1. Kirsten! Thanks so much for doing an interview. Matty and I are excited to feature you and Tretbar Therapy. Please tell us a little bit about Tretbar Therapy and what inspired you to go back to school to get your Masters of Science in Marriage and Family Therapy? (Congratulations, by the way!)
Hi, lovely people! I’m Kirsten Tretbar, LMFT. I’m a psychotherapist, and owner of Tretbar Therapy, a mental health private practice based in Kansas City. We serve clients of all ages and life stages. I specialize in family therapy for people who are neurodivergent, on the spectrum, gifted and/or highly intelligent. We work with anyone dealing with depression, anxiety, stress, or the debilitating effects of trauma, such as PTSD: helping individual adults, kids and teens, couples, siblings, parents and their children, and whole families no matter how big. I think one of the reasons I became a therapist, despite the fact that I faced my own difficulties with depression and anxiety through the years, has to do with my own difficult experiences being a really smart little kid. I was opinionated, talkative, and sensitive. I might have had ADD, but honestly, I think I was just really bright. I would get into fights with a lot of young boys, mostly the school bullies who were hurting my friends, and I’d get sent home from school with a fat lip and black eye, after defending everyone. I like to think I’ve always had a kind of warrior spirit!
As I grew up, I discovered my tribe- the other weird, bright, bouncy kids in theater and choir, and this probably saved me. Expressing my feelings in dramatic ways, and living the emotional experiences of others, helped soothe my own struggles with being different and seeing the world in complicated ways. It also helped alleviate the discomfort I was dealing with at home, with my brilliant Doctor father who had his own bouts of depression and alcohol dependence, and my intuitive, over-functioning mother, who was stuck always smiling and loving us, and keeping it all together. I think I always felt protective of those who couldn’t fight for themselves, and I was always seeking out ways to save my friends and family. I don’t consider this codependence by the way. I consider this kindness, hopefulness, courage, and love! And now I get to do it professionally, and it’s so fulfilling.
Kids who are smart are often super anxious. This is due to their brain development being asynchronous. In other words, their emotional and logical intelligence are often at odds with imbalance between the strength of the right and left side. On top of that, brain development is much slower for the upper, logical, levels of the brain, than the lower, emotional levels, so there is a kind of imbalance in childhood brain functioning – coming on line at different periods – over years at a time. For example, almost all the 7-year-olds I see yell to their parents, “I hate you!” or “You hate me!” or “I wish I was dead!” Families come to me frantic about this. This shout out is really just a young person who still views the world in black and white terms, but is intelligent enough to see that things are unfair. It’s super confusing to them. They see everything as either safe, or a threat. This isn’t their fault. It’s because their brain hasn’t developed the logical prefrontal cortex part, which controls the ability to experience empathy, say, for a tired dad who’s trying to get his kid into bed.
This brain issue leads to kids acting out, with wild emotional mood swings, and what expresses itself as depression and anxiety. When we are kids acting weirdly, then our parents worry, and then they act weirdly, then this worries us and we act even weirder. Pretty soon, everyone’s acting really really weird, and all is chaos! As kids, we become the class clowns, or the teacher’s pet, or we cause trouble, making honking, farting noises with our hands under our arms, throwing ourselves upon people inappropriately, pushing people we actually like, freaking out and screaming about germs, crying uncontrollably! I love having creative sessions with kids like this where I let them do all the weird, hilarious, nervous system regulating stuff they need to do, and then discussing it all with them afterward, or drawing, or using puppets and funny voices to try to understand their emotions. Kids and their parents need this. I’ve found that it’s been really helpful for clients who come to Tretbar Therapy to get this kind of integrated mental health help for the whole family. It’s quickly becoming my specialty.
2. As a therapist, how do you balance taking care of your clients’ mental health while also prioritizing your own?
Taking care of yourself as a therapist, for me, means getting plenty of rest, unplugging when not working, laughing a lot, walking, not drinking much alcohol, if ever, and eating healthy food. It also means physical affection and touch, lots of hugs and kisses, with my family and husband, and lots of unplanned time to just putz. Put music on. Do some laundry. Lie in bed. Walk.
Do we always have to be goal-oriented? No. Time unplanned is possibly the most important thing a person can do for themselves. This is especially true for those who work long hours, for kids who are over-extended with after school events, for adults with jobs that keep them plugged into computers, tablets, and phones. Learning to relax is hard. It’s taken me years to not feel guilty. I often just relax by reading or writing. Reading gets you out of your reactive brain and into your PFC. It’s a soothing activity. You can also use the mantra, “Nowhere to go, nothing to do,” while you do the dishes or sit on your sofa petting your cat.
I’m a huge science fiction and spy thriller reader, as well as a reader of biographies and Civil War histories, and I even read stupid Regency romance books. I probably read two books a week on my Kindle. There’s nothing more relaxing than a lazy Saturday, when I’ll unplug with a book, have a fireplace blaring on my TV screen with loud crackling noises, make myself some hot chocolate, put on my sweats and a huge comfy sweatshirt, and sit beside my husband, while he DJs or plays a video game, or fiddles on the piano. I’m just a big believer in allowing yourself to do as little as you need to do to be happy. If there are a pile of dirty dishes, so what. Seriously. You will get to them when they bother you enough. I believe in being very, very gentle with yourself, your body, your emotions, your needs, and slowing way, way down. Say no, often, and easily. Your body will thank you.
I’m pretty well-balanced, because I always keep my focus on the positive aspect of therapy, and that is, that I have never seen a client get worse with therapy. They have ALWAYS, and I mean, ALWAYS, felt better after doing therapy.
There’s proof in the pudding, as they say. I have this positive view of healing because I live and experience it every single day. I’ve spent two years with some clients, and have seen the whole cycle of coming in to therapy in a total state of crisis, to terminating therapy after months or years, with complete healing, growth, and change, over time. I have experienced for others, and for myself, what therapy can do, the change and growth and strength it can foster; and so I am never as afraid as the client is, who comes in feeling desperate. I am the hope that they are seeking, but are unable to feel right now. I know first-hand how much better they will feel, with time.
Another important thing to realize about therapists, is that they do this work, because they also have their own therapy and support systems. Almost all therapists do some version of what is formerly called supervision. No matter how long they’ve been practicing, most therapists organize weekly or monthly hour-long sessions, with either one particular therapist supervisor, or a group of fellow therapist/colleagues. If we feel anything brewing in our bodies, like obsessively thinking and worrying about a client, we know we are going through the age-old therapists’ experience called countertransference. Freud was obsessed with transference and countertransference. It’s not a shameful thing. It happens. And we talk about it with our supervisors, and we laugh and cry, and learn that it’s okay to feel deeply. Hey, we’re just people sitting in a room listening and caring, of course we’re gonna feel emotional.
Most beginning therapists see a supervisor for almost three years, on a weekly basis, one to two hours a week! In grad school we are also under supervision for almost two years, up to three hours a week. So our work and our emotional process is always being discussed, supported, monitored, taught, held, advised. Supervision also means that the MFT therapy profession is a very serious, very well trained and monitored one. Marriage and Family therapists have some of the longest, most vigorous training standards, in the entire counseling/therapy profession.
3. Many people struggle with anxiety or depression, especially during life transitions. What’s one personal experience you’ve had with mental health challenges, and how has it shaped the way you support others?
I think it was Carl Jung who once said something like, “wounded people heal wounded people.” The short and the long of my journey toward opening Tretbar Therapy, and becoming a therapist in private practice, relates to my own health challenges and growth. For most therapists, this is usually true. My first day of grad school many of us admitted that we had struggled with our own mental health. We were all also very obviously, smart, opinionated, reserved, funny, strong, truth-speaking, private, articulate, sensitive, and natural leaders. It was the most incredible thing to experience, to come into a room full of complete strangers, who you very quickly realize are people who are like your total mirror image!
My own health challenge happened in 2020, during Covid, when so many people were facing their own similar struggles. I was dealing with crazy exhaustion during the pandemic, and my own anxiety, and I felt so alone, overwhelmed, and sick. To quote Matty in one of his stand-up routines, “I have anxiety. I’m the only one.” I’m feeling anxious that I didn’t quote him correctly – Sorry Matty!
I think all the stress just made my body freak out and shut down. I started having horrible panic attacks and was in and out of the hospital with worries about heart arrhythmia. I had the feeling I was going to die. I had no idea it was actually stress and anxiety. I was working 50 hours a week in a surgery center, having to sell procedures to 25 patients a day, wearing a mask and a face shield. I eventually got help. My doctor advised me to quit my job or take FMLA, and seek help immediately. I did.
This period of my health struggles really influenced my choice to become a therapist, as well as helping me determine the way I do therapy. My own psychotherapist, Tim, is a brilliant, gruff guy who uses humor constantly in sessions and he is absolutely my role model. He wears stupid, ironic t-shirts that say things like, “Due to unfortunate circumstances, I am awake!” He’ll show you his diploma on his wall, which is a silly sign that reads, “Don’t ask me, I just work here.” He cracks jokes in between more serious, heart-felt, insightful work, sitting back in a huge reclining chair. He looks more like a fire chief than a therapist, like he came out of Central Casting, or like Judd Hirsch in “Ordinary People.” He likes to send me funny video clips throughout the week, such as Bob Newhart in the famous Mad TV skit “Stop It!” This brilliant therapist, with his funny down-to-earth personality, really saved my life.
For those of you who know a bit about Psychiatrists and Psychotherapists, my therapist was a lot like the famous Carl Whitaker, one of my favorite MFT founders, that I studied in grad school. Carl called his method Therapy of the Absurd. He was one of the great physician/founders of the Marriage and Family Therapy field, a specialty that had its groovy roots in the 60s and 70s, and grew out of research on communications/systems theory, cybernetic functioning in computer systems, as well as Anthropology.
Whitaker was known for his gruff personality, which included going to sleep on his patients/clients, because “I probably found you just as boring as your wife does.” Anyway, my funny, wonderful therapist, who was a lot like Whitaker, helped me heal in a big way that year. I got on top of my panic and anxiety issues, and I realized, with my husband’s support, I could go back to school and do this for a living. I’d been an actress and acting teacher in my past, as well as a documentary filmmaker, and I was really used to working creatively with people to uncover emotions and truths. I’d been a medical educator and counselor for several years too. So it just made sense to do this. Having had my own mental health struggles, as well as my own healing, had given me a kind of strength and positivity, behind what I do in the session room. I believe in the process because it worked for me too.
4. How has the role of humor affected your life or your career?
My own therapist really modeled this for me, and it’s been incredibly helpful using humor with my patients/clients. I love the name of this blog website. I’m guessing that you comedic geniuses already innately know this: that creating absurd mental images like “control, alt, delete” for stress and anxiety, is actually a treatment intervention called externalization? If not, you’re already doing your own therapy, so good for you!
Externalizing is questioning the stress outside of your body, separating it from your own self, using humor to take its strength away, as if it’s just a stupid computer program. And isn’t that what our nervous system is, really? Just a stupid computer we should be able to throw at the wall? Doing this kind of whimsical reframe is the basis of Narrative Therapy, and it’s also called “challenging the narrative” which is another way of saying, “externalizing the stressor.”
Incidentally, I used puppetry and lots of humor in my thesis Capstone project and I wrote my thesis about this exact thing! In fact, I just used this Narrative method of externalizing only yesterday with a young client. We named and drew out our anxiety, making huge funny pictures of our “bully brains” on the giant white board in my office. My anxiety bully was called Anxious Arnie and he looked like a skinny old man with a long goatee, who was always freaking out about everything. I encouraged my young client to come up with funny names and silly voices for their anxiety bully too, and we were in hysterics! It was a really profound session. (Please understand one thing here: It may sound like everything is fun and games when I tell a story like this. That’s not really the case.) Just so you know, my client came into the session that day, tearful and very shut down after a truly scary situation at school earlier that day. They are a very young child who is extremely smart and they struggle with terrible fears that control their life. It’s been a very debilitating situation for this child and family. For them to let go and be able to giggle and laugh about their fears, is a sign of incredible progress, a true breakthrough!
Externalizing a problem is so helpful. It takes you into a place of humor and silliness. The reason this helps with healing, is not just that it’s fun, although that’s a wonderful thing too. The work I do may sometimes be playful, but there’s a scientific, well-researched reason for this. The reasoning has to do with the brain’s neurobiology. In order to understand humor and silliness, you are forcing your nervous system to calm down and your logical prefrontal cortex has to kick in. Your PFC wakes up and gets back online, in order to understand the logic of the joke. This takes you out of the stress response – the fight, freeze, flee, or fawn response (which rules OCD and causes even more trauma!) So even if your body is stressed and anxious, it can’t stay that way when you’re trying to get the joke, tell the joke, or lighten your mood by being funny. Your nervous system can’t do both at once – be in a panic mode AND laugh at a joke. So humor forces the nervous system to calm down in order to understand the joke.
Hey comedians! Might there be a reason you are drawn to your profession? (Duh!) Knowing this is the reason that I feel comedians must have free reign in all societies. They are our truth speakers, our unifiers, our mystics, our regulators, our healers, and our challengers. In short, you are healing all of us with your humor. Thank you! You are calming us and our stupid anxiety bully brains by making our nervous systems switch gears, to make sense of the joke. In short, you are also therapists!
5. Is this the first time you’ve owned your own business, and how do you handle the unpredictabilities of Entrepreneurship?
Having a private practice in the mental health scene is a very personal business. Luckily, I have the love, support, and great good energy of a life soul-mate, who after 23 years, is still the funniest, most authentic person I’ve ever met – my British husband, Ozzy. Ozzy’s my best friend in the whole world, and he’s been helping me all along the way, always believing in me like a rock. I do not take that kind of support for granted. I’m really lucky to have it. I’m pretty lucky to be married to a designer/computer engineer/coder guy. Ozzy helped me do all the marketing, design, and promotions for our office and business. Incidentally, he designed and ordered the business card I shared as a picture here. When I realized it had a familiar look to it, but couldn’t name why, he laughed and told me, “Do you like the ecru color, or the watermark?” I instantly got the joke. He told me about how he found a website that does the exact same designs for cards from the hilarious scene in “American Psycho.”
A while back, Ozzy was handing out our business cards at a party full of therapists, and I was horrified. I still wasn’t entirely on board to use them. I was oddly certain no one would get the joke, or that if they did, then they’d be super offended. You have to be careful with humor in the business of therapy, because people can get triggered over things you aren’t aware of; and you really want to be careful to protect people from harm at all times. Anyway, all my friends at the party thought the cards were hilarious. They instantly got the joke. So maybe I was being overcautious.
A few weeks later, I put those cards on my desk, but I still wasn’t really handing them out. One day one of my clients was finishing her session, putting on her coat to go, and she happened to see one of the cards on the stand by my computer. She grabbed it and shouted, “American Psycho, right? Oh my God! I love it! That’s one of my favorite movies! Can I take a few and show my husband?” I told my client the story about how Ozzy had ordered them and before I could even say that I wasn’t sure about them, she interrupted me and said, “No, Kirsten! You HAVE to use these cards! They’re wonderful! People will laugh and love it!” After that, I started using them. I mean, if you get it, you get it. If not, then they’re just very elegant, classic business cards, right?
6. What’s one piece of advice you’d give to someone who’s thinking about seeking therapy but feels hesitant or overwhelmed about starting?
For those of you who already go to a therapist, please know that we really, really do think about you in our off hours, and we worry about you. We really, really do care about you! We take our jobs very seriously. And if your therapist doesn’t, then I’m so sorry, because they are “el-jerk-arinos” and they don’t deserve your business or your trust. I might recommend that you tell them how you feel, or if this feels too scary, it’s really okay to either quit, or ask for a referral, or just find someone else. They’ll get over it, and maybe they’ll learn and get better.
Psychology Today is a great place to find a therapist. There are also so many online forums as well, and they’re all pretty good. For those of you who are nervous about finding a therapist or getting into the elusive thing we call therapy… I like to tell new clients that therapy doesn’t have to be scary, or even sad. You don’t have to sob your heart out in a session for it to be a great session. I think this image is really a myth, and it keeps people from coming. I encourage you to let that image go. I believe therapy can be emboldening, encouraging, and uplifting. It should be clarifying and balancing, and feel easy and gentle. It can even be boring and slow, and really effective. It can be loud, full of anger, or wacky, even hilarious, wildly creative, and even fun.
Every therapist and every session is different. You can think of therapy as going on an adventure to uncover all the stories of your family, and ways you are the same and different. It’s almost like doing an ethnographic or archeological field dig on yourself. Thankfully, going to therapy has become so normalized. If you’re worried about getting into too much heavy stuff, or feel shame around going to therapy, you might learn that this idea is really changing. Just go on TikTok, Insta, or Snap and see how the 15-to-30-year-olds view therapy. They come into my sessions with everything already figured out. This younger generation is incredible. They’ve been going to therapy and learning about self-care for years. But note, they’re also very good at hiding, or masking that they’re okay. In my honest opinion, this generation is really struggling.
Therapy doesn’t have to be a big deal. Going to therapy has become totally mundane, which is great. It should be a normal, everyday thing. When done right, it can be both simple and complex, mundane and totally profound, all at the same time. That’s the paradox of therapy. Sometimes the most boring, slow sessions, do the most healing. A lot of the work, or processing, done in sessions, actually happens after the session, or between sessions, by YOU!
Every single year there seem to be new findings about how the brain works. There are just so many new studies and findings related to anxiety and depression, and how the nervous system, and brain/body connection, work together and can be healed. If it’s been a while since you thought about therapy, you might think about trying something new along these lines. I might suggest looking into finding a therapist with a more body/brain focus, more neurologically-based methods. I would highly recommend therapists who are trained in EMDR and/or Somatic or movement techniques.
People who need therapy, and who choose to go to therapy, are AMAZING PEOPLE! And amazing people are usually good at making decisions when the moment suits them. There’s really nothing I can say to motivate you to get help. You can make the decision to go to therapy. You will go when you are ready. If you don’t want to go, you won’t go. But if you want to, I promise you that you will know exactly when that time is near. When that happens, you will have no fears. You will find someone to talk to. You will call someone. It will be a relief. You will see them. You will feel better. It might take some time, but you will feel better. Change is possible. Hope is possible. You can do it! Sending you love and virtual hugs. – Kirsten Tretbar, LMFT
7. I guess we already posted a picture of your business card (that’s bone by the way- lol) but where else can people find you?
I’m always posting things and offering unsolicited advice on:
http://www.facebook.com/tretbartherapy
Ctrl Alt Delete Stress 
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