Teralyn Sell and Jenn Schmitz: Breaking Out of the Prison of Prescribing and Finding the Freedom of Therapy

On the Mad in America podcast this week, Brooke Siem, author of May Cause Side Effects, talks with Teralyn Sell and Jenn Schmitz about their journey from working in the prison system to challenging conventional psychiatric narratives in their therapy practice and podcast, The Gaslit Truth.

Dr. Teralyn Sell is a distinguished expert in Psychology and Brain Health, holding a PhD in Psychology and an MS in Counseling Psychology. She bridges the gap between traditional mental health care and integrative brain health solutions with formal training in holistic nutrition and biology. She is the author of Your Best Brain and the co-host of the internationally acclaimed podcast, The Gaslit Truth, where she challenges conventional narratives around mental health and medication. Dr. Teralyn is dedicated to promoting safe medication practices, responsible tapering and a paradigm shift in mental health care, one that prioritizes brain health over symptom management.

Jenn Schmitz is redefining the field of psychology with a unique blend of expertise and lived experience. Holding a Master of Science in Clinical Psychology and having spent over a decade as a traditional therapist, Jenn took a bold step beyond the conventional boundaries of Western education and mental health treatment. Her personal struggle, marked by the challenging process of tapering off psychiatric medication, revealed insights that reshaped her entire approach to mental health. As a holistic, de-prescribing consultant, Jenn integrates psychological and brain health expertise with physical wellness, mindfulness and nutrition to safely guide the brain through the intricate process of medication tapering. Jenn hosts The Gaslit Truth podcast along with Dr. Teralyn and is a writer for the international wellness publication, Live, Love and Eat magazine.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

 

Brooke Siem: How did you two start working together?

Teralyn Sell: We first came across each other in the prison system probably 15-plus years ago. Jenn stayed in, and I broke out. I went into private practice and was in private practice for 10 years or so before I even heard from Jenn. Then a couple of years ago, I got a phone call from Jenn.

Jenn Schmitz: I decided there was more to life than working in the prison system, and that if I stayed there, it wasn’t going to be good for me. Retirement and all the things that look so fantastic within a state system don’t matter when your brain and body are shutting down from the amount of stress and hypervigilance and the acuity of an environment where your job is to keep people alive all day long. I reached out to Terry and said, “Hey, you got out. I want out—tell me how to do it.”

Sell: The breakout happened, but I think the bigger story is why both of us left that environment. It was relatively the same—our mental health was declining, essentially, and that’s why we decided to leave.

Siem: What kind of work were you doing there?

Sell: Mental health therapy for inmates. Jenn and I met while working with the most mentally ill inmates in our state, and that’s where we got our original training. I was in maximum security and then went into this hybrid medium–maximum security unit. That’s where they housed all the seriously mentally ill or those who couldn’t acclimate to the prison environment. Working in an environment was the most extensive training a therapist could get.

Schmitz: We were working with psychopaths and those with extreme personality disorders. We both worked with the borderline personality disorder population. We had a high level of acuity, not just in the environment, but also individually, with the patients we were helping. Our niches came with a lot of mental health baggage for us and a lot of traumatic experiences that we were seeing and reliving with these patients every day.

Sell: Let’s just say that some of the things we were witness to were traumatizing. But because you’re doing it all the time, you don’t realize how traumatizing it is. When this becomes your norm, and you see these things over and over again, you act like it doesn’t impact you—but it absolutely does. Neither of us came out of there unscathed.

Siem: What stands out to you about how treatment in prison compares to treatment in the general population?

Sell: The “individualized treatment plans” that we had in the prison weren’t individualized at all. They were just prescribed treatments we knew how to do. In private practice, I believe therapy is more of an art than a science. I’m really leaning into that these days, because I felt like in prison it was more of a prescribed approach, partly because of liability. You had to do evidence-based practice, which is very manualized and stepwise. Now, I view it more as an art, because you have to move in a way that involves real understanding and knowing what to say or do next. That feels more like art than prescription.

Schmitz: To answer your question about the difference in prescribing—whether in the community or within prison walls: there isn’t much of a difference. I’m making blanket statements here, so take this as my experience after 13 years in the prison system, not only as a therapist but also as a supervisor overseeing mental health units.

Psychiatry was the bread and butter. It was a huge part of what was considered “mental health treatment.” We had intricate treatment plans, but they always included the same standard, siloed areas. There was someone from rec therapy, a psychologist, a psychiatrist, an education component—it was very structured.

The way medications were prescribed was very similar to what I’m seeing now in private practice. The amount of time and attention given to the patient—getting to know them, understanding them—it’s the same. You get a 20-minute appointment with your provider once or twice a year if you’re lucky. That’s it. There really isn’t that much of a difference.

Sell: We’ve come to understand that prescribing isn’t very scientific, nor is it individualized—and that’s true across both settings. But I do think more people were prescribed medications in prison than what I’m seeing now in private practice. Though that could be because I tend to attract people who either want off meds or want to avoid them.

Jenn and I lived on the units. Our offices were with the inmates, and we spent eight hours a day living and breathing with these men. We monitored them constantly.

One thing I didn’t expect to carry with me was how much I learned about psychiatric medication—especially side effects. We were very good stewards of psychiatry. We monitored, we learned the medications. Psychopharmacology was a big deal in prison. We had to know the meds because we were the right arm of psychiatry, and I didn’t think that experience would be as important as it is now—for me and Jenn. That foundation has carried over in ways I didn’t expect. I don’t think most people realize how much a therapist’s experience can inform their understanding of meds.

Siem: It sounds like you were fully on board with the Western psychiatric model.

Sell: One hundred per cent.

Schmitz: I was deep in that box and twisted myself into it. I slept next to the DSM, literally. When Terry and I first met, I had to memorize everything: the diagnoses, the stats, all of it. I memorized that book. Today, I’d burn it, but back then, it was my Bible.

Siem: What changed? What was the breaking point?

Schmitz: I left for the same reason Terry did—extreme burnout. I knew if I stayed, I wouldn’t make it. Sure, maybe I’d retire, but I’d be one of those statistics. People in corrections, police, EMTs—many don’t make it long after retirement. I knew I had to get out.

Once I did, I thought, “Okay, I’ll go back to therapy.” I’d done that for years. But what surprised me was how, outside that environment, it became clear everything I’d learned didn’t work. I already knew my patients weren’t getting better in the prison system. There were a few success stories, but overall, people weren’t improving.

I stepped out and started private practice. One of the beauties [of private practice], as Terry said, is that therapy becomes art. You have freedom—freedom to get training in whatever you want, not just what the state funnels down as the intervention of the week, handed down by some representative in office. I realized I could learn about things we weren’t even allowed to bring up before. If Terry and I tried to talk about nutrition or omega-3s in prison—

Sell: I did try, yeah.

Schmitz: That was not a thing. We got laughed at or demeaned terribly. I realized there’s a whole other world. And for me, there’s a personal component. I’m a psych med harm survivor. I’ve been trying to get off Lexapro—been on meds since I was 18. I’m almost 42 now, and I’ve been tapering for nearly 17 months.

I met Terry, joined her practice, and we just started talking. She asked, “Why are you still on this med?” That launched me into a whole world of, “Why didn’t anyone ever teach me this?” All the degrees, all the schooling—and no one talked about this alternative, holistic, functional world.

Terry introduced me to it. It started with a neuro health coach training—learning how to support the brain without psychiatric meds—and my mind was blown. I haven’t looked back. I’ve bought every book on functional medicine, amino acids, and integrative nutrition. I probably went a bit far—Terry had to reel me in a little. But it worked.

I applied it to my own taper. I changed my lifestyle and used holistic strategies, and it helped. Then I brought it into my private practice—and it started helping my patients too. That was my shift.

Sell: My [shift] started a bit earlier, while I was still in the prison. I remember reading a research article about omega-3 fatty acids. There was an inmate who was always getting in trouble—fighting, ending up in segregation—and I started digging. I wasn’t a researcher, but I was Googling like crazy, trying to find answers. I found a study that showed reduced aggression in male inmates who were given high-quality omega-3s.

I thought, holy crap, I need to bring this in. Someone just republished a similar study recently, but this was over 15 years ago. I brought it to a treatment planning session and handed it out. The psychiatrist looked at me and said, “You’re not a dietitian. You shouldn’t be talking about this.” I sheepishly gathered the papers back but I told people, “If you want a copy, come see me later.” That moment stuck with me. I felt shut down—but I also knew I was part of a system designed to do that.

Fast forward to private practice—I had a patient on a benzodiazepine, an SSRI, and a sleep med. Every time she came in, she seemed worse. But she was doing all the “right” things: meds, psychiatry, therapy. Still, she wasn’t getting better.

You can’t process information if you’re heavily medicated. You’re not even feeling your emotions. I kept thinking, there has to be something else. I was feverishly Googling “natural ways to increase dopamine” and similar things. We talk about dopamine in addiction or serotonin in depression, but no one teaches us how to improve it. It just stops there.

Siem: Which isn’t even accurate.

Sell: We know it’s not accurate now, but it’s still talked about that way. It’s still prescribed that way. I found the Alliance for Addiction and Mental Health Solutions—this was probably 12 years ago—and they were using amino acid therapy. I thought, what is this? I started researching. I remember asking a client, “Would you like to try some tyrosine?” I was so sheepish, like, “Here’s where you can get it. I know I sound ridiculous.” They’d come back, and I’d ask, “Did you try it?” And they’d say, “Yes, and it actually made me feel better.” I’d go, “It did? Are you kidding me?” I was shocked every time.

I just kept going—kept learning. But it wasn’t until the last few years, with Jenn, that I really started thinking deeply about withdrawal and how bad it is for people. To be fair, Jenn’s experience has been eye-opening for me. It’s been so long, and she has gone through so much suffering. I really commend her for still showing up every day, doing what she does while in the throes of withdrawal. That’s been educational for me, too.

I think it’s about staying curious—wanting to learn more and not taking no for an answer. We’re all individuals. We’re all suffering. But why? Psychology often stops short at the why. The answer is always trauma. Psychiatry’s why is always a chemical imbalance. And I’m like, what universe do we live in where a debunked theory from the ’90s is still being used to guide treatment? That doesn’t happen in any other field—except ours. It’s fascinating. I don’t get it.

Schmitz: The field is very archaic. We’re stuck in the ’30s and ’40s—when the “fathers of psychology” laid out the foundations. That’s still what’s being taught in school today, whether you’re training to be a therapist or psychologist. We entered this field, got into the prison system, and were just grateful to have jobs. But what we’d been taught was so siloed. And we stayed siloed—until something personal happens. That’s usually what sparks the shift. For me, it was trying to get off meds. For others, it might be escaping a system that’s killing your adrenal glands. There’s always a story behind it. Then we change and go, “Oh my gosh, there’s this whole other world of things to learn”—especially in functional medicine.

Amino acids blew my mind. I’ll never forget when Terry trained me. I thought, why does no one know this? Why wasn’t it ever part of treatment to say, “Hey Jenn, let’s talk about your nutrition because you eat like crap,” instead of “How’s your antidepressant? Should we up it or lower it?” That was never part of it. Even as therapists, we don’t get training in nutrition or herbal medicine. Even somatic work—we barely scratch the surface. Freud didn’t do it, so we don’t teach it.

Sell: When it comes to diagnosing, I learned pretty quickly—especially doing diagnostic assessments in the prison system—that diagnoses don’t really matter. In private practice, the intervention you’re given isn’t tailored to your diagnosis.

Jenn and I knew this early on. Our supervisor taught us the best therapeutic intervention is rapport. It doesn’t matter if you’re doing CBT or DBT—if the relationship is poor, it won’t work. The outcomes are worse.

I realized quickly that diagnosing is mostly for payment and insurance. But it can be detrimental. I’ve had clients denied life insurance because of a diagnosis from five years ago. I’ve seen kids denied military enlistment because of something labeled in childhood.

People need to think about how a diagnosis might negatively affect them or their children. Most of the time, it’s just for billing. That giant diagnosing book—it’s full of contradictions, buyouts, and non-truths. The intervention your therapist picks for you isn’t individualized to your diagnosis. Anyone can fight me on that. I’ll see you in the backyard.

If you’re trained in DBT, you’ll apply DBT to almost anyone. Same with EMDR or CBT. Therapists lean on what they know and like. It’s rarely about a specific diagnosis. I learned that real quick.

Siem: Teralyn, I know you’ve also spent time on psychiatric meds, and that’s informed how you practice today. Can you share a bit of your background with that?

Sell: Pretty much anytime I went to the doctor as a middle-aged woman, the result was a psych med. The first time was during pregnancy. The doctor put me on something to avoid postpartum depression. I was 32, it was my last kid, and I didn’t know what I know now—I wasn’t in grad school yet. I figured, “Okay, I guess that’s what I need to be a good mom.” But the medication changed my chemistry. I became dependent and stayed on it for five or six years. I couldn’t get off. That was my first experience.

The second was when I was working for the state, in a supervisory role that was not going well. I had extreme anxiety and near-daily panic attacks—crying in the car on the way home. I went to the doctor and got a second prescription. I took it for two days and felt completely out of my mind—dizzy and disconnected. I told my husband, “I either try to medicate myself or I quit.” The last time I drove home in a panic attack, I decided to quit my job and the anxiety disappeared. Gone.

The third time was more telling. I went to an endocrinologist because I was so fatigued. In 20 minutes, she prescribed me an antidepressant, a stimulant, and a sleep aid—all three. This was while I was just getting into brain health work, so I said, “No, thank you.” She looked at me and said, “Then why did you come here?” I told her, “Because I was hoping you’d figure out why I’m so tired.”

Turned out it was my thyroid. That was the issue. But she still defaulted to meds. That lit a fire in me. I realized I was being targeted as a middle-aged woman and flagged as a psych med client. I’m sure my file says “non-compliant.” Needless to say, I never went back. This is how easy it is to be prescribed. Is that science? I don’t think so.

Siem: What I’m seeing now is how often women over 40 are being given psych meds. They come to me years later and say, “I was put on all these drugs, and I’m still miserable. I can’t get off. What do I do?” We already know there’s an overprescription epidemic, but when we look at where it’s concentrated—it’s women over 40.

Sell: This is such an important conversation. In the early 2000s, a big research article came out saying estrogen significantly increases breast cancer risk. I think another article came out in 2024 debunking that, but the damage was already done.

Back in 2002, about 90 million women were on hormone therapy. After that study, it dropped to nearly zero. What the graphic shows is that, instead of hormones, doctors started prescribing antidepressants. In 2015, there were 61 million antidepressant prescriptions. Another 25 million for Xanax-type benzodiazepines. Twelve million sleep meds. All of that replaced hormone therapy. And during that time, suicide rates for women in that age group also skyrocketed.

Now, did suicide increase because we stopped giving women hormones? Possibly. But here’s the piece no one talks about: what if it skyrocketed because we started giving them antidepressants? Or both?

So many women are now stuck on these medications, suffering, and a lot of doctors still believe in that original study. They don’t look further. That’s the problem—when you take one study and stop there. Look deeper. Search for the opposite. Ask more questions.

That’s why I think so many women in that age category are now psychiatric patients. And honestly, historically, we always have been. I used to work in a county-run nursing home that had records going way back. I found old roll calls that listed diagnoses—and so many women were institutionalized for “hysteria due to menopause.” We haven’t come that far. Now, we’re just psych patients instead of women going through hormonal phases.

We miss the boat on women’s health. We make them sicker. Men have hormonal shifts too, but they’re not the same. And frankly, they’re lucky to be left out of this conversation. Women go to the doctor and believe what they’re told. Not because they’re naive—but because we were taught that doctors always know best.

Siem: Jenn, since you and I are closer in age, what are your thoughts on all this?

Schmitz: I was 16 the first time I took a psych med. And I have no memory of a big chunk of my life—I have to rely on medical records. That’s my reality. Our central nervous systems aren’t fully developed until our mid-20s. When you interrupt that development, it stunts everything. And that affects so much—your emotional development, brain growth, organ function, hormone regulation. All of it.

Now we look at our hormone levels later in life and we think, how could they be so off when we’re doing all the “right” things? Well, no one can tell me how my central nervous system was altered when I was a teenager. No one knows how that ripple effect impacted everything else.

And when you try to taper or get off these medications, your body freaks out. I’ve had extreme depression, unexplained rashes, a million things. Our systems were never given a chance to develop normally. And you can’t deny someone that truth. You can’t say it wasn’t caused by early med exposure—because we don’t know.

This is where I get skeptical about “evidence-based” practice. Terry and I talk about this all the time. It’s a blanket gold star that gets slapped on everything. But evidence-based doesn’t mean one-size-fits-all.

Siem: Evidence-based for six weeks in a lab—not for 16 years in someone’s life.

Sell: Exactly. And that makes me worried—for you and anyone else dealing with early hormonal issues. What happens when you’re in your 50s? If your hormones are this off now, what’s next?

You didn’t test them through your 20s or 30s—you only check when something feels wrong. That’s part of it. But what Jenn said about the disconnection from self really resonates with me. One of my biggest regrets from staying on meds so long—because I couldn’t get off, not because I needed them—is the memory loss.

I lost six years of my kids’ lives. Birthdays, Christmases, the moments you’d normally recall, I can’t. Those memories should have emotion tied to them—joy, chaos, whatever—but I was so chemically restrained, I was neutral. To make a memory, you need emotional input. On meds, there’s nothing. It’s all flat.

You don’t realize it when you’re in it. Someone called it “spellbinding”—and that’s exactly what it is. You don’t know until you come out of it. Then you look back and realize how bad it was. I was disconnected from my husband, my kids, my life.

I wish people could get out of that spellbinding earlier. But we live in this weird, fear-based narrative: “Better this than dead.” That’s where we’ve landed. We’d rather neutralize a teen with an antidepressant than risk anything else.

How did we get to a place where that’s the only answer? I don’t get it. I think that fear—fear of suicide—is what keeps the prescriptions going. As long as that fear exists, the prescribing won’t stop. And maybe that’s exactly what Big Pharma wants. Maybe the message is: “Be afraid. Take the drug.”

But those same drugs are also contributing to the problem. It’s such a big conversation—and hard to have. Especially on social media, where people love to gaslight you. “How dare you say that? You’re going to make people not want to take meds.”

What if I make them think for themselves? What if I give them the informed consent they’re not getting anywhere else? I wish someone had done that for me.

Siem: Jenn, you’re still tapering. What’s helped you most?

Schmitz: Staying curious. I constantly look things up—anything someone mentions, I’ll say, “Okay, that’s good to hear,” and then I research it. I want to see if it makes sense for my life and lifestyle because some things take a lot of time, money, or energy—and those can work against me. So I stay curious, and I do a lot of reading.

Second, the power of nutrition. I had no clue how much what goes in your mouth can affect how you feel. Terry once told me I was one of the healthiest people she’d met because I introduced her to Greek yogurt. But really, I wasn’t eating well. It wasn’t high-protein, high-omega-3, or nutrient-dense. I’ve completely changed that. I pay attention to what works and what doesn’t. What makes me feel good the next day? I track that and adjust.

Third, somatic work. I’m still working on this. I do bodywork and my own touch-based techniques. I try to connect emotions to the body, but it’s hard. I still struggle to feel those emotional states. But occasionally, something comes through and I go, “Oh my God, that’s what joy feels like.” Recently, I experienced pride for the first time—through bodywork. I went, “That’s pride. I’ve never felt that.” So those are the big three for me: curiosity, nutrition, and somatic connection.

Siem: Any specific somatic practices or teachings you’ve connected with?

Schmitz: The biggest shift was basic mindfulness. I’ve gotten into yoga—true yoga, not the Westernized fitness kind. I focus more on the Eastern roots, connecting to breath and body, not just doing poses in Lululemon. I do a lot of breathwork—sometimes between clients. If I have 10 minutes, I’ll spend four just breathing. I also practice mindful eating, and mindful walking—little things. The idea is to stay out of the performance mindset and instead just connect inward.

Siem: Given all your experience, where would you most like to see change in the mental health field? What’s the area you think advocates—or either of you—could make the biggest impact?

Sell: I think there’s a huge void in therapist education. We have to do CEUs every two years, but there are so few that fall outside the traditional path. I want to see more education for therapists around medication, withdrawal, advocacy, and working collaboratively with prescribers.

If we’re treating whole human beings, we need to meet them where they are—including when they want to come off medication. Be the therapist who advocates for them, not the one who keeps them stuck.

I also think nutrition should be part of our training. Brain health, nutrition, basic physiological understanding—that should be part of the therapist’s toolbox. Therapy isn’t stigmatized anymore; people are going. The opportunity is there. We’re just missing it. And that’s where I think we could make the biggest difference.

Schmitz: When you were talking about educating therapists, I kept thinking about educating prescribers. That’s where my brain goes immediately. If it were up to me, there would be another level of education specifically for them.

Now, I have a bias—I’m a de-prescriber. I help people get off psych meds. Prescribers are taught how to put people on meds, the basics of what can be done. But there’s not a ton of science behind how to prescribe well—and there’s even less around de-prescribing. They don’t know how to talk about coming off. They’re not trained to ask, “Are you ready? What does tapering look like?”

They’re not curious about what it takes to come off safely. And I think that’s because they weren’t taught. My dream would be to create more education in psychiatry around this, so prescribers understand how to both start and stop these meds responsibly.

Sell: If there’s one training Jenn and I should create, it’s this: how to recognize and avoid manipulative language in psychology and psychiatry. What is gaslighting in this space, and how do you not do it?

We’ve talked about this a lot. We’ve both used a lot of manipulative language around psych meds—telling people it’s the right thing to do, that they have to stay on. We did it for years.

Schmitz: We perpetuated it.

Sell: We did a whole podcast episode on that. We kept people on meds because we thought it was best. But now, I think a CEU course on this would be powerful—like trauma-informed care, but for communication. How do you avoid manipulating your clients into compliance? That might be the training I actually create this year.

Siem: Thank you both so much for being here. I know the audience got a lot out of this.

Sell: Absolutely.

Schmitz: Thanks, Brooke. Thanks for having us.

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