Thoughts From A Psychotherapist

4 Ways To Support Those with Invisible Illnesses

I recently wrote a blog post about the “Spoon Theory”.  That is a way for people with disabilities to explain how they allocate their energy during each day. I got a lot of positive feedback on that post and wanted to further expand it to ways to support people with invisible disabilities.

1. Never say “But you look fine.”. You may mean it as a compliment but to a person struggling in pain in can be instead construed as invalidating. Looking okay to the world and feeling okay in side are two very different things.

2. Offer advice judiciously. Everyone has access to Google. That means whatever diet or exercise plan that, you have read about that cures these illnesses the person with it has read also. Healthy living is good for everyone, but most of these illnesses do not have a cure. Hearing about such things can again come across as a judgment. The person hears that if they had only done this thing they would be okay. This is something they have thought about and they are trying to live the best they can so be careful with the advice.

3. Be flexible. When you are living in chronic pain or with fatigue you don’t know how you will feel day to day and sometimes minute to minute. It is hard to make plans that way and many people just stop doing it because they don’t want to cancel at the last minute. Let people know that you are okay with being flexible in regards to the plans. If they can’t go out offer to come over to their house. It can feel very isolating to live with an invisible disability so any way you can connect with people is great.

4. Ask them. What you can do for them or what they need. Many people can be prideful about asking for help but if they know you mean it maybe then they can ask for things. Ask them what is hard in particular and see if there is something you can do to help.

 

Meditation In Practice Continues

Not to long ago I wrote a blog piece about my struggles with keeping a regular meditation practice.  A friend recently recommended the book Full Catastrophe Living to me. This book is one by Jon Kabat-Zinn who is a founder of Mindfulness Based Stress Reduction Programs. In class form this consists of 8 2.5 hour classes plus one full Saturday class. You have to commit to meditation 45 minutes a day while in the program. In fact, there is some recent research that doing this program can change your brain in the 8 week period.

My first reaction to looking at dong the home program was “No Way!” I If you are didn’t think I could do 45 minutes a day of meditation. But I tried it. I am now starting week 3 of the program where you can add Mindful Yoga to your routine if you are able. I have to say that since I have been doing this I have felt really good. I have also found myself looking forward to doing my 45 minute meditation every day. It is hard no doubt. Right now I am doing the Body Scan Meditation which is focusing on one part of your body at a time. I have to redirect my thoughts about every 5 seconds or so it seems. But I do it and I feel like it is making a difference. Interestingly enough I have been more engaged in doing the longer meditation daily than I ever was in the shorter ones I did previously. I know I can keep up on the practice for the 8 weeks it is structured for and I hope I can keep it up as an ongoing practice beyond that. I have read so much research recently on how meditation can improve both physical and mental well being that it seems really important to add this to my day.

If you are interested here is a resource to get the meditations for free. And here you can find more information on MBSR and buy Jon Kabat-Zinn’s cds for the program.

I would love to hear from you more about how you try and integrate mindfulness into your day.

 

 

 

 

 

 

 

 

 

 

 
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December 30th, 2014|anxiety, mindfulness, Thoughts From A Psychotherapist|0 Comments

The Spoon Theory-How to Understand Those With Invisible Illnesses

Christine Miserandino who has Lupus came up with the Spoon Theory” to explain what it is like living with a chronic illness. This explanation is now used by people who have so called “invisible illnesses” to explain to others what their days are like. Many people with depression, autoimmune disorders, and other chronic illnesses may not look sick to an outsider. That is generally because they don’t want you to know they are sick, they are trying to live their lives as normally as possible, or they may not want to hear or respond to comments that can make them feel bad.

Then comes a time when they can’t do something because they just don’t have the spoons left. Sometimes they experience others thinking they are exaggerating their symptoms and they feel unseen and misunderstood. The spoon theory is a way of trying to explain to someone kindly what it is like to have to think about every action they take in a day in order to make sure that they can get through their day. Or to be planning things well and just find out that today for some random reason you have less spoons than normal.

I think it is a good way of trying to put yourself in someone’s shoes so you can understand. No one who hasn’t experienced chronic fatigue and/or pain can understand that experience fully.  That is actually a good thing. No one who counts spoons wants others to have to do the same. But if you know someone with one of these illnesses the spoon theory can give you some perspective so that perhaps you can look at them a little differently and in a more understanding way.

 

 

 

 

 

 

 

 

 

 

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How I Nagged Myself into Regular (almost) Meditation

As a therapist I try to practice what I recommend to clients. As a human I struggle with these habits as much as anyone. I try to meditate every morning. Just a few minutes. I have apps on my Iphone that I use. The current one is Stop, Breathe, Think which evaluates how you are and then recommends three different meditations. Still I just wasn’t doing it every day. I would do it for a day or two  then miss. I was frustrated because it is just 10 minutes a day, how could I not get this in my day? I know how valuable that daily meditation is to a persons health and well being.

So I set up a self nag. I put a reminder into my Iphone and set it to go off at 8am everyday reminding me to meditate. If I don’t check it off it will continue reminding me all day long. So if I don’t find the time in the morning I come back to it in the evening. And while I am still not perfect in my practice I find that the reminder has increased the days I do find the time to meditate.

Everyone has to find the meditation technique that works for them. For me using a app that talks me through the meditation and reminding myself until I actually do it is what works for me. I would love to hear from you what you do to keep yourself committed to your mindfulness practice.










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November 18th, 2014|mindfulness, Thoughts From A Psychotherapist|3 Comments

Why You Can’t Get A Therapist on Your Insurance Plan

I get an average of five calls a week for people who want me to see them and have Insurance X. I can’t take most of these people and often they ask me for a referral. I have to say I don’t have one. I have no therapist on Insurance X I can refer to. What I don’t get into with them is why. Insurance X hasn’t taken new providers in my area for at least ten years. In fact, when I applied to get on them they turned me down several times. I actually got on their panel when they took over Insurance W and just absorbed all of their providers. didn’t even know I was on their referral list until I started getting phone calls from prospective clients.Insurance X maintains that they have an adequate number of providers in their network and therefore will not accept new providers. Now the people that call me and say I am literally the 20th person they have called (and that is not an exaggeration) would probably beg to differ.

The second issue with Insurance X is that they have not given a raise to providers for at least ten years and I have heard it has been more like twenty or more years. Their rates are at least 10% under other companies rates. As a therapist we can only see a certain number of clients a week and remain effective. We can’t just add more clients to make more money and do good ethical work. So if the opportunity exists for a provider to take clients with Insurance Z that pays more which clients do you think they will accept first?

In fact last year one of the providers sent out contracts with a provision buried in it where providers would accept rates 30% lower than the already low rates. I actually almost missed that provision and the ability to opt out of that plan. This year I dropped two of the plans I am on and I am moving towards getting off of Insurance X. I am one of the only area providers that takes this insurance and has the expertise in gender identity and is also EMDR trained. I want to work with people that want to use their insurance for their treatment. I recognize that out of pocket therapy services are pretty costly. But I can’t work until retirement without any increase in my income.

This is the dilemma that psychotherapists that take insurance face. In my area there are a substantial number of providers that refuse to take insurance. They will provide a superbill for clients to submit and then fight out with their plans. Insurance X has a higher deductible for members that use providers out of network so essentially that means unless you have high medical bills you have no out of network coverage. My guess is that this dilemma with insurance affects other providers as well which is why your doctors visits now are only ten minutes. They compensate by adding more patients. We can’t.

So if you have experienced the inability to find a provider that is on your plan perhaps this is why. I encourage people to complain to their state managed care departments, their HR departments, and the insurance companies. Until people say no more the companies will continue to do what they can to keep their profit margins.

 

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October 25th, 2014|Thoughts From A Psychotherapist|5 Comments

Hurry Up-There Will Be No Relaxing Here

Here I am at home mid day and what have I done? Ate lunch, prepped dinner, and am now writing my blog posts. I am fortunate to have a job that sometimes allows me random daytime hours off. However, I will confess that during that time I have difficulty relaxing. It is a beautiful day out. I have many books to read yet I made my choice to work. Why? I feel guilty about having this time, somehow it just seems wrong. It is one thing if I had work I had to do but I don’t. I could have continued to procrastinate on writing my blog post for this month. But I have bought into the cultural values about time and wasting time. Which is flat out silly. How can it ever be said that enjoying yourself is a waste of time?

I admit to be being a work in progress. I am listening to the ballgame as I type (Go A’s!) and after I finish this post I promise to go sit on the front porch with a book. I wish I was at the point where I could have relaxed the entire three hours I have off but I am happy to at least go have some fun for an hour. Because life is to short to spend it busy.

I challenge my readers to find some time in the next week to goof off. I myself will promise to do this again next week. Practice makes perfect.

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September 24th, 2014|mindfulness, Thoughts From A Psychotherapist|0 Comments

Can thinking positively help you be more positive?

Recently someone referred me to Shawn Achor. He researches and writes about positive psychology. He believes that if you do certain things everyday for 21 days you can be happier.  He recommends doing the following.

1. exercise 10 minutes daily

2. write 2 minutes daily about postive interaction you have had

3. write down 3 things you are grateful for with no repeats

4. meditate each day for at least 2 minutes

5. do something nice each day

Since reading this I have talked with a few people that have tried the challenge and have found that they are thinking in a more positive way. Why don’t you take on the challenge and see how it makes you feel. I would love to hear in the comments how it has worked for you.

And here is Shawn Achor’s Ted Talk. It focuses on the business benefits of his philosophy but is still worth a listen.

 

 

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Why is it so hard to stay in the moment?

I want to start this by saying I love my Iphone. I love Facebook. I feel like I have been able to stay more connected with some people because of Facebook. The reality is I wouldn’t be calling many of these people on the phone but I love to see pictures of their children and their lives. The reality is this is a false sense of connection. There is no vulnerability involved in posting our happy pictures on Facebook. And vulnerability is where connection really lies. However, vulnerability is really hard for most of us. It is far easier to be checking our phones than to say to someone I had a tough day today and it was really hard for me to get through it.

While we all seem to be craving connection at the same time our actions seem to indicate otherwise. We want to connect with our partners but then we check our email ten times during dinner. We have a magical moment and our first thought is “I have to post this on Facebook.”  How many times have you been doing something you enjoyed but also struggling not to look at your phone while doing it? We have become a society really uncomfortable with being in the moment and having our feelings.

I often wonder as I have the impulse to check my phone while waiting in line for something what did I do in line before cellphones? I imagine I just stood there but the concept seems so strange now. But it shouldn’t be. I should be able to stand five minutes in line and think about life or breathe or just let my mind wander. It isn’t instinct to do that anymore though. It is an effort. An effort that I think is worth it. I believe the more we check out the hard it is to stay present. So it is important to find ways to stay engaged in the world. What about talking to the person in line next to you? There is some connection and it would probably even feel good for both people.

I am finding ways to be less cell phone involved and more present. I would love to hear the things that work for you in the comments below.

 

 

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July 29th, 2014|mindfulness, Thoughts From A Psychotherapist|4 Comments

Pet Grief-How To Cope When You Lose Your Best Friend

Losing our pets is one of the most painful experiences many of us go through. Part of the pain is having to make the decision to let them go.  How do we ever know when the right time is? And how do we not question that decision after it is made? Robyn Arouty a photographer has recently gotten a lot of press. She did a photo essay on the last day of life for a friend’s dog. Called “I Died Today” it is a beautiful tribute to one families’ love for their pet. One of the most touching aspects of this story is that this family adopted Dukey knowing he was sick. They had him for 3 years. Be warned reading it will cause numerous tears!

Robyn herself lost three animals in the last few years so she is no stranger to the grief of losing your pet. She has another post where she talks about that.

But I am going to quote it here because I think there is comfort in these words for anyone going through this experience. And I know people are starved to connect about this because Robyn’s site crashed because of all the visitors. Thank you to her for sharing her experience.

Her words on what she learned from her loss.

Dog Death, Dying, & Grief

What I know about doggie death, dying, & grief:

1. The time spent worrying about them leaving steals from the time you give them while they are here.

2. They leave when their mission is complete.

3. You can love again & again.

4. Experiencing death with your heart makes you stronger. You can overcome your fears. I’m living proof.

5. Letting them go when it’s time is the most selfless thing you can do.

6. Your soul is in your pet. Just look in their eyes & you will see it.

7. Loving hard means you will lose hard too.

8. Grief is only temporary.

9. They do come back. But you have to let them go first.

10. Animal lovers are a super special breed. Accept the love & support when you really need it. It’s ok.

– See more at: http://www.robynarouty.com/blog/#sthash.DUKIQCmE.dpuf

1. The time spent worrying about them leaving steals from the time you give them while they are here.

2. They leave when their mission is complete.

3. You can love again & again.

4. Experiencing death with your heart makes you stronger. You can overcome your fears. I’m living proof.

5. Letting them go when it’s time is the most selfless thing you can do.

6. Your soul is in your pet. Just look in their eyes & you will see it.

7. Loving hard means you will lose hard too.

8. Grief is only temporary.

9. They do come back. But you have to let them go first.

10. Animal lovers are a super special breed. Accept the love & support when you really need it. It’s ok.

 

 

What I know about doggie death, dying, & grief:

1. The time spent worrying about them leaving steals from the time you give them while they are here.

2. They leave when their mission is complete.

3. You can love again & again.

4. Experiencing death with your heart makes you stronger. You can overcome your fears. I’m living proof.

5. Letting them go when it’s time is the most selfless thing you can do.

6. Your soul is in your pet. Just look in their eyes & you will see it.

7. Loving hard means you will lose hard too.

8. Grief is only temporary.

9. They do come back. But you have to let them go first.

10. Animal lovers are a super special breed. Accept the love & support when you really need it. It’s ok.

– See more at: http://www.robynarouty.com/blog/#sthash.DUKIQCmE.dpuf

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July 17th, 2014|grief, Thoughts From A Psychotherapist|2 Comments

Lean Into Joy

I am on a Brene Brown kick. I am listening to The Power of Vulnerability which is Brene giving one of her workshops. She is a great speaker with lots of good things to say. One of the things she talks about in this recording is leaning into joy. She talks about a scenario that goes something like this: Imagine it’s Christmas Eve and a family is in the car. The radio is playing Christmas carols and everyone is singing along. What happens next? Number one audience answer is-  Car crash. She talks about how we have become programmed to expect these dramatic and negative scenarios. How we don’t allow ourselves to “lean into joy”.

I found myself doing that this week. We are buying a new car. An exciting event and one that happens infrequently. The car is on order and we are waiting to pick it up. Have I spent the week thinking about all the exciting new features that are in my new care? No. What I have been thinking most about is how I am scared to drive my current car because we are trading it in. We got an estimate based on its condition last week. Which means I have to keep it in the same condition to get that money. So what I have found myself thinking about this week is how I could have an accident and not be able to trade the car in.

Now while that would be a cruddy thing to happen, focusing on my energy on thinking about a potential car accident is probably not the best use of my time. I could instead be imaging how I will be able to connect the music on my phone to play in my new car. How I will then be able to always be able to drive listening to my own funky mix of music. Or how this car will warn me if I leave my lane or how my gas mileage will almost double. I should be leaning into the happiness of getting a new car.

Brene talks about how when people suffer loss it isn’t the big things they miss the most. It is the everyday things. The grocery shopping together or watching that new series on Netflix. I am working on letting myself lean more into joy and to embrace the ordinary.

 

 

June 13th, 2014|gratitude, Thoughts From A Psychotherapist|1 Comment