Clinicians on the Couch: 10 Questions with Catherine O’Brien

Catherine O'Brien headshot

Every month we turn the tables and ask clinicians to take a seat on the figurative therapy couch. We ask them to reveal everything from what they love about working with clients to what they find to be the most challenging part. They also give us a glimpse into their personal lives, sharing how they cope with stress and if they’d follow the same professional path today. Plus, they share the biggest myth about therapy and the biggest obstacle for clients — and a whole lot more.

This month we’re pleased to feature relationship therapist Catherine O’Brien, MA, LMFT. She specializes in helping families prepare for the transition from pregnancy to parenthood by managing overwhelm, creating more ease and deepening connection. O’Brien is the founder of She provides counseling and coaching for new and expecting parents. And she facilitates courses to help parents manage the expectations of parenthood and understand developmental milestones of infants and children.

She also is a Postpartum Support International (PSI) Co-Coordinator. She helped launch the Mother’s Heart, the Sacramento Regional Perinatal Mental Health Network, which focuses on the screening for pregnant and postpartum women for pregnancy-related or postpartum mood or anxiety disorders and provides a support line for women and their families. They continue to focus on support, education and resources to families and healthcare professionals.

O’Brien is married to her perfect partner and is a mother of a 6-year-old son and 2-year-old daughter. She knows what it’s like to be a parent that is overwhelmed, exhausted and doubting her competency.

Learn more about O’Brien, and download free resources at . Follow her at  or  or .

1. What’s surprised you the most about being a therapist?

That who I am as a therapist has evolved the way it has. I knew from a young age I always wanted to be a therapist, but as life experiences have happened, my focus has changed. I think one of the great things about being a therapist in private practice is that I can change my focus [according to] what my interests are (though personally, I don’t see that changing anytime soon). And it’s not just about seeing clients in my office individually or as a couple, but offering groups and workshops, and opportunities to speak to large groups, as well as other professionals.

2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?

I’m currently reading and really loving the book, All Joy and No Fun: The Paradox of Modern Parenthood by Jennifer Senior. It definitely puts things in perspective, which is interesting for me as a mom and as a therapist whose focus is with new and expecting parents.

3. What’s the biggest myth about therapy?

That all a therapist does is sit there and listen, say “How do you feel about that?” and then deposit your money in the bank. But it is so much more than that: the time spent between clients researching to prepare for a session; consultation with other clinicians to make sure we’re providing the best care; and also reading and taking courses to continue to advance our knowledge.

I also talk to potential clients about making sure to find a therapist that is the best fit and I might not be it, and that’s OK. I’m still happy to try and help them find a therapist who is. There are so many different modalities of therapy. I think it’s worth taking the time to pause and really identify what it is you need from a therapist, and then take the time to interview a few until you find a therapist that feels right for you. The connection with the therapist is so important for effective therapy.

4. What seems to be the biggest obstacle for clients in therapy?

Finding a therapist that is a good fit and one they can build trust and rapport for the best therapeutic outcomes. I think many clients struggle with developing trust in their therapist. But, the most important thing when considering therapy is really in taking the time to find one that you feel comfortable with — one you can build that therapeutic bond with so you can really do the work.

5. What’s the most challenging part about being a therapist?

Not taking my work home. When I first started out as a therapist this was definitely much harder for me to do. But I think learning how to balance my self-care and a caseload that is manageable has been very helpful.

6. What do you love about being a therapist?

Seeing people feel better about themselves, watching them reconnect with their partners in their relationships, and learning to value themselves.

7. What’s the best advice you can offer to readers on leading a meaningful life?

Of course the path is going to be different for everyone. But the one thing that I think is true universally is that we all need to first learn how to be honest with ourselves so that we can be truthful and honest about finding the things that will make us happy and how to get there. We all need to identify the things that are most important to us and let those guide our choices. And in doing that, we need to not compare our choices to someone else’s choices, because they might be guided by totally different needs or values.

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?

Yes, because it got me where I am today. I love the work I’m doing and the clients I work with. I love my schedule and love going to work!

9. If there’s one thing you wished your clients knew about treatment or mental illness, what would it be?

That there are real biological reasons beyond one’s control for mental illness, and it’s not their fault. A large part of my practice is working with perinatal mood and anxiety disorders. So often I’ve had moms tell me that if they were a better mom, then maybe this wouldn’t have happened this way. But unfortunately, it is so much more than just willing yourself to be better.

Anyone who has lived through anxiety or depression will tell you that they can’t just snap out of it or look on the bright side. They can’t just decide to be better. And postpartum mental issues are no different in that way. Sometimes it takes extra support, like hiring a nanny, a housekeeper or a therapist. Sometimes it takes medication to restore a balance. Sometimes it takes self-help books or an exercise program.

There are so many ways to improve the situation, but the main thing to understand is that it is not a flaw in the mother’s character and she is not inherently bad. It’s like if you taste a cake and it’s just not sweet enough, you wouldn’t blame the cake for not having enough sugar. Something’s just not right with the recipe.

10. What personally do you do to cope with stress in your life?

Dates with my husband. I know that probably sounds totally cheesy, but honestly, life with two young children, I really need him and his support. At times it can be really stressful managing both our jobs, two children and all the things they have going on too. I find that when we connect on a regular basis and also allow for time for each of us to do what we like to do, whether it’s hanging out with friends, working out, whatever, and making our relationship with each other a priority, then everything else (parenting, household management, work, etc.) seems to be so much easier.

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Shared by: Margarita Tartakovsky, M.S., Contributing Blogger

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