Navigating the Pressure to Perform: Rachel Terrell, LCPC, on Supporting Women’s Mental Health
Rachel Terrell, LCPC
In reflecting on Women’s History Month, I had the opportunity to speak with Rachel Terrell, LCPC and founder of Integrative Mental Health and Consulting LLC, about the invisible struggles many women carry. Our conversation explored the silent pressure to “have it all together,” the ways stress shows up in the body, and how women can begin reclaiming their emotional well-being.
A Calling Rooted in Connection
Rachel discovered her calling in mental health through a series of surprising turns that revealed what she truly loves about connecting with people. Beginning in social work, then detouring into cosmetology and teaching, one theme remained constant: connection.
“The part I loved had nothing to do with cosmetology or teaching,” she shared. “It was the intimate conversations I had with people about life.”
That love of depth led her to pursue graduate education in clinical mental health counseling and start her own private practice. Interestingly, her niche, working with high-achieving, often minority women in executive and leadership roles, found her naturally. Through word of mouth, her caseload organically grew into a community of C-suite leaders, attorneys, politicians, and highly educated professionals.
When Excellence Becomes Armor
Many of the women Rachel works with are exceptionally accomplished. They are used to running meetings, leading teams, and performing under pressure. That same skillset often shows up in therapy.
“They intellectualize,” Rachel explained. “They understand what’s happening cognitively. But the work is helping them get out of their heads and into their bodies.”
For minority women in particular, workplace stress often includes microaggressions, the pressure to be flawless, and the unspoken fear that mistakes won’t be forgiven in the same way as others. Over time, that constant vigilance creates anxiety, rigidity, and emotional exhaustion.
And yet, the distress is often masked.
“Women don’t always say, ‘I want to hurt myself,’” Rachel noted. “They say things like, ‘I just wish I could go to sleep for a week.’ If you’re not listening closely, you can miss the depression underneath the performance.”
How Stress Shows Up in the Body
One of the most powerful parts of our conversation centered on how stress manifests physically. Rachel sees high levels of gastrointestinal issues, chronic pain, inflammation, sleep disruption, hormonal shifts, and even heart-related concerns in her clients.
Many of these women spend months navigating medical appointments before being referred to therapy. The idea that emotional stress can produce very real physical symptoms can be hard to reconcile, but it is common.
“When someone has their first panic attack, they think they’re having a heart attack,” Rachel explained. “The body doesn’t feel like it’s ‘just stress.’ It feels dangerous.”
This is where psychoeducation becomes empowering. By explaining the nervous system, the vagus nerve, and how breath regulates the stress response, Rachel helps her clients understand that their bodies aren’t betraying them, they’re responding to chronic pressure.
Practical Tools That Work
To help women manage the physical and emotional effects of stress, Rachel combines psychodynamic insights with practical, body-centered strategies. Some of the tools she frequently uses include:
Intentional breathwork grounded in nervous system education
Mindfulness practices to anchor presence
Narrative work, including naming anxiety to create distance from it
Mantras and affirmations, which help retrain the brain through the brain’s natural ability to form new thought patterns
Resourcing techniques, such as recalling positive memories to build emotional safety
Redefining Self-Care
When discussing guilt around self-care, Rachel reframes the concept entirely.
“Self-care isn’t just spa days,” she said. “It’s restraint. It’s discipline. It’s loving yourself enough to take care of yourself.”
She offered a powerful analogy: a child wanting a lollipop for every meal. A loving parent says no, not to punish them, but to protect them. In the same way, loving ourselves may mean scheduling five minutes of stillness, setting boundaries, or managing stress proactively, even when it feels inconvenient.
Self-care, she reminds her clients, sometimes looks like structure.
Advice for Women Balancing Success and Well-Being
Rachel’s key advice? Don’t wait for a crisis to seek therapy. It’s a proactive way to care for yourself, helping you process stress, prevent burnout, and cultivate a deeper sense of fulfillment.
For those without access to therapy, she suggests small, accessible practices:
Stepping outside for morning light
Taking gentle walks in nature
Engaging in restorative yoga
Using aromatherapy (like lavender before bed)
Carving out even three minutes of intentional breathing
Even small practices like these can add up, helping create more balance and resilience over time.
Women’s History Month invites us to celebrate women’s achievements. It also invites us to acknowledge the unseen labor—the emotional load, the microaggressions, the perfectionism, the silent anxiety—that so many women carry.
As Rachel’s work illustrates, success and emotional health are not mutually exclusive. But maintaining both requires intention, support, and the courage to remove the armor, even if just for 45-60 minutes in a therapy room.
