Narrative Therapist | Founder at Naratively | Writer | Poet

Resident of Netivot, Israel. Born and raised in Philadelphia, Pennsylvania.  Attended Hebrew University and the University of Houston, BA in English and chemistry. 

אני מדברת עברית. 

Girl nerd. KDE or bust!

Trauma is a family affair.
It doesn't happen to individuals. It happens to families.

The ripples move outward into the living room, the dinner table, the car ride to school. Trauma rewrites the rules of a household without anyone voting on the changes. It becomes the uninvited guest that never leaves.

Families adapt. They develop their own languages around what happened. Sometimes that language is silence itself. A parent who survived war learns not to speak about it. Their children learn not to ask. Their grandchildren inherit a wordless weight they can't name but carry anyway.

This isn't dysfunction. It's adaptation. The problem is that strategies designed for crisis often outlive the crisis itself.

In Narrative Therapy, we learn to separate the person from the problem.
Your father isn't "an angry man." He's a man shaped by rage that took root during experiences no one should have to survive.

Your daughter isn't "anxious." She has a complicated relationship with fear that makes sense given what she's witnessed.

When families externalize together, they ask different questions:
How has Trauma tried to isolate us from each other? When has our family refused to let Fear run the household? Where has Trust shown up despite everything?

Healing requires witnesses. Families can learn to become better ones: to listen without fixing, to remember the person underneath the pain, to hold space for stories that are difficult to tell.

Trauma barges into a family's life without asking. But families can choose, together, how much power they give it over their story.

Ad spotted outside Azrieli, Tel Aviv.

Nofyah Shem Tov

Founder, Effective Therapy (ET) | Narrative Therapist exploring how continuity of care shapes mental health outcomes

Notice how stress spreads through a team?

One person panics, everyone tightens up.
 One person stays calm, others settle down.

That's co-regulation.

Your nervous system takes cues from the people around you.

And it's happening in your organization right now.
↓↓↓

Whether you know it or not. Every workplace either helps employees regulate their nervous systems. Or it dysregulates them. There is no neutral option

Your Organization Is a Nervous System Regulator

The Mental Health System Has a Dirty Secret

We tell people to "get help."

Then we make them tell their trauma story to seven different strangers over two years because the therapist moved, the rotation ended, the panel changed, the agency restructured.

We call this "treatment."

I call it something else.

Here is what nobody wants to say out loud:

For many trauma survivors, the mental health system recreates the original injury. Attachment forms. Relationship ends. Start over. Repeat.
This is not a funding problem. Veterans at the VA experience it. People with private insurance experience it. People paying out of pocket experience it. The fragmentation is baked into how we have organized care itself.

We label people "treatment-resistant" when what they actually are is exhausted. Exhausted from being assessed. Exhausted from compressing years of pain into a 50-minute intake. Exhausted from hoping this time will be different.

The person who stops showing up is not "non-compliant." They learned exactly what we taught them: connection is temporary and help has an expiration date.

More money will not fix this. A new program will not fix this.
We need to rethink trauma care from the ground up.

Why do we train therapists by rotating them through clients who need stability? 

Why do we structure treatment around billing cycles instead of healing timelines? 

Why do we measure "access" but not "did anyone stay long enough to matter"?

The system is not broken. It was never built for what trauma actually requires.

What would it look like if it were?

We know what works in mental health care.
We do the opposite.
$14.1 trillion.
That's the annual cost of adverse childhood experiences in the U.S.
And we allocate 2-7% of health budgets to mental health.
Here's what the research actually shows:
↓↓↓

The research on continuity of care is unambiguous. So why do we build mental health systems designed to fragment it? We know what works in mental heal

The Science Is Clear. We Do the Opposite.

What do we mean when we say “stoicism”?

And what do we assume it asks people to do with pain?
Is stoicism about emotional control, or about emotional clarity?
Does it teach regulation, or does it reward endurance at the cost of awareness?

Stoicism can assist emotional regulation only under one condition:
pain must be recognized, named, and taken seriously.
What happens when pain is not allowed to exist?
When distress is reframed as weakness, excess, or something to rise above?

In those cases, stoicism becomes avoidance.
People learn to override signals rather than interpret them.
Emotion is not regulated; it is postponed, often until it returns as burnout, illness, or collapse.

But what if pain is acknowledged rather than dismissed?

What if stoicism is used to distinguish what can be influenced from what cannot, without denying what is felt?

In that form, stoicism offers containment without erasure.
It creates space between sensation and reaction, without demanding silence from either.

This question matters for people with trauma histories.
Is emotional intensity a failure of regulation, or is it information?
Is control the goal, or access?

Regulation is not obedience.

It is the ability to remain present with feeling without being overtaken by it.

So the question is not whether stoicism “works.”
The question is what version of stoicism we are teaching.
Does it help people stay with pain long enough to respond wisely,
or does it teach them to abandon themselves in the name of control?

What would stoicism look like if pain were treated as information rather than something to overcome?

Stoicism, Pain, and Emotional Regulation

Proud to announce that Dotan Cohen and I completed the 8400 The Health Network  Nextgen Medtech course this evening and will be using what we learned to manage Effective Therapy R&D's path forward.

Thank you, Nitsan Toussia Cohen and Gilad Glick for your help and mentoring over the last few months.

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