This Blog Is About

This blog is about---You! Each and every post is about you. Use it to challenge your usual patterns, as a tool for self-discovery, to stimulate your thinking, to learn about yourself and to answer your questions about others.

Thursday, April 25, 2013


This blog is like a reference book

There are now 419 posts on this blog.  Unlike some blogs which focus on current events, the posts on this blog are almost all, timeless.  There are some on new research findings and a few that have time limited announcements.  But, for the most part, you could look anywhere in the archives and find a post that is relevant now.  This is because most of what I write comes from my own experience, present and past - with my patients and also with myself. 
It is a blog written about real life, as we all know it. 
~There are posts on happiness, on depression, on personal growth, on addiction, on relationships, on therapy, on psychological theory, on families, on communication, on therapists, on boundaries, on anxiety, on aging, on societal problems, on health; there are quotes from actual therapy patients of mine (used with their permission, of course), quotes from other therapists, inspirational quotes from friends and from the famous, there are synopses of lectures, and there are ideas for you to try.~
I write what I am inspired about or what is on my mind at the time.  All of it is intended to be helpful.  I have worked a long time with human dilemmas and suffering as well as personal joy.  I want to share what I have learned.  This blog is an outpouring of my knowledge and experience.  It's a reflection of what I offer my patients in the office.  I put it here in the hope that you, as you read here and think about yourself and your life, can benefit.   Because of the "butterfly effect", the possibility of you offering something positive to another, as a result of considering yourself in relation to what you read here, is something I believe in, and  it makes writing the blog meaningful to me:   I feel I may be contributing something positive to the world.

"butterfly effect - the phenomenon whereby a small change at one place in a complex system can have large effects elsewhere, e.g., a butterfly flapping its wings in Rio de Janeiro might change the weather in Chicago..."

There are a number of ways to access earlier posts:  You can simply type a topic into the search bar.  Or go to a year and look at the list of titles.  You can click on a label.  Etc.  Take a look around---you might find something you like!

A related post:

Did you search,find a post,not on the landing page,that you liked?

Tuesday, April 16, 2013

Disconnect to Get Grounded

A very interesting article by Ariana Huffington about how the use of technology affects us*1_*1_*1_*1_*1&trk=who_to_follow-b

Other unrelated to the above, but good information:
  If you are looking for a counselor in California, here is a good list with basic info:               
A good discussion of a difficult topic, infidelity:

Friday, April 12, 2013

A Clarification for Therapy Consumers

Some problems that come up for people paying for therapy with health insurance

 Surprisingly sometimes clients in therapy are confused about who the insurance company is and who their therapist is...  Somehow the fact that they are 2 different entities escapes the understanding of the client.  When you pay for therapy with insurance (usually it is the bulk of the fee paid by the insurance and the patient pays a small co-payment), the insurance comes with you, not the therapist.  You are a subscriber to that insurance; your employer has made an agreement with them to pay a certain amount per employee every year to them and, in exchange, they will pay for a certain amount of therapy for any employee who chooses to use it.

 It has nothing to do with the therapist:  The therapist doesn't make their rules nor determine how they do business.  The therapist is independent.  They have created and built their practice; it belongs to them; it is an entity on it's own with nothing to do with your particular insurance company.  (In fact, sometimes some of us feel like the insurance companies have taken advantage of us by inserting themselves in between us and our patients)

Most insurance that therapy clients present with are called HMO's. This means that the company will only pay "providers" (this is what they call therapists) who are on their list.  To be on that list, a therapist agrees to their conditions, primarily to be paid at usually about half their normal rate.  For a new therapist, just building their practice, this is helpful to them as it brings patients to their practice.  For a seasoned, established therapist, they are doing you a favor to agree to deal with your insurance.  That's because for the therapist, it is extra paperwork, tracking, and phone calls-so, they do more work for less money.
The reason I am bringing this up is the occasional odd and unpleasant interactions I have had with some patients over insurance issues.  Somehow, they think I am responsible for what their insurance company does!  And the insurance companies, for their part, do seem to set it up that way, i.e. to make it look that way.  (They leave it to us to do their dirty work as you will see in the following 2 examples).
For example, recently one of the companies a few of my patients use, decided to raise the co-payment on some of their subscribers.  They didn't inform anyone---not me, not the patients.  It wasn't until I sent in my claims that I  saw this discrepancy.  Since I usually bill for a number of sessions at a time, usually about 6, there were some debts accumulated.  In this case, they had more than doubled the co-payment.  So, I had the unhappy task of telling my patients that they owed me money.  Some of them reacted angrily to me as if it were my doing.  One patient said:  "It sounds like the old 'bait and switch' to me."
Another time, the company decided that the patient had used enough of their benefit and, basically, didn't want to pay for anymore therapy for that patient.   When I told the patient, word for word, what the insurance representative had told me (basically that a limited number of sessions could be used going forward and that they had an end date), he thought that I was throwing him out of therapy.  I was able to straighten that out with him but, then, when I suggested that he could continue, paying himself for his sessions, he immediately and unequivocally refused.

Maybe you can see that these kinds of incidences can be hard on the therapist.  From our point of view, it is unfair.  Sometimes we feel devalued.  These examples I gave are but 2 of many things like this that happen.  So, I just thought that, for the sake of all of us---patients who want to use insurance to pay for the bulk of their therapy, and all therapists who agree to accept insurance---that I would try to clarify how this works.
Insurance is just an alternative method of payment but therapists are independent entities and are not the insurance company and have zero power over them.  (Most health insurers are for-profit businesses and so, naturally they have their eye on the bottom line; they are not helping professionals; they are in business to make a profit, not to help people.)
The therapists are just as subject to the whims of the insurance companies as the clients are.

Was this explanation useful to you?

Sunday, April 7, 2013

Appearances Can Be Deceiving

It isn't often that anyone thinks about what it took for someone else to achieve what they have

Sometimes I get the impression, from clients or from others, that they think that becoming a therapist is easier than it actually is.   Once a client said to me:  "You must have an easy life!"  The opposite is the case; I've worked very hard, all my life.  The only help I had was from my Dad with paying for my college education, although I also worked part time and contributed that way myself. After that I did everything on my own steam! Clearly, I can't make that kind of response in a therapy session; I include here as an example of comments that have led me to this impression.

To become a licensed professional, the first requirement is a graduate degree.  So, first you must graduate from college, then apply and get accepted to a graduate school (no small task:  got to get good enough grades in college to be considered, usually have to go through an application interview and, depending on the institution, fulfill some other requirements), then follows anywhere from 1 to 3 additional years of education, including a practicum.  To graduate at my institution, there was a choice of a 4 hour comprehensive written exam and, once having passed that, a one-on-one interview with the dean or, writing a thesis (25% of graduate students finish the program and then cannot graduate; either they can't pass the exam or they can't finish their thesis).   The training is slightly different for each license but for my license, in addition to the master's degree, this is required:  3000 hours of supervised (unpaid) internship hours, and an oral and written exam from the state.  It's one thing to read through this but, just imagine doing it.  It takes fortitude! Once the license is awarded, it has to be renewed every 2 years.  To do this,  36 hours of continuing education must be completed by the therapist every time.

To be fair, we all don't know what is required for every profession.  Sometimes we assume that to do any particular job, it may take the same approximate qualifications as for whatever job we do ourselves does.   This is natural.  I know, for example, sort of what it takes to earn a medical license, but not exactly.  I do have a sense of how it is to do the work for a PhD, the next degree up from mine.  A high school graduate may not really have a sense of what has to go into graduating from college.  Most college graduates will probably have some appreciation for what graduate school entails.  And, of course each profession has other requirements, such as those I wrote about above, that will be unique.  Most people won't know about them.

We may also, on the other hand, give more credibility to a particular title than warranted.  Sometimes we make assumptions that a medical technician, because he has on a white coat, has more knowledge about medical matters than he really does.  So this can work the other way too.

Perhaps because we therapists don't, in fact, wear a white coat, we are thought of as knowing less than we do.  We dress in professional style work clothes.  We are in an office with no special equipment.  In fact, most of us have an office that looks more like a living room.  They are designed to be comfortable and inviting, not intimidating.  But sometimes I wonder if these cues are misinterpreted---if some patients think that a session is just a visit almost like what one does with a friend.

Obviously , everyone is going to be different about the assumptions they make---about any of us in any job.  But, over the years, I have had enough comments and indicators to know that the level of training and expertise that I and my colleagues must have is often not understood by the very patients who seek our help.  Sometimes when we work with a patient, we seem to be simply engaging in a conversation, sometimes we sit in silence; these are times when it is easy to see how someone new to therapy, (or, even an on-going client), may have no idea what the therapist is thinking, much less what  has gone into putting that therapist in that position.

I don't mean to imply that I feel unappreciated. Not at all.  I feel very valued by my patients.  I have a unique relationship with each one.  Trust has developed.  They recognize the benefit of their therapy.  Nonetheless, I find that the other part, the huge amount of work and determination that goes into becoming a therapist and maintaining that license is  not always recognized.                                                           
We all know that we each have areas of more fragile self-esteem.  But, after all my training and experience, I do have a sense of self value in my work.  So, sometimes I have had the odd experience of being treated, by a patient, with less respect than I have for myself.

I have seen some therapists become irate at paraprofessionals and at practitioners whose title is "coach"(some certified, some not) because they see them wandering into counseling areas that really require the professional expertise of a licensed therapist.  Not only do they feel that it is an incursion but they also worry about the welfare of the clients.  However, despite some apparent lack of information on the part of consumers, most states do have a state board that licenses many professions and business people.  Those boards are in place to protect people.

Part of the reason I wrote this post is because you, the readers, have indicated that you want to know about the behind-the-scenes aspect of a therapist's practice.  I do have some readers who are studying to become therapists so they and, of course the other therapists who are also readers, know all about this.  But those readers who are in therapy themselves or considering therapy or are just interested in this subject may not know.

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Tuesday, April 2, 2013

A New Member Today

A new member is always a pleasure

It was lovely for me to get up this morning, putter over to check in with the blog and discover our new member, Wendy.
In the large picture, it helps all of us when a new reader joins the blog.  It means they will probably read more here and, hopefully feel encouraged as a result, a message that will then transfer to others in their encounters.
Welcome Wendy!