Many Washington, D.C. residents who find their way to therapy have already looked inward, already know the vocabulary, already have a pretty good sense of what's going on with them. What they're looking for isn't someone to explain anxiety or trauma to them — it's someone who can actually help them change. D.C. attracts people who are drawn to purpose, impact, and high-stakes work — and who are often the last to notice when that drive has curdled into exhaustion, or when a life organized around achievement has quietly stopped feeling like enough. Political transitions, career pivots, and the particular pressure of a city where what you do and who you are tend to collapse into the same thing — these create a specific kind of strain that doesn't always announce itself as a problem. Until it does, and suddenly it's the problem.