Category: This is Life Page 1 of 2

2025: Just the Beginning of What’s Coming

If there are two things that are a must-have when you’re self-employed, it’s a strong comfort with change and a well-tuned ability to be flexible. I apparently have those in abundance, given I’ve been my own employer for going on 30 years now.

I live in a beautiful place – I want to see more of it.

And this year, I’m moving forward by returning to some old ways of doing things.

After years of having a self-pay-only practice, the Covid pandemic and related economic downturn in my clients’ situations led to my getting on this country’s Health Insurance Train. The idea, frankly, was to assure that my practice stayed afloat by way of referrals from insurance companies. That, it did, to the point of overwhelm. But the Return On Effort has never been there.

Therapists Don’t Usually Whine (but therapy consumers should be informed about these details…)

Some of you have, by now, started hearing what it’s like for practitioners (like me and your other medical care professionals) to be hog-tied by the insurance industry. It’s been about five years now of increased administrative burden and time and financial costs. Briefly put, by ‘taking insurance’, I am working almost twice as much but being paid less by sometimes as much as two-thirds. Then there’s the feeling of having a billion-dollar industry breathing down my neck about every clinical move I make. To sum it up: Trained, dedicated professionals who thrive in a self-employment environment do not flourish when entities that do not know better are allowed to direct the course of their work. Just as clients are not all the same, neither are therapists cogs in the healthcare wheel. Therapy, as conducted by people who were trained in the same ways as me, is dependent on a therapeutic relationship, not a programmatic recipe for fixing people.

Rant Over. Adjustments to Benefit Everyone.

The most precious resource to me has always been time; now, as I head farther into my 60’s, that’s even more the case. I have to carefully weigh the return from my effort, in order to stay healthy and capable of being of service to clients. In other words, I can no longer work myself to the bone if I want to work at all.

I have no intention of “retiring” – that’s a concept that has never been part of my life. So I am making adjustments that will enable me to work for as many more years as I can, while maintaining my health.

This is why 2025 will be (as far as I know right now, and unless something drastically changes in the healthcare insurance industry) the last year I am paid by corporations. Again.

And I am so very much looking forward to being free of those shareholder yokes.

What does this mean for you? All of my current clients have been well informed about these details in writing and conversation, but to sum up:

You and I can continue our therapeutic relationship.
Over the next few months, we’ll continue talking about whether you wish to
- engage in a standard fee for service arrangement (whether full fee or discounted) or
- move to another therapist who is being paid by your insurer.

What do I believe this means for me? More time to nurture my own wellness, which will translate into greater ability to be more fully available for you.

Here’s to 2025 bringing us all good things,
Tracy

Gratitude, Mindful Listening, and Transitions

In & Loss, Communication, Our Narratives, Self Care, This is Life, Uncategorized

First — it is with gratitude and a little sense of sadness that I say goodbye to my practice’s Master-level intern of this last year. Haley Fielder is one of those individuals who entered into training having already experienced life challenges and honed some valuable counseling skills as a result. It was so enjoyable to work with her and now that she has graduated, I look forward to being able to refer clients to Haley Fielder LMHC-Associate wherever her future career travels take her. Haley, may all of your grandest dreams come true (and I’m looking forward to Sunday visits)!

Next, a little article I recently stumbled upon at the Gottman Institute site that’s perfect for anyone who is struggling within a relationship of any kind. For some, the piece “4 Mindful Listening Principles to Better Navigate Conflict” will be a basic refresher, and some will find these principles life-changing.

Finally – Welcome Autumn! My favorite time of the year, with all of its transitions, will see me honoring my own self-care and relational needs with visits from family and friends. I hope the season’s changes bring you good things, too.

A final look at summer on the Columbia…

Seasons flow like a river.

Constructing Reality & Healing From Grief

In Finding Community, Holidays, Our Narratives, Resilience, This is Life

This time of year often makes our pre-existing pains loom larger, sometimes to the point of feeling overwhelmed by sadness. If you’ve been “dealing with grief” in the usual ways (you know, “the 5 Stages of Grief” etc…) — Now is the time to upgrade your tools.

Did you know that the person who came up with those “5 Stages” was really talking about the experience for the dying, and not what it’s like to be a grieving survivor? It’s yet another example of how our consumer society took a complex psychological topic and over-simplified it to the point of not just being off-track but even destructive.

How many people have talked with me about feeling like they ‘must be broken’ because those “5 Stages” don’t seem to happen in order, or come along at all, or feel never-ending…

If you’ve lost loved ones, you know that Grief Does NOT End. But how do we keep going if that’s true (and it is…)?

First, above all, remain open to new ideas about Grieving. Even “experts” are simply humans who have made the time and paid the prices to study something a lot. Not just regarding Grief, but virtually all psychological ideas should be held lightly with a dose of skepticism, even when they ring true to our minds. Just give it all another decade or two, and you’ll see how new thoughts shift research, and vice versa.

Next, as for grieving itself, try this up-and-coming perspective: Grief is a lifelong process that changes shape over time and can enrich our lives.

You can read part of Hope Edelman’s book “The AfterGrief” here, but I also really recommend listening to the interview with her recorded in 2020. (It’s only 10 minutes long!)

More than simply a rote list of how-to-heal tips, Edelman explains how the concept of “Grief” was created and changed by society and culture – and how that then impacts those of us who are grieving and our expectations.

Edelman proposes that there only 2 “stages of grief”: “…the one where you feel really bad, and the one where you start feeling better.” She calls this second stage “the AfterGrief,” saying it extends for the rest of our lives.

Her work here is an excellent example of social constructionist psychology, a theoretical perspective that heavily informs my own psychotherapy practice.

If you’d like to dive a bit deeper into the social construction of grieving, here’s a 20-minute long interview on HealGrief.org with Robert Neimeyer PhD, director of the Portland Institute for Loss and Transition and someone at the forefront of re-shaping our understanding of grief and meaning.

Importantly, all students of grief and grieving agree that it is best done with others. Whether that’s a formal or informal group of peers, psychotherapy, or simply a personal confidante or two, the human species is wired to connect to others in our temporary existence.

Here’s to achieving post-loss growth and deepening peace, for all.

Accepting (Even Inviting) Influence

In Resilience, Self Care, This is Life

Well. 2022, wtf?
As I write this, roughly 3 months after my last post, which was full of hope following the prior two years of hard, RADICAL acceptance, we’re all witnessing (and some of us, more directly experiencing) a whole lotta more, and not necessarily in the enjoyable ways. More Covid variants with more infection possibilities as employers and employees alike wrestle with in-person comingling opportunities, more financial traffic jams (is this inflation or recession??), and what feels like the piece de resistance — terrifyingly up-close images and sounds of senseless, deadly war.

How are we holding up?

I won’t bother to offer simple consolations on the above-mentioned. I do, however, offer space and room for shaking it off, putting all the thoughts (including the hardest) out on the table for display, airing, deconstructing. I may occasionally offer a different POV; sometimes, though, my own brain comes up short. Human, I am.
I am a fan of humility.

The only way that I know of (okay, maybe not the only way, but it’s what’s coming to mind right now) to make Humility a good — no, REALLY good — thing in my existence, is to connect it with the rest of that stuff that keeps me from crumbling: For me, those things are dogged persistence, deep deep deep belief in The Good including Nature, and years of experienced knowledge that if I let life impact or influence me and I ride it like a big wave on a long board, I can not only survive but find joy in the journey.

What and who are you allowing in, on, around – to influence who you are? And who is that, exactly?

One of the ways my influences are shaping me is toward bringing my session fees up to market standards. My practice has been based all these years on making sure I’m at least offering lower fees and including a sliding scale for uninsured people who are living on wages considered lower-middle to lower income. Getting in-network with the insurance ‘train’ in 2021 was another way of making my services available to people who cannot afford full fees for mental health services.

Starting in June 2022, my regular fee per session for new clients will increase to $150 per session hour (still below the market rate for my location.) Now, if you’ve been a client of mine for awhile, you already know that I don’t bump everyone’s fees up when I raise the rates for new clients. You have each experienced a $5 raise starting in the past January, so whatever your fee is now is good to go. But — if you’ve ever considered referring a friend, acquaintance, or family member to me, now (before June) would be a good time, to save them a little money.

One big reason for accepting this influence toward bringing my fees closer to market standard: I’m now available more often to see clients in person at my Lacey, Washington office. My in-office hours are technically 3 days a week, but as things with the pandemic change for the better, my in-person availability will change as I and my clients see fit. In short, keeping an office available for more days each week requires more office rent. It’s all interdependent (or, as we like to say in the LMFT world, “it’s all relational”…)

So — if you refer friends, family, colleagues to me, be sure to advise them to let me know you’ve sent them. Also, if you have any concerns about being able to afford therapy for yourself, please please let me know: I will work with you to see that your mental wellness needs are addressed. And finally, I encourage everyone to intentionally practice bringing to their mind those times in life when comfort and joy were the prevailing emotions — dwell in those moments regularly, to feel the influence of your own life’s wisdom, so that you can keep putting one foot in front of the other and influence others around you thusly.

Caring for My Practice, One Adjustment at a Time

In This is Life, Uncategorized

Whew — we made it, y’all! 2022 is here, and we’re all hoping it brings better things for everyone. The past couple of years have been rough and called on us to be in constant adjustment mode.

One of the ways I tried to make things a little better for all was to start taking insurance a year ago. I’ve always used a sliding scale to offer lower fees, even before I became an in-network provider with several insurers. But I was unprepared for the result — so many new clients that it became challenging for existing clients to squeeze a session in without a month-long wait.
So I adjusted again — instituted some new policies and scheduling protocols — opening up more space, finally, for all of my existing and a few new clients to be seen in a timely way.

Now that 2022 has begun, I am further adjusting by slowly becoming out-of-network with insurers. The process to de-contract with insurers is slow and lengthy (as is everything with insurance), so it will take several months before I am only seeing clients who are self-pay.

At this time, the insurance that I am discontinuing with is Blue Cross Blue Shield. All clients who are insured by BCBS have plenty of time to talk with me about their options, which include self-pay at my full fee or at sliding scale, as well as referrals to other therapists. As we move through the year, clients who are using Aetna, Optum/United, and Ambetter will be hearing from me about when they can anticipate needing to select from those options.

Also, every client is being asked to read and, if in agreement, sign an updated version of the practice policies. There is an additional piece now, thanks to the Federal No Surprises Act — at first, you’ll just be given a vague document that describes the upcoming Good Faith Estimate (GFE). Until we’re informed differently by the government, only my self-pay clients will be given an individualized GFE, a document that I will create specifically for you and your individual situation. Unless you’re using insurance, you can look for a GFE in your inbox within the next few weeks.

I know that’s a lot of info! Please feel free to contact me directly with any questions or concerns. I’ll do my best to contiue protecting your professional therapeutic relationship with me while honoring the legal requirements of Federal and state laws.

2022 — Let’s do this!
(and btw — all the pics you see in my blogposts were taken by me, in & around my world, so YES, I’ve been learning all about snow!)

Unplugging Helps Me Refocus

In Finding Community, Resilience, Self Care, Support Groups, This is Life, Uncategorized

Back from a very long road trip (just about 5,000 miles), I returned feeling refreshed. The drive itself was eventful — my first experience in a major dust storm (me & hundreds of others hunkered down on a major highway for 4 hours), plus a day’s driving carefully through mountainous terrain surrounded by thick smoke from wildfires. My dog (who is a champion traveler!) and I were thrilled to see family after 8 months of quarantining, tested out many a motel bed, and enjoyed chatting with strangers all along the route in rest stops and convenience stores. Masked all the way.

The weeks away from my home/office brought into sharper focus one of my deepest values: time.

It helps that I am a person who enjoys my own company and that I have a faithful canine companion who offers affection and fun. Also, working remotely has given me and many others the ability to continue offering therapy services while looking out of different windows at varied landscapes. I know that I am lucky, and my gratitude is huge.

I like to bring lessons from my time-off back to “regular” life. This go’round, the lesson is about Time itself. So, I’m adjusting my hours of availability to reflect the positive impact of having more open time in my life. Starting in October, I will be offering hours as late as 6:30pm only on Mondays and Wednesdays. If you find scheduling a session challenging, just get in touch with me or my assistant Darbi, and we’ll work together to figure it out.

I encourage you to continually explore what it is you value most in living, and then take steps to bring those values to life with your choices.

On a slightly related note: I want to let everyone know about a new community support group that is forming. It’s for anyone who experiences Dissociative moments and would like to feel free to speak openly with others who “get it.” The group — which is virtual — will be peer-led by a dear colleague, Karrie Hardin, MT-BC, NMT, who is both a mental health professional and a person who experiences dissociation. If you would like to find out more, please see this flyer with contact info and other details. The Dissociation Association – flyer

My, How Quickly Things Change. Again.

In Finding Community, Madness, Psychotherapy, Resilience, Self Care, This is Life

Because I am moving to another state, I am unable to take new clients until July 2021. After the move, I will still be licensed in the state of Texas and, therefore, able to continue to seeing any clients who understand and agree to see me by video or phone only.

For the time being, I will only be seeing clients remotely — that is, by video or phone (your choice). My hours remain the same, and you can still schedule our conversations in the usual ways: by texting/emailing/calling me or my assistant, Darbi, or through the online scheduling calendar.

During our sessions, this is where I’ll usually be:

Of special interest to some of you: My colleagues at Affordable Counseling Collaborative Associates are also available for your lower-cost counseling needs. You’ll find them through the link to their site.

Stay safe and healthy, and flex your emotional management muscles!

Another Way to Look at Things (When Things Seem So Gloomy)

In Meditation, Our Narratives, Resilience, Self Care, Self Help, This is Life, Uncategorized

It’s likely been a rough week for you and those around you. Besides constant streams of news, you’re probably being bombarded with emails from all kinds of companies and organizations letting you know what they are doing to handle this current public health situation. Me, too.

I want to offer another window to see through… It is possible that some “good things” might come from this experience. I’m not dismissing what it feels like/seems like right now. And I also think the best things that might come in the near future from this distressing event depend a whole lot on our intentional, conscious use of the moment.

This idea struck me yesterday after opening yet another email from some company saying that they care so much for their consumers, and here’s how they’re demonstrating that concern… While, yes, these businesses are doing so partly to keep their business going, it’s also been kind of nice to hear so many expressions of “We’re all in this thing together.” There’s never been quite enough of that thought in this world.

So I added these thoughts to my own coping toolbox.

When I start to feel the tension in my neck, shoulders, and back that reflects my mind’s anxiety, I do a few things to restore myself to immune-boosting/restoring relative calm. I invite you to join me:

Imagine each emailed expression of solidarity with humanity as genuine. Take 3 seconds to conjure up images of actual people discussing and then writing those emails. Repeat any words to myself that are calming — things like “We’re going to get through this together. Yes.”

If you wish to add a very brief meditative practice to your immunity-building activities, try this — you can do this virtually anywhere, no need to find any special kind of place or time:

Pull your vision away from any screen that may be in front of you. Let your gaze gently turn toward the ground, but keep your head erect.
Straighten your posture by imagining the very top of your head is connected to the sky and being gently lifted upward. Move your shoulders down and slightly back, causing your chest to rise and move forward a little.
If possible, flatten your feet (in shoes or not) to the ground. If not possible, at least try to uncross your legs and feet, and wiggle your toes.
If possible, raise your arms briefly over your head and reach for the sky. If not, straighten your arms in front of you or down your sides, focusing on opening your hands wide, stretching your fingers. Then release your hands and arms.
While you are doing the above slow, light, gentle movements, take a few slow, deep breaths and think to yourself:
- This is a moment in time. And here is another one. And another one.
End your “session” (there’s no magic amount of time — do it as long as you want/can) by thinking to yourself:

We’re all learning to be human, together.

If you feel an immediate sense of dismissive scoffing (“This is BS. This won’t change a thing”), just let the thought be there and then drift away, maybe with a little “mm hm” and a friendly pat to your own head.

And Also…

“Out of an abundance of caution” (there’s a phrase I’ve never heard more in my life than in the past 2 weeks), my Houston office colleagues have instituted some protective policies for our clients. You’ll find it on the wall when you come into the office, or you can download it here. And if you’re seeing me at my office in The Woodlands, feel free to take similar actions (like washing your hands when you arrive), but we haven’t hung the policy on the wall there.

If you have a session scheduled in the next two weeks, please look in your email for a Client Portal link to a document called “In Case of an Emergency During Video or Phone Sessions (Telehealth)” — If you choose to reschedule your in-person session to make it by video or phone, I’m asking that you read over and complete the form before your session. It’s not related to the current public health situation, but is a state requirement of any health care professional (including mental health) to have clients complete such a form.

Linking arms with you from here,
Tracy

How We’ll Manage with COVID-19

In Resilience, Self Care, Self Help, This is Life, Uncategorized

COVID-19 (a new name for the Coronavirus disease 2019) is teaching us some lessons about anxiety and the impact of feeling prepared for possibilities. I’d like to invite you to join me in feeling empowered by taking meaningful actions to “flatten the curve” (as described in this Scientific American blogpost by Zeynep Tufekci) of a potential crisis.

Anxiety is a normal human response to threats, both perceived and real. If you want to manage your anxiety level and keep it at a healthy reality-based level, you can avoid hyper-sensational news headlines and social media posts, and stick to scientific sources of information.

In addition to reading Scientific American, I am also using the U.S. Centers for Disease Control website to stay updated on the latest numbers and any changes in where COVID-19 has been diagnosed.

Besides staying updated on real news about COVID-19, we’ve taken the usual steps that we do every flu season in our offices: You’ll find plenty of handsoap and water for washing (find out how here–>20-seconds each time — sing “Twinkle Twinkle Little Star” to time it, and bonus points if you sing it out loud!), as well as alcohol-based hand sanitizer, and of course, loads of tissues. These things are here for you, and your use of them could help keep a whole community healthy. (We even brought in a few more air-cleaning plants, because you never know… and they’re pretty.)

I’d like to encourage you to feel empowered to cancel any scheduled sessions if you or any of your household members are ill. Plus, I will be happy to hold your session appointments by phone or video, too, if you’re feeling up to it.

Finally, listen to those of us who’ve been here, done this: This is not the first virus outbreak to scare everyone into taking better care of themselves. Feeling panic at such times is only human, but it won’t protect you. If anything, panic could bump up your usual amount of stress and decrease your immune system’s response. So, do what you can to know what you must, unplug daily from the media chatter, take a few steps to feel empowered (like the ones mentioned in the Sci American blogpost,) and bring your gaze & focus back, time and again, to the important people and tasks in your life.

Ideas from NICABM for managing anxiety

The National Institute for the Clinical Application of Behavioral Medicine (NICABM) offers a great infographic with 4 basic approaches to managing anxiety. Feel free to download it here and — most importantly — add some of these ideas to your own personal toolbox.

Affordable Counseling Collaborative Associates

New Windows to Gaze Through

In Finding Community, Psychotherapy, This is Life, Uncategorized

Have you noticed that I get bored easily? That’s not really accurate — truth is, I want to experience more than I think any one place can offer. But it sure might seem like I “just can’t stay put”! I hope you’ll reap the benefits of my ongoing search for experiences.

New Houston Office

Some of my Houston clients have had the opportunity to visit in more than one of my office rooms at The Spectrum. Now, as of February, I’ll be in the same room each day — but at a different address: My new Houston office will be located at 3707 Graustark #4, Houston, 77006. We’ll be able to take advantage of the sunlight streaming through century-old windows in this original 4-plex in Montrose, just across Alabama Street from the University of St Thomas and down the way from the Menil Museum. (This office location might make for ideal pre- or post-session date-nights or self-soothing excursions!)

I’ll be sharing #4 with dear colleagues, Sarah & Skeetz, and I’ll be re-adding Tuesdays to my availability. Starting on February 2, you can schedule with me in Houston on Sundays, Tuesdays, and Thursdays.

Affordable Counseling

You may already be acquainted with this project of mine and with my February move, Houston clients will be seen in the new main office of Affordable Counseling Collaborative Associates. In fact, Skeetz Edinger is one ACCA’s counselors, also seeing clients in The Woodlands plus on Graustark Street. Our other therapists are located around Houston and in south Harris and Galveston Counties. If you know people who would like to talk with a counselor but are unable to afford it, please give them ACCA’s phone number (601) 533-8255 where our Administrative Assistant will answer their questions and help them find affordable counseling.

Meet Darbi Lockridge

Speaking of ACCA’s Admin Assistant — you may have already met her when trying to schedule a session with me. Darbi Lockridge assists me in responding to calls, emails, and texts, so I can be sure that everyone who tries to contact me can hear back from someone as soon as possible. Darbi has many years experience working with people from all walks and circumstances, and her natural compassion shines through all of her busy life’s activities. I hope you’ll feel perfectly comfortable interacting with Darbi for your scheduling needs, and she knows when any situation requires contacting me directly.

Now, let’s get this Decade started!