Though I have information elsewhere on my site about insurance coverage and payments for sessions, I want to post about it since a number of people have recently been asking about it, and I’ve also tightened up my policy a bit. Here’s how it works:

The fee for each 55-minute session is $100. I offer one 85-minute session (preferably when we first start working together) at the same price, and after that, 85-minute sessions cost $140 ($10 savings, which I offer because 85-minute sessions tend to be a richer experience for both of us).

You can pay by cash or check at the beginning of your session. I can’t accept credit cards in my office, but I welcome your credit card on my site via PayPal.

If you have insurance coverage, here’s how it works: I am a preferred provider with Uniform Medical Plan, and I can receive partial reimbursements from Group Health Options (note: your plan has to be an Options plan). If you are covered by either Uniform or Group Health Options, you would pay me a co-pay of $10, $20, or $30, depending on your plan, and I would then bill your insurer directly for the remainder of the fee.

If you are not insured by Uniform or GHO, then you would pay me the whole fee up front, and file a claim yourself with your insurer. I can provide a detailed receipt for you to file your claim. I need to follow this policy because the insurance-claim system I use does not reimburse me except when I file claims with Uniform and GHO. In my experience with clients, if they have out-of-network-provider coverage, filing claims on their own has been successful.

If you have any questions about these policies, please ask, and I hope this helps you as you discern whether you want to make this investment in your health and relationships. Thanks!

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In my work with many clients, we deal with the concept of acceptance. I’ve never been a big fan of that word. It sounds weak, passive, tentative. There are all kinds of things I don’t want to accept. I don’t want to accept that, say, Haiti will always be a nation marked by tragedy. I don’t want to accept that half the marriages end in divorce. I don’t want to accept that gay couples (and gay singles) will have to live as second-class citizens just because a small percentage of the population hasn’t figured out how to be open and affirming.

But acceptance is often useful, and sometimes essential. If I lost my leg in an accident, I would have to go through the difficult process of acceptance to make sense of my loss and move forward with my life. If I got dumped or suffered some other kind of painful relationship loss, I would have to accept what happened so that I wouldn’t be imprisoned by my own resentment and anger.

To illustrate this, I will use a silly example. (Why? Oh, I don’t know, maybe because it’s Friday, and I haven’t blogged about my dogs in a while.) Our younger dog, Hoku’ala, turned nine months old this week. In three months, he’ll be a yearling who presents far fewer behavioral challenges. In about fifteen months, he’ll truly be a full-grown adult dog. But right now, he’s a chew-chew train. He ripped holes in three pieces of our living room furniture, which have now been moved to a back bedroom. We’re sitting on IKEA furniture that looks like it belongs in a college dorm room, and hoping that by summer we’ll be able to return our living room to its normal condition.

When I first noticed the damage, I had to do some self-soothing (to use a Therapyland term). It won’t be cheap to fix this! Of course we didn’t punish Hoku, because it wasn’t his fault. He’s a dog. He behaves according to his nature. It was our fault for leaving him unsupervised with our furniture. But I felt frustrated. And I worried: my partner isn’t any more of a fan of expensive furniture damage than I am. I imagined that there would be a lot more anger and difficulty when he got home.

But I was wrong. “It’ll be fine,” my partner said. As we moved the furniture out of harm’s way, we talked about how we’ll eventually take it in for repairs, and when we might be able to put the main floor back together again. I was surprised: I thought I would be the calm one!

Like I said, this is a silly example. But it’s a good illustration of the power of acceptance. If you’re upset or frustrated about the consequences of a decision you made, or the outcome of a relationship you cultivated in your life, it helps to take a deep breath and remember that you made a lot of choices in your life that carried some amount of risk, and sometimes things don’t go as planned. Sometimes the furniture gets chewed up, or your feelings get hurt, or a painful lesson is learned. It doesn’t mean you made the wrong choice. (Honest, I love Hoku and don’t regret his membership in our family for one minute!) It just means that life is messy, and sometimes painful, and doing the work of acceptance is just a part of the adventure.

Stella (left) and the Chew-Chew Train.

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The devastation in Haiti just keeps coming. As late as yesterday afternoon, I didn’t appreciate the magnitude of the catastrophe. Now I can hardly believe what I’m seeing. It’s hard to remember what I was thinking about as recently as a day ago. Health care reform? Stopping by the post office? What to have for lunch? Who cares?

I was thinking this morning that if I were in a different place in my life, I would seriously consider going down there to help. But that wouldn’t be the best thing to do. Here’s what I recommend you (and I) do to respond to this tragedy:

1. If you can do only one thing, do this: contribute cash to an organization that is already on the ground. Go here or here to get started. Sometimes I hear people criticizing others for “just writing checks” to respond to human crises, but that criticism is misplaced. Checks help. A lot.

2. Redouble your efforts here at home. The human suffering in Haiti is heart-wrenching to see, and it’s easy to forget how much human suffering is occurring within your own community. It would be a very human (or, humane) response to this disaster to use it as a motivator for your own local contributions of time, energy, and treasure. I do volunteer work at a day-labor agency in Seattle, and today, one of the reasons I do that is Haiti.

3. If you are a medical professional, you might be able to go to Haiti now and make a difference. Click here for more information. If you’re not a medical professional, go to New Orleans. (That’s not a typo!) If you’re in a place in your life that allows for a more radical response, a drop-everything-and-go response, I recommend you go to a disaster site that is better prepared to receive you and get you to work right away. Haiti is in chaos; they’ve only recently secured their airport (with your government’s help), so if non-medical helpers aren’t already on site, they may not be able to make a difference in this early stage of response. But If you flew to New Orleans and found a place to stay, they’d have you hanging sheetrock in the Lower Ninth in just a couple of days!

4. Finally, whatever you do, hold the people of Haiti—and all the people on earth who suffer—in your mind and heart today, and in the coming weeks and months (okay, years). If you’re so inclined, hold them in your prayers. The person who most benefits from this activity might be you yourself, but that’s okay—you’re human, too. You’re able to suffer, and you have suffered. Your openness to the suffering of others makes you more human, and can transform your life. You can be a part of the recovery just by being emotionally present to the people of Haiti.

Photo was found here.

This post was edited with updated information about how medical professionals can go to Haiti now.

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I found a lot to like in Lee Siegel’s recent thoughts on the trouble and strife of John and Elizabeth Edwards. (I posted about their crisis last year.) As a therapist, I sat up in my chair when I read this:

“A friend of mine once said that the only two people who know what’s going on between a man and a woman are the man and the woman themselves. He was half right. The man and the woman—or man and man, woman and woman; it’s all the same—are the last to know. The idea that we can precisely fathom people’s emotions and motives is absurd. We can barely comprehend our own.”

I’m nodding my head up and down right now. Siegel is right about this. As a therapist, I’m paid to know a lot about relationships, learn a lot about my own clients, and use that knowledge to help them work through their most difficult relationship problems. And I know that to do my job well, I have to have a high degree of self-awareness and self-confrontation. And yet, there’s always something going on that will escape my awareness, and that of my clients. No human being can be fully understood or known by another human being (or themselves, for that matter). I expect that even if I live to be ninety years old, I’ll still not have taken the full measure of my own character, let alone those of others.

But if that’s the case, why do people make judgments about the Edwardses? Or—here’s a more difficult question for me—why do people go to therapy? My answer: as right as Siegel is about the need for humility in these matters, there’s a lot we can know about ourselves and each other. I will die not knowing everything there is to know about myself, but that doesn’t mean I plan to live an incurious life. The fact that we will never know everything about the universe didn’t stop us from launching the Hubble telescope.

So I’ll draw a lesson on humility from Lee Siegel’s reflections, but I won’t be paralyzed by that humility. I’ll keep wrestling with myself and engaging with other people in the adventure of self-discovery because I have faith that our exploration of the human universe will take us far. We’ll never reach the end, but our effort is part of what makes us human in the first place.

Meanwhile, I wish both John and Elizabeth Edwards well. As with all couples who are going through a hellish time, I hope they can find their way to a peaceful resolution of their crisis, and learn a lot about themselves along the way.

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Are you in a relationship with someone—at home or at work—where you feel like you have to walk on eggshells? You’re afraid that if you speak the truth, he’ll blow up. You’re afraid that if you tell her she’s wrong about something, she’ll explode. You feel like you’re walking on eggshells.

If you and I are working on this together, chances are I’ll talk with you about experimenting with breaking those shells. It’s not always wise to say or do things that lead to another person blowing up, but then, it’s not always wise to tiptoe through your life out of fear that another person is going to lose it if you act like your real self.

Interpersonal explosions can be painful and destructive. Sometimes discretion really is the best option, particularly if you don’t know someone too well, or if you’re new to a situation (particularly a job) and you need to get your bearings before you start acting decisively. But other times, it’s best to challenge yourself a little bit…particularly if the person you’re afraid of is your longtime spouse! And the best way to do it is to look at it as a growth opportunity—not for the other person, but for you.

Here’s what I mean. The other person may or may not learn how to control and effectively use her anger. He may or may not learn how to be more responsive and less reactive to the thoughts and behaviors of others. She may or may not learn how to be a truly powerful adult—and the adults who are truly powerful are the ones who know how to work with their rage and make sense of it. But if the other person is not willing to learn, not interested (or perhaps not able) to develop his or her emotional maturity, you can get better at handling this kind of person. The learning for you is not learning how to change or reform the other person, but rather to break the eggshells, allow the other person to do whatever he does, and manage your own anxiety—and your own behaviors—in the process.

Having said all that, I need to add that your safety is important. I’m not recommending that you “break the eggshells” with a person who has been violent with you or others, or a person with whom you don’t feel safe. But if it’s just a situation where the other person’s anger is highly uncomfortable for you, then it can be a chance for you to build your skills at working with angry people without avoiding them or tiptoeing around them.

Remember: the person over whom you have the most control—and the person most likely to learn and grow in this situation—is you. Think about breaking those shells. Imagine how satisfying it would be for you to be more skillful at this!

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2009 has been a hard year. Many people have struggled with unemployment, the fear of unemployment, and all the other effects of a down economy. (Don’t ask me about my retirement accounts!) But I am confident that 2010 will be better. There are many positive signs: our economy is no longer in freefall, so even if we suffer a double-dip recession, our situation is not as dire as it was a year ago. And though we haven’t yet made health-care reform into a new law, we’re pretty close. There are many challenges ahead, but I truly believe that 2010 will be a better year.

All good wishes to you and yours as we prepare for another year, and I look forward to working with you. Happy New Year!

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