painting a room, tending a garden, attending events, that highlight how quality of life can sometimes matter more than symptom minimization.The episode also explores the emotional layers beneath choosing to “overdo it”: anger at the unfairness of illness, grief for lost capacity, and even moments of rebellion as a way of reclaiming humanity. Kari normalizes these feelings while encouraging safe, thoughtful decision-making rather than high-risk behavior.Practical strategies are woven throughout, including planning rest before and after activities, adjusting hydration or medication when appropriate, modifying events, accepting help without shame, and avoiding stacking multiple high-cost activities. Kari also offers scripts for responding to people who repeatedly warn or monitor, helping listeners protect their autonomy without escalating conflict.The episode closes with reassurance and permission: wanting a full life does not make someone reckless. Choosing joy is not denial; it’s human. Sometimes rest is the right choice. Sometimes the moment is. Both are allowed.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn Episode 12, Kari explores the therapy of nature and how time outdoors can support people living with chronic illness, pain, fatigue, and nervous system dysregulation.  Kari begins the episode by reflecting on a familiar moment in nature, using sensory details to model what it means to slow down and simply be present outdoors. Kari reflects on how nature offers something rare in modern life: non-demanding, predictable sensory input. She explains why this can be especially regulating for chronically ill bodies and for people experiencing anxiety, depression, or emotional overwhelm. Nature, she says, doesn’t ask us to push, improve, or prove anything, it gives permission to exist as we are.The episode explores how nature supports the nervous system, including parasympathetic (rest-and-digest) activation, reduced stress hormones through visual exposure to greenery, and regulation of breathing and heart rate through natural sounds. Kari connects these effects to chronic pain, fatigue, migraines, and autonomic dysfunction, emphasizing that regulation—not exertion—is often what the body needs most.Kari reframes accessibility by expanding the definition of “nature time.” She reminds listeners that nature doesn’t have to mean hiking or physical activity. It can be a porch, houseplants, sunlight, bird sounds, or simply opening a window during a migraine. She emphasizes that passive exposure still counts and encourages listeners to let go of doing nature “the right way.”The episode also touches on the emotional healing that nature can offer, particularly during grief, sadness, anger, or frustration. Kari reflects on how nature helps people feel smaller in a comforting way, offering perspective, continuity, and a reminder that life moves in cycles without urgency.She shares her own journey of redefining her relationship with nature as chronic illness changed her physical capacity. Through sitting still, nature photography, and watercolor painting inspired by the outdoors, Kari discovered new ways to connect that felt even more therapeutic than the high-exertion activities she once loved.Kari closes with a gentle reminder: nature doesn’t cure chronic illness, but it can make living with it more bearable. Healing isn’t always forward motion, sometimes it’s settling, resting, and allowing yourself to be held by the world around you.Episode links:https://rosaliehaizlett.com/https://rosaliehaizlett.com/collections/booksSupport the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn Episode 11, Kari explores a major but surprisingly under discussed scientific breakthrough: the creation of a cellular atlas of the human ovary, recognized as one of the most important discoveries of 2024. Kari explains why this research is long overdue, given the historic underfunding and neglect of women’s health and the health of people with ovaries.She begins by naming an important distinction, while this research is often framed as “women’s health,” not everyone with ovaries identifies as a woman. Throughout the episode, Kari intentionally uses inclusive language to reflect the full range of people impacted by ovarian biology, including trans men, nonbinary, and intersex people.Kari breaks down the science in accessible terms, describing the ovary atlas as a high-resolution, cell-by-cell map created using advanced imaging and molecular sequencing. She compares it to “Google Maps for the ovary,” allowing researchers to finally see how ovarian cells develop, communicate, age, and respond to hormones, something that was previously impossible due to the complexity and variability of ovarian cycles.She outlines why this research matters so deeply: improved understanding of fertility and unexplained infertility, major implications for menopause research, and potential breakthroughs in diagnosing and treating conditions like endometriosis and PCOS. Kari also highlights how this atlas may lead to more targeted, preventative, and personalized hormonal care across the lifespan from puberty through menopause.Drawing from both her professional and personal experience, Kari connects this research to chronic illness, explaining how hormonal shifts affect fatigue, pain, autonomic function, migraines, autoimmune flares, and dysautonomia. She shares her own delayed diagnosis of endometriosis and reflects on how earlier scientific understanding could have changed her treatment and quality of life.The episode also addresses the emotional impact of medical dismissal and gaslighting, naming how generations of people with ovaries have been told their symptoms were “normal,” “too emotional,” or not worth investigating. Kari emphasizes that scientific validation restores dignity and may prevent future generations from experiencing the same harm.She closes with practical encouragement: trust your lived experience, ask informed questions, seek second opinions, and advocate fiercely. Kari frames the ovary atlas as a turning point. This blueprint will shape women’s health and ovarian research for decades and reminds listeners that while the body has always held wisdom, science is finally starting to listen.Research Referenced in This Episode: Cellular Atlas of the Human Ovary Using Morphologically Guided Spatial Transcriptomics and Single-Cell Sequencing Jones AS et al. (2024) https://www.ginecologiarobotica.com.ar/assets/documentos/CANCER-OVARIO-sciadv-adm7506.pdfSupport the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode, Kari says she wants to shine light on an uncomfortable but very real issue in the mental health field: sexual harassment toward therapists. She explains that although it’s shockingly common, therapists rarely receive training on how to talk about it, which leaves many clinicians feeling isolated, ashamed, or unsure of how to respond. Kari says she was inspired to record this episode after seeing a TikTok where a therapist blamed herself for being harassed during a video consult.Kari shares a personal story from early in her private practice, describing an “accidental” sexual text a client sent her and how being alone in an office made her feel especially vulnerable. She notes how gender shaped the feedback she received from colleagues—female colleagues naming the inappropriateness, male colleagues minimizing it as “normal guy talk.” Kari says these experiences made her rethink safety, boundaries, and the emotional burden therapists carry.She then outlines three categories of sexualized behavior therapists may encounter:Accidental or clinically meaningful, where transference or attachment wounds may be explored therapeutically.Boundary-pushing, involving repeated flirtation, fantasies, or testing behaviors that require firm limit-setting, documentation, and consultation.Harassment or threatening behavior, such as explicit messages or exposure, where Kari says therapists should respond immediately, end the session, terminate care, and consider legal or safety steps.Kari explains why these situations happen—trauma histories, unmet relational needs, blurred lines in emotional intimacy, telehealth disinhibition, and power dynamics that shift back and forth between client and therapist. She emphasizes the importance of therapist safety plans, supervision, and policies, and says clinicians often minimize their discomfort because they’re trained to put clients first.Kari also discusses the aftermath: the freeze response, the shame spiral, and the subtle trauma therapists carry. She says it’s vital for clinicians to acknowledge these experiences instead of downplaying them. She offers a gentle PSA to the public: therapists are people with bodies, boundaries, and histories, and harassment deeply impacts their ability to help.Kari closes with validation—therapists are not dramatic, not responsible for harassment, and are allowed to feel shaken or angry. Ending therapy in these cases isn’t a failure but an ethical success. She says relief comes from naming what therapists were trained to keep quiet, and she encourages clinicians to seek consultation, talk openly with peers, and reinforce boundaries before issues escalate.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari explores the surprising fear and guilt that can surface when chronic illness symptoms finally ease. After years of struggle, she’s experiencing real relief thanks to a new medication, and discovering that feeling better isn’t as simple as it sounds.She dives into the emotional complexity of healing, explaining how our brains crave predictability, even when that predictability is pain. Feeling better can trigger an identity crisis (“Who am I without my symptoms?”), anxiety about relapse, or guilt toward others who are still struggling. Kari connects this reaction to trauma responses, showing how the body remembers flare cycles and can mistake safety for danger.Ultimately, Kari reminds listeners that relief doesn’t mean you imagined your illness, it means your body finally has space to rest and recover. Healing, she says, is learning to let yourself enjoy life again without fear of what might come next. Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode, Kari challenges the deeply ingrained belief that our worth is tied to productivity, a mindset rooted in internalized capitalism, where value is measured by hustle, output, and efficiency. She shares a personal story about a physical breaking point that forced her to face her chronic illness and reevaluate the drive to constantly “push through.”Kari explores how this mindset leads to guilt around rest, toxic work cultures, and burnout, both for individuals and within systems that reward overwork. She dismantles the idea that “rest is laziness,” redefining it as a regulation strategy, essential maintenance for the mind and body, not something to be earned.Kari also calls out how this affects therapists and their clients: when helpers model exhaustion, they perpetuate the very systems that harm them. She urges both therapists and listeners to embrace rest as rebellion, a way to reclaim worth beyond output and to model balance, peace, and humanity.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari pulls back the curtain on the business behind therapist directories, from her own experience leaving Psychology Today to uncovering what really happened with Therapy Den after its founder sold it.She shares her firsthand story of how therapist listings became big business: pay-to-play exposure models, low compensation for writers, hidden ownership structures, and profit-first operations disguised as mental health advocacy. Kari connects these discoveries to a broader issue: the corporatization of mental health and how tech-driven “solutions” often hurt both therapists and clients.Listeners will hear why so many people struggle to find a therapist, what really happens when you send a contact form through a directory, and how investors, rather than clinicians, are increasingly steering the mental health space.But Kari also offers practical advice, from ethical alternatives to how clients can vet directories, find legitimate therapist websites, and ask the right questions before starting therapy.✨ Takeaway: Mental health shouldn’t be a marketing industry. If you’re searching for care, you deserve transparency, integrity, and connection, not a sales funnel.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari explores one of her favorite topics, boundaries, through both a therapist’s and a chronically ill person’s lens. She reflects on how the body sometimes enforces limits long before the mind does, especially when chronic pain, fatigue, or stress make “pushing through” impossible.Kari shares how she’s learned to honor physical boundaries just as much as interpersonal ones with family, friends, clients, and even herself. She dives into the difference between boundaries and consequences, the grief that can come when others don’t respect our limits, and why enforcing boundaries is an act of self-respect, not rejection.She also discusses how boundaries evolve over time, how to negotiate them in relationships, and why clear communication makes them healthier and less intimidating. Whether it’s saying “no” to a draining conversation, recognizing your body’s need for rest, or renegotiating time with a loved one, Kari reminds listeners that good boundaries protect both connection and well-being.✨ Takeaway: Boundaries aren’t walls, they’re clarity. Start treating your body’s signals and your relationships’ needs as part of the same conversation.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari gets honest about imperfection,  the kind therapists aren’t always allowed to show. She explores what it means to make mistakes in the therapy room, how she recognizes when she’s missed the mark, and why taking responsibility strengthens rather than damages relationships.Kari shares her own experiences of acknowledging errors with clients, reflecting on moments she’s caught them later, and the courage it takes when a client calls out a mistake she didn’t notice. She also discusses the importance of modeling accountability, not defensiveness, and draws parallels to the medical world, where chronic illness patients often face providers who struggle to admit when they’re wrong.The core message? Admitting mistakes is an act of integrity, not failure. It creates trust, repair, and connection in therapy, in medicine, and in everyday relationships.✨ Takeaway: Practice saying, “I made a mistake.” Small acts of accountability build the muscle to handle bigger moments with compassion, confidence, and care.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari unpacks the often sneaky onset of burnout, not just as a therapist, but as a human living with chronic illness. She shares how her definition of “enough” has evolved from grinding through nine clients a day to creating sustainable balance with a four-client maximum.Kari reflects on how burnout doesn’t always announce itself with warning signs, sometimes it just hits, and other times it slowly builds through physical, emotional, or “health burnout,” where managing chronic illness becomes its own full-time job.She offers insight into recognizing early warning signs, building a wellness plan, and using the “wellness wheel” to identify areas of imbalance before exhaustion takes over. Kari emphasizes that burnout can’t always be prevented, but it can be managed, with boundaries, community, and compassion.✨ Takeaway: “You can’t manage burnout alone.” Check in with yourself, reevaluate your balance, and accept help, because no one can hold it all by themselves.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari opens up about the unseen emotional and physical toll of holding space for others while managing her own chronic illness. She shares how, early in her private-practice career, she began noticing deep exhaustion, not just from long therapy hours, but from the intensity of listening, empathizing, and carrying others’ pain while masking her own.Kari reflects on what it’s like to work through migraines, fatigue, and emotional depletion while still showing up as the “best version” of herself for clients, only to crash the moment sessions end. She pulls back the curtain on what emotional labor really means for therapists, and why the line between professional empathy and personal energy can get blurry.Ultimately, Kari explores how chronic illness, self-employment, and empathy intersect, and how even the most compassionate therapists must intentionally protect their energy. She challenges listeners, therapists and non-therapists alike, to rethink self-care as a daily necessity, not a luxury.✨ Takeaway: “Think of your energy as a luxury item.” When you treat it that way, every boundary and act of rest becomes an investment in your ability to keep showing up, for yourself and for others.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn this episode of Both Sides of the Couch, Kari dives into a rarely discussed topic: what happens when the therapist has to cancel. From both the professional and human sides, she explores the guilt, boundaries, and grace wrapped up in letting people down, even when it’s unavoidable.Kari shares two deeply personal stories: the first time she ever had to cancel sessions due to sudden illness, and another when chronic pain made it impossible to follow through on plans to pick someone up from the airport. Both moments highlight how easily compassion can flow outward but how hard it can be to extend it inward.As a therapist and a chronically ill human, Kari reflects on the emotional weight of canceling, the fear of disappointing others, and the importance of building systems, both in work and in life, that make room for humanity. She reminds listeners that being your own boss means you can (and should) treat yourself like a good boss: one who honors limits and creates balance.The episode ends with a thoughtful takeaway: ✨ Reflect on how you handle cancellations—are you holding yourself to harsher standards than others? How can you align your expectations and give yourself the same empathy you’d offer someone else? ✨Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.

Send us Fan MailIn the very first episode of Both Sides of the Couch, Kari, a therapist, writer, and human navigating chronic illness, introduces the heart behind her new podcast: bridging her professional insight with her personal reality.She opens up about her dual roles as therapist and patient, and how living with chronic illness has reshaped the way she works, connects, and finds balance. The episode centers on one truth many can relate to: it’s easier to give advice than to follow it.Through a story from her own therapy session, Kari explores the trap of labeling days as “good” or “bad,” especially when every day includes challenges. She shares how both she and her clients are learning to embrace neutrality, seeing days not as successes or failures, but simply as experiences.Drawing from DBT’s concept of Radical Acceptance, Kari reflects on how acceptance and gentleness toward herself create space for peace, even on hard days. Her therapist’s reminder, “There is never a not enough for you,” becomes a grounding mantra against perfectionism and overdoing.Kari closes with a heartfelt takeaway: instead of asking whether today was good or bad, ask, ✨ What did I enjoy today? What were my peaceful moments? ✨ And when in doubt, focus on mini moments, small, restorative pauses that feed your energy without demanding more from you.Support the showThanks for listening to Both Sides of the Couch! If something you heard today resonated, share the episode or leave a review, it helps others find the show.Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouchSupport the show: buymeacoffee.com/karirusnakI currently run off donations only, I pledge to only work with advertisers I can 100% support.