Sunday, February 18, 2018

When Therapy, Insurance, and the Workplace Collide

Because I’m a therapist in my own profession, I get to learn lots of interesting things about other lines of work, jobs, and careers through my clients. (For anyone who thinks that therapy is a one-way relationship, this is a case-in-point to the contrary!) The stresses of sales goals, the effect of long-term irritation (or attraction to…) coworkers and bosses, and also the particulars of a whole variety of jobs. One thing I don’t often hear about though, but that must be an issue for all of my clients, is what it’s like as an employee to start therapy on a company medical plan.

More Than Water Cooler Chat

From a friend of a friend, I heard that it’s not totally uncommon for information that’s interesting, or salacious, in people’s insurance records to get shared in offices. Now, I’ll preface this by saying that I have no idea how common it really is, or exactly what kind of information might get passed around. And not to mention, whenever it does happen, it’s completely unethical! But those considerations aside, it occurred to me that it could be pretty difficult to disguise a weekly therapy appointment from a boss or a small office of colleagues. After all, for most people, the appointment is at the same time each week, so you’d have to tell your boss you have some kind of appointment. And if you’re vague about it, and you work in the kind of place where HR isn’t exactly hermetically sealed from management, your boss or your coworkers may not have a hard time finding out exactly what your appointment is for.

Therapy: Your Dirty Little Secret

Of course no one should feel shame or embarrassment about working with a therapist, but it’s widely acknowledged, both anecdotally and statistically, that social stigmas associated with therapy are one of main explanations for why people delay seeking treatment. Those stigmas aren’t just beliefs that patients have, but indeed, are ways that they’re treated by their associates (friends, family, anyone!) who might know they’re seeking treatment.

Now, imagine that you’re struggling with depression. Suddenly, you face not only the difficult decision to seek help, but also the anxiety that a coworker or boss might find out and ‘think things’ (because that’s what a stigma is!) about you, or face the uncertainty that this might change how they perceive you. It’s so easy to imagine someone waiting even longer to seek help, and I can’t tell you how many traumas could’ve been eliminated, how much less pain my own clients might’ve experienced, if they would’ve sought help sooner.

Ways to Support Therapy in the Workplace

It should go without saying that we’ll all be luckier once the stigmas associated with therapy are weakened and disappear, and we can ‘normalize’ talk therapy the same way we’ve normalized physical therapy. But until then, we have to consider how to address these stigmas in ways that will allow people who need help to get it. So, if you’re in HR, or even a manager, you should be extra diligent in observing your ethical responsibilities with respect to your employees medical information. And if you do happen to learn that an employee has a regular therapy appointment, do you best to treat it like you would any other outside-of-work obligation. Tempting as it can be, don’t try to ‘offer a shoulder’ or let him or her know you’re there to talk—even if you’re friends! It’s difficult enough for many people to make the decision to seek out therapy, and many of the emotions we experience in therapy are new and uncertain. The last thing anyone wants, at least at first, is to feel forced to share those experiences, even when the offer is well-intentioned.

For therapists, I’m trying something in my own practice that works not only for workplace issues, but solves several insurance problems in one go. I made the decision to stop taking client insurance and allow clients to file reimbursement claims with their carrier. Clients can decide how they want to disclose medical information to their insurers, and when necessary, I work with clients to help assign them the most appropriate diagnostic codes to their situation. For clients who use workplace insurance, evening or even weekend sessions (if possible) may be an option for keeping out nosey colleagues.

I’ll be spending the next few posts writing about therapy and therapy-related issues in the workplace. If you have questions, comments, or topic suggestions, I’d love to hear what you have to say.

Monday, February 12, 2018

How Giving Yourself Gifts Improves Your Relationship

It’s the month of love! At least the month of Hallmark-love that is!

I’m writing this after returning from my birthday trip! If you don’t know what I’m typing about, get caught up here. Check out the awesome of pic and rare sighting of the BFF! (You may remember him from such scandalous adventures as the counter-sitting pleasure device.) Before we jump into some self-love advice for February, though, I’m going to address some reader questions and talk about my birthday trip and why I chose Nashville.

From a Speakeasy to NashVegas

I have a bucket list of places I’d like to visit, and it was a no-brainer when I realized that so many were in or near Nashville. But that said, I have to be honest here it got added to the list for a very specific reason (actually three reasons):whiskey...and gin...and rum...and I think you get the picture! About four years ago, I attended a wine festival in Atlanta. Of course, it was just like me to stumble
Photo Credit:
across the only booze vendor in the place. Hidden away. Out of sight. In a dimly lit speakeasy. Classic prohibition style! The vendor was Corsair, and they had the most amazing selection of liquor, like Quinoa Whiskey and (Rum) Barrel Aged Gin. Honestly, I don’t think I had any wine that day after I planted myself at the Corsair table and began tasting like it was the ice cream shop! When I woke up the next morning, I was determined to visit their distillery—in Nashville! Four years later I made it happen! To add the cherry on top, the BFF had an interesting encounter with a group of swingers...but that’s a blog for another time!

Do You Speak Your Own Language?

Back to the month of Hallmark love! This month is about buying yourself gifts. Well-known author and therapist, Gary Chapman, wrote a therapy book that’s broken into the mainstream, The Five Love Languages. One chapter deals with giving and receiving gifts. Essentially, he says that many people feel loved and give love through giving and receiving gifts. Gifts don’t have to be expensive, materialistic items such as jewelry, but could be smaller or more meaningful items such as plant or
Credit: Serge Bertasius Photography
household item. The point is that the giver puts thought into the gift, thinking from the perspective of the recipient about what he or she would want.

With the cultural ramping up of Valentine’s Day, February can be a depressing month for some, especially those who are single or recently lost a partner. It’s hard not to feel the impact of knowing that no one is finding a gift for you—that no one’s speaking that love language to you. Many social events are geared towards couples, and most stores market towards buying that someone special the “gift of a lifetime.” Apart from the negative effects this sort of commodifying of affection has on couples, what about those who are unattached? Sure, you can host or attend a singles event or V-day bashing party, but is there any way to be a little more proactively optimistic?

Affirm Yourself!

Image courtesy of kittijaroon 

Instead, why not treat yourself! Why wait around for someone to buy you a gift or sulk because you don’t have someone to treat you? Buying yourself a gift not only ensures you get the thing you want, but also is another way of meeting your needs and nurturing yourself. Those feelings—importance, appreciated, included, loved—you get when someone buys you a gift comes from you—instead of from someone else. Does this take away from another buying you a gift? Not at all! Instead, it
enhances those feelings of importance, included, appreciated because you’ve been allowing yourself to experience these feelings from the most important person in your life (you!) on a regular basis.
When you don't buy yourself gifts, you begin to desensitize yourself from enjoying gifts when waiting for others to fulfill that need. By treating yourself every now and then, you’re constantly reminding yourself what it feels like to be though of, to feel important, or to feel appreciated.

So, what are you buying yourself this month? I have my eye on a couple of things, for instance... Comment below!

Sunday, February 4, 2018

When Sex Becomes A Pain

I wanted to share with my blog readers a new group I’m starting that I think some of you regulars might find interesting. It’s a group focused on women’s sexual pain. There’s a lot of stigma and presumption about what each of those words mean, so if you’re looking for the tl;dr version, imagine interesting, informative conversations, led by experts (like yours truly!) to help the participants work through feelings—physical and psychological—related to sexual pain.

Is Sexual Pain a Real Thing?

Sexual pain can encompass all sorts of different experiences for women. To focus purely on the physical first, we often associate sexual pain with a variety of clinical disorders, like vaginismus or vulvodynia. If you know about women who literally cannot use tampons because of involuntary muscle spasms or firey pain when touching the vulva, these are the disorders you have in mind. Naturally, these conditions can make penetrative sexual intercourse difficult, if not impossible. Discussing this sort of pain openly, the experiences women have had with it, and beginning to look toward treatments or coping skills is the best way to overcome sexual pain and topics I discuss with individual clients and in my group sessions.

But pain in the form of clinical disorders make up a pretty small percentage of the pain women experience with sex. Pain in general, vaginal discomfort, which can make intercourse less enjoyable and orgasm more difficult, is more central feature of sexual intercourse for women than it is for men. Indeed, 30% of women say they experience pain during sex regularly, and while half of all women say they have faked an orgasm, this same study does not even offer “pain” as an option for why women fake orgasms. There are loads of hypotheses and articles for why, as a matter of sexual culture, female pain seems secondary to male pleasure. As a therapist, one way to begin to address this issue is just to start talking through what these painful experiences are like, and help group members develop strategies for addressing them, both with their partners and on their own.

Not Just a Pain in the Butt...

As we all know, pain isn’t just physical. It’s emotional qualities are just as, if not more influential, on our sex lives. At the extremes, there are experiences like rape and sexual assault, in which the emotional wounds often last much longer than the physical ones. We also grow up in a culture shaming sexual development and experience. When these messages are internalized in childhood, they can be difficult to adjust in adulthood when se becomes expected with a spouse. These are experiences we’ll absolutely be addressing. Developing a fulfilling, functioning sex life is a rewarding process, and having people supporting you makes the process much easier.

It's Not Just You!

I started the When Sex Hurts group after hearing client after client make comments such as, “Am I the only one?,” “I feel so guilty,” or “No one else really gets it.” Clients can hear me say over and
over, “No, many women and couples experience sexual pain,” or “You’re not the only one! I work with many clients experiencing sexual pain.” However, sometimes we need to see things with our own eyes to really believe it! Sexual pain is also near and dear to my heart due to my own experience and treatment for sexual pain. During my own treatment with Drs. Jaci Brandt and Shelley DiCecco, I leaned much more about the human body than I was ever taught in my grad or certification courses. I wondered why no one ever told me all this important information about how my body works! 

Now, if all of this sounds like a lot, that’s because it is. No worries! We’re going to be diving into these difficult yet sexy topics together! If you’re able, I really hope you’ll consider joining us or continue reading posts about sexual pain and the impact on the self and relationships to gain further knowledge.