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In 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. 

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In 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.

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Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouch

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In 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.

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Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouch

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In 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.

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In 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.

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Read more at bothsidesofthecouch.substack.com or karirusnakcounseling.com/bothsidesofthecouch

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In 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.

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In 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.

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In 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? ✨

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In 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.

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Thanks 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/bothsidesofthecouch

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I currently run off donations only, I pledge to only work with advertisers I can 100% support.