Chat Room Group Therapy?

Yesterday, I had a professional meeting in a “chat room.”  I must admit I’m still getting used to this concept. It seems so different than sitting in person with a group of people. People that I experience as more talkative in person seemed more reserved on-line. It’s odd to have people fill the space with a “smiley face” or a question mark rather than saying “ummmmm or hmmmmmmm.” I’m sure there are people holding therapy groups in chat rooms. There is certainly nothing preventing it from happening. In fact, considering how expansive the internet is, a therapy group would provide a worldwide experience of issues commonly discussed within the context of a very finite community. And who knows what insights might come from that. Have you tried chat room group therapy? Would you? What do you think?

Iphone Therapy?

As I checked out all the “smart phone” options today, I was struck by the capability to have face to face conversations with the Apple Iphone. Is this the future of therapy? I realize some therapists use their computers for individual and group sessions. Also it isn’t that uncommon for therapists to have phone sessions. So it make sense that the smart phones will be next. However I’m not sure I’m ready to log on.

There is a presumed effort and commitment that goes into showing up for a therapy appointment. It is not nearly as easy as pinging, which I think is a good thing. It does require sitting with another person and experiencing your thoughts and feelings in front of another person. It’s easy to rationalize this is no difference between a therapy session over the internet or face to face-but I don’t believe it. Perhaps the distance provided by talking into a phone or screen, where we can be in control of so much more than we can in person has some appeal to people?

I realize as more people live their lives through their “smartphones,” this will include conducting therapy sessions there too. How will it work though? Will there be therapy apps for each therapist? Will sessions still be scheduled or will therapists just leave their google calendar on their webpage, so anyone can see when they have some open time and either schedule or call for a session. So if you are waiting at JiffyLube for your car to get an oil change, you can use your “jiffyshrink” app. and get your own check up.

What do you think?

What did you think of the Angry Flight Attendant?

Did you read about Stephan Slater,the  flight attendant who got so fed up with a passenger, he ranted about it to all of the other passengers on the plane, grabbed a beer, and released the emergency slide and drove away? It appears this was an isolated incident for him. He was a 20 yr flight attendant who sounds like he couldn’t hold back the frustration and anger any more. Many people responded to the article in support of his actions. It’s as if he was acting out the fantasy of many employees of many corporations. At another time, this was best captured in the song, “Take this job and shove it.”

His behavior presents us with a question about how we express anger. Most people I see openly describe their discomfort with expressing anger or dealing with someone else who is angry. Is anger bad? Aren’t their situations where anger can be used to protect you or establish a boundary between you and someone else? And does anyone believe this man’s reaction is the result of one interaction with a passenger? In my experience, most people can handle small irritating, frustrating, annoying interactions with someone else. But when those situations get pushed aside, denied, or acted out with drinks, drugs, or other addictions, the feelings start to compound, until it feels like there’s nothing left to do but blow! What do you think? http://cityroom.blogs.nytimes.com/2010/08/09/flight-attendant-activates-exit-chute-after-dispute-at-j-f-k-then-flees/?scp=1&sq=jet%20blue,%20flight%20attendent&st=cse

What key words do you use to find a therapist?

Several months ago, many colleagues were shocked that I didn’t have a web site. I didn’t realize so many people did. While I do have one now, I continue to find the process of  identifying “keywords”, “tags” or “search engine optimizations” confusing and challenging. What words will it take to bring someone to my site? It sounds easy at first. Of course, just type in “therapist in Chicago.” And watch as hundreds of names appear. Do I use therapist, clinical social worker, a specialty, or add a city, state and zip code? And then how much information do I provide on my site? Are you more prone to read a site with many pages or do you prefer a brief paragraph and a phone number? And then there is the question of a photograph? I can’t help but wonder how many therapists are selected simply because their photograph looks great.  I wonder how many patients have felt surprised or duped by a therapist who looked nothing like their photograph? How would you pick a therapist online? What words would you type in? What would lead you to pick one professional over another? What do you think?

Did you know September is “Recovery Month?”

Did you know that September is “Recovery Month?” http://www.recoverymonth.gov No?neither did I, till I received a response to a post I did about Stage 2 Recovery. I’m not one for using this blog to promote other programs or events, but I believe this is important. More than any survey I’ve done, the one that gets the most responses is one which asks about how much alcohol do you drink. It appears there are many people who drink while wondering if they are drinking too much. It’s understandable. Alcoholism and drug addiction touch most of our lives in one way or another. The great majority of clients I see will bring it up about themselves, a close family member or a friend.

What seems less clear is what it means to be in “recovery” from an addiction. In my professional experience, those people who choose to “recover” the parts of themselves they gave up to their addiction are usually more content for doing so. No doubt, they must endure the painful process of letting go of their addiction. But it appears this process is often more tolerable when there is a vast network of supportive people in 12 step meetings and professional settings. For those who stick it out past the start-up phase, there are often positive surprises waiting for them.

If you want to learn more, check out the SAMHSA website. It will provide you with information on Recovery month and give you a glimpse into what recovery may offer you. What do you think?

Should insurance companies pay for psychotherapy?

If it’s been some time since you were in therapy, you may not realize that many therapists have bid farewell to accepting insurance. It’s really not that hard to comprehend. Insurance companies are a business. They want to get the highest trained therapists for the lowest fees they can pay. Therefore many clinicians have refused to participate in their plans. I think it’s reasonable to ask ourselves if  insurance companies should even be a part of the therapeutic relationship?

Do you really want your insurance company to  know you are in therapy?  When you use your insurance, you must be given a diagnosis.  It doesn’t matter if you are coming in due to an eating disorder, suicide attempt, or you were anxious about moving on after then end of a relationship, you must have a diagnosis. Is a diagnosis really applicable to every person that uses their mental health benefits? Isn’t there a difference between a patient with severe mental illness and patient that voluntarily seeks professional help to help them transition through a difficult time? Also isn’t ironic that using your “benefit” could lead the insurance company to penalize you if you need to buy insurance on your own?

Do you pay for your own therapy? Does it seem to expensive? Are you able to pay for it with a tax deductible health savings account? Can you use your flex account to pay for it? And are any of these options preferable to using insurance? What do you think?

Stage 2 Recovery from Substance Abuse

While I was leading a group therapy session, one of the members indicated he was doing “stage 2 recovery work.”  I was unfamiliar with the expression, but I was fully supportive of the idea.  This is the work that happens after you have stopped drinking, drugging, or acting out in some way. Once the behavior seems under control more days than not, the work of figuring out what drives this behavior and how to live and function as a sober person begins.

Personally, I find this work the most challenging and interesting part of the recovery process. It’s the time when men and women in recovery are ready to dig deeper and confront the demons from their past. I know for many in recovery, the work begins and ends with changing the behavior. For them,  the behavior is never truly under control, so their work is to make sure they don’t act out each and every day. While further investigation into their life stories may be helpful, it is not their priority. What do you think?

Can the 12 steps solve all problems?

I work with many clients who have benefited from the 12 steps of AA and Alanon.   I’ve also seen an explosion of meetings based on the 12 steps. I’m left wondering if there’s really a need for a 12 step meeting for every malady one faces? I tend to believe the principles are universal enough to be applied to many issues such as clutter, emotional unawareness, shopping, debt, food, sex and love-but does there need to be a meeting for each concern? At times, I wonder if clients go from one support group to the next and end up avoiding the more central core concerns that may be triggering the behavior. Having heard many clients say they wish they had a family member that was an alcoholic, so they could connect to the support in AA, I can’t help but wonder if these other meetings have been created for those who were unable to find a home in the more traditional AA and Alanon groups. What do you think?

The suit against “Mrs. Robinson”

According to the Chicago Tribune,” a Chicago area father claims in a lawsuit that Southwest Airlines failed to protect his teenage son from an older female passenger who made sexual advances and offered him illegal drugs during a flight two years ago.” While many have commented on the lawsuit and many men have expressed the wish that they were propositioned, it seems it is hard to believe a 14 year old boy could have felt uncomfortable or afraid.  Would the airline have responded differently to a  girl voicing a complaint against a man offering her drugs and sex? And how would people have responded  if an older man made the same advances to the boy? What do you think?

Check Oil every 3000 miles-Willing to do the same with your marriage?

As I read some comments from people who have been disappointed in couples therapy, I found myself agreeing with them. In my experience, couples therapy presents unique challenges that differ significantly from individual therapy. The greatest one is the fact you are dealing with two people who need to be the foundation for the marriage/family to exist. If both parties are on the same page regarding the overall direction of the relationship and family, the system generally runs well. If not, then  trouble starts to bubble up.

When couples come in for therapy, it is often because one party has cheated on the other. It is rare that this just happens for no apparent reason. Usually, there are little problems that are not handled well by the couple. Eventually, the couple starts avoiding the problems. The problems don’t go away. It’s just one party may distract themselves with an affair, drugs, alcohol, scheduled activities, or work. Inevitably one person is “caught” and that is when a couple wants to go to therapy in attempt to “fix” or “save” the marriage. By then, it is often an uphill battle. It is like going to your mechanic with a car that has been neglected for years and then wanting it to run like it did when it was brand new. Sure it can happen, with time, and a lot of money.

An alternative is for couples to consider taking care of their marriage like they do their cars. Specifically, change the oil every 3000 miles. Go for 3-10 sessions every year of the marriage. Fix the little things before they get overwhelming. Accept that as each person in the couple ages, their needs and wants change. Evaluate what has worked and what hasn’t. Try to work on how to take the things you like and leave the rest.  If we thought of tending to our marriages like we do our vehicles, I believe we would have relationships that stayed together longer and were stronger.

What do you think?