Letters from the practice September 2026

Letters From The Practice

September 2026

Two Things at Once

Dear friends,

By the second week of September, the house has a schedule again. Lunches get packed. The bus comes at the same time every morning. From the outside, everything looks settled.

Inside it is rarely that clean. A parent can be relieved the summer is over and sad that it is over, in the same hour. A kid can like their teacher and dread third period. Someone can want the structure back and resent it once it arrives. None of that is confusion. It is what happens when a person tells the truth about more than one thing at a time.

We are not really trained for this. Most of us picked up somewhere that feelings are supposed to resolve. You figure out how you actually feel, and then you act on it. So when two feelings hold their ground and refuse to collapse into one, it registers as a problem. People sit down in September and say some version of *I don't know what is wrong with me, I should be happy about this.* The word *should* is doing a great deal of work in that sentence.

Ambivalence is not a malfunction. More often it means something real is at stake on both sides. The change that produces no mixed feeling at all is usually the change that did not matter much.

What helps is not choosing a side faster. It is tolerating the discomfort well enough that you stop reading it as evidence of failure. Letting a child say she likes her teacher and does not want to go, without rushing in to correct the second half.

September asks us to hold a lot at once. Newness and loss. Routine and the end of something. I hope you can let both of them sit there this month without needing to sort them.


Free resource: change one word

The practice this month takes about four seconds, which is what makes it usable.

Notice the word *but* in the middle of your sentences about how you feel. *I am glad she is settling in, but I miss having her around.* *I like the new job, but I am overwhelmed.* Then say it again and replace *but* with *and*.

The grammar matters more than it seems. *But* is a subtraction. It cancels the first half of the sentence and tells you the second half was the real answer. *And* holds both. This is the plain-language version of what dialectical work in therapy is built on, the position that two opposing truths can be accurate at once and neither is the correction of the other.

Try it out loud, especially in front of your kids. Children learn what to do with contradictory feelings by watching an adult handle them. A parent who can say I am proud of you and I am worried about you is teaching something no lecture will.

A closing reflection

The pressure this month is to have it sorted. School is underway, the schedule is set, and everyone is supposed to be fine by now.

Most people are not fine by now, or they are fine and also not, which is closer to how it usually goes. That is not a sign that the fall is going badly. It is a sign that you are paying attention to something that matters, from more than one angle, which is a harder and more honest thing to do than picking a story and sticking with it.

Two things at once is not a state to fix. It is most of an adult life. September just makes it louder.

Stay connected

• Read this month's essay on AuDHD, and send it to someone who has never quite fit either description.
• If school has raised questions about your child's attention or learning, reach out about an evaluation now rather than in December.
• Clinicians, the fall course interest lists are open, and the pilot cohort is a good way to see how we teach.
• Follow Phoenix Rising with Dr. Z to catch the episode when it airs.

Everything is at balancedlivingde.com. Thank you for reading, and for being part of this community.

With warmth,
Dr. Niki Serravalle
Center for Balanced Living

This Month at Center for Balanced Living

Fall is our busiest teaching season, and this year all three parts of our work are moving at the same time.

At the practice, September is when evaluation requests climb. A few weeks of school give teachers and parents something concrete to notice, and the vague sense that something has been harder than it should be finally has examples attached to it. If attention, learning, or coping has become a question in your house, this is the month to start the conversation rather than the month to wait. Amanda Foxwell also has openings for individual therapy, which is worth knowing if you have been holding a name on a list somewhere.

For our professional community, CFBL Institute teaches its first live intensive this month, and three twelve-week courses open this fall, including EMDR Basic Training. More on that below.

On the writing side, MUSA has a new essay in Make It Make Sense, and I recorded a podcast conversation this season about the book. Both are below.

Staff Spotlight: Welcoming Brittany

Professional Education, Grounded in Real Clinical Depth

Trainings, courses, and workshops for the people who do this work

For Clinicians, from CFBL Institute

Foundations of Trauma Therapy A two-day live virtual intensive in thinking across trauma modalities rather than within one. September 18 and 19, 9:00 to 5:00 ET, via Zoom. 12 NBCC CE clock hours, approval pending. A beta cohort, limited to 15 clinicians, at 200 dollars. Register: https://balancedlivingde.com/products/foundations-of-trauma-therapy-two-day-live-virtual-intensive-sept-18-19-2026-beta-cohort

Nature-Informed EMDR For clinicians who already practice EMDR and want to integrate nature-informed elements into the work. August 21, 9:00 AM to 12:00 PM ET, virtual. Registration details to follow.

Featured Blog: Make It Make Sense

This month's essay in Make It Make Sense takes on a profile clinicians see constantly and the field only recently allowed us to name. Until 2013, the diagnostic manual prohibited diagnosing autism and ADHD in the same person. A generation of people got one label, or neither, and spent years wondering why the standard advice kept failing them.

The essay looks at what it is like to live with both. A drive for novelty and a need for sameness. Craving company and finding it exhausting. Wanting the plan and resisting the plan. From the outside that reads as inconsistency. From the inside it is two real systems asking for opposite things, at full volume, at once.

The useful part is how it reframes the failure of ordinary strategies. If routines have never held and flexibility has never felt safe, the problem may not be your follow-through. It may be that you were handed interventions designed for half of you.

Read the full essay on the blog at balancedlivingde.com.

## From MUSA: a conversation about loving and losing a liar

I sat down recently with Dr. Christina Zampitella for her podcast, Phoenix Rising with Dr. Z. She is a clinical psychologist and thanatologist, and her show is built around grief and loss, which turned out to be exactly the right room for this conversation.

We talked about the book, *The Stories We Told*, and about what happens to a person who loves someone who lies. The part people underestimate is the loss. When a relationship built on deception ends, you are not only losing the person. You are losing the version of your life you believed you were living, and there is no ceremony for that one. Everyone around you expects relief. You feel relieved and you feel sick, and both of those are correct.

The episode is coming to Phoenix Rising with Dr. Z. You can find the show at youtube.com/@phoenixrisingwithdrz, and I will share the link when it goes live.