Nik Ruthless, LCMHC, LPCC
he/they, fully licensed in NC and CA
You are not too much, too weird, or too different-
you just haven’t found the right therapist yet.
I have heard some version of this story so many times from clients: they were told their needs were too complex, their previous therapists seemed to struggle to connect, and they left sessions feeling more pathologized than understood. I’ve lived it myself. As an AuDHD person with chronic illness, I know what it’s like to move through the world in a body and brain that doesn’t always cooperate with what’s expected of you.
I am Nik Ruthless (he/they), LCMHC, LPCC- I have been practicing for 9 years and I built Fathom Counseling specifically to be the kind of practice I wish had existed when I was looking for a therapist myself: affirming, genuinely competent, and unwilling to treat complexity as a problem to be managed.
Who I Work With
I specialize in queer and trans identity at any stage, including those who are still figuring out what their identity even is. I also work with neurodivergent teens and adults (Autistic, ADHD, self-diagnosed or formally diagnosed) and chronically ill and disabled people who are navigating the grief, identity shifts, and daily reality of living in an unpredictable body. I love working with people who have felt dismissed, misunderstood, or over-pathologized by previous providers. And people who have convinced themselves that therapy simply does not work for them- which is almost always a story about therapeutic fit, not about them.
My Story
I grew up moving constantly- more than 30 times, across most of the United States. I got very good at reading people, fitting in, meeting expectations. I was successful by every external measure and deeply lost inside. Eventually I did some serious work to figure out which dreams were actually mine, and which ones I had absorbed from other people's expectations. That work changed everything. It is also, in many ways, the same work I do with clients every day.
I live with chronic illness- I understand what it is like to manage a medical reality while also just trying to live your life; to have a body that requires accommodations the world does not always offer, to grieve what you thought your life would look like while building something real from what you actually have. If that is part of your story, you don’t have to explain it to me from scratch.
My clients tell me all the time:
“I feel very comfortable and un-judged by you.”
“I don't feel my issues make you uncomfortable.”
“I feel more empowered as a person.”
“I like that you aren’t trying to fix me. You’re helping me fix myself.”
If you’re ready to work with someone who won’t flinch- who actually finds the hard stuff relevant and relatable rather than inconvenient- I would love to connect. I’m glad you’re here.
My Approach
Therapy should feel like I’m adjusting to you, not the other way around. You don’t have to worry about saying the right things or staying “on topic.”
I use CBT, ACT, and DBT grounded in a feminist framework, and I will always tell you what we are doing and why. Consent requires understanding -- it is not really possible to consent to something you do not understand -- and I think that principle applies to therapy as much as anything else. You will never be in the dark about what is happening in our work together.
I acknowledge that some modalities I’ve been trained in (like CBT and DBT) can be very invalidating and harmful to neurodivergent brains, and I only use tools from them when appropriate and with client consent.
Training + Specialty Areas
Cognitive Behavioral Therapy (CBT)
Dialectical Behavioral Therapy (DBT)
Acceptance and Commitment Therapy (ACT)
Attachment Therapy (Attachment Styles Assessment)
Deaf Cultural Competency
Somatic Therapy for Trauma
Gender Affirming Care
Supporting Marginalized Groups
Education + Credentials
Licensed Clinical Mental Health Counselor, LCMHC #20058 (North Carolina)
Licensed Professional Clinical Counselor, LPCC #15668 (California)
MA in Counseling, Clinical Mental Health from Indiana Wesleyan University
BA in Comparative Cultures and Politics from Michigan State University: James Madison College