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In 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:

1. Accidental or clinically meaningful, where transference or attachment wounds may be explored therapeutically.
2. Boundary-pushing, involving repeated flirtation, fantasies, or testing behaviors that require firm limit-setting, documentation, and consultation.
3. 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.

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

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

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

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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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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

Support the show: buymeacoffee.com/karirusnak
I currently run off donations only, I pledge to only work with advertisers I can 100% support.