Thoughts From A Psychotherapist

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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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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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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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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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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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.

 

 

Is Fear Based Parenting Hurting Kids?

There is a very interesting article that has been making it’s rounds on social media this week. This mother left her son in the car when she ran an errand and was reported to the police. The story was fascinating enough on how the system worked and her story on how the situation happened. However, what I find really fascinating is how this mom talks about being the overprotective mom. She made this one bad decision but overall she reports she is a a hovering helicopter mom. She really talks honestly about how cultural values and parenting have changed enough that if you take your kids to the park and just sit on the bench while they run around you will be judged.

I know my upbringing was not so different from many middle aged people who were sent out to play. When you were sent out to play you were allowed to come back to use the bathroom and have lunch but other than that you were expected to play outside until dinner time. If something happened with another kid you dealt with it. If another parent saw you doing something you shouldn’t be they yelled at you and called your mom. And your mom thanked them for doing that. This attitude forced us to learn how to be bored, how to interact with other children, and how to be independent. All qualities that serve us well as adults.

Now kids are wearing helmets while on their big wheels. They don’t play outside they have structured “play dates”. If they aren’t involved in the thirty activities most kids are and they get bored they get given a device. Another parent would never yell at a kid that isn’t theirs because you can’t yell at children nor can you be involved with other parents children.

So what has changed? There has been a cultural shift where parents let their entire lives be run by their children. Parents are naturally afraid of making parenting mistakes so they are very susceptible to parental peer pressure. If other parents are doing it, whatever it is, many parents then feel like they should be doing it. But what if the “it” is wrong?

There are many safety things that are good for kids to learn. However, you cannot no matter how hard you try, protect your child from all danger. It simply isn’t possible. So the parenting focus should be instead on resiliency. Raise your child so that they can deal with failure, with danger, with adversity. That doesn’t mean you don’t protect them in every way that you can but it does mean that you also let them fail and take some risks. Protecting your child from failure is something parents do because they cannot tolerate their own feelings when their child has failed. That is done for parental gain not to raise a stronger child. Letting your child fail and take risks means as a parent you have to tolerate your own fears around them being hurt.

If you don’t let these things happen then when your child becomes a young adult they can’t tolerate failure. They can become anxious and/or depressed. The goal of parenting is to raise kids that become successful adults. Parenting from fear hinders that goal. Limits with children are great, just make sure those limits are there for the right reasons.

 

Let me know your thoughts on how to raise resilient children in the comments below.

 

 

 

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7 Misconceptions about seeing a therapist

Many people avoid therapy because they have some preconceived notions about what therapy is. Some of the ones I hear the most are

1. Therapists don’t talk they just nod their heads and say UM HMM. Now this I will admit is sometimes true. I have had clients see me say that their prior therapists never said anything. However, it isn’t always true. I interact a lot with people I work with. If it is important to you to have an interactive therapist then when you are looking for a therapist ask what they are like in the room.

2. I can just talk to my friends-why would I need to talk to a therapist? Friends are great. You want to talk to friends about what is going on in your life. Friends also will give you advice you may not want, try and solve your problems for you, and/or have some personal bias about the situation you are describing. Now those things can be positive. But there is something freeing about talking to someone who has no agenda, isn’t trying to fix you, and who doesn’t express any judgement about how you handle something.

3. Only crazy people see therapists. It is sad that there is such a stigma about seeking therapy. The majority of people in therapy are everyday people who are trying to learn to negotiate some aspect of their life better.

4. You have to go to therapy forever. This is generally up to the person seeking therapy. There are many times a person just needs some short term work to help them negotiate a difficult transition. Other times people are seeking problems to resolve long standing issues. A good therapist will work with you until you have met the goals that brought you to therapy and no longer.

5. You will just talk about your mother. Now again I will say that if there are longstanding issues what happened in your childhood is often very relevant. That is not to say you will spend your sessions talking about your mother. You will look at the patterns in your life and how they started as a way to create a different way of doing things.

6. What is in the past is past and doesn’t effect me now. This is one of the most common things I hear. I am over this incident. I don’t even think about it anymore. Now in some cases that may be the truth but often it just means you buried the feelings about whatever happened and spending some time dealing with those feelings can free up much emotional energy. Check out an earlier post I wrote about this.

7. I can’t afford it. Most insurance policies have some coverage for therapy since the Mental Health Parity Law was passed. Many therapists will also negotiate a sliding scale based on income. However, the real question here should be what is it worth for me to feel better? Therapy is an investment in your future.