I’m not saying it’s easy to live anywhere else. In San Francisco, however, the competitive professional culture places a unique sort of stress on the clientele of Shrein Bahrami, MFT, a therapist who practices in the Marina / Cow Hollow neighborhood of San Francisco — by all accounts one of the wealthiest neighborhoods in the city, with a 2015 median household income of $147,573 (over 50 percent higher than the median income for SF at large). Shrein specializes in disordered eating and primarily sees professional women in their 20s and 30s. We spoke with her a bit about what it’s like being a therapist in San Francisco specifically, and what kind of pressures she sees affecting her clients the most.
The wealthier parts of SF are breeding grounds for distorted body image. “Just on the street where my office is, Union Street, there are so many juice places and ‘clean eating’ places…there’s definitely an interesting culture around dieting.”
After growing up and going to school in the Midwest, Shrein came to California for an internship at UCSF and continued on to receive her master’s degree from the University of San Francisco. “[School] is what brought me out here,” she said. “But my love for the city is what made me stay.” Beyond her passion for the area, she described the city as extremely therapist friendly and the people as more open to the idea of therapy than what you may find in other cities. “It felt kind of…natural,” Shrein added.
I was curious to see if Shrein felt that her specialty, disordered eating, was unique to San Francisco. “Yes and no,” she answered. While eating disorders are issues that are prevalent everywhere, the wealthier parts of SF are breeding grounds for distorted body image. “Just on the street where my office is, Union Street, there are so many juice places and ‘clean eating’ places…there’s definitely an interesting culture around dieting.” Shrein described the particularly bright, hardworking and anxious people who are drawn to San Francisco. As a way of coping with the extreme pressures of living in the city, many people choose to neglect their mental and physical health, which leads to a lack of self-care and an inability to nurture relationships outside of work.
In a way, our tech culture provokes this never-ending cycle: stressing out people enough to the point where they need a therapist but then giving them the resources to find said therapist.
“I think the gender dynamic is an issue as well in the tech world,” Shrein continued — a telling statement given the persistent gender-bias news from the tech industry. And while Shrein works in one of the wealthiest areas of the city, she may not often console clients facing eviction but definitely sees those who are struggling financially. Anxiety around sharing small spaces with iffy roommates (classic San Francisco) or comparing oneself to a coworker or friend who, say, “goes to Tahoe every weekend,” may both be #firstworldproblems, yet they can cause some serious emotional trauma for those experiencing them.
Given San Francisco’s techie culture in the city, Shrein is able to connect with future and existing clients very easily online and on social media. Rather than relying on word of mouth or insurance references, Shrein said she can create and post in Facebook groups, reach out to clients online and network through various platforms that may not be utilized as much in other cities. So in a way, our tech culture provokes this never-ending cycle: stressing out people enough to the point where they need a therapist, but then giving them the resources to find said therapist.
What’s the takeaway? The San Francisco lifestyle has its positive qualities. But SF’s professional culture pits people against one another, often in a subtle but very present way, which can lead to anxiety, eating disorders and, in general, undernourished self-care.
