Written by Lovisa Engstrand, Nervous System & Stress Specialist Lovisa Engstrand is a Nervous System & Stress Specialist and founder of The Exhale Collective, dedicated to helping high-functioning women rebuild their internal capacity and overcome chronic burnout. Combining psychology, breath science, and her own health recovery, she guides global clients to regulate their stress through her integrative framework and targeted lifestyle design. It is a Tuesday morning. I am crouched over my husband's groin with my reading glasses on, forensically examining the surgical stitches covering his penis. We have been married for nine months. My mother-in-law is leaning over my shoulder, she wants a better look too. Joel shuts his eyes. He does not flinch. "Looking good," I say, and I mean every word. This is what our first year of marriage looked like. It is the best thing that ever happened to us. The man who lied about being 6 feet on Tinder Joel and I met on a dating app in Sydney a decade ago. He lied about being six feet tall on his profile. On one of our very first dates, though, he told me the truth about something considerably more significant: he had been born with a condition called hypospadias, a urological condition in which the urethra does not sit where it should. Multiple surgeries as a child had given him a functional life, but they had not held. By his late twenties, scar tissue had begun narrowing his urethra again, making it increasingly difficult to urinate. The childhood surgeries had failed. What is hypospadias and why most men suffer in silence For the next seven years, Joel sought eight different medical opinions. Some recommended reconstructive surgery, others urged him to wait. A full urethroplasty, a complete reconstruction of the urethra, was the only permanent solution. But with almost no surgeons experienced in complex cases, and almost no one publicly sharing what success and recovery looked like, he spent years feeling alone with his issue and postponing the inevitable. Eight years of friendship before we became us Although our romance did not take off in those early years, our friendship deepened. We regularly spoke from opposite sides of the world. In 2019, even though we had not seen each other in five years, I was the first person Joel called from a car park after an upsetting doctor's appointment. I did not think much of it at the time. In retrospect, it tells you everything about what we were to each other. It was not until 2023, when I found myself single and completed a writing exercise describing the qualities I wanted in a partner, that I had a startling realization. I was not describing some imaginary future husband. I was describing Joel. We reunited in Los Angeles and fell back in love almost instantly. We married in June 2025 on a tiny Swedish island. Five months after our wedding, the surgery began. What a sexless marriage actually looks like: From the inside Conventional wisdom says a sexless marriage spells trouble. By that logic, Joel and I should have spent our first year bickering over the dishwasher. Instead, we have never felt closer. We train together at the gym, tackle escape rooms, dance in the kitchen while making dinner. We kiss and cuddle with no expectation that it needs to lead anywhere else. If we are intimate, it is focused on my pleasure, which, I joke, has its perks. We have learned, through necessity, that penetrative sex is not the only way to have a fulfilling intimate life. There are more ways to be close to someone than the ones we typically default to when they are available. But I want to be honest, because the honest version is more useful than the tidy one. This year has also genuinely been one of the most demanding of both of our lives. Joel has been through surgery, pain, fear, and the particular kind of loss that comes with having something taken from you, however temporarily, that is tied to identity, intimacy, and manhood. Because of the shame and silence that surround conditions like hypospadias, he spent years feeling completely alone in this experience. Until recently, he had never met another man who had it. He has since started an online support group, and hundreds of men have reached out to share stories they had never told anyone. I have been his primary support through all of it, while building a business, navigating painstakingly slow visa processes, living out of a suitcase across three continents, and trying to process my own experience of a year neither of us chose. No version of this is easy. That's exactly why I want to talk about what made it navigable. What chronic stress does to a relationship Because of the work I do as a nervous system specialist, Joel and I spent more than two years before the surgery preparing, not just practically, but physiologically. Sleep, nutrition, breathwork, stress regulation. Not because any of it could change the surgery itself, but because it meant Joel went into it calmer, stronger, and more resilient than he would otherwise have been. The window of tolerance and what happens when sustained stress narrows it His nervous system was regulated enough to face something genuinely frightening without being completely destabilised by it. That groundwork has mattered more than I can adequately explain during the recovery itself. Here is why. When your nervous system is under sustained load, when cortisol has been elevated for weeks or months, when sleep is disrupted, when there is ongoing physical and emotional stress, your window of tolerance narrows. Things you could previously absorb without reacting now land differently. Small irritations become arguments. Silences become loaded. The person you love most becomes, in certain moments, the person you are least patient with. This is not a character flaw. Co-regulation: Why your partner's nervous system directly affects yours It is physiology. It compounds, because nervous systems are contagious. This is what we call co-regulation: when one person in a relationship is dysregulated, the other person's system picks it up. Two chronically activated nervous systems in a small space during a surgical recovery is not a formula for connection. It is a formula for two people who love each other saying things they do not mean and having to find their way back. The most regulated person in the room has the most influence. I have come back to that sentence more times than I can count this year. Choosing, as often as possible, to be the one who responds rather than reacts, who comes back rather than escalates, is not suppressing your own experience. It is what makes the relationship a safe place when everything outside it is not. Real teamwork is not always 50/50. This year it has sometimes been 80/20, occasionally 90/10. The capacity to carry more when your partner cannot, without resentment calcifying into the load, requires a regulated nervous system underneath the relationship. Without it, the imbalance becomes the story. With it, it is just a season. What this year has actually taught us about marriage It was not a surgeon who ultimately convinced Joel to have this surgery. It was our relationship, and knowing that whatever happened afterward, we would face it together. That is worth naming, because it speaks to the thing I believe matters most in a partnership: safety. Not romance. Not chemistry. The deep, cellular experience of knowing that this person is not going anywhere. Judge your relationship by how you treat each other when things are hard, not when things are easy. Everyone has a good relationship when things are easy. The question is what you find when the ease is gone. What we have found this year, in its least glamorous, least Instagram-friendly moments, is that we genuinely like each other. We make each other laugh. We still choose each other every morning, including the mornings when choosing is a conscious decision rather than an effortless one. This was not the first year of marriage I had imagined. It was something better, it was the year I learned what marriage actually is. Not candlelit dinners or honeymoon stages. Being in a king-sized bed at 9 am with reading glasses on, looking at surgical stitches covering a graft on a penis, and saying 'looking good' and meaning every word. What nervous system regulation looks like when life is actually hard Living through the hardest season of my own life has made the value of this work impossible to overstate. A regulated nervous system does not mean the hard things stop being hard. It means you have something to come back to when they are. That is the difference. I have never been more certain that it matters. This work is available to you If you want to become the most regulated person in the room and stay steady even when things are hard, I am opening two small cohorts: one for my Swedish community and one for my English-speaking community across the US, Canada, and Australia. Small groups, real support, a structured plan, and accountability across three months. This is not a course you do alone. This is a group of women moving through the work together, with me alongside them the whole way. Swedish cohort starts on September 29: Apply here! English cohort (US/Canada/Australia) starts on October 3: Apply here! Both are by application only. Enroll before September 15 for an early bird discount. Learn more about the framework and programme here. You can follow Joel's and my journey on Instagram. Visit my website for more info! Read more from Lovisa Engstrand Lovisa Engstrand, Nervous System & Stress Specialist Lovisa Engstrand is a Nervous System & Stress Specialist and breathwork practitioner working at the intersection of psychology, physiology, and behaviour change. She specialises in helping high-functioning women who feel exhausted, overstimulated, anxious, or stuck in survival mode. Her work is grounded in her own lived experience of training, eating well, and still waking up anxious, bloated, and depleted - until she understood her nervous system. Through her Regulate & Restore Framework, Lovisa addresses stress regulation, sleep, movement, nutrition, and identity to help women rebuild capacity from the body up. She lives between Australia, Sweden, Canada, and the USA and works with clients globally through 1:1 containers & online programs. Please note: This article reflects personal experience and is for informational purposes only. It is not a substitute for medical or psychological professional support. Hypospadias and urethroplasty are complex medical conditions - if you or someone you know is affected, please seek guidance from a qualified urologist. Related articles: Why You Feel Like a Teenager Around Your Family and What Your Nervous System Has to Do with It Why Stress Is Causing Your Constipation and Bloating — And Why Fiber Alone Won't Fix It You're Not Bad at Sleep, Your Nervous System Has Never Been Told It's Safe to Rest

Written by Dr. Hussein H. Rifai, Thought Leader and Chairman Dr Hussein H. Rifai is a global business leader, investor, and company chairman with more than four decades of experience across 85 countries. He writes on leadership, corporate governance, private equity, artificial intelligence, and international business. My own cultural journey has been a slightly complicated one. I was born in Nablus, grew up mainly in Amman, and left Jordan at seventeen. From there, I went to the United States, returned to the Arab world in Saudi Arabia, later spent time in Canada, and eventually made Australia home. Much later, I also spent eight years living in Dubai. Along the way, I worked with people from dozens of countries and travelled through many more. I mention this only because each move required something more complicated than learning where to live, what to eat, or how to get to work. Every country had its own unwritten rules. How you speak to your boss. How you disagree. What family means. How much of your private life belongs to your relatives. What is considered rude, funny, respectable, offensive, or none of anybody else's business. The mistake migrants sometimes make is believing that migration is mainly geographic. You leave Jordan, Palestine, India, China, or Lebanon and move to Sydney, Toronto, or Los Angeles. Your body has certainly migrated. Whether the rest of you has moved is another question entirely. America was my first major cultural adjustment. The individual mattered more than the family unit I had grown up with. Young people were expected to become independent earlier. People spoke to professors and bosses with a casualness that would have seemed strange in Jordan. Ambition was not something to hide. Americans were comfortable telling you what they had achieved and what they planned to achieve next. Canada had similarities, but the edges were softer. Saudi Arabia then moved me back into an Arab environment, but certainly not the same Arab environment I had left. That itself was an education. We often speak about “Arab culture” as though several hundred million people from Morocco to Iraq received the same operating manual. They didn't. Then came Australia. By then, I had learned one useful lesson, when you enter another culture, don't immediately decide that everything they do differently is wrong. That sounds obvious. In practice, it is much harder. Every culture has characteristics that affect work, family, and personal relationships. Australians tend to be informal, direct, egalitarian, and suspicious of anyone who takes rank or status too seriously. Jordanians tend to place greater importance on family, relationships, hospitality, respect, reputation, and social obligations. Neither description applies to everyone, and neither culture is better, but pretending those differences don't exist is equally silly. At work, the differences become obvious very quickly. An Australian employee may openly disagree with the boss in a meeting and think absolutely nothing of it. A Jordanian employee may regard doing that publicly as disrespectful and instead raise the issue privately, or perhaps not raise it at all. The Australian manager can interpret silence as agreement. The Jordanian employee can interpret the manager's bluntness as arrogance. Both go home convinced the other person has a problem. Australians also separate hierarchy from personal dignity more easily. The Chief Executive Officer (CEO) and the junior employee may call each other by their first names. Someone can challenge my idea without challenging me. In much of the Arab world, relationships, seniority, and the manner in which disagreement is expressed can be just as important as the disagreement itself. Neither approach is automatically right. In Australia, excessive directness can become unnecessarily insensitive. In Jordan, excessive concern about hierarchy can stop people telling the boss something he desperately needs to hear. Having worked in both cultures, I would rather understand the strengths and weaknesses of each than pretend one has discovered the perfect management system. Family life is where adaptation becomes much more personal. Jordanian family culture can be wonderful. Families are close. People show up. Parents remain involved in their children's lives well into adulthood. Hospitality is genuine. If something goes wrong, you can suddenly discover relatives you didn't even know you had offering to help. There is another side. Family involvement can become family interference. Concern can become control. Everybody can know everybody else's business. Privacy sometimes appears to be a suspicious Western invention. A family disagreement can rapidly acquire advisers, commentators, historians, and several people who were not present but nevertheless know exactly what happened. Australia is different. Families can be extremely close, but adulthood usually carries a stronger expectation of independence. Your adult child's decisions are ultimately their decisions. Your neighbour does not need to know where your daughter went last night. Your cousin does not automatically acquire voting rights over whom your son marries. For a migrant, this is where things become complicated because you don't simply observe the difference. You have to decide which rules you are actually going to live by. I have watched immigrants move to Australia and then spend decades recreating the country they left. This is not particularly Jordanian or Palestinian. Almost every migrant community does some version of it, but I know my own community best, so I can make fun of us with greater authority. Some Jordanians and Palestinians effectively build a small Jordan or Palestine in Sydney. They live near each other, socialise almost exclusively with each other, eat the same food, watch Arab television, follow Jordanian or Palestinian politics, use Arabic at home, shop at the same businesses, and sometimes know more about what happened in Amman yesterday than what happened in Australia. The neighbours change, but the neighbourhood in their heads doesn't. Then comes the gossip. Who married whom? Who divorced? Whose daughter was seen with somebody? Whose son is earning what? Who bought a house and how much did it cost? Why wasn't someone invited to a wedding? Why was somebody invited and seated at table seventeen rather than table twelve? We have successfully transported an ancient communications system across continents without requiring fibre-optic cable. The food, incidentally, should absolutely survive migration. I am strongly in favour of cultural integration, but there are limits. Nobody needs to abandon mansaf to prove commitment to Australia. The problem is not keeping your food, language, traditions, or friendships. Those are part of who you are. The problem begins when you move to another country but construct your life so carefully that you never really have to encounter it. There is an enormous difference between living in “Jordan-Australia” and living in Australia. If almost everyone you see socially shares your background, values, and assumptions, adaptation becomes optional. You can live in Sydney while continuing to apply Amman's social rules. Your children, however, cannot. They go to Australian schools. Their friends are Australian, Chinese, Indian, Lebanese, Korean, Greek, Vietnamese, Muslim, Christian, Jewish, Hindu, atheist, and everything in between. They absorb Australian humour, attitudes, and expectations. Then they come home to parents who occasionally appear surprised that Australia has somehow entered the house. This is where migrant parents can make life unnecessarily difficult for their children. Adaptation means accepting that your host society will contain behaviour you don't like. Sometimes behaviour you strongly dislike. You may come from a conservative society and see teenagers kissing in the street. You may see young women wearing clothes you would never have imagined your daughter wearing in Jordan. Your children may date in ways you did not grow up with. Young people may speak to adults with a level of informality that initially feels disrespectful. You don't have to like any of it. That distinction matters. Integration does not require you to personally adopt every Australian habit. I can live happily in Australia without getting a tattoo, wearing shorts to a business meeting, or developing an emotional attachment to Vegemite, but living here does require me to accept that other Australians are entitled to make choices I would not make myself. You cannot move voluntarily into another society and then demand that the society stop offending you. That is part of the bargain of migration. This does not mean abandoning your own values. It means understanding the difference between values you choose for yourself and rules you are entitled to impose on everybody around you. That was particularly important to me in raising children. I never wanted to raise Jordanian children who happened to live in Australia. I wanted to raise Australians who understood and were proud of their heritage. There is a big difference. Heritage gives children roots. It gives them family history, language, food, stories, and an understanding of where their parents and grandparents came from. It should enrich their identity, not imprison it. My children did not grow up in the Jordan I grew up in. Why would I expect them to behave exactly as though they had? They were growing up in Australia and preparing for an Australian future. They needed to be able to form friendships across cultures, operate comfortably in Australian workplaces, make independent decisions, and develop their own identities. If I had insisted that they live according to the social rules of the Amman of my childhood, I would not have preserved their heritage. I would simply have made their lives more difficult. This is perhaps the hardest adjustment for first-generation migrants. We sometimes confuse preserving culture with preserving time. The Jordan I left at seventeen no longer exists exactly as I remember it anyway. Jordanian teenagers today are not growing up as I did. Amman itself has changed enormously. Yet an immigrant can preserve an idealised version of the country from the year he left and then attempt to impose it on children born twenty or thirty years later on the other side of the world. There is something slightly absurd about being more culturally conservative in Sydney in 2026 than your relatives are in Amman. Successful integration, to me, is not assimilation. I don't believe people should erase themselves when they migrate. Australia would be a poorer country if every immigrant arrived and immediately abandoned their language, food, history, and traditions. The better outcome is addition rather than subtraction. Keep the mansaf. Keep the Arabic. Keep the family stories, hospitality, generosity, and connection to where you came from. Teach your children about Nablus, Amman, Jerusalem, or wherever their family story began. Take them there. Let them understand their grandparents and the history that produced them, but also let them belong completely to the country that is actually theirs. After living across Arab, American, Canadian, and Australian cultures, I have become increasingly suspicious of anyone who tells me one culture has all the answers. Each has given me something. Each also has habits I could happily live without. The real advantage of living across cultures is that eventually you realise you are allowed to choose. You can keep the warmth of Arab family life without importing every piece of family interference. You can embrace Australian independence without becoming disconnected from family. You can admire American ambition without needing to announce every achievement before dessert. You can respect tradition without allowing it to dictate your children's future. Perhaps that is what genuine multiculturalism should mean. Not different communities living beside each other while remaining culturally sealed from one another, but people confident enough in where they came from to participate fully in where they are. Migration changes your address almost immediately. Changing your habits takes longer. Changing your assumptions takes longer still. Allowing your children to build an identity different from your own may be the hardest move of all, but if you chose another country to build a future, particularly for your children, then surely that was the point. Give them the roots. Then let them grow in the country you chose for them. Follow me on Facebook, LinkedIn, and visit my website for more info! Read more from Dr. Hussein H. Rifai Dr. Hussein H. Rifai, Thought Leader and Chairman Dr Hussein H. Rifai is a global business leader, investor, company chairman, and thought leader with more than four decades of experience across 85 countries. His career spans multinational corporations, entrepreneurship, investment banking, private equity and corporate governance, advising boards and business leaders on strategy, mergers and acquisitions, capital raising, business transformation and international growth. Holding a Doctor of Philosophy (PhD) in Business Administration, Hussein writes on leadership, corporate governance, artificial intelligence, international business and global competitiveness, combining academic insight with practical experience gained at the highest levels of global business.

Written by Jamie Alexander, CEO, Certified Online Fitness Trainer, and Author Jamie Alexander is the CEO of Living Well With Jamie, a Certified Online Fitness Trainer, and author of the Mind, Body & Soul Fitness Journal, helping high-performing women transform through holistic wellness, fitness, and mindset coaching. What if getting fit didn't require overhauling your life? Most women are stuck believing it's all or nothing when the truth is, small changes done consistently can create big results. If your schedule is jam-packed, but you're tired of putting yourself last, these hacks are made for you. Why do so many women struggle to prioritize their health? Between careers, caregiving, and constantly pouring into everyone else, high-performing women often find themselves burned out and out of balance. The pressure to do it all leaves little time or energy for self-care. And when it comes to fitness, we're often told that success means long workouts, strict routines, and endless discipline. But that's just not realistic. According to the CDC, only 24% of women in the U.S. meet the recommended physical activity guidelines for both aerobic and muscle-strengthening activity. This tells us the problem isn't motivation, it's time, structure, and flexibility. The truth? Fitness can work for your life, not against it – Here's how 1. Start your day with movement, before the chaos begins You don't need to wake up an hour early, just 10 to 15 minutes of intentional movement can activate your body and shift your mindset. A power walk, a set of bodyweight exercises, or a quick dance session can help you take ownership of your day before it gets away from you. 2. Turn phone time into step time Whether you're on a Zoom call, talking to your best friend, or listening to a podcast, use that time to pace around your house or step outside. Walking while talking can easily help you hit 7,000-10,000 steps a day without ever setting foot on a treadmill. 3. Use the "trigger habit" method This technique is simple but powerful: stack a new habit on top of something you already do. Try squats while brushing your teeth, calf raises while waiting on your coffee, or glute bridges before bed. These micro-movements add up to major results over time. 4. Keep dumbbells where you can see them If you keep your weights hidden in a closet, you're less likely to use them. Keep resistance bands or dumbbells in the living room or next to your desk. That visual reminder makes it easy to squeeze in a quick set between emails or during your favorite show. 5. Drink 16 oz of water first thing in the morning Hydration isn't just about skin and digestion – it affects energy, hunger, and even metabolism. Studies show that drinking 500 ml of water can increase metabolic rate by 30% for up to 40 minutes. Start your day hydrated, and your body will thank you all day long. 6. Don't skip strength training Cardio burns calories, but strength training builds lean muscle that helps you burn fat even at rest. If you're short on time, prioritize two or three full-body strength sessions each week. It's one of the most efficient and transformative things you can do for your metabolism, body composition, and confidence. 7. Progress over perfection, always Real talk: you're not going to hit every goal every week, and that's okay. What matters is that you keep showing up, even when it's messy. One imperfect workout is better than none. One mindful meal is better than giving up for the day. Give yourself grace, and keep going. 8. Walk after a meal to support digestion and blood sugar One of the simplest, most overlooked fat-loss hacks? Walking for 10-20 minutes after a meal. This helps regulate blood sugar, improve digestion, and reduce bloating. A 2022 meta-analysis found that post-meal walking significantly lowers glucose levels compared to being sedentary. Bonus: it helps fight that midday energy crash and supports weight loss goals over time. You don't need hours in the gym or a flawless plan to see progress. You need a few smart strategies that align with your life, and the consistency to show up for yourself every day. Start small. Stay consistent. And watch how your energy, body, and confidence shift. Want more strategies like these? Subscribe to my YouTube channel where I share quick workouts, mindset tips, and real-life wellness strategies for women who are ready to transform. Ready to create a fitness and wellness plan that actually fits your life? Let's talk. Click here to book a free discovery call! Follow me on Facebook, Instagram, LinkedIn, and visit my website for more info! Read more from Jamie Alexander Jamie Alexander, CEO, Certified Online Fitness Trainer, and Author Jamie Alexander is the founder of the Elite Transformation Accountability Program, helping high-performing, busy moms all around the world prioritize their health and create lasting change. She’s the CEO of Living Well With Jamie, a Certified Online Fitness Trainer, and author of the Mind, Body & Soul Fitness Journal. Jamie’s mission is to help women thrive from the inside out through holistic wellness, fitness, mindset, and sustainable habits. Her work empowers women to feel strong, confident, and in control of their health, no matter how full their plates are. Follow Jamie for real-life strategies, expert insights, and inspiration to live well in every season of life.

Written by Sarah Pearce, Certified Doula Sarah Pearce is a nationally recognized full-spectrum doula, former pediatric nurse, placenta specialist, and midwifery student. With nearly a decade of experience, she supports families through fertility, birth, postpartum, and newborn care. She is the founder of Trinity Doula Services, one of the largest doula agencies in the St. Louis region. Right now, with the Lindsay Clancy trial bringing postpartum mental health into the national conversation once again, many people are hearing terms like postpartum depression and postpartum psychosis and asking questions they may have never considered before, but these conversations shouldn't only happen when there is a tragedy in the headlines. We spend months preparing for a baby. We create registries. We choose car seats. We decorate nurseries. We discuss feeding, diapers, swaddles, pediatricians, and birth plans, but somewhere in all of that preparation, we often forget to make a plan for the person who is about to give birth. Who is going to take care of the mother? Postpartum depression, postpartum anxiety, and postpartum psychosis are very different conditions, but they have something important in common, families deserve to know about them before they are experiencing them. Maternal mental health shouldn't become a conversation only after someone is already struggling. The postpartum period is more than six weeks There is still a tendency to treat postpartum recovery like a short chapter. Have the baby. Go home. Attend a postpartum appointment. Resume normal life. The postpartum period is a massive physical, hormonal, emotional, relational, and social transition. Perinatal mental health conditions can begin during pregnancy or emerge during the first year postpartum. While we often use the phrase "postpartum depression" as a catch-all, maternal mental health is much broader than depression. A mother may experience depression. She may experience overwhelming anxiety. She may have intrusive thoughts that terrify her. She may experience panic attacks. She may develop obsessive or compulsive behaviors. Much more rarely, she may develop postpartum psychosis. Knowing the difference matters. Postpartum depression doesn't always look like sadness When people picture postpartum depression, they often imagine a mother crying while holding her newborn. Sometimes it looks exactly like that, but sometimes it doesn't. It can look like anger and irritability. It can look like feeling completely disconnected from the baby. It can look like going through the motions of caring for everyone while privately feeling empty. It can look like guilt, hopelessness, loss of interest in things she previously enjoyed, difficulty concentrating, changes in appetite, or feeling like everyone would be better off without her. This is also different from the "baby blues." Mood changes, tearfulness, overwhelm, and emotional sensitivity are extremely common during the first days after birth. Symptoms that are severe, worsening, interfering with daily functioning, or simply making a mother feel like something isn't right deserve attention. A mother does not have to wait until she is suicidal or unable to care for her baby before she deserves help. Postpartum anxiety can hide in plain sight Postpartum anxiety can be especially difficult to recognize because some anxiety after having a baby feels almost socially expected. Of course you're checking whether the baby is breathing. Of course you're worried about germs. Of course you're researching everything, but there is a point where vigilance becomes debilitating. Postpartum anxiety can include racing thoughts, constant feelings of dread, panic attacks, physical tension, inability to relax, difficulty sleeping even when given the opportunity, repeatedly checking the baby, or becoming consumed by fears that something terrible will happen. Some parents also experience intrusive thoughts. This is an incredibly important distinction, having an intrusive thought is not the same as wanting to act on that thought. Intrusive thoughts can be unwanted, frightening, and completely inconsistent with what a mother actually wants. Parents can become so horrified or ashamed by them that they are afraid to tell anyone. That silence can make an already frightening experience even more isolating. We need to create an environment where mothers can tell their providers what is happening inside their heads without immediately fearing judgment. Postpartum psychosis is different, and it is an emergency Postpartum psychosis is rare, but every family should know what it looks like because it requires immediate medical attention. Symptoms can include hallucinations, delusions, paranoia, severe confusion, bizarre or dramatically changed behavior, extreme mood changes, disorganized thinking, and significant insomnia. A person experiencing psychosis may not recognize that what they are experiencing isn't real. That is one of the major differences between frightening intrusive thoughts and psychosis. If a postpartum parent appears to be experiencing hallucinations, delusions, severe confusion, mania, or a significant break from reality, this is not something a family should simply monitor at home. Postpartum psychosis is a medical emergency. Immediate professional evaluation is necessary. If there is an imminent danger to the parent, baby, or anyone else, call emergency services. Can we prevent postpartum mental health conditions? Not entirely. I think it is important to say that clearly. Postpartum depression, anxiety, and psychosis are medical conditions influenced by many factors. No amount of meal trains, sleep schedules, doulas, supportive partners, or prenatal education can guarantee that someone won't experience them. There is a lot we can do to reduce some risk factors, recognize symptoms earlier, and make sure a mother isn't left to deteriorate unnoticed. Instead of asking only, "What will we do if Mom develops postpartum depression?" we should also ask, "What can we put into place now to protect and support her mental health after this baby arrives?" Protect her sleep Sleep is not a luxury. Yet extreme sleep deprivation is treated almost like an initiation into parenthood. "Just wait. You'll never sleep again." We joke about it. Perhaps we shouldn't. Before the baby arrives, families should discuss what nighttime care will actually look like. Who can take a feeding? Who can settle the baby afterward? Can a partner handle diaper changes and bring the baby to a breastfeeding parent? Can family members take a shift? Could the family hire an overnight postpartum doula if that's financially accessible? Could responsibilities be divided so that each parent gets a protected stretch of sleep? "Sleep when the baby sleeps" is often useless advice. A better question is: How are we going to make sure you actually get opportunities to sleep? Sleep protection becomes particularly important when someone has a history that puts them at higher risk for serious postpartum psychiatric illness. A history of bipolar disorder or previous postpartum psychosis, for example, warrants proactive conversations with qualified medical and mental health providers during pregnancy. Don't wait until the baby is born to figure out what the plan will be. Stop making Mom manage her own help "Let me know if you need anything." It's one of the most common things we say to a new mother. We mean well. We've just given an exhausted person another job, identifying what she needs, figuring out who can do it, reaching out, and asking. Try something different. Bring dinner. Wash the dishes. Refill her water. Walk the dog. Fold the laundry. Take the older children somewhere fun. Hold the baby while she showers. Ask whether she'd like to sleep while you care for the baby. Support should reduce her workload rather than require her to coordinate it. When you visit a postpartum family, remember that you're not only visiting a new baby. You're visiting someone who just gave birth. Take care of her, too. Create a postpartum plan, not just a birth plan Families can spend weeks creating detailed birth plans while giving almost no thought to what happens after they bring the baby home. Before birth, talk about it. Who will provide meals? Who can help overnight? Who are the people Mom feels emotionally safe calling? How will household responsibilities change? What happens when a partner returns to work? Who will notice if Mom stops acting like herself? Does she already have a therapist or mental health provider? Does she have a history of depression, anxiety, bipolar disorder, trauma, or previous postpartum mental health challenges? What symptoms should prompt a phone call to her provider? What symptoms mean the family should seek emergency care? Where are those phone numbers? Put them somewhere everyone can find them. The person experiencing a mental health crisis should not have to research resources while experiencing that crisis. Screen and then actually follow up Mental health screening should be a routine part of prenatal and postpartum healthcare. The American College of Obstetricians and Gynecologists recommends screening for depression and anxiety at the initial prenatal visit, later in pregnancy, and at postpartum visits using standardized, validated tools. Tools such as the Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire 9 (PHQ 9), and Generalized Anxiety Disorder 7-item scale (GAD 7) can help identify people who may need further evaluation. Screening only works when something happens after a positive screen. A checkbox isn't treatment. Families need pathways to further evaluation, therapy, medication when appropriate, community resources, follow-up, and emergency care when necessary. Mental health also shouldn't be assessed at one postpartum appointment and then forgotten. The transition into parenthood continues long after that appointment. We need to ask better questions Sometimes "How are you doing?" is too easy to answer with "fine." Ask something more specific. Are you sleeping when someone else has the baby? Are you able to eat? Do you feel like yourself? Are you enjoying anything right now? Do you feel connected to your baby? Are your thoughts ever frightening you? Do you feel safe being alone? Do you feel like you're constantly waiting for something bad to happen? Perhaps most importantly, "Do you want to tell me how you're really doing without me trying to fix it or judge you?" Then listen to the answer. Don't immediately minimize it. Don't tell her every new mom feels that way. Don't remind her how lucky she is. Listen. If what she's telling you concerns you, help her connect with someone qualified to help. National resources every family should know National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262). The National Maternal Mental Health Hotline provides free, confidential mental health support 24 hours a day, seven days a week, for pregnant and postpartum people and their families. Counselors can provide support, information, and referrals to local or telehealth providers. Postpartum Support International (PSI): Call 1-800-944-4773 or text HELP to 800-944-4773 for English language support. Spanish language text support is available at 971-203-7773. PSI provides information, peer support, online support groups, and connections to perinatal mental health providers. The PSI HelpLine is not an emergency crisis line. 988 Suicide and Crisis Lifeline: Call or text 988 for free and confidential crisis support throughout the United States. If someone is experiencing symptoms of postpartum psychosis, appears disconnected from reality, is in immediate danger, or may harm themselves or someone else, seek emergency medical care. Taking care of the baby means taking care of the mother Our culture is remarkably good at rallying around a new baby. Everyone wants to meet the baby. Everyone asks how the baby is sleeping, how the baby is eating, how much the baby weighs, and whether the baby is "good." I want us to become just as interested in the person who brought that baby into the world. How is she sleeping? Has she eaten? When did she last shower? Does she feel supported? Does she recognize herself right now? Does someone know what to do if the answer is no? Supporting maternal mental health isn't simply telling mothers to practice self-care. We cannot bubble bath our way out of a postpartum environment where someone is chronically sleep deprived, isolated, overwhelmed, unsupported, or afraid to admit that she is struggling. Sometimes self-care looks like therapy. Sometimes it looks like medication. Sometimes it looks like an uninterrupted stretch of sleep. Sometimes it looks like someone else washing the bottles. Sometimes it looks like a postpartum doula walking through the door at 10 p.m. and saying, "I've got the baby. Go sleep." Sometimes it means recognizing that what we're seeing is an emergency and helping a mother access care immediately. We cannot promise that every case of postpartum depression, anxiety, or psychosis can be prevented, but we can build families and communities where mothers are educated before birth, screened appropriately, supported practically, protected from unnecessary exhaustion, taken seriously when something feels wrong, and connected with treatment before they reach a breaking point. We spend so much time preparing mothers to take care of their babies. Maybe it's time we put just as much effort into preparing to take care of them. Follow me on Facebook, Instagram, and visit my website for more info! Read more from Sarah Pearce Sarah Pearce, Certified Doula Sarah Pearce is a highly sought-after birth and postpartum expert, a former Licensed Practical Nurse (LPN) specialising pediatrics, a placenta encapsulation specialist, and the founder of Trinity Doula Services, a rapidly growing full-spectrum doula agency serving Missouri and Illinois. With over a decade of hands-on experience in fertility, labor support, physiologic birth, postpartum recovery, newborn care, and high-pressure pediatric nursing, she has become known for combining evidence-based education with deeply intuitive support. Sarah has supported families through all types of birth settings and is working towards becoming a Certified Professional Midwife. Her work empowers families during life's most transformative moments. Sources and Further Reading: American College of Obstetricians and Gynecologists (ACOG). Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum and Patient Screening: Perinatal Mental Health. ACOG recommends standardized screening for depression and anxiety during pregnancy and postpartum, systems for appropriate assessment and follow-up, and immediate medical attention for postpartum psychosis. Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau. National Maternal Mental Health Hotline. Free and confidential 24/7 support for pregnant and postpartum people and their families: 1-833-TLC-MAMA (1-833-852-6262). Postpartum Support International (PSI). Provides perinatal mental health education, support, provider referrals, peer resources, and online support groups. HelpLine: 1-800-944-4773. 988 Suicide and Crisis Lifeline. Free, confidential 24/7 crisis and emotional support throughout the United States. Call or text 988. WBUR, Associated Press, Reuters (August 2026). Current reporting regarding the Lindsay Clancy trial and the ongoing discussion surrounding postpartum psychosis and maternal mental healthcare.

Written by Beth Rohani, Entrepreneur, Speaker, and Creator Beth Rohani leads the No. 1 moving company serving the Houston Multi-Family Industry, and her company is considered one of the Top 3 Best Rated Moving Companies in Houston. As a first-generation Iranian-American, former TV news assignments editor, and CEO of a transportation and logistics-based business in a male-dominated industry. Here’s the truth, vulnerability isn’t weakness. Vulnerability is courage repackaged. Every time I put myself out there, sharing my story, opening up about my past, or speaking on something I know people may disagree with, I’m taking a risk. I’m exposing a part of myself that could be judged, criticized, or misunderstood. Yes, sometimes that criticism stings. Sometimes it hurts more than I want to admit. But over time, I’ve learned to see it differently. I’ve learned to repackage it. When you choose to be vulnerable, you are declaring that your growth and your message are more important than your comfort. You’re showing yourself that you can handle feedback, take hits, and still stand tall. Some of what comes at you is noise, you dismiss it. Some of it is valuable, you take it, reflect on it, and use it to grow. That necessary filtering process is where the power lies. The resiliency you build when you’re exposed The decision to share your vulnerability, whether it's admitting a business failure or talking about a personal hardship like divorce or loss, is the first step in building true resiliency. You are giving yourself the evidence that you can survive exposure. Early in my career, I shared a bold operational idea at a leadership meeting. A few people dismissed it outright, almost condescendingly. My first reaction was embarrassment, followed immediately by doubt. I wanted to retreat and never speak up again. But instead of retreating, I paused. I separated the delivery, the harshness, from the content, the actual idea. I asked clarifying questions, focused on the operational flaws they identified, and adjusted my approach based on what made logical sense, not what hurt my feelings. The result? That same core idea, refined through necessary criticism, eventually became one of the most successful initiatives our team launched that year. I could only have reached that successful outcome by leaning into vulnerability, listening to criticism without instantly taking it personally, and using it as fuel instead of fear. Vulnerability forced the conversation, and resilience allowed me to stay in it. The leader’s filter: Noise vs. Signal Let’s be honest, people will always talk. They’ll always have opinions. But the moment you stop fearing the noise and start filtering it, everything changes. As a leader, you must become an expert at filtering. You start to see criticism as a tool, not a threat. This involves a crucial, direct process: Acknowledge and separate: Acknowledge the emotional sting, but immediately separate the person's emotion from the information. Don't react to the anger, react only to the data. Check the source: Is the feedback coming from someone whose opinion you respect, whose core values align with yours, or who has achieved the results you are seeking? If not, it’s highly likely to be noise, a distraction rooted in their own insecurity. Discard it. Find the signal: If the feedback is coming from a trusted source, or if you hear the same critique from multiple, unrelated sources, it is a signal. It means your blind spot has been exposed. Use this data to refine your plan, your process, or your approach. The criticism is not about you, it’s about the flaw in the current system. That’s where growth actually happens, in the space between hearing the feedback and choosing a thoughtful, intentional response. Vulnerability as an act of service I won’t sugarcoat it, putting your personal experiences into the world is uncomfortable. It makes you feel exposed. It goes against the conventional wisdom that leaders must maintain a perfect image. But here’s what I’ve realized, the act of sharing your vulnerability isn’t just about you. It’s about the impact it can have on someone else. By being open about the difficult parts of my journey, whether it’s managing death, divorce, or major business setbacks, I give others permission to face their own struggles without shame. If my story gives one person the courage to face their own challenges, to speak up, or to make a necessary change, then the discomfort was worth it. If my transparency helps a team member feel safe enough to admit they made a mistake, which allows us to fix a critical process, the discomfort was absolutely worth it. Vulnerability in leadership builds trust and loyalty, because it proves you are human, just like them. It closes the gap between the perfect facade and the real person running the show. The courage to keep moving So the next time you face feedback, criticism, or judgment, resist the instinct to shrink back. Take it in. Sort it. Decide what serves you and what doesn’t. Repackage what strengthens you, discard what doesn’t, and keep moving forward. This is the Do It & Prove It™ mindset applied to emotional resilience. Vulnerability isn’t a liability. It’s a choice. The people who choose it consistently, who put themselves out there despite the risk, are the ones who grow the most. They build not just resilience, but self-trust and confidence. They build a life of authentic impact. Criticism doesn’t have to hurt. It can teach. It can sharpen. It can transform you into a better leader. That’s not weakness. That’s courage. The kind that builds leaders. The kind that builds strength. The kind that builds a life worth living. For similar content, consider following me on any of my social media platforms: TikTok X Threads YouTube Follow me on Facebook, Instagram, LinkedIn, and visit my website for more info! Read more from Beth Rohani Beth Rohani, Entrepreneur Beth Rohani leads the No. 1 moving company serving the Houston Multi-Family Industry, and her company is considered one of the Top 3 Best Rated Moving Companies in Houston. As a first-generation Iranian-American, former TV news assignments editor, and CEO of a transportation and logistics-based business in a male-dominated industry, Beth embraces the stereotypes while inspiring and mentoring others to build a successful business with a balance to live their best life.

Written by Amanda L. Neiley, Founder of StillGrounded Labs & Creator of Return to North™ framework Amanda Neiley is the founder of StillGrounded Labs and creator of the Return to North™ framework. Drawing on her experience as an educator and school leader, she helps high-capacity women and leaders recognize overwhelm earlier, reconnect with what they need, and make more intentional choices before depletion becomes burnout. There is a particular kind of woman I recognize almost immediately. She is capable, and people rely on her for it. She remembers the appointments, answers the emails, solves the problem, notices what everyone else needs, keeps the project moving, makes the decision, and somehow figures out what to do when the plan falls apart. She might be a leader, a mother, a business owner, a caregiver, a professional, or several of those at once, and from the outside, she often looks like she's doing remarkably well. Sometimes she is. But there's something very capable women can become exceptionally good at, functioning while no longer noticing themselves. I know because I've done it. For much of my life, I thought strength meant being able to handle things. I loved goals and loved challenging myself. I trained for endurance events, built a career in education and leadership, raised children, kept pursuing my own education, and navigated some genuinely difficult personal seasons. When something was hard, my instinct was always the same, keep going, solve it, adjust, do what needs to be done. There are wonderful qualities inside that kind of strength, and I still value ambition, responsibility, discipline, and resilience. The problem wasn't that I was strong. The problem came when strength stopped including the ability to hear myself. When "I'm fine" becomes a habit There have been seasons in my life when my calendar was full from morning until night. I was accomplishing things I genuinely cared about, showing up for people I loved, doing meaningful work, and yet somewhere inside all that functioning, I had stopped asking some very basic questions, "How am I actually doing? What's happening in my body? How much capacity do I have today? What do I need?" Eventually, my body began answering those questions for me. I went through a period of significant physical depletion that forced me to stop and recover. At the time, I experienced that as something going wrong. Looking back, I see it differently. My body had been communicating for a long time. I simply hadn't learned to listen early enough. That experience changed how I understood strength. I didn't need to become less ambitious. I needed a different relationship with my own capacity, and I needed to notice sooner. That became one of the beginnings of what I now call Return to North™. What if stress is information, not failure? One of the things that troubles me about some modern wellness messaging is the idea that calm is the goal. It can subtly create one more standard for women to fail at. You're already managing work, relationships, family responsibilities, deadlines, and the completely unpredictable nature of life, and now you're supposed to remain perfectly regulated while doing it? That isn't realistic. Life activates us. We become anxious, frustrated, tired, and overwhelmed. We move through grief, conflict, uncertainty, responsibility, and change. The goal isn't to eliminate those states. The goal is to become better at recognizing them. That's why I began imagining our internal state as a compass. The return to North compass At the top of the compass is North. North doesn't mean blissful, stress-free, or perfectly calm. It simply means you're steady enough to choose. You have enough capacity to respond rather than react. You can think, connect, make decisions, and hear yourself. But no human being stays North all day. Sometimes we move East. East is activation. Your mind is racing. You're rushing even though no one is actually rushing you, and your shoulders creep up toward your ears. You replay conversations, check your phone repeatedly, and may be physically exhausted while still unable to switch your brain off. Sometimes we move South. South is where emotions get bigger, frustration, fear, anger, sadness, and overwhelm. You might snap at someone and immediately realize your reaction was larger than the moment. Tears sit unexpectedly close to the surface. Then there's West. West is depletion, flat, drained, disconnected. It's the state where you catch yourself thinking, "Please don't ask me for one more thing." Here's the part I believe we need to talk about more, you can still be extremely functional in West. You can attend meetings, answer emails, parent, lead, organize, smile, and help everyone else. That's exactly why depletion is so hard to recognize in highly capable people. Everyone around you may think you're fine. You may even think you're fine because you're still getting things done. None of these directions are bad This may be the most important part of the framework. East is not failure. South is not failure. West is not failure. They're information. Your internal state is giving you clues, and instead of asking, "What's wrong with me?" we can learn to ask, "Where am I right now?" and then, "What might I need?" That shift sounds deceptively small, but judgment and curiosity take us in completely different directions. If I notice I'm irritable and immediately tell myself I shouldn't feel like this, I've added another layer of pressure. If I get curious instead, I have somewhere to go. Maybe I haven't eaten, maybe I've had six difficult conversations back to back, maybe I need movement, ten quiet minutes, sleep, or help. Maybe something genuinely hurt me. Maybe I've said yes too many times. The answer isn't always a three-minute breathing exercise. Sometimes what you need is a boundary. Sometimes you need support. Sometimes the problem isn't your ability to cope with an unsustainable situation. Sometimes the situation needs to change. The question is not always "How do I get back to North?" This is where I want Return to North to be different. When you notice you're struggling, the immediate goal doesn't have to be to get calm. If you're depleted, you don't necessarily need another productivity strategy. If you're overwhelmed, you don't need to shame yourself into becoming more resilient. If you're angry, that emotion might be telling you something important. Before fixing anything, notice, "Where am I? What do I need?" There are days when you won't be able to return to North immediately, and that's okay. Sometimes a small choice simply changes the direction you're traveling, three minutes outside, a glass of water, movement between meetings, calling someone, canceling something, closing the laptop, eating lunch before 3 p.m., taking five slow breaths before you walk through the front door, saying, "I can't take that on right now," or going to bed instead of pushing through. Small choices interrupt momentum. Over time, those choices build something far more valuable than constant calm, they build self-trust. Returning, not arriving North isn't a destination, and that idea matters enormously to me. We aren't supposed to become perfectly regulated people who never feel anxious, depleted, or emotional again. A compass is useful precisely because we move. Life changes, we drift, something happens, we orient again, we adjust, and eventually we drift again. That's not failure. That's being human. Progress might mean that ten years ago, you lived in an activated state for three weeks before realizing something was wrong. Today, maybe you recognize it after three days. Eventually, you might notice it after three hours. Sometimes you'll catch yourself in the moment and think, "There I am, I'm moving East." That's awareness. Awareness creates choice. A two-question practice For the next week, try asking yourself two questions three times a day, "Where am I right now?" and "What do I need?" You don't even need to act on the answer right away. Simply notice. You may start to see patterns. Maybe you begin most mornings North and drift East by lunchtime. Maybe you operate in East all workday and crash into West the moment you walk in the door. Maybe certain environments reliably pull you South, or you notice you feel more like yourself outdoors, after movement, when you've slept enough, or around certain people. This isn't data to judge. It's information to use, because you can't respond to something you haven't noticed. Strong women need to be included in their own lives There is something I want capable women to hear clearly, you do not have to become less strong. You don't have to stop pursuing meaningful goals, and you don't have to abandon ambition, leadership, motherhood, business, or whatever matters deeply to you. But you do need to exist inside the life you're working so hard to create. You can be capable and tired. Grateful and overwhelmed. Strong and in need of support. You can love your work and still need boundaries around it. You can adore your family and still need an hour when nobody needs you. Two things can be true at once. For years, strength meant seeing how much I could carry. Now I think strength includes knowing what I'm carrying, noticing what it's costing me, and trusting myself enough to decide what should happen next. Sometimes the journey back to yourself begins much earlier than we imagine, not with a dramatic life change, not with a retreat, not with becoming a completely different person. Sometimes it begins with one quiet question, "Where am I right now?" And then another, "What do I need?" Because you don't need to know the whole way back. You just need to know where you are before you can begin finding your way North. Follow me on Instagram and visit my website for more info! Read more from Amanda L. Neiley Amanda L. Neiley, Founder of StillGrounded Labs & Creator of Return to North™ framework Amanda Neiley is the founder of StillGrounded Labs and creator of the Return to North™ framework. Drawing on more than two decades in education and leadership, along with her own experience of endurance training, burnout, recovery, and caregiving, she helps high-capacity women recognize what they need before stress becomes depletion. Her work focuses on self-trust, sustainable leadership, boundaries, and practical tools that help women care for themselves without stepping away from the lives and ambitions that matter to them.

Written by Sass Allard, Strategic Coach & Change Consultant Sass Allard is a strategic coach and change consultant helping leaders and high-performing women navigate complex change with clarity and resilience. She brings over 20 years of experience in global organisations, offering practical insights to support meaningful transformation and growth. Women in their fifties are being removed from the workforce at the point of their greatest professional value, and the reasons given are so vague as to be unfalsifiable. Press anyone for detail and the answer circles around adaptability. There exists a belief, never stated in a form that could be tested, that women of this age have hardened into their methods and will falter at whatever arrives next. I have spent twenty years moving organisations through change. I have never worked with a group holding a stronger claim to adaptive capacity, or a weaker ability to evidence it. The evidence is missing for reasons that have nothing to do with the women concerned. We were trained to make adaptation invisible. The adaptation was never narrated, because narration read as struggle. Three decades of that produces a generation whose adaptive history went entirely unrecorded, and a market that has taken us at our word. The consequences show up in the data now. An American Association of Retired Persons (AARP) survey published this year found 64 percent of workers over fifty had seen or experienced age discrimination, with around a quarter feeling pushed out of jobs they had not chosen to leave. Research from Brookings found that of the workers most exposed to artificial intelligence (AI) displacement and least equipped to move on, 86 percent are women. There is a layer beneath this that the workforce conversation never touches. Many of the women being written off as unable to handle change are, at that moment, in the middle of the most demanding physiological adaptation of their adult lives. Perimenopause reorganises sleep, memory, emotional regulation, and confidence in one's own judgement over a period of years, with no timetable and very little acknowledgement. Women are doing this while running teams and hitting their numbers. Whatever else that is, it is not evidence of diminished adaptive capacity. Nobody tells you it was your age, because that would be actionable. You are handed a gap where a reason should sit, and capable women fill that gap with themselves. I hear the same sentence from women who have never met one another, which is that they think they have lost their edge. It survives on almost no evidence, mainly because there is nothing to compare it against. Say some of it aloud to another woman who will recognise it, and listen to what comes back, because what returns is almost always a version of your own account. The isolation is doing more damage here than the bias. A pattern that thousands experience separately will go on looking, to every one of them, like a personal failing. None of this will be argued out of the people making these decisions by an article. What it can do is settle the account in your own mind, which is where the real erosion happens and where it can be stopped. You have spent thirty years demonstrating the exact capability you are now presumed to lack. That nobody wrote it down does not make it untrue. Follow me on Instagram, LinkedIn, and visit my website for more info! Read more from Sass Allard Sass Allard, Strategic Coach & Change Consultant Sass Allard works at the intersection of leadership, behaviour, and wellbeing, supporting individuals and organisations as they navigate demanding periods of change. Her background spans two decades in global companies, where she has helped senior leaders strengthen culture, clarity, and capability. She brings a grounded understanding of how hormonal shifts shape women’s experience at work without limiting the broader conversation. As a UN Women delegate to the Commission on the Status of Women, she brings a global lens to agency and progress. Sass writes about adaptation, resilience, and the practical shifts that create real movement in work and life.

Written by Masithokoze Moyo, Aviation Professional-Entrepreneur and Philanthropist Masithokoze Moyo is the Founder and Chief Executive Officer (CEO) of Angel Wings Aviation and the Masithokoze Foundation. She combines her expertise in aviation with a mission to empower youth and girls in under-resourced communities through skills development and mentorship. Leadership is often treated as a fixed quality. Some people are described as naturally visionary, resilient, or decisive, while others are assumed to lack those qualities. Neuroplasticity offers a more useful and humane perspective: the brain can reorganise and modify its connections in response to experience, learning, environmental demands, and injury. This does not mean that positive thinking can solve every challenge. It does not erase adversity or suggest that people can overcome every barrier through individual effort alone. It does mean that the patterns through which we pay attention, interpret events, respond to pressure, and relate to other people can be influenced by what we repeatedly practise. That insight changes the leadership question. Instead of asking, “What kind of leader am I?” we can ask, “What kind of leader am I rehearsing through my daily choices?” “We do not change by wishing for a different life. We change by repeatedly practising the behaviours that make a different life possible.” – Dr. Masithokoze Moyo Identity is a direction, not a verdict Statements such as “I am not disciplined,” “I am a poor communicator,” or “I do not handle pressure well” can sound like permanent verdicts. They close the door before practice begins. A developmental alternative is to say, “I am learning to become more disciplined,” “I am practising clearer communication,” or “I am learning to respond more thoughtfully under pressure.” This is not empty affirmation. It is a shift from a fixed description to a direction that can guide behaviour. Each prepared meeting, honest conversation, thoughtful pause, and completed commitment provides evidence of the person a leader is becoming. The same principle applies to teams. When leaders describe people only by their current weaknesses, they can unintentionally reinforce limiting expectations. When they define growth precisely, “You are developing your delegation skills, let us create opportunities to practise,” they make learning visible without pretending that competence already exists. Repetition turns intention into leadership practice Leadership development is not created by attending one workshop or reading one inspiring book. It is built through repeated experiences that make some responses more accessible and familiar. Research on habit formation shows that habits involve multiple neural processes and changes across brain regions, repeated practice can make behaviour more consistent, although behaviour remains sensitive to context and learning. For a leader, the small moments are not small. Asking one more question before giving an answer, offering specific feedback rather than vague criticism, pausing before responding defensively, and acknowledging a colleague’s contribution can all become part of a leadership repertoire when practised consistently. A practical rule is to make the desired behaviour small, observable, and repeatable. Leadership intention A practice to repeat Improve listening Ask one clarifying question before offering a solution. Strengthen emotional regulation Pause when triggered and accurately name the issue. Build learning agility Conduct a short after-action review after important work. Develop people Delegate one meaningful responsibility with clear boundaries and support. Build trust Match commitments with visible follow-through and transparent updates. Leaders shape the environments in which people learn Dr. Moyo’s reflections emphasise that change is personal, but it is also shaped by context. This is especially important in leadership. It is not enough to tell people to be resilient, innovative, or collaborative while maintaining systems that punish questions, overload attention, or reward short-term individual performance at the expense of collective learning. Leaders influence what receives attention in meetings, what happens after a mistake, whose ideas are invited, how priorities are communicated, and whether people have the time and psychological space to learn. A leader does not merely develop personal capability, a leader helps shape a learning environment. If leaders want candour, they must respond to unwelcome information without humiliation. If they want innovation, they must distinguish between intelligent experimentation and careless execution. If they want ownership, they must give people real authority rather than responsibility without control. Neuroplasticity also has an ethical dimension. Personal agency matters, but circumstances, resources, health, culture, and structural barriers matter too. Empowerment must never become an excuse to blame people for conditions they did not choose. Responsible leadership combines accountability with fairness, ambition with humanity, and challenge with support. Turning pain into purpose without romanticising suffering Many leaders carry experiences of loss, exclusion, disappointment, or hardship. These experiences can shape how a person interprets risk, trust, and belonging. Yet pain does not have to become the final author of a person’s story. As Dr. Moyo writes, the brain can reinforce patterns that leave people fearful, defeated, or stuck, but it can also strengthen patterns associated with hope, learning, connection, and purposeful action. The qualification matters: neuroplasticity is not a promise that every wound disappears, and healing is not instant or guaranteed by willpower. Growth can involve building new pathways through repeated choices, support, and honest reflection. For leaders, a useful distinction is this: reactivity is information, not destiny. A strong emotional response may reveal a prior experience, an unmet need, or a perceived threat. It deserves attention, but it does not have to dictate the next action. A leader can learn to replace self-rejection with self-respect, reaction with reflection, isolation with connection, and surrender with one disciplined next step. Purpose becomes especially powerful when it moves beyond personal achievement. The most meaningful outcome of development is not simply becoming more productive or influential. It is becoming more useful to others through service, mentorship, opportunity creation, and institution-building. A five-step practice for neuroplastic leadership Notice the pattern. Identify one recurring response that limits your leadership. Describe it without turning it into an identity. “I become defensive when challenged” is more actionable than “I am a defensive person.” Choose the replacement behaviour. Decide what you will practise instead: ask a question, take a pause, request feedback, name the risk, delegate the decision, or acknowledge the emotion before moving to the task. Reduce the behaviour to a reliable minimum. Make the practice small enough to perform even on a difficult day. Sustainable repetition is more valuable than dramatic intensity. Redesign the cue and the context. Add the practice to the setting where it is needed. Put a reflection question on the meeting agenda, schedule the after-action review, set a reminder before a difficult conversation, or ask a trusted colleague for feedback. Review, repair, and repeat. Progress is not perfection. After an imperfect interaction, review what happened, repair any harm, and return to the practice. A leader who can acknowledge a mistake demonstrates that learning is possible. Your leadership reflection Leadership is not only what happens when we stand at the front of a room. It is what we rehearse when no one is applauding: how we interpret difficulty, how we speak to ourselves, how we respond to another person’s vulnerability, how we use authority, and how we turn experience into service. Take a few minutes this week to consider four questions: What pattern no longer deserves to define me? What behaviour must I practise consistently? What environment will help me sustain it? How will my growth make life better for the people I lead? Three years can pass while we repeat the same patterns, or while we intentionally practise new ones. Neuroplasticity meets leadership not in the promise of instant reinvention, but in the disciplined possibility of becoming different through what we repeatedly choose to do. Follow me on Facebook, Instagram, and LinkedIn for more info! Read more from Masithokoze Moyo Masithokoze Moyo, Aviation Professional-Entrepreneur and Philanthropist Masithokoze Moyo is a Zimbabwean-British aviation professional, entrepreneur, and public figure who gained international media attention following a high-profile banking error. She is the founder and CEO of TripleM Group Holdings, which trades as Angel Wings Aviation, a private jet charter brokerage firm based in the United Kingdom (UK).

Written by Trishiana Shelton, Feminine Wellness Coach & Global Advocate Trishiana is a global Feminine Wellness & Sensuous Living Coach, an inspiring author, speaker, and coach. Her work explores how women can access deeper healing, vitality, and creativity by aligning with the body's natural intelligence and higher states of awareness. Every January, millions of people make sincere promises to themselves. This will be the year they exercise consistently, eat more nourishing food, reduce stress, strengthen their relationships, or finally pursue the project they have been quietly imagining. Yet only weeks later, many quietly return to familiar patterns. For decades, we have been told that lasting change requires greater willpower or stronger discipline. Modern neuroscience tells a more compassionate and ultimately more empowering story. Change does not begin with determination. It begins with biology. Understanding that distinction may be one of the most important shifts available to anyone who has ever tried to change and wondered why it was so difficult. The greatest discoveries of the twenty-first century may not be about what humans can build, but about what humans can become. The brain was built to adapt, not to keep you comfortable Our brains are remarkable organs, designed not primarily to make us successful or happy, but to help us survive, adapt, and learn from experience. To operate efficiently in an endlessly complex world, the brain continually transforms repeated thoughts, emotions, and behaviors into familiar patterns that require progressively less conscious effort. In other words, what we repeatedly experience gradually helps shape who we become. This is not a character flaw. It is intelligent biology. Understanding this changes the question we ask ourselves. Instead of asking why we cannot change, we begin asking how we can work with our biology rather than against it. What neuroscience actually is Neuroscience is the scientific study of the brain, the nervous system, and how they influence our thoughts, emotions, behaviors, learning, memory, and overall health. Drawing from biology, psychology, medicine, and cognitive science, neuroscience seeks to understand one of the most complex structures in the known universe: the human brain. Over recent decades, advances in brain imaging and research have transformed our understanding of human potential. Scientists now know that the brain is not the static organ it was once believed to be. It is dynamic, adaptable, and continually shaped by experience throughout life. That discovery changes everything about how we think about change itself. If the brain can change, then perhaps we can too. Your brain is designed to predict, not to observe Although the human brain accounts for only about two percent of our body weight, it consumes roughly twenty percent of the body's energy at rest. One of the ways the brain manages this extraordinary demand is by using previous experience to predict what is likely to happen next. Every routine, every belief, every emotional reaction, and every habit becomes part of a familiar predictive pattern. These patterns allow us to navigate daily life efficiently, but they also explain why meaningful change can feel genuinely uncomfortable. The unfamiliar demands attention, learning, and adaptation. When we understand this, we stop asking what is wrong with us and start asking what conditions would make the new behavior easier to repeat. That is a fundamentally different and more productive relationship with change. Every experience leaves a physical trace in the brain For much of the twentieth century, scientists believed the adult brain was relatively fixed after early development. That view changed dramatically with research into neuroplasticity, the brain's lifelong ability to reorganize itself in response to learning, experience, and practice. Research by neuroscientists Bryan Kolb, Robbin Gibb, and Terry Robinson demonstrated how experience can measurably alter brain structure and function. A striking human example came from a study published in "Nature" by Bogdan Draganski and colleagues, who observed measurable changes in gray matter after adults learned to juggle. The message was significant: the adult brain remains capable of meaningful change. A useful way to understand this is to imagine walking across an untouched field. The first journey leaves only the faintest impression. Walk the same path repeatedly, and a trail begins to form. Continue, and eventually there is a well-worn road. Our brains adapt in much the same way. Repeated experiences strengthen neural pathways. Repeated behaviors become increasingly familiar. Repeated responses become increasingly automatic. The brain does not simply remember what is important. It becomes more efficient at what it repeatedly practices. Why information alone does not create transformation Have you ever read an inspiring book, attended an extraordinary event, or listened to a powerful conversation, only to discover that very little actually changed afterward? Most of us have had that experience. Information expands awareness, while transformation requires integration. We can intellectually understand that we should exercise more, sleep better, manage stress, or change a pattern of behavior. Knowing and doing, however, are very different neurological processes. Lasting behavioral change requires repeated experience until healthier responses become increasingly natural. Learning begins cognitively, while transformation becomes biological. The nervous system: The hidden gatekeeper of change One of the most important insights emerging from neuroscience is that chronic stress does not simply affect how we feel. It influences how the brain functions and adapts. Research by neuroscientists Richard Davidson and Bruce McEwen, including work published in Nature Neuroscience, has shown that prolonged stress can affect neural systems involved in attention, emotional regulation, memory, and decision-making. Encouragingly, these same systems also retain the capacity to adapt through supportive experiences and intentional practices. When the nervous system perceives persistent threat or overwhelming stress, the brain naturally prioritizes protection. Creativity narrows. Curiosity diminishes. Patience becomes more difficult, and decision-making becomes increasingly reactive. This is not weakness. It is biology attempting to protect us. Our ancestors relied on rapid survival responses when confronting physical danger. Today, many people activate those same stress systems through relentless deadlines, financial uncertainty, digital overload, inadequate sleep, relationship strain, and constant stimulation. This leads to an important realization: before we can create sustainable external change, we often need to create the internal conditions that support it. The biology is always listening If the brain is continually adapting, what is teaching it? The answer extends far beyond our conscious thoughts. Every moment of every day, the brain and nervous system receive information from both inside and outside the body. Breath and movement Light and nature Sleep and nutrition Touch and sound Relationships and conversation Stress and perceived safety Beauty, meaning, and purpose These experiences become biological information that the brain continually interprets. Am I safe? Am I supported? Can I recover? Can I grow? The answers to those questions, shaped by our daily experiences, quietly determine the quality of our attention, emotional regulation, creativity, and resilience. The biological inputs of human experience Over recent years, this line of thinking has led to a framework that deserves broader attention: what might be called the biological inputs of human experience. These are the continuous internal and external signals that shape the brain, regulate the nervous system, influence our biology, and ultimately determine the quality of our lives. Some of these inputs are widely recognized, including breath, nutrition, movement, and sleep. Others are easily overlooked, including natural light, nature, touch, beauty, music, meaningful relationships, purpose, curiosity, gratitude, silence, and even the stories we repeatedly tell ourselves. None of these inputs exists in isolation. Together, they create the biological environment in which our minds and bodies function. Breathing patterns influence autonomic nervous system regulation. Light helps synchronize circadian rhythms that govern hormones, mood, and cognition. Movement supports brain health and neuroplasticity. Sleep strengthens learning, memory consolidation, and restoration. Relationships influence stress physiology and emotional regulation. Nature, beauty, music, gratitude, and contemplative practices are increasingly studied for their effects on attention and well-being. This perspective fundamentally changes how we think about personal growth. We are not simply thinking beings trying to change our minds. We are biological beings continually responding to our environment, including the one we consciously create. Change the inputs, change the conversation Instead of continually asking how we can force ourselves to change, perhaps the more useful question is: what signals am I repeatedly giving my biology? What does my morning teach my nervous system? What does my environment communicate to my brain? What do my breathing patterns tell my body? What do my relationships reinforce? What does my sleep, or the lack of it, make easier or harder tomorrow? What am I repeatedly practicing with my attention? When we improve the quality of the biological inputs we experience each day, we begin changing the conditions under which our brain and nervous system operate. As those internal conditions evolve, new behaviors become easier to sustain. Transformation becomes less about force and more about alignment, less about intensity and more about consistency. Why we return to old habits under stress This also helps explain something almost everyone experiences: why old habits return during difficult seasons. Research by Lars Schwabe and Oliver Wolf, published in the Journal of Neuroscience, suggests that under stress, the brain often relies more heavily on established habits than on flexible, goal-directed thinking. The brain seeks efficiency, and familiar pathways require less effort. Returning to an old behavior during a stressful period does not necessarily mean failure. It often means that the conditions supporting the new behavior need strengthening. Understanding this replaces self-judgment with self-awareness. Instead of asking what is wrong with us, we begin asking what conditions would make the healthier response easier to repeat. That is a profoundly different relationship with change. Small inputs, over time, create extraordinary lives We often underestimate small actions because we evaluate them individually rather than collectively. One conscious breath, one nourishing meal, one walk in morning sunlight, one meaningful conversation, one restorative night of sleep, one moment of genuine gratitude, and one decision to pause rather than react can all contribute to meaningful change. None of these appears life-changing in isolation. Yet transformation rarely arrives through one dramatic breakthrough. It accumulates quietly. One healthy choice makes the next healthy choice slightly easier. One new behavior becomes increasingly familiar. Weeks become months. Months become years. Gradually, what once required tremendous effort begins to feel natural. Sustainable change may never have been about perfection. It has always been about practice. Becoming architects of our own biology Perhaps the most hopeful insight emerging from modern neuroscience is not simply that the brain can change. It is that we can consciously participate in that change. We cannot control every circumstance or eliminate every source of stress. But we can become more intentional about many of the experiences we repeatedly provide our brains and bodies. Every choice becomes information. Every experience becomes instruction. Every repeated action becomes practice. Every day, in ways both large and small, we are teaching our biology what to expect from the world. The question is no longer whether your brain is changing. It is. The deeper question is: what are you teaching it? Because your greatest asset is not simply your intelligence, your income, your title, or your accomplishments. It is your capacity to consciously influence the biological inputs that shape your attention, emotions, relationships, decisions, resilience, and creativity. The future we seek is not created in one extraordinary moment. It is created through thousands of ordinary moments that quietly shape the extraordinary human being experiencing them, one breath, one experience, one conversation, and one choice at a time. Perhaps that is the true neuroscience of change. Experience the shift If this article opened something in you, the most effective next step is not more information. It is experience. The Sensuousity Reset is a guided nervous system restoration experience that puts the principles in this article directly into practice. Through a guided audio activation, reflective embodiment journaling, and science-informed education around stress physiology and regulation, it offers a practical entry point into the kind of biological shift this article describes. Access the Sensuousity Reset. To subscribe to the complimentary Feminine Wisdom Newsletter and explore ongoing articles, guided resources, and wellness education, visit here. To explore the full Sensuousity Method, including immersive retreats, private coaching, and educational resources, visit my website. Follow her on Facebook and LinkedIn for more info! Read more from Trishiana Shelton Trishiana Shelton, Feminine Wellness Coach & Global Advocate Trishiana, a feminine wellness coach, author, & editor of Feminine Wisdom Newsletter, a free feminine wellness publication for high-achieving women that reports on research on how to reduce stress, restore nervous system coherence, and elevate their lives through feminine wellness & sensuous living practices. She integrates modern science, ancient wisdom & lifestyle practices that cultivate vitality & lasting transformation. She is an inspiring speaker, coach, and global advocate for feminine wellness. Her work explores how women can access deeper healing, vitality, and creativity by aligning with the body's natural intelligence and higher states of awareness. References: Davidson, R. J., & McEwen, B. S. (2012). Social influences on neuroplasticity: Stress and interventions to promote well-being. Nature Neuroscience, 15, 689 to 695. Draganski, B., Gaser, C., Busch, V., Schuierer, G., Bogdahn, U., & May, A. (2004). Neuroplasticity: Changes in grey matter induced by training. Nature, 427, 311 to 312. Kolb, B., Gibb, R., & Robinson, T. E. (2003). Brain plasticity and behavior. Current Directions in Psychological Science, 12(1), 1 to 5. McEwen, B. S., & Morrison, J. H. (2013). The brain on stress: Vulnerability and plasticity of the prefrontal cortex over the life course. Neuron, 79(1), 16 to 29. Schwabe, L., & Wolf, O. T. (2009). Stress prompts habit behavior in humans. Journal of Neuroscience, 29(22), 7191 to 7198.

Written by Stella Dimitrakakis, Founder & Physical Therapist Stella Dimitrakakis is a Doctor of Physical Therapy, Board-Certified Orthopedic Specialist, and Certified Functional Manual Therapist specializing in orthopedic and women’s health. She helps people move better and avoid unnecessary injections or surgery through personalized care and evidence-based approaches. You've done the magnetic resonance imaging (MRI). You've tried the chiropractor, the massage therapist, maybe even a round or two of physical therapy focused on your spine. Your low back pain, or that nagging hip or knee pain, gets a little better, then creeps right back. If this sounds familiar, there may be a piece of the puzzle no one has looked at yet: your pelvic floor. As a pelvic floor physical therapist, I see this pattern constantly. Clients arrive convinced their pain is purely structural, a disc, a joint, a "bad hip," when the real driver is a group of small, deep muscles most people have never heard of, let alone had assessed. This isn't just a postpartum issue When people hear "pelvic floor," they usually picture postpartum recovery and assume it has nothing to do with them. That assumption keeps a lot of people in pain longer than they need to be. The executive sitting through nine consecutive hours of meetings a day is loading their hip flexors and pelvic floor in a shortened position for most of their waking life. The runner, cyclist, or CrossFit athlete pushing through unexplained hip tightness may be dealing with the same guarding pattern, just from overuse instead of underuse. Men have a pelvic floor too. It's just as capable of becoming tight and poorly coordinated as a woman's, even though it rarely gets mentioned in that context. If you've never given birth and you're still dealing with unexplained hip, groin, or low back pain that hasn't responded to the usual treatment, the pelvic floor is still worth ruling out. Trigger points that masquerade as sciatica Muscles all over the body can develop trigger points, tight, irritable bands of muscle fibers that refer pain to other areas, sometimes far from where the trigger point actually lives. This is well documented in muscles like the piriformis. What's less well known is that the pelvic floor plays by the same rules. Take the obturator internus, a deep hip rotator that also forms part of the pelvic floor and pelvic sidewall. When it develops trigger points, it can refer pain into the buttock, the sacroiliac (SI) joint, the posterior thigh, and even down the leg in a pattern that feels a lot like sciatica. Clinically, this muscle gets mistaken for piriformis syndrome or a disc problem all the time, simply because no one thought to check the pelvic floor. Other pelvic floor muscles, including the levator ani, coccygeus, and the obturator internus fibers closer to the pelvic floor itself, have their own referral patterns, often sending pain into the front of the lower abdomen, the groin, and around the hips. If your "hip pain" or "lower abdominal pain" has never responded to treatment focused on the hip, this may be why. The pelvic floor, the hip, and the low back are one system The pelvic floor isn't an isolated structure. It works together with your deep abdominals, your diaphragm, and your spinal stabilizers as part of what most people call "the core." When the pelvic floor is chronically tight or simply uncoordinated, meaning it doesn't know how to fully contract and, just as importantly, fully relax, it can quietly limit hip mobility. A hip that doesn't move well doesn't stay quiet. It hands the job off to whatever joint is willing to compensate. This is where things get interesting for anyone chasing knee pain or low back pain that "comes out of nowhere." Limited hip range of motion, whether from restriction in the joint itself or in the muscles surrounding it, forces the body to borrow movement from somewhere else. Often, that somewhere is the lumbar spine, which starts absorbing rotation and extension it was never meant to handle. Sometimes it's the knee, which compensates for a hip that won't rotate or extend properly. Either way, the symptom shows up far from the actual source of the restriction. Why external treatment isn't always the full answer Manual therapy, dry needling, and targeted stretching for the deep hip rotators, including the obturator internus, genuinely help a lot of people, and treating these muscles externally should absolutely be part of the plan. But here's the honest clinical truth: it isn't always 100% effective on its own because some of the muscle simply can't be fully reached or assessed from the outside. I like to compare it to washing a window from only one side. You can get it quite clean, and it will look a lot better. But if there's residue on the other side, you'll never get full clarity until someone addresses both sides of the glass. The pelvic floor works the same way. External work addresses one side, while a skilled internal assessment addresses the other. Combining both is often what finally resolves a case that's been "80% better" for months but never fully clears. To be clear, not every patient needs an internal assessment. Many people improve significantly with external treatment alone, and a good clinician should be able to tell the difference between the two groups. The clues that point to the pelvic floor So how do you know which category you're in? A few screening questions usually point us in the right direction: Do you deal with constipation, straining, or a sense that you never fully empty your bowels? Do you experience urinary leakage or unusual urinary frequency or urgency? Do you have to push or bear down to get your urine stream started, or does it not come out easily on its own? For women, is there pain with intercourse? These aren't random questions. Bowel, bladder, and sexual function are directly governed by the same muscles we're discussing, so difficulty in these areas is a strong signal that the pelvic floor deserves a closer look. One more clue we use in the clinic: even without an internal exam, we can often palpate the obturator internus externally, near the hip or next to the ischial tuberosity, the sit bone you feel when you sit on a hard chair. If that spot is tender, or if pressing on it reproduces or refers pain to the SI joint or glute, that's rarely the whole story. It's usually just the tip of the iceberg, with more of the pattern living deeper in the pelvic floor itself. The takeaway If your low back, hip, or even knee pain has been stubborn, has bounced between providers, or keeps almost resolving but never quite does, it may be worth asking a different question: not "what's wrong with my back?" but "what's happening at my pelvic floor and hip that's forcing my back to compensate?" A thorough evaluation, one that considers trigger points, hip mobility, coordination, and yes, sometimes an internal assessment, can uncover what months of treatment focused on the back alone may have missed. If this sounds like your story, it's worth having a conversation with a pelvic floor specialist who treats the whole system rather than just the site of the pain. You can learn more about this approach, or reach out with questions here. Follow me on Facebook and Instagram for more info! Read more from Stella Dimitrakakis Stella Dimitrakakis, Founder & Physical Therapist Stella Dimitrakakis, Physical Therapist (PT), Doctor of Physical Therapy (DPT), Board Certified Clinical Specialist in Orthopaedic Physical Therapy (OCS), Certified Functional Manual Therapist™ (CFMT), Pregnancy and Postpartum Corrective Exercise Specialist (PCES), and Selective Functional Movement Assessment Level 1 (SFMA L1), is the Founder of Soma Vita Physio & Wellness. She specializes in orthopedic rehabilitation, pelvic health, and temporomandibular joint (TMJ) dysfunction, helping active adults recover from pain, rebuild strength after pregnancy, and optimize long-term resilience. Her holistic approach blends advanced manual therapy, movement optimization strategies, and nervous system integration to support sustainable performance at every stage of life. Stella’s work centers on empowering individuals to move confidently and future-proof their bodies for lifelong health.

Written by Vicky Vimbai Goredema, Chartered Certified Accountant, UK Vicky Vimbai Goredema is an award-winning chartered certified accountant, entrepreneur, and author of The Numbers Behind the Business: Tax Structure and Systems for the Modern UK Entrepreneur. For healthcare and social care businesses preparing for Care Quality Commission (CQC) registration, regulatory compliance is often the main focus. Policies, procedures, safeguarding, staffing, and operational readiness all require careful attention. But another important consideration can be overlooked: financial viability. Where a Financial Viability Statement is required as part of the registration process, an accountant or other appropriately qualified financial specialist may be asked to assess whether the proposed business has the financial resources to operate and continue providing its regulated services. This is much more than simply looking at a bank account balance. What does financial viability mean? Financial viability is about whether the business has a realistic and sustainable financial model. For a new healthcare business, this means understanding how much funding is available, what the expected income will be, and whether that income is sufficient to cover operating costs. A business may have £50,000 in the bank, for example, but if its projected monthly expenditure is £30,000 and it does not expect sufficient income for several months, the cash position needs to be considered carefully. This is why cash flow forecasting is so important. What will an accountant look at? Before signing a financial viability statement, an accountant should have sufficient information to support their professional opinion. Depending on the circumstances, this may include: The business plan Financial forecasts Projected income and expenditure Cash-flow forecasts Evidence of available funding Business bank statements Existing accounts or management accounts Staffing and payroll costs Premises and operating costs Loans and finance arrangements Existing creditors and liabilities HM Revenue & Customs (HMRC) obligations The source of funding for the business For an established business, historical financial performance can provide useful evidence. For a newly established business, however, the focus is likely to be much more heavily based on the business plan, assumptions, funding available, and financial projections. The importance of realistic forecasts One of the biggest mistakes I see when businesses prepare financial forecasts is being overly optimistic. A forecast should not simply demonstrate that the business will make a profit. It should demonstrate that the business has a realistic plan for funding its operations and managing its cash flow. For healthcare businesses, costs such as payroll can be significant. Recruitment, training, pension contributions, employer National Insurance, insurance, premises, software, professional fees, and other overheads can quickly add up. A strong forecast should therefore consider different scenarios and allow for unexpected costs. Financial viability is about sustainability Financial viability should not be viewed as a box-ticking exercise. If you are responsible for providing care, your financial position can directly affect your ability to maintain staffing levels, meet operational costs, and continue providing a quality service. This is why healthcare business owners should understand their numbers from the beginning. Your accountant should not simply prepare your accounts after the year has ended. They can play an important role in helping you understand your financial position, forecast your cash requirements, and make informed business decisions. Don’t wait until registration If you are preparing for CQC registration, start preparing your financial information early. Having your business plan, forecasts, and funding evidence organised can make the process much smoother and, importantly, gives you a clearer understanding of whether your business model is financially sustainable. CQC readiness isn’t just about compliance. It’s also about having a business that is financially prepared to deliver the service you have committed to providing. As accountants, our role is not simply to report on the numbers. It is to help business owners understand what those numbers mean and use them to build sustainable businesses. Your care business needs a strong foundation. Your finances are part of that foundation. Follow me on Facebook, Instagram, LinkedIn, and visit my website for more info! Read more from Vicky Vimbai Goredema Vicky Vimbai Goredema, Chartered Certified Accountant UK Vicky Vimbai Goredema is an award-winning chartered certified accountant, entrepreneur, and author of "The Numbers Behind the Business: Tax Structure and Systems for the Modern UK Entrepreneur." She is the Founder and Director of VCK Accounting Services Ltd, a UK-based accountancy practice supporting small to medium-sized businesses with strategic financial expertise.

Written by Chelsea Rothschild, PhD, HMCT & CEO of Heart Connected Healing, PLLC Dr. Chelsea Rothschild is a licensed Clinical Health Psychologist and executive coach with over two decades of experience leading trauma-informed care and high-stress disaster response. Through her private practice, Heart Connected Healing, she uses biofeedback science to help high-responsibility leaders build the resilience to sustain their mission. I have watched people perform under conditions most of us will never face. Early in my career, working within federal healthcare and emergency response systems, I had the privilege of supporting teams operating in high-stakes environments. These were men and women in command structures where the cost of losing presence, of becoming reactive, disconnected, or physiologically overwhelmed, was not a bad quarter or a difficult conversation. The stakes were fundamentally different. That experience shaped everything I understand about performance, leadership, and the physiology underneath both. Later, through my work with performing artists, executives, and leaders carrying enormous responsibility in very different arenas, I saw the same pattern emerge. The same quiet erosion. The same slow separation between who they were on stage, in the boardroom, in the clinic, and who they were becoming underneath it. Presence was the first thing to go. It was the last thing anyone talked about. "Presence isn't a personality trait. It is a physiological state, and it can be lost, quietly and gradually, long before anyone on the outside notices." What presence actually is and what steals it When we talk about presence in leadership and performance contexts, we tend to treat it as something mystical. A quality some people have and others don't. The magnetic speaker who owns the room. The executive whose calm steadies everyone around them. The performer who makes ten thousand people feel seen. But presence is not charisma. It is not confidence. It is not a communication skill you can workshop on a Saturday afternoon. Presence is the physiological state in which your nervous system is regulated enough to allow full access to your cognitive flexibility, your emotional attunement, your creative intelligence, and your capacity for genuine connection. When the nervous system is in coherence, when the heart and brain are communicating in synchrony rather than conflict, presence is the natural result. What steals it is chronic stress. Not acute stress, the kind that sharpens focus and mobilizes resources. Chronic stress. As I explored in my earlier piece, Why Burnout Is Not About Motivation But Your Nervous System, the ambient, low-grade activation that high-performing people carry so effectively becomes invisible, even to themselves. Over time, chronic nervous system dysregulation narrows cognitive range, increases emotional reactivity, degrades decision-making under pressure, and severs the connection between what a person knows to be true and what they can access in the moment it matters most. You can know your material. You can have prepared for years. You can be the most qualified person in the room. Still, if your nervous system is dysregulated, your presence will be fractured. Your audience, your team, your clients will feel it before they can name it. "The most dangerous thing about losing presence is that performance can continue long after it is gone. You can function without it. You cannot lead without it." What performing artists taught me that the boardroom had not My clinical work has taken me into environments that most psychologists never encounter side by side. Veterans navigating reintegration, executives managing organizational crisis, and performing artists whose entire livelihood depends on their ability to be fully present in front of an audience, night after night, regardless of what is happening in their nervous system. What the performing artist understands viscerally and experientially is something that leaders in every field are only beginning to name. I wrote about this pattern in detail in When Passion Overrides the Pause and the Hidden Cost of Chronically Pushing Through. Passion alone is not enough. The love of the work, the commitment to the mission, the fire that drives extraordinary output. None of it protects the physiology. In many cases, it accelerates the erosion. When passion overrides the body's signals, when the drive to perform, to deliver, to give consistently outpaces the capacity to recover, the nervous system adapts. It learns to override its own warning signals. It lowers the volume on fatigue, on disconnection, on the quiet loss of presence, until the performer no longer notices what they have stopped feeling. I have seen this in the touring musician who cannot remember the last time they felt genuinely moved by their own music. In the physician who realizes mid-sentence that they have stopped actually listening to their patients. In the executive whose team describes them as brilliant but somehow unreachable. These are not failures of character. They are physiological adaptations to unsustainable demand. This is precisely what I describe as Chronic Altruistic Dysregulation in You're Not Burned Out, You're a High-Capacity Giver with a Dysregulated Nervous System. They are reversible. But only if we are willing to name them accurately. Regulation is the precondition, not the reward One of the most persistent and damaging myths in high-performance culture is that regulation, rest, recovery, and nervous system restoration are something you earn after the work is done. A luxury for when things slow down. A reward for when you have finally achieved enough. This is physiologically backward. Regulation is not the reward for high performance. It is the precondition for it. When the nervous system is in a state of chronic activation, the prefrontal cortex, the seat of strategic thinking, emotional regulation, empathy, and nuanced decision-making, loses access to its full capacity. The brain shifts its resources toward threat detection and survival. What gets lost in that shift is precisely the cognitive and emotional sophistication that makes great leadership, great performance, and genuine presence possible. In my clinical work, I use HeartMath-based biofeedback and heart-rate variability training to create measurable, observable shifts in nervous system coherence. When clients begin to see their own physiology change in real time, when they experience rather than simply understand what regulation actually feels like, the conversation about presence stops being abstract. They feel it. Then they understand why they stopped feeling it. "You cannot think your way into presence. You have to regulate your way there, and that is not weakness. It is the most sophisticated form of performance preparation available." What this means for leaders, speakers, and performers If you are reading this as a leader, a speaker, a performer, or someone who carries significant responsibility for others, I want to offer you a reframe that may be the most practically useful thing in this article. The moments when you feel least present, when you are going through the motions, when your words are technically correct but somehow not landing, when you finish a session or a set or a meeting and feel strangely hollow. Those moments are not evidence that you have lost your edge. They are physiological signals. Your nervous system is telling you something that your schedule, your commitments, and your identity as a high performer have been trained to ignore. Presence is recoverable. It is not a fixed trait. It is a state. States can be shifted, trained, and protected with the right clinical tools and the right level of honest engagement with what your body has been trying to tell you. The leaders I work with who make this shift describe the same experience. They don't become less ambitious. They don't slow down in the ways they feared. They become more precise. More intentional. More genuinely connected to the people they are leading and to the mission that brought them into the room in the first place. That is presence. It is not a luxury. It is the foundation of everything worth building. If this resonates, explore the full series on nervous system regulation, sustainable leadership, and high performance at my Brainz contributor page. To explore working together, visit here. Follow me on Facebook and LinkedIn for more info! Read more from Chelsea Rothschild, PhD, HMCT Chelsea Rothschild, PhD, HMCT & CEO of Heart Connected Healing, PLLC Dr. Chelsea Rothschild is a licensed Clinical Health Psychologist and Certified HeartMath Trainer with over two decades of experience in integrated, trauma-informed care. She built her career inside the U.S. Department of Veterans Affairs, where she led a nationally recognized program pioneering same-day mental health access for Veterans. Through her practice Heart Connected Healing, she works with executives, physicians, Veterans, and mission-driven leaders using clinically validated biofeedback and her proprietary MAP Theory™ framework. She doesn’t help people push harder, she helps their nervous systems catch up to their mission.