Nicki Ditch LMHC, CCTP, AMTP

Mental Health and Counseling

  • Borderline Personality - A Haiku by Nicki Ditch

    My anger ablaze

    Emotions singed from the flames

    I’m hollow inside.

    ~Nicki Ditch

  • Borderline Personality - A Limerick by Nicki Ditch

    There once was a person with Borderline

    Whose behaviors were less than benign.

    Temper tantrums he’d throw

    With shouting and cutting in tow

    But his passion and compassion were divine.

    ~Nicki Ditch 

  • Suicide: The Ripple Effect 

    Nicki Ditch LMHC - Counseling and Mental Health is hosting this film on Tuesday, May 29th at Webster AMC Theaters in Webster, NY. It is a "Theater on Demand" film which means that it will only show ("tip") if enough seats are filled by 5/20. LETS FILL THIS THEATER! Cost is only $12!!

    I heard Kevin Hines speak when I worked for Unity Hospital's Outpatient Behavioral Health clinic. This man is nothing short of remarkable and his message to the public is genuine, so vulnerable, and healing. This film is only currently available via Theater on Demand! If you are interested in attending this event, click on this link:   If this trailor moves you in the even the smallest way, order a ticket now! What else do you have that is more important to do on a Tuesday evening?   


  • I'm Not Fragile!

    "Fragile" is an adjective that not many of us like to use to describe ourselves. We like to think of ourselves a strong and durable and we are! We have withstood the pressures and injuries in life to be here today so of course we are strong and durable! But aren't we also delicate at times and meant to be handled with tenderness even when we are strong and durable? What if you were only durable and as a result, you were only handled with carelessness? I mean, it's fine! You won't break! What would it be like to honor your fragility and invite the opportunity to be handled with tenderness?


  • How Will You Care For You Today?

    Two common immediate reactions following a tragedy are feeling as if a prior loss or traumatic experience is happening again and re-evaluation of priorities. While the first immediate reaction is generally very emotionally and sometimes even physically painful, the second reaction can be helpful. It is so easy to get lost in the overwhelm of the current crisis and despair has a way of taking over if we are not intentionally fending it off. It is during the immediate aftermath of tragedy when we should find ways to be self-caring, determine our own values, and identify at least one behavior we can do now that align with our values. In doing so, we allow ourselves to continue to heal our older wounds and begin to heal the newest wounds.  So, how can you be self-caring right now? What do you promise yourself to do today to take care of you? What do you value TODAY and HOW COME? Is it because you’ve been told you should value it while wondering if you truly do? Is it because you had a life experience that either instilled or reinforced that value? Is it because it’s just been a habit to value it; something you’ve always done without really giving it much thought? Can you imagine cleaning the closet out? Can you dump all the values, opinions, shoulds, shouldn’ts into a pile and sort through them, deciding what you want to toss, what you want to give back to its rightful owner, and what you want to hold onto and place neatly back in the closet? After you’ve done that, can you take it one step forward and do one thing today that aligns with the values that you have decided are yours to keep? 

  • Sometimes Therapy Feels Shitty

    Many clients and even therapists believe that if something is therapeutic, it means it feels good. The truth is that sometimes it feels good and other times, it feels shitty. If something is therapeutic, it means that it aids in healing and sometimes that hurts! Have you ever heard of a bone needing to be “rebroken” so it can heal properly? Have you ever had stitches or surgery? Healing fucking hurts!!!


    A lot of people think that their loved ones in therapy with me are spending an hour and good money to be complimented, to be told about how right they are and how wrong their loved ones are, or to talk to me while I sit passively nodding my head with smiles and “mm hmm’s.”


    Here is a reality check for you. If your loved one is in therapy with me, they have one of the most confrontational and challenging therapists I know. It is true that my clients feel safe in their therapy. Feeling safe is my ultimate concern for my clients. I tell my clients often that while they should always feel safe, they will often feel uncomfortable. I also tell them that if we work together long enough and if they and I are doing our jobs right, I will probably piss them off. My clients hear me say things like,


    • What do you need today?
    • Your presence matters. Your absence matters. What you do matters. What you say matters. You matter.
    • What do you need right now?
    • I’m feeling protective of you right now.
    • What do you need from me?
    • When you allow yourself to show your hurt in here, you help me to understand how hurt you are.
    • What do you need? (Are you noticing a pattern here?)
    • I hate that you are hurting so much.
    • I am pissed that that happened to you.
    • Even if you smile or laugh in here, I promise I won’t forget how much you are suffering.
    • What is preventing you from getting your needs met?
    • Trust in your process, be patient with your timeline, be kind to yourself.
    • Can you work to get your needs met in here?


    My clients also hear me say things like,


    • What gives you the right to tell other people how to feel?
    • You don’t get to decide how _____ does life.
    • It is none of your business what they are saying about you.
    • How do you expect to get your needs met when you haven’t made them clear to anyone?
    • ______ is not responsible for your emotions; you are.
    • ______ is entitled to his experiences even if you don’t agree with or understand them.
    • I am beginning to resent your frequent tardiness to your sessions.
    • What are you avoiding?
    • What are you doing right now?
    • How does what you are saying have anything to do with what I just asked you?
    • Talk to me about your anger with me right now.


    Despite what stigma has taught society, THERAPY IS NOT FOR THE WEAK! My clients are so strong and brave! When I was leaving the clinic and had my clients meet their new therapists, what I heard my clients say the most to their new therapists were things like, "I need you to call me out on my shit like Nicki does," "Don't let me stay comfortable," "Push me out of my comfort zone like Nicki does." Therapy with me is rough at times. It is often uncomfortable, confrontational, challenging, brutally honest, and incredibly therapeutic. 

  • ; This Is Not How Your Story Ends Should You Choose To Keep Writing It!

    A dear friend of mine is in pain, especially this week, as she grapples with the 19th anniversary of her brother's suicide. As a therapist and also someone who has been a very active EMT for 19 years of my life, I have heard a lot of people contemplate suicide and idealize suicide and I have seen a lot of suicide attempts and some suicide completions. How do I cope with that? I compartmentalize. As an EMT responding to a suicide call, I needed to in order to do the job at hand. As a therapist, I have to compartmentalize JUST ENOUGH to stay focused but not so much that I am unfeeling. While compartmentalization (which is a defense mechanism used to sort of stuff or numb pain) enables us to go about our day without having a melt-down, it also inhibits empathy. It is sometimes hard for me to imagine the enormity of the pain a person must have felt to have decided that suicide is THE answer. It is sometimes hard for me to imagine the amount of pain the survivors of a person who has suicided feels. I thank my friend for putting her pain out there so that I can be reminded of the pain people feel and my responsibilities to my fellow humans!

    I had the fortunate opportunity to watch Kevin Hines speak at a conference. He is an amazing man who survived a jump from the Golden Gate Bridge in an attempt to end his life. He opened his speech up with this: "'How are you? Is there anything you need? Can I help?' If anyone had said any of those things to me, I would not have tried to end my life that day."

    As he states in this video, it is okay not to be okay and recovery happens!!! It is NOT okay to NOT ask for someone to back you up. If you are contemplating suicide and someone asks you how you are, even if they are just making small talk, tell them you are not okay and ask them to help you to not end your life today. I know that you don't want to go to the hospital but remember that it is part of the healing process and that you CAN feel better! HOW YOU FEEL TODAY IS NOT HOW YOU WILL ALWAYS FEEL EVEN IF YOU DON'T BELIEVE THAT NOW! THIS IS NOT HOW YOUR STORY ENDS should you choose to keep writing it!

  • Mindfully getting your facts and stories straight

    A collaborative video with my friend Stacey Steinmiller of Authentic Self Counseling demonstrating ways we can be mindful about facts versus stories.

  • "What do you do with YOUR feelings?" 

    People often wonder how I, as a therapist, manage my own feelings that result from therapy sessions with my clients. 

  • Choosing your words wisely can help you feel better!



    When we misuse words, we are less understood and can feel worse about our situations. In this video, I'm giving attention to the use of the word "literally" and how it can literally make is feel worse.

  • Fear Versus Anxiety

    Fear is NEVER rational by its very definition. It is emotional.
    FEAR FITS WHEN you are faced with an ACTUAL IMMEDIATE threat.True, actual fear is adaptive; it aids in our survival and reproduction. Example: "There is a man in my office with a gun pointing at me."In fear, all of the following behaviors are appropriate and should be utilized based on what will most help you survive: fight, flight, freeze.
    Anxiety is NOT fear! Anxiety is NOT rational, it is not a true emotion, or adaptive. It does not aid in our survival; it contributes to ill health, suicide, and unnecessary violence! It can lead to our death!!!
    ANXIETY IS MANAGEABLE even when it is overwhelming.
    ANXIETY FITS WHEN we imagine or perceive a threat. Example: "I worry that a man will come in my office and kill me."
    Sometimes what we are anxious about becomes a true fear and often it does not!!
    To manage anxiety, take these steps:
    1) Recognize that this is anxiety, this is not true fear and remember that you can manage your anxiety skillfully if you want to. Even if it has a possibility to become true fear in the future, recognize that it is NOT true fear now, in this very moment.
    2) Recognize that you are catastrophising.
    3) De-catastrophise!!! 
    3a) Identify the specific "catastrophic what-if." such as "What if a man comes in my office with a gun and kills me?"
    3b) Turn the what-if into a declaration of fact such as "A man will come in my office and kill me."
    3c) Challenge the validity of the statement in 3b by answering the following questions BASED ON LOGICAL EVIDENCE, NOT ANXIETY: Has this ever happened to you before? How often has this happened to you before? Although it is a possibility, is it LIKELY to be COMPLETELY true? It is not likely a man will just walk in my closed office now, it is less likely that if one does, he will have a gun. It is even less likely that if a man with a gun comes in my office, he will actually shoot me, and even less likely that if a man comes in my office with a gun and shoots me, I will die. Is there ANY reason at all to doubt that this will ACTUALLY happen?
    3d) For every catastrophic what-if from 3a, come up with AT LEAST THREE positive what-ifs. What if a man does not come in my office with a gun and kill me? What if I can call for help? What if I can de-escalate the man and talk him out of shooting me? What if I can take proactive steps to increase security at my place of employment? What if other people in the office become aware of a disturbance in my office and they call 911? What if I actually do get shot and the wound is not fatal? 
    If you get through all of this and your anxiety has not lessened, DISTRACT yourself. Stop playing the catastrophic thought loop that is contributing to your anxiety.
    ***Try this now. I promise you, if you truly want to feel less ANXIOUS right now and you really honestly engage in these steps and challenge yourself to answer all of these questions, you do have the power to reduce your anxiety.*** God bless you as you continue to work through your struggles today and every day!