Stress can play a role in breakouts through its effect on cortisol and inflammation, but from what you’ve said, you’ve managed that with therapy. There aren’t any obvious lifestyle factors here that are driving your skin, which tells me this is much more of an internal, hormonal pattern. Things like sleep, routine, and nervous system regulation all quietly influence your skin over time. Your guides will break this down further, but for you, it’s about staying consistent with what you’re already doing rather than overhauling anything.