Work stress therapy for professionals in the Seattle area
Is it the job, or is it you? That's usually the question underneath a first call about work stress, and it's a fair one. My answer is almost always some of both. The useful work is figuring out the proportions.
You've done what you were supposed to do: the role, the title, the salary, the thing you would have been thrilled about ten years ago. What you feel about it now is mostly a low hum of dread and a steady certainty that you're one bad quarter away from being found out. The performance is still intact. You're still the person others rely on, the one who picks up whatever falls through the cracks, which is exactly why nobody has noticed you've been running on reserves since sometime last spring.
I'm Dania Uritskiy, LICSW. I offer work stress counseling from my office in Edmonds and online anywhere in Washington, and a good share of my clients work in or around Seattle. Most of them are functioning at a high level and are not okay. That combination is very treatable.
Where work stress usually lands
Work stress is a broad label, and it tends to settle into a few shapes. I've written a separate page for each. If the main thing is exhaustion a weekend doesn't touch, and a growing coldness toward work you used to care about, start with burnout therapy. If you aren't exhausted so much as unable to stop, with every achievement resetting within a week, read about therapy for high achievers.
Tech has its own version, with layoff rounds, calibration season and on-call weeks, so it gets its own page on therapy for tech workers in Seattle, which is a somewhat unique work environment. And sometimes work is just where a wider anxiety is easiest to see. If the dread follows you into weekends and relationships and 3am, anxiety therapy may be the better door. You don't need to choose correctly before we talk. Most people are a blend.
Why I'm well suited to help with work stress
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Many of my close friends and family work (or have worked) in different parts of the tech industry, and so do a large share of my clients, especially at Microsoft and Amazon. I have a first-row seat to understanding the the systems behind performance reviews, reorgs, layoff rounds, RTO policies, etc. And this is not only coming from my sessions. And of course I have seen first-hand what these practices do to people’s mental health.
This means you can say "calibration," "PIP," "my skip-level" or "my RSUs vest in March" without stopping to translate. We can spend the hour on what the job is doing to you instead of on how the company works. There's more on the industry-specific side on my page about therapy for tech workers in Seattle.
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Before I opened my own practice, I spent several years leading other clinicians. In 2021 I was clinical lead at Eleanor Health, a substance-use treatment provider in Seattle, managing a team of nurses and other practitioners. After that I was a clinician and team lead at a Seattle group practice, and ran its internship program on top of my own caseload.
Both jobs put me squarely in the middle. I was responsible for other people's work and for how they were holding up, with limited say over the systems that shaped either. If you manage people, you probably know the feeling. You carry decisions down that you didn't make, and your team's frustration up to people who would rather not hear it. You're expected to be candid with your reports and loyal to leadership in the same afternoon.
Capable managers protect their teams by absorbing things: the extra cases, the hard conversation pushed to after the busy season, the gap someone has to cover. For a while that looks like good leadership. Kept up for a year or two, it's also how good managers end up in a therapist's office. So when you tell me about a director who resets priorities every Monday, or a reorg you have to sell to your team while privately doubting it, you won't need to explain the shape of it. I've sat on both sides of that one-on-one.
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In the last 6 years of working as a therapist in Seattle, I have already successfully supported many high-level tech professionals through many difficulties, and I know what works and what does not. Promo cycles, workload adjustments, drastic career transitions, difficult work-life balance decisions, and layoff/PIP stress - I have seen a lot of pain and suffering in my clients. However, I have also seen that balance and happiness is usually achievable with the right approach, provided the client is also willing to put in the hard work and hours to make these difficult changes in their mentality, life approach, and ways of doing things.
What we would actually work on
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Most of the professionals I see have already changed jobs at least once. They found a better manager, a saner team, a company with nicer values on its careers page. Within six months or so, the same feeling had reassembled itself in the new role.
People tell me this with some embarrassment. I hear it as the most useful information we have. If the dread travels with you, the employer was never the whole problem, and leaving again won't fix it on its own.
What usually travels is a small set of beliefs that got rewarded for years before they started costing you anything:
Your worth is something you re-earn every quarter, and the relief of earning it lasts about a week.
Rest needs a reason. Being tired isn't one.
Saying no comes with an instant story about being replaceable.
If something might go wrong, you should be the one holding it.
None of these were invented at work. They were learned earlier, often in a family where being capable or easy or impressive was how you got noticed or kept the peace. Work just turned out to pay well for them. If agreeing to things you don't want is the heart of it, my page on people-pleasing and boundaries goes further. If your mind replays every meeting and drafts tomorrow's arguments at midnight, try overthinking and rumination.
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This is the center of the work. When your value depends on performance, no achievement can settle the question, and the bar moves up to meet you. So we look at what your worth was originally made to depend on. It's almost always older than your career.
Alongside that, we work on rest that isn't collapse. Most of the people I see don't rest; they crash, recover just enough to function, and repeat it a few weeks later. We build a version of recovery that doesn't need a breakdown to authorize it.
We also sort the stress you can change from the stress you can only carry better. A deadline you didn't set, a reorg you didn't choose, a manager who isn't going anywhere: some of this is weather. Less energy goes to fighting the weather, more to what's actually yours to decide, which is usually more than it feels like at 11pm on a Tuesday.
If you manage people, we'll also look at what you're absorbing on their behalf, and whether all of it is yours to absorb. In my experience leads underestimate this badly. (I did.)
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Sometimes it is, and when that's what I think, I'll say so plainly. No amount of insight fixes a role with impossible demands and no control, or a manager who is cruel, or work that asks you to act against what you believe. Therapy is not in the business of talking you into staying somewhere that's hurting you.
What I will push for is making that decision from steadier ground. Leaving in the middle of a crisis tends to mean taking the first exit available. Leaving after you've recovered some footing means choosing. There's usually a middle ground people forget: scope, hours, a rotation, a leave you're entitled to and have never asked for. Having sat in the lead's chair, I can tell you managers say yes to more of these requests than people expect. Testing what's negotiable is often one of the first concrete things we do.
If a setback has already happened (a layoff, a missed promotion, a role that didn't work out), the task becomes rebuilding. I've written about how to rebuild confidence after a career setback.
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Most of the people I see don't really rest; they crash. They hit a wall, recover just enough to keep functioning, and then repeat the whole thing a few weeks later. Together we build a version of recovery that doesn't require a breakdown to authorize it, so that slowing down becomes something you're allowed to do on purpose.
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Not scripts lifted from a productivity book, but actual language for your actual situation. And, just as importantly, the harder work of tolerating the discomfort that arrives right after you use one. That discomfort is usually the thing that makes people abandon a boundary a day later, so we practice sitting with it until it loosens.
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Perfectionism, over-preparation, and rumination are, at bottom, anxiety-management strategies that happen to get rewarded at work, which is exactly why they're so hard to put down. We treat them as strategies you developed for good reasons rather than as flaws to be scolded out of. If anxiety turns out to be the dominant thread for you, anxiety therapy may be the better starting page.
What happens next
You pick a time for us to meet, directly on my calendar. Fifteen minutes, free, by video or phone. You don't have to have the words ready or fill out long forms; I understand the first step can be difficult.
We meet virtually and talk about what's going on. I'll tell you honestly whether I'm the right fit, and if I'm not, I'll point you toward someone in my network who is.
If it feels right, we schedule your first full session, usually within a week. I see clients at my office in Edmonds on the waterfront, or virtually across Washington State.
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No. Many people come in while they're still performing well, because they can see where the current pace is heading. That's often the easiest time to make changes, before exhaustion has narrowed your options. If you're already past that point, that's fine too. We start wherever you are.
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No. I'm private pay and not connected to your employer or any workplace program, so nothing is reported to your company. If you submit superbills for out-of-network reimbursement, those go to your insurance plan, not to your employer. What you say in sessions stays confidential, within the legal limits that apply to every licensed therapist, which I explain in the first session.
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Therapy. Coaching focuses on performance goals: getting promoted, leading better, managing time. Therapy looks at why the pressure lands on you the way it does, including the patterns you brought into the job long before you had it. Performance often improves as a side effect, but it isn't the goal. If what you want is purely a career strategy, a coach may be the better fit, and I'll tell you so.
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Often, yes. A layoff or a performance plan tends to hit both your finances and your sense of who you are, and the weeks right after are when people make the decisions they later wish they'd thought through. We can work on steadying you first, then on what comes next. I've also written about rebuilding confidence after a career setback.
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Absolutely not. Tech is a large part of my practice because of where we are, but I work with professionals in many demanding fields. The patterns are usually similar: high standards, a lot of responsibility, and a sense of worth that has become tied to performance.
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Some, but not for its own sake. The belief that your worth depends on your output was usually learned early, in a family with particular rules about what got noticed. Understanding where it came from is what lets us change it, rather than managing its symptoms indefinitely. Most of our time still goes to your life as it is now.
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Many people notice some relief within the first couple of months, often in sleep and in how much work follows them home. Changing the deeper pattern takes longer, and I'll be honest with you about where things stand as we go. I wrote a longer answer to how long therapy takes.
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I'm private pay and out of network with all insurance plans. If your plan has out-of-network mental health benefits, I provide a monthly superbill you can submit for partial reimbursement. Current rates, and what to ask your insurer, are on my fees page.