CARY ANN ROSKO, LMFT
Specialties
If you’re someone who thinks deeply, your brain can easily become a double-edged sword. The same mental machinery that lets you excel in some parts of life can just as easily turn inward, spinning into exhausting cycles of overthinking, over-analyzing, and hyper-vigilance.
I work well with complex thinkers, high achievers, and neurodivergent adults who find themselves caught in the bewildering friction between what their minds understand conceptually and what their nervous systems can’t seem to resolve on their own.
You Might Recognize Yourself Here
You might be a high achiever whose anxiety has helped you stay ten steps ahead for years, a gifted or highly sensitive person who’s exhausted from adapting to everyone around you, or someone beginning to realize that your perfectionism, relationship patterns, or chronic self-reliance grew up together.
You don’t have to fit neatly into any one of these categories or know exactly what’s troubling you (that’s part of what I’m here to help with!). But if you’re curious, you can learn more about the areas I work with most often and how I approach them below.
SPECIALTY
Anxiety & Trauma
When your mind knows one thing and your nervous system seems to know another
Anxiety isn’t always particularly logical. You can know something is probably fine and still spend hours thinking about it, recognize that a situation isn’t dangerous and still feel your body bracing for it, or understand exactly where a fear comes from without being able to convince yourself not to feel it.
Sometimes there’s an obvious experience behind these responses. Other times, what we call “trauma” is less about one identifiable event and more about what accumulated over time: chronic stress, relationships that didn’t feel safe, needs that repeatedly went unmet, or years spent adapting and protecting yourself in ways you may not have even realized you were doing.
You might notice:
- Anxiety or worry that's difficult to turn off
- Overthinking, rumination, or repeatedly second-guessing yourself
- Feeling hypervigilant or unable to fully relax
- Avoiding things even when part of you wants to move toward them
- People-pleasing, codependency, or difficulty setting boundaries
- Shutting down, disconnecting, or feeling overwhelmed during conflict
- Reactions that feel much bigger than the situation in front of you
- Old experiences continuing to show up in your relationships or daily life
How We Might Work Together
Rather than treating anxiety as something we simply need to eliminate, I’m interested in what it’s doing there in the first place. We’ll get curious about the beliefs, emotions, physical responses, and protective strategies involved, including what your mind and body may have learned from earlier experiences. Depending on what you need, I may draw from Internal Family Systems (IFS), EMDR and the Flash Technique, somatic psychotherapy, mindfulness, attachment theory, and neuroscience.
Pacing matters. Trauma and anxiety work isn’t about digging up the most painful thing that’s ever happened to you and flinging open the floodgates. We’ll build enough safety and capacity to approach difficult material without overwhelming the same system we’re trying to help.
Over time, the goal is for old experiences to feel more like something that happened to you and less like something your mind and body are still preparing for.
SPECIALTY
High-Achievers & Burnout
When the things that made you successful start making you miserable.
You’re capable, driven, and used to figuring things out. You’ve probably accomplished quite a bit because of those qualities.
But some of the strategies underneath that success may have become increasingly difficult to live with: perfectionism that makes “good enough” nearly impossible, an inner critic who keeps moving the finish line, overworking that you can’t seem to turn off, or the uncomfortable feeling that if you stop holding everything together, something important might fall apart.
You might notice:
- You have trouble resting without feeling guilty or unproductive
- Your standards for yourself are much harsher than the ones you have for other people
- Accomplishments provide relief, but not necessarily satisfaction
- You're exhausted in a way that sleep or a vacation doesn't seem to fix
- You overprepare, overthink, or second-guess yourself despite being objectively competent
- You're carrying more than you want to and quietly resenting it
- Slowing down sounds appealing in theory and deeply uncomfortable in practice
How We Might Work Together
The instinct is often to treat burnout as a scheduling problem, but more frequently the patterns driving the overworking, perfectionism, self-criticism, or need to stay in control have been doing something important for you for a very long time. They may have helped you feel safe, competent, valued, prepared, or less vulnerable to criticism and failure. Simply telling yourself to work less doesn’t necessarily change any of that.
Using IFS and other approaches, we can get curious about the parts of you keeping these patterns in motion rather than fighting with them or trying to get rid of qualities you genuinely value.
Because the goal isn’t to make you less ambitious. It’s to give you more choice about what’s driving that ambition, so the drive that got you this far can stay useful without running your whole life.
Neurodivergence
Minds that don’t fit the mold.
Understanding whether you’re neurodivergent—and discovering what kind of neurodivergence applies to you—can make an enormous difference in deciphering some of the difficulties you may be going through emotionally or in your relationships. Of course, being neurodivergent comes with many gifts, but the world at large isn’t built for neurodivergent brains and that mismatch can result in low self-esteem, persistent negative self-talk, and painful experiences of not understanding yourself or being misunderstood by others. Knowing how your unique brain works can help relieve confusion, rewrite your story, and open up space to appreciate all the ways neurodivergence enhances your world.
You don’t need a formal diagnosis for us to be curious about whether neurodivergence is relevant to what you’re experiencing.
I've worked with clients who identify with:
ADHD
ADHD can affect executive functioning, attention, and emotional regulation in ways that vary from person to person and may be easy to miss, particularly in adult women.
Giftedness
Giftedness can shape how you think, relate to others, and experience the world, sometimes bringing intense pressure, social isolation, or a tendency to minimize yourself in order to fit in.
OCD
OCD can involve intrusive thoughts and repetitive behaviors or mental processes that may become increasingly distressing or disruptive, and it frequently overlaps with other forms of neurodivergence.
HSP (Highly Sensitive Person)
High sensitivity can mean experiencing emotional, environmental, and sensory stimuli more intensely, making overstimulation, overwhelm, and even physical or emotional shutdown more likely.
Autism (with low support needs)
Autism can influence social interaction, communication, sensory experiences, and responses to routines or transitions, with the particular combination and expression of these traits varying from person to person.
How We Might Work Together
Neurodiversity-affirming therapy isn’t about teaching you how to appear more neurotypical.
We’ll get curious about how you experience and move through the world, including what’s been challenging and what genuinely works well for you. We can also look at the coping strategies you may have developed over years of navigating environments, relationships, expectations, or systems that didn’t always fit.
We can also look at whether neurodivergence might be playing a role in what you’re going through. This might mean learning about assessments to clarify what you notice about yourself or considering specialized treatment or medication, when applicable. It could mean figuring out how you can support your brain and nervous system’s needs or finding community with folks who share your neurodivergence. I can also help you work through any challenging or traumatic experiences related to your neurodivergence that you couldn’t contextualize before. Whatever neurodivergence looks like for you, we can explore what that means in your life.
Frequently Asked Questions
Because understanding a pattern and changing your response to it aren’t necessarily the same process. Our responses are shaped by thoughts and beliefs, but also by emotions, relationships, past experiences, and what our bodies and nervous systems have learned to anticipate. You can understand perfectly well why something happens and still find yourself reacting before that understanding has much chance to intervene.
In a word: nope! Our inner critics are often trying to help us survive and thrive but in a way that increases emotional and psychological drag. Research shows that self-compassion improves performance more than self-criticism, which promotes insecurity, defensiveness, and a lack of resilience. Self-criticism might push you forward at first, but it isn’t “clean-burning fuel” and eventually leads to system-wide breakdowns and isolation. By using parts models like Internal Family Systems, we can help your inner critics adopt a less extreme role so they can be your advisors and supporters, not your punishers.
No. EMDR is often associated with single-incident trauma, but it’s just as useful for the cumulative effect of chronic stress, neglect, or years of pushing through without support. If your body reacts more strongly than the current situation seems to warrant, that’s often a sign EMDR might help. We can talk about what you’re experiencing and whether EMDR, the Flash Technique, or another approach makes the most sense for you.
Better than most people expect! Somatic therapy doesn’t require me to be physically in the room with you. We’re paying attention together to what’s happening in your body as we talk: changes in your breathing, tension, impulses, sensations, or other physical responses that give us information about what your nervous system is doing. Those moment-to-moment responses can help us work with experiences that talking about them intellectually may not fully reach.
Trauma isn’t limited to one catastrophic event. Sometimes it comes from something clearly identifiable, but it can also develop through experiences that accumulate over time, such as chronic stress, emotional neglect, unstable or painful relationships, or repeatedly having to adapt to situations that didn’t feel safe. I’m less interested in whether an experience meets some arbitrary threshold for being “bad enough” and more interested in how it affected you and whether your mind and body are still responding to it now.
Therapy for High Achievers in California
What does it mean to be gifted or a high achiever?
Gifted and high-achieving individuals process information more quickly and intensely than most people. They make connections others miss, hold themselves to exacting standards, and often find themselves three steps ahead in conversations. This cognitive intensity is a genuine strength, but it can also lead to overthinking, perfectionism, imposter syndrome, and difficulty finding therapists who can keep up with the pace and complexity of their inner world.
Why do high achievers benefit from specialized therapy?
High achievers are often praised for the very patterns that are causing them distress. Overworking looks like dedication. Perfectionism looks like high standards. Hypervigilance looks like preparedness. Because these traits are rewarded, it can be difficult to recognize when they have become unsustainable. A therapist who understands giftedness and high-achieving traits can help you preserve what works while untangling the anxiety, burnout, and self-criticism underneath.
Why High Achievers Need Specialized Therapy
Therapy for high achievers requires a nuanced understanding of giftedness, perfectionism, and the unique pressures that come with being highly capable. High achievers are often praised for the very patterns causing them distress—overworking looks like dedication, hypervigilance looks like preparedness, and self-criticism looks like high standards. They may have spent years being rewarded for pushing through discomfort, making it difficult to recognize when those strategies have become unsustainable. A therapist experienced with high-achieving clients understands that the goal isn’t to lower your standards or reduce your ambition. It’s to help you preserve what works while untangling the anxiety, burnout, and self-criticism underneath.
A Therapist Who Understands High Achievers
Finding the right therapist for high achievers matters because traditional approaches may not fully account for the speed, complexity, and intensity of a gifted or highly driven mind. High achievers often come to therapy with strong insight and extensive self-awareness, yet still feel stuck in patterns they understand intellectually. They need a therapist who can keep pace with their thinking while helping them access the emotional and somatic layers that insight alone cannot reach. Specialized therapy for high achievers creates space to explore perfectionism, imposter syndrome, burnout, and identity without pathologizing ambition or asking clients to become less capable.
See if this is the right fit
Booking a consultation isn’t a commitment; it’s twenty minutes to talk through what’s going on and get a sense of whether this is the right kind of support for you.