Clear guidance for people struggling with addiction and for their families

Alcohol dependence is not a problem that can be solved with arguments, control, or shaming. It is an emotional, biological, and behavioral condition that requires patience, consistency, and a professional therapeutic approach. In the article “Alcohol Dependence – Mechanisms, Psychology, Examples and Professional Therapeutic Approach in Therapy,” I already explained how the addicted brain works, why a person cannot “just stop,” and which neurobiological mechanisms drive the compulsive use.

Here, we continue logically forward — how therapy with an alcohol-dependent person actually works, and how work is done both in the therapeutic process and within the family system.
Alcohol dependence is a topic that always involves two sides: the dependent person and the system around them — partner, children, parents, employers.

Many articles confuse these roles.
Working with addiction has three sides:

1. the therapist

2. the close family members

3. the addicted person

The therapist works in one way.
The family works in another.
And the addicted person works in a third way.

The first two sides are supportive.
But real change comes only from the behavior and decisions of the addicted person.

HOW THE THERAPIST WORKS

with a person struggling with alcohol dependence

1. The first session — the goal is safety, not accusation

The first session never starts with interrogation. It is not: “How much do you drink?”, “Why do you drink?”, “Don’t you have willpower?”
In my office, I create a sense of safety — the exact opposite of what the addicted person usually feels at home. I speak calmly, and what I say is: “I understand that this is hard for you. Let’s see together how we can help you feel more stable.”

During this session, the therapist does three things:

✔ 1) Assesses the amount of use — without criticism

Not to judge, but to evaluate risk.

✔ 2) Assesses whether withdrawal symptoms are present

If the person is trembling, sweating, unable to sleep — this can be dangerous and may require medical supervision.

✔ 3) Calms the nervous system

Real therapeutic work begins only after the body is stabilized.

Why is this important?
The dependent person lives in constant anxiety — if they feel attacked in therapy, their brain immediately shuts down.

2. Working on motivation — the person must want change for themselves

The therapist does not persuade with: “Stop drinking.” Instead, the therapist asks questions that help the person understand:

✦ What does alcohol give them? (calm, escape, silence in the mind)
✦ What does it take away? (family, health, trust)
✦ Which part of them wants sobriety? (the part tired of suffering)
✦ Which part is afraid? (the part that doesn’t know how to live without alcohol)

3. Trigger mapping — discovering the moments when the person “breaks”

The therapist and the client sit together and create a clear map:

• At what moments does the urge to drink appear?
• Which emotions trigger the need?
• What automatic thoughts arise?
• Which people or places activate the craving?

These are things like:

– loneliness in the evening
– arguments at home
– meeting a specific friend
– anticipation of failure
– celebrations
– shame

Example: “When I hear someone raise their voice, my stomach tightens and I want to drink to numb the tension.” This is the key: the person begins to understand themselves.

4. Emotional regulation — new reactions instead of alcohol

Alcohol is not the problem. Alcohol is the method a person uses to cope with overwhelming tension. In therapy, the person learns:

• how to calm their breathing
• how to recognize when they are close to the edge
• how to ‘freeze the moment’ before reaching for a drink
• how to wait 2 minutes, 5 minutes, 10 minutes

This is practical, body-based work.
It creates habits in the body, not only in the mind.

5. Breaking cognitive traps

Alcohol lives in the mind long before it reaches the hand. Common thoughts include:

• “Just one.”
• “I did well today — I deserve it.”
• “I’m irritated; better to drink.”
• “I can’t live without it.”

In therapy, the person learns to observe these thoughts like passing clouds — appearing, but not true.

✔ “Last time, ‘one’ became five.”
✔ “I deserve care, not self-destruction.”
✔ “I can wait.”

At this stage, the client begins to recognize the thought traps — those seemingly logical sentences that actually lead directly to drinking. The therapist helps replace them with thoughts that support sobriety.

6. Working with the family — stepping out of destructive roles

The therapist helps the family understand:

• that rescuing harms
• that controlling harms
• that emotional distance harms
• that the addicted person is neither an enemy nor a child
• that everyone is part of the system

We work around one clear principle:

✨ “I love you, but I will not cover anything up.”
✨ “I support you, but you are responsible for your choices.”

7. Relapse plan — because no one is a robot

Therapy prepares the addicted person for moments when they may slip — not because failure is expected, but because it is realistic.

The plan includes:

• early warning signs (irritability, restlessness)
• what to do in the first minute
• who to call
• how to avoid the “all-or-nothing” trap

This gives the person peace and structure.

8. Building a new identity

The final stage is not “I don’t drink.”
The final stage is:

“I am not a person who runs away.”
“I have a purpose.”
“I take care of myself.”
“I have boundaries.”

The therapist helps build the new identity — not as a punished person, but as a renewed one.

HOW THE FAMILY WORKS

(this is an entirely different role — and it also requires therapeutic support)

The home can never be a therapeutic office. Family members cannot — and should not — be the therapist of the addicted person.

But there is something even more important: Very often the family is codependent.  Meaning: they have lived for so long in tension, fear, guilt, and control that their reactions have become automatic and destructive.

Codependency is a wound of its own — one that needs therapy. Not because the family is “guilty,” but because they are exhausted, hurt, and confused. Their patterns often maintain the addiction without realizing it.

1. Support without rescuing

(rescuing is one of the main symptoms of codependency)

Family members often become “rescuers.” They:

• cover consequences
• justify behavior
• stay silent
• lie
• pay debts
• hide embarrassing scenes

This is an attempt to protect the family, but in reality, it prolongs the addiction. Healthy statements sound like:

✔ “I believe you can handle this.”
✔ “I am ready to help if you want treatment.”
✔ “I’m here, but I can’t do things instead of you.”

Unhealthy behaviors:

❌ covering up drinking
❌ lying to employers or relatives
❌ paying debts caused by alcohol
❌ excusing drunken behavior
❌ taking over responsibility

This is the essence of tough love — warmth combined with boundaries.

2. Conversations must be calm, not dramatic

(codependent people often swing between silence and explosions)

In families affected by addiction, conversations often turn into:

• yelling
• accusations
• tears
• punishments
• threats
• silence from pain or fear

This creates a climate of shame — and shame is the strongest trigger for drinking.

Harmful phrases:

✘ “Stop drinking already!”
✘ “You ruined our life!”
✘ “I’m ashamed of you!”

These deepen the pain and reinforce the cycle.

Helpful alternatives:

✔ “I see that you are struggling.”
✔ “I will talk with you when you’re sober.”
✔ “I won’t attack you, but I won’t hide anything either.”

This tone calms the system instead of exploding it.

3. Family members must protect themselves and the children

(this too is therapy — because codependent people often cannot protect themselves)

Living with a dependent person often leads to emotional illness. Family members develop:

• anxiety
• depression
• constant tension
• fear of outbursts
• feeling they must “walk on eggshells”
• disrupted sleep
• guilt
• broken personal boundaries

Therefore, the family must protect themselves, which includes:

• financial safety
• emotional distance when needed
• clear boundaries: “This is not allowed in our home.”
• self-care (sleep, therapy, support)
• protecting children from traumatic scenes

Family members have the right to say:

“I love you, but I cannot save your life for you.”
“I can support you, but I cannot carry the consequences instead of you.”

This is an extremely healthy position.

4. The most important rule: family members do not heal — they support

(and they themselves need therapeutic support)

Here the picture becomes clear:

✔ Therapy is the therapist’s job.
✔ Change is the addicted person’s job.
✔ Support and boundaries are the family’s job.

When family members try to become “the therapist”:

• they get overwhelmed
• they fail
• they feel guilty
• they burn out
• the relationship collapses
• codependency deepens

This is why family members also need therapy — to:

• learn to set boundaries
• release guilt
• heal their own trauma
• recognize their patterns
• step out of the roles of Rescuer / Persecutor / Distancer
• reclaim their own identity

Short summary for family members

Your job is not to heal — but to protect yourself and create conditions for change. Your pain matters. Your codependency also needs healing.
You are not guilty. But you do have a role. And you have the right to support.

---

WHAT THE ADDICTED PERSON THEMSELVES DOES

( the third pillar in working with alcohol dependence )

It must be said clearly:

❗ No one can heal an addicted person instead of them.
❗ But no one can do it completely alone either.

Real change happens when the addicted person takes these steps:

1. The addicted person tells the truth — to themselves and to the therapist

The first step is always honesty. Not to be blamed, but to understand where they truly are.

They begin to say:

• how much they drink
• when they drink
• why they drink
• what happens before drinking
• what they think before reaching for a drink
• what they feel afterwards

Often this is the first time they have ever spoken the truth about themselves.

❗ Honesty heals. Lying feeds the addiction.

2. The addicted person begins to observe themselves

(instead of acting automatically)

Until this moment, drinking was an automatic response:

“I’m angry → I drink.”
“I’m ashamed → I drink.”
“I’m scared → I drink.”
“I’m alone → I drink.”
“I’m excited → I drink.”

In therapy, they begin to see the process:

“I feel the tension rising.”
“My stomach is tightening.”
“The thought ‘just one’ appeared.”
“I’m already in the trigger.”

This awareness breaks the autopilot.

3. How the person learns to interrupt the automatic reaction

For someone in addiction, there is no space between tension and the drink. It happens instantly and predictably. In therapy, they begin to create something very small but powerful:

a moment of noticing
right before reaching for alcohol.

Not meditation, not long pauses — just the thought:

“Here is the moment.”
“The tension arrived.”
“I want to drink.”
“I’m getting activated.”

And in this moment they can choose something tiny but different:

• take a deeper breath
• step away from the situation
• relax their shoulders
• go to the balcony
• write a sentence in their phone
• call someone who supports their process

This is how new neural pathways are built.
Not through perfection — through repetition.

4. Replacing alcohol with other reactions

The therapist teaches, the family supports, but the addicted person is the one who:

• breathes instead of drinking
• talks instead of drinking in silence
• walks instead of isolating
• rests instead of pushing themselves
• writes down emotions
• uses cold water
• listens to calming music
• takes small grounding actions

This is the creation of a new brain.

5. Taking responsibility

Not guilt — responsibility.

Guilt says: “I am terrible.”
Responsibility says: “I have behaviors I can change.”

The person begins to:

• acknowledge consequences
• talk openly
• avoid blaming others
• stop using excuses
• own their part in the process

This is maturity.

6. The addicted person becomes an active participant in therapy

They:

• do assignments
• track triggers
• analyze situations
• speak about shame
• ask questions
• seek help

Therapy works when the person participates — not when they just “come so others calm down.”

7. Choosing sobriety daily

Change is not a one-time decision.
It is a daily practice.

Every day they choose:

✔ not to buy alcohol
✔ not to go to risky places
✔ not to meet people who drink heavily
✔ to use grounding techniques
✔ to call someone when they’re close to drinking
✔ to be honest with themselves

Every day is a victory.

8. Building a new identity

Eventually, they begin to see themselves not as
“an alcoholic who isn’t drinking,”
but as a person with a new life:

“I have goals.”
“I have boundaries.”
“I care about myself.”
“I am valuable.”
“I can handle things.”
“This is my life.”

This is recovery.
Not the absence of alcohol — the presence of a new self.

WHAT THE ADDICTED PERSON DOES — SUMMARY

✔ tells the truth
✔ observes themselves
✔ pauses before the impulse
✔ uses new strategies
✔ takes responsibility
✔ participates in therapy
✔ chooses sobriety daily
✔ builds a new identity

This is the third pillar of change.

With love and care,
Petya Bankova

WHAT IS ALCOHOL DEPENDENCE

(My therapeutic perspective on working with alcohol dependence is based on my experience in the Bilani Therapeutic Community.)

Alcohol dependence is a chronic, relapsing brain disease characterized by compulsive drinking, loss of control over the amount consumed, and continued use despite negative consequences. It is not a “lack of character” but a biopsychosocial disorder that changes brain homeostasis, emotional regulation, and behavioral patterns.

A person with alcohol dependence cannot control drinking even when it already causes serious physical, psychological, family, and financial harm. It is a combination of:
• neurobiology,
• psychological mechanisms,
• past trauma,
• family models,
• and strongly conditioned behavior.

Case Example: A 42-year-old successful professional says, “I only drink in the evenings to relax.” After one month of therapy, it becomes clear that he drinks almost an entire bottle of wine every night, has begun hiding empty bottles, and lies to his wife. He feels guilty but says: “When I enter the house at night, I am so tense that my body automatically reaches for the glass.”
This is a classic example of a conditioned reaction.

NEUROBIOLOGICAL MECHANISMS — HOW THE BRAIN LOCKS THE CYCLE

1. The Dopamine Trap

Alcohol sharply increases dopamine levels → the body relaxes → the brain stores this as a “quick fix.”
Over time, the brain begins to demand repetition to achieve the same relief.

Example: A person who drinks “to fall asleep” may, after six months, be unable to sleep without alcohol because the brain has changed its natural balance.

---

2. Tolerance → Withdrawal → Dependence

Tolerance: the need for more alcohol.
Withdrawal: trembling, anxiety, irritability, heart palpitations when stopping.
Dependence: drinking becomes “necessary” for normal functioning.

PSYCHOLOGICAL FACTORS

Alcohol often begins as a “solution,” not a “problem.”
It is used to:
• numb anxiety,
• replace missing emotional closeness,
• avoid conflict,
• silence the inner critic,
• manage stress.

The pattern: “I drink because I can’t cope – and then I can’t cope because I drink.”

Example: A 35-year-old woman drinks “only on Fridays” to “switch off exhaustion.” After one year, Friday becomes Friday + Saturday. Then Wednesday “to fall asleep.” She no longer controls her use.

SIGNS AND SYMPTOMS

Hidden Signs:

• Buying alcohol secretly
• Inventing excuses
• Emotional outbursts
• Avoiding social events
• Hidden drinking, controlling amounts
• Memory loss (blackouts)
• Irritability when not drinking
• Increasing tolerance
• Problems in family, work, and health
• Self-blame and double thinking (“I am doing this to myself but I cannot stop”)

Functional Signs:

The so-called “functioning alcoholic”: behaves normally in public but collapses at home.

THE CYCLE OF ADDICTION — FULL EXPLANATION WITH EXAMPLES

This is a typical emotional-behavioral cycle observed in all forms of addiction — alcohol, drugs, gambling, pornography.

TENSION BUILD-UP

This is the initial phase. Internal tension builds up which the dependent person cannot regulate maturely. It may come from:

• work stress
• conflict
• feeling of failure
• loneliness
• shame
• inner criticism
• unresolved emotions
• physical exhaustion

How it looks:
A person becomes irritable, anxious, withdrawn, tense. Thoughts appear:
“I want to switch off,”
“I can’t take it,”
“I need a break.”

Example: A man comes home after a stressful day. He feels unappreciated at work, fears a conversation with his partner, and has intense internal tension. His body knows he will drink even before entering the house. The brain has learned: “Alcohol will switch me off.”

ALCOHOL → SHORT RELIEF

When a person drinks, tension drops sharply. Alcohol temporarily blocks:

• anxiety
• self-criticism
• negative thoughts
• social fear

Here the brain receives the “reward” → dopamine.

The effect:
• relief
• feeling of calmness
• perceived control
• “breathing space”

But this is short, chemical, and artificial.

Example: A woman who feels tense and exhausted drinks two glasses of wine and feels the tension “evaporate.” This reinforces the belief:
“See? This works!”

GUILT → PROMISES

After the relief fades, guilt arises:

• shame
• self-criticism (“Why again?”)
• self-disgust
• fear of being found out
• promises like “I won’t drink again starting tomorrow”

At this moment the dependent person sincerely believes they can stop.
But the brain has already learned a quick path to relief → alcohol.

Example: After a binge, a person says: “I am disgusted with myself. Never again.” They even throw away the bottles. But the next day tension returns → the cycle restarts.

NEW TENSION

Guilt itself creates new tension. Additionally, dependent individuals often experience:

• humiliation
• fear
• thoughts like “I failed”
• withdrawal from loved ones
• passive aggression
• anxiety

Meanwhile, external stress continues:

• work
• conflicts
• problems
• exhaustion

This reactivates the internal feeling: “I cannot handle this.”

REPEAT

When tension becomes unbearable → the dependent person seeks the old “solution.”
Alcohol becomes the escape again.
This is the moment when the cycle closes.

Example: A person stays sober for three days. A difficult situation arises → the brain automatically links:
tension = drinking. And the cycle repeats.

Cycle Summary

Addiction does NOT begin with alcohol. It begins with emotional inability to regulate tension.
Alcohol is only a tool for temporary relief → but the cost is enormous.

THE ROLE OF THE FAMILY — THREE CLASSIC DYNAMICS

In families where there is a dependent person, the following roles almost always appear automatically. They are not “bad” roles but protective strategies people use to survive in a chaotic system.

THE RESCUER

(Justifies, covers, “puts out fires”)

Characteristics:
• justifies the dependent person
• hides the substance use
• cleans up consequences
• takes over obligations
• pays debts
• lies for them
• feels responsible to “save” them

What really happens:
The Rescuer unintentionally prolongs the addiction because they:
• remove natural consequences
• create comfort for use
• take away the dependent person’s chance to take responsibility

Example:
A wife who hides traces, calls work for him, says “He is just exhausted.” In reality — she prevents consequences from reaching him.

THE PURSUER

(Criticizes, controls, punishes)

Characteristics:
• constantly dissatisfied
• nags
• controls
• raises their voice
• punishes (silent treatment, controlling money)
• seeks “justice” and “order”

How this affects the system:
The Pursuer creates an atmosphere of fear which:
• increases tension in the dependent person → more use
• deepens shame
• triggers rebellion (“I’ll drink out of spite!”)

Example: A partner says: “You are a failure! Look at yourself!” This increases shame → shame is fuel for addiction.

---

 THE WITHDRAWN

(Emotional escape, distance, coldness)

Characteristics:
• avoids conflict
• behaves as if “nothing is wrong”
• suppresses feelings
• emotionally shuts down
• protects themselves with distance

How this affects the system:
• strengthens the dependent person’s isolation
• lack of closeness is a trigger for use
• the atmosphere becomes cold and disconnected

Example: A child who grew up with an alcoholic parent learns “not to feel.” In adult relationships they recreate the model: “I stay out of it.”
This allows addiction to grow unnoticed.

IMPORTANT: The Three Roles Are Part of One System

The dependent person is not alone. Addiction is a family dynamic, not an individual defect.

People often shift roles:

• Rescuer → Pursuer
• Pursuer → Withdrawn
• Withdrawn → Rescuer

This happens automatically and unconsciously.

If you want to understand how therapy for alcohol dependence works in practice — stages, methods, and real processes in the therapy room — continue to the next article:

How Therapy Works in Alcohol Dependence – Petya Bankova’s Approach

---

With love and care,
Petya Bankova

In recent years, there has been an unprecedented rise in complaints related to brain function —
chronic distraction, weakened focus, poor memory, and even fatigue when reading short texts.

And this is not limited to people over 50; young and middle-aged adults are even more affected.
We are no longer talking about temporary tiredness or stress — but about a structural change in the way the brain operates.

The Real Cause? Constant Digital Connection

The smartphone, created to make life easier, has quietly become a device that reprograms the brain into “fast-scroll” mode.
The problem isn’t technology itself — it’s how it’s designed to capture and hold our attention.

What Research Says

As early as 2008, studies by the Nielsen Norman Group showed that the average internet user reads only about 20% of any webpage, following the so-called F-pattern — the first lines carefully, the middle skimmed, the end skipped.

“Scanning is the new normal.” — Jakob Nielsen, Web Usability Expert

Over time, this changes neural pathways. The brain stops searching for depth and starts craving keywords, triggers, and brief stimuli.

The result is what psychologists now call “brain rot” — information overload leading to cognitive degradation.

The Internet: The New Psycho-Stimulant

Constant scrolling activates the brain’s dopamine centers in a way strikingly similar to gambling.
Each notification, meme, and video creates a micro-reward loop that traps attention.

“When rewards become too easy, motivation disappears.” — Dr. J. Lee, Harvard Medical School

This explains why:

• long texts seem “boring”

• concentration drops

• anxiety rises without internet access

• intellectual stamina declines

Even the Educated Are Not Immune

Professors and writers admit they struggle to read complex texts after a day online.
As Nicholas Carr wrote in “The Shallows”:

“The Internet is making us shallow thinkers. This isn’t a metaphor — it’s a neural reality.”

Our brains are literally being rewired for scrolling, not understanding.

80% of Online Time? Wasted.

Over 80% of our time online is spent on:

• short videos

• social media

• headlines without content

• memes and entertainment

• low-value information

“We’re the first generation to trade focus for instant gratification.” — Sherry Turkle, MIT

The Decline of Deep Reading

Deep reading — the ability to follow complex structure, reason, and reflect — is becoming rare.
As in Umberto Eco’s “The Name of the Rose”, only a few may retain access to deep understanding.

No Supplement Can Fix It

No vitamins, caffeine, or nootropics can heal a brain overloaded with digital junk.
The only cure is a change in lifestyle:
less digital noise, more meaningful content, more silence.

How to Restore the Brain – A Practical Program

1. Minimize Phone Use – Airplane mode is the new luxury.

2. Disconnect After Work – Protect your psyche.

3. Bring Books Back – Start with half a page a day.

4. Limit Social Media – Set boundaries and timers.

5. Filter Information – Replace scrolling with reading.

6. Take a Digital Sabbath – One day a week offline.

7. 

In Conclusion

If we train the brain to scroll, it becomes fast but shallow.
If we train it to think, it regains depth and clarity.

“The free mind is the one that can stay alone with itself.” — Pascal

The digital age gave us everything — but took our most precious resource: attention.
Without attention, there is no thought, no identity, no inner world.

---

Analysis by Petya Bankova, written with love and care for those who wish to stay truly awake.
With love and care,
Petya Bankova

(by Petya Bankova, psychologist)

The idea of psychotherapy is still surrounded by many misconceptions. These myths often prevent people from seeking help in time, even though therapy can be the key to deeper self-understanding and a more fulfilling life.
Here are nine of the most common myths about psychotherapy – and the truth behind them.

Myth 1: Psychotherapy is only for people with “serious problems.”

Many believe that only those with mental disorders, severe trauma, or deep crises need therapy. If someone is “just sad” or “feels lost,” they often think it’s not serious enough to ask for help. As a result, people wait for years before they reach out – until their suffering becomes unbearable.

Fact:
Psychotherapy is not only a form of treatment – it’s also a path of personal growth.
People go to therapy to improve their relationships, manage stress, anxiety, burnout, the sense of emptiness, or a loss of direction.
Seeking help doesn’t mean you are “sick”; it means you want a better life.
As Dr. Howes says, “There’s no shame in asking for a better life.”

Myth 2: All therapists just give compliments.

Popular movies often show therapists as endlessly kind and agreeable people who nod and say, “I understand, you’re doing great.” This creates the impression that therapy is simply about receiving reassurance that you’re right.

Fact:
A therapist is not there to applaud you but to walk beside you in the process of awareness and change.
Sometimes therapy can feel challenging or even uncomfortable because it helps you face the truths you’ve been avoiding.
As Howes says: “An applauding therapist makes good television, but not necessarily good therapy.”

Myth 3: Therapists do it only for the money.

There is often skepticism toward helping professions. Some people think therapists profit from human pain.

Fact:
Being a therapist requires years of study, personal therapy, and ongoing supervision. It’s a profession that demands emotional depth, responsibility, and maturity.
Good therapists don’t work out of greed – they work out of a deep motivation to help others.
If a therapist were only in it for the money, clients would feel that immediately. Authenticity is at the heart of this work.

Myth 4: Psychotherapy deals with obvious truths.

Many assume that therapy just repeats what people already know – that we should trust ourselves, forgive, calm down, or “think positive.” This view underestimates the depth of the therapeutic process.

Fact:
Therapy doesn’t deal with general truths but with your personal truth.
The insights you discover in therapy shed light on your own patterns, fears, and experiences – often hidden from awareness.
It’s knowledge that can’t be found in books; it’s discovered through experience.
That’s why therapy doesn’t offer ready-made recipes – it helps you discover yourself.

Myth 5: Therapy is unnecessary if you have friends to talk to.

At first glance, this sounds logical – why pay a therapist if you have close friends to confide in? Friends indeed give love, understanding, and advice, so it may seem like the same thing.

Fact:
Therapy is a unique space, different from friendship.
Friendships are reciprocal – both people share and support each other.
In therapy, the entire focus is on you.
A therapist is trained to recognize deep psychological mechanisms that friends often can’t see, and is bound by confidentiality.
You can express anything in therapy – anger, shame, fear, or grief – without worrying that you’ll hurt or burden the other person.

Myth 6: Therapy is too expensive.

The price of a session often seems high, especially when compared to daily expenses. Many believe that therapy is a luxury only for the wealthy.

Fact:
In Bulgaria, session prices usually range between 40 and 100 leva, and many therapists adjust their fees according to the client’s financial situation.
It’s essential to view therapy not as an expense, but as an investment in your quality of life.
Therapy improves emotional health, relationships, work performance, self-respect, and even physical well-being.
As Howes asks, “How much do you spend every year on things that help you live a better life?”
Therapy is exactly that kind of investment.

Myth 7: A therapist can help only if they’ve been through the same thing.

This belief comes from the idea that only someone who’s “been there” can truly understand. People often think a therapist must have personally experienced loss, addiction, or trauma to be effective.

Fact:
A professional therapist doesn’t need to have lived the same experience – they need to understand the psychological processes behind it.
Empathy, education, and clinical experience allow them to support you without being entangled in your story.
Sometimes, it’s precisely the therapist’s inner distance that makes change possible.
They are a mirror, not a participant.

Myth 8: Psychotherapy is for weak people who lack willpower.

In many cultures, we’re taught that strong people “handle things on their own.” Admitting you need help can feel like a failure or weakness.

Fact:
In reality, seeking help takes courage and maturity.
Everyone faces difficult moments, and there’s no shame in asking for support.
True strength is not in pretending to cope alone, but in being aware enough to care for yourself.
Therapy is an act of responsibility, not helplessness.

Myth 9: Therapists become therapists to solve their own problems.

Some believe that people choose this profession because they have unresolved issues and want to “heal through others.”

Fact:
In every serious psychotherapy training, personal therapy is mandatory.
Yes, many therapists are drawn to the field because they have gone through their own struggles – but that gives them depth and compassion.
The difference is that they have worked through their issues, allowing them to be a stable and present support for others.
The therapist is the main instrument in therapy – and if that instrument isn’t tuned, it can’t help anyone.

Psychotherapy is not a luxury, a weakness, or a last resort – it’s a conscious choice of self-care and awareness.
It’s a space where you can be heard, seen, and understood just as you are.
And sometimes, being truly seen is the beginning of real change.

“Change begins the moment a person dares to be seen.”

✨ With love and care,
Petya Bankova
Psychologist and a person who believes in the healing power of the meeting between two human beings.

Introduction: The World You Don’t Choose

No one imagines becoming the parent of a premature baby. No one dreams that the first embrace will be replaced by beeping machines, that the first photos will be taken in the intensive care unit, that the first prayer will not be for joy, but for survival.

I have stood beside the incubator and felt time stop. I have breathed in fear with every breath my child took. I have listened to every word of the doctor with a heart breaking apart. And I have known that painful distance – wanting to be close, but feeling far away, separated by glass, by gloves, and by my own terror.

And I want to tell you right from the start: you are not alone. What you feel – guilt, anxiety, confusion, isolation – is not your weakness. It is a normal human response to an unbearably heavy situation.

The Psychological Trauma of Premature Birth

From a psychotherapeutic perspective, premature birth is a traumatic event – sudden, unexpected, and associated with the threat of death.

Research in neonatal psychology shows that:

• Mothers of premature babies have an increased risk of developing post-traumatic stress disorder (PTSD) – nightmares, intrusive thoughts, constant anxiety.

• Fathers often develop hidden depression and heightened irritability, which remain unnoticed because their social role expects them to be “the strong ones.”

• Levels of anxiety among parents of premature babies are many times higher than those of parents of full-term babies.

This is not just a “difficult start.” It is a shock that changes the way you perceive the world and yourself.

Guilt: The Inner Judge

I clearly remember those first days – that thought that wouldn’t let me rest: “Am I to blame?”

How could I allow this to happen? My body failed – it betrayed me. Was I too stressed, too busy, too… everything?

Guilt is like an inner judge who never stops accusing you. Even when the doctors said, “There is nothing you could have done. This just happens,” the inner voice insisted: “You failed.”

Guilt in parents of premature babies is a well-documented phenomenon. It is part of the traumatic reaction – the mind searching for a cause to restore the illusion of control. Because if the guilt is mine, then I have an answer. If it is just chance – then I am powerless.

But the truth is that in the vast majority of cases, premature birth has nothing to do with any mistake by the mother or father. These are complex medical and biological processes that cannot be predicted or prevented.

Anxiety: Living in Constant Readiness

Anxiety was my constant companion. I listened to every sound from the machines. If the monitor beeped – my heart stopped. If my baby’s breathing changed – panic. I slept with the phone next to me, even when I was at home.

And the worst part – I couldn’t relax even in the good moments. Even when the doctors said: “There is improvement,” I thought: “Yes, but tomorrow it could change.” I was terrified to say that I had given birth. I had decided that until I was told my baby was safe, I would not tell anyone.

Parents of premature babies live in a state of constant anxiety. Every update from the doctor, every monitor reading, every breath of the baby can shake them or give them hope.

Scientific data show that:

• Levels of anxiety among parents of premature babies are up to three times higher compared to parents of full-term babies.

• Many mothers and fathers report somatic symptoms – insomnia, panic attacks, tightness in the chest.

• Even after discharge, anxiety may persist for years – every cold or fever can feel like a potential danger.

Anxiety also has a protective function – it keeps the parent alert and ready. But when it becomes chronic, it exhausts and turns the joy of parenthood into a constant state of readiness for disaster.

This is hypervigilance – one of the symptoms of trauma. The psyche lives in permanent anticipation of danger. For parents of premature babies, this anxiety often continues long after discharge. Every sneeze, every cough can feel like a signal of catastrophe.

Normalizing anxiety is important. It is not proof that something is wrong with you – it is proof that you love, that you fight, that you are finely attuned to your child.

Isolation: “We Are Not Like the Others”

When my friends posted photos of happy babies at home, I didn’t know if I could share a photo of mine – surrounded by tubes, with a tiny oxygen mask.

I felt like I lived in a parallel world. In my world, joy and fear coexisted, but those around me could not understand. Some said: “Don’t worry, everything will be fine.” Others exaggerated the drama. And I just needed someone to be there with me and endure the silence.

Socially, parents of premature babies often fall into isolation. They cannot take part in the typical joys of other families – first walks, gatherings, photo sessions. The photos from the intensive care unit look different – instead of a smiling baby, parents see a small body surrounded by machines and tubes.

This creates a sense of “otherness” that is hard to share. Friends and relatives often don’t know how to react.

Isolation is one of the strongest psycho-emotional factors for parents of premature babies. They often feel “different,” “excluded from normal life.” This feeling can lead to social withdrawal and depression.

This is why support groups are so important – when you hear another parent say: “I’ve been through this too,” suddenly the world feels less lonely.

Bonding with the Baby: Love Through Glass

I remember the first time I was allowed to place my hand on my baby’s chest. So fragile, so tiny, and yet the heartbeat pulsed with unimaginable strength.

In that moment, I realized – our bond was there. Even through the machines, even through the fear, even through the glass. My baby somehow heard me and responded.

Parents often cannot hold their baby immediately. Touch is limited. Skin-to-skin contact is a dream that comes later. Bonding is fundamental to the child’s development, and many parents fear that they “won’t be able to build a connection.”

But research shows that the bond still forms:

• Psychological studies demonstrate that kangaroo care – skin-to-skin contact, even for minutes – reduces stress in both the child and the parent.

• The baby recognizes the voice of the mother and father even in intensive care, and it has a soothing effect.

• Small rituals – singing, praying, leaving a stuffed animal with the parent’s scent – build an invisible bridge of closeness.

This is love through glass – but it is real and transformative. Bonding is not destroyed – it is tested.

How to Cope? Practical Guidance

1. Name your feelings. Guilt, anxiety, anger – they are all normal. When we name them, they lose some of their power.

2. Seek support. Talking to a loved one, a therapist, or joining a support group for parents of premature babies can ease isolation.

3. Create small rituals. Speak to your baby, leave a song, keep a journal. These create a thread of connection.

4. Take care of yourself. I know it sounds impossible, but your resilience is oxygen for your child.

5. Live day by day. The bigger picture may frighten you, but small victories each day build strength.

Conclusion: Hope

Being the parent of a premature baby means being thrown into a battle you never wanted. But this battle also brings out strength you never knew you had.

I have walked this path.
I know its darkness, its loneliness, its terror. But I also know its light – that moment when you hold your child and realize that everything you went through has brought you back to each other with an even deeper love.

And I want to leave you with this: your child feels your heart. Even through the glass, even through the fear, even when you yourself doubt. That love is the truest gift you can give.

And it is enough.

With love,
Petya Bankova