Welcome to snowy Seattle! I’m not seeing a lot of clients this week, since safety and warmth trumps counseling. If you’re scheduled to see me this week, it’s no problem rescheduling, just let me know.

Meanwhile, I’ll be catching up on some admin work, writing a blog post or two, and making up new apocalyptic names for the storm and its effects on a city that’s not used to digging out from under snow and ice, let alone driving through it. (Ice-chaton is a twist of “eschaton,” a term for the end of the world. And no, you don’t need to know this, or care!)

Oh, and I’m taking these lovely creatures out for regular snow romps. Be safe!

Stella and Hoku ala enjoy the winter wonderland.

Like This Article? Please Bookmark It!

The city of Seattle will be spending the next ten months rebuilding and resurfacing NW 85th St., Greenwood Ave. N, and N 85th St. between 15th Ave. NW and I-5. The first phase, beginning January 4th, will likely have the biggest impact on my office in terms of noise and traffic delays. Go here for more information. If you’re coming to my office from the south, I suggest coming up through Ballard if possible. If you’re coming from the north, take Holman until it bends onto southbound 15th Ave. NW, turn left at 80th, and come up 14th to get to my office. Wherever you are, give yourself a little extra time to get here.

Like This Article? Please Bookmark It!

I’m on vacation this week, so this is just an announcement post. No major content, except a nice little photo I captured of our tree ornament in honor of Hoshi, our beloved late puppy dog. Have a safe, restful, and lovely holiday! See you back in the office on December 27.

Like This Article? Please Bookmark It!

Today there are tributes all over the Internet to Christopher Hitchens, writer and polemicist. I’ve always enjoyed reading Hitch, even though often enough (particularly on Iraq) I disagreed with him. His atheism helped me sharpen my own views about ultimate reality and my spiritual tradition. His relentless, well-researched criticism of global scoundrels (Kissinger, first and foremost) was inspiring in its depth and incisiveness. And he was a lot of fun. I admired his unapologetic love of a non-P.C. lifestyle, and he was that rare public figure: one whom I’d love to meet for a drink.

But what I liked best was his courage. Here’s an excerpt of what his brother had to say about it. I harp on courage with my clients. The old song “Love is all you need” has been a bane of this therapist’s existence: love is not all you need. It’s courage that you need. Courage to confront your partner about the truth that needs to be told. Courage to confront yourself about your failings, blind spots, weaknesses. Courage to pursue the best possible relationship: one that is filled with honesty, vigorous argument, ecstatic union, and thousands of days of ordinary kinship and friendship. Love also requires courage in no small part because the price of love is grief, and that price is often staggeringly high.

Chances are good that if there’s something wrong in your relationship—it’s falling flat, or it’s driving you crazy, or it seems to be slipping away from you, right before your eyes—you will probably find your way to a new, rewarding relationship when you begin to think, talk, and act courageously.

I highly doubt that Hitch would have been very interested in my line of work. But he has contributed something to it, nonetheless. I remember him for this, and raise a glass of Jim Beam to his memory. (Just one! I would never have been able to keep up with him.)

Like This Article? Please Bookmark It!

I’m in the process of updating my site pages that address your questions about insurance coverage, but until that’s all done I want to say a word about couples counseling and insurance. Here’s the word: if you’re a couple working with me, I accept only out-of-pocket payments for my full fee. Insurance isn’t part of our relationship.

Here’s why. If you have medical insurance, it’s possible that your insurer has listed me on their website as a provider, whether I’m “preferred” with them or not, and it’s also possible that they have told you they cover couples counseling. But this is technically incorrect. And to do it, I’d have to breach my own ethical code. Here’s the explanation:

The insurance industry is built to serve individuals, not couples, which means if we bill your insurance, I have to diagnose one of you with a mental disorder and bill the session as an individual session (with the individual’s spouse/partner present), implying that the session is intended to treat that one individual’s mental disorder. This is why insurance companies don’t really cover couples counseling: they cover individual counseling with the (presumably non-disordered) spouse/partner in the therapy room. And in my book, that’s not couples counseling.

If I were to bill the session properly and ethically, I would diagnose neither of you with a full-blown disorder, but would code it V61.10, which is “partner relational problem.” And there are two reasons why that won’t work. First, I’m still billing your insurance for one of you, not both of you, and that’s inconsistent with my view of you as my client. You are both my client—my singular client. Your dyad is my client unit. And I believe that these little details do matter. They have an effect on how we see ourselves and each other, try as we might to avoid it. And the second problem is that no insurance company I know of pays claims with V61.10 as the diagnosis. It’s a V-code, and my guess is that the V stands for Very Unlikely We’re Going To Take Your Problem Seriously.

“But,” you say, “I do have a mental disorder! I’m depressed, and my relationship problem contributes to my depression. So I’m fine with you diagnosing me and billing it as an individual with his partner in the room.” I understand that, I really do. I even share your belief that working on couple issues can alleviate depression and other disorders like anxiety, PTSD, and many more. Maybe it seems like an absurd distinction, but to serve you ethically I still have to hold the line on my belief that what we do in couples counseling treats both of you as a unit, and to do that effectively, I can’t have the paperwork telling me, you, and your partner that your depression is the central problem. It truly might not be. Let’s say your partner also has a disorder in the category that includes depression—bipolar, say, or alcohol dependence. Why should I put your name on the chart and not his? Maybe his alcoholism is a bigger issue than your depression…but your depression is also a really big deal. It becomes an ethically shady game of drawing false distinctions. I know many therapists (my past self included) who have blurred this line and said, “Oh, it’s not a big deal, I know the truth,” but I’ve been doing this work long enough to know that blurring a line like that is dangerous.

Two more points and I’m done, I promise! I want to add that my holding the line on this can be a source of comfort for anyone who is afraid to begin couples counseling because they (understandably) fear that the therapist is going to side with their partner. I am doing everything I can in and out of my sessions with you to prevent that from happening. In the sessions themselves, when I am naturally drawn to your partner over you, I go on alert and wonder how I’m being “drawn in,” and what you’re all about, and how I can be as well connected with you as I am with your partner. And outside of sessions, I pay attention to things like this insurance issue to be sure the structure of our therapy—even the tedious paperwork—is not getting in our way.

And finally, I have learned through long experience that out-of-pocket therapy is generally more effective and powerful, both for couples and individuals—and perhaps more so for couples. You’re investing time and hard-earned money on your relationship. That motivates you, and it makes it a true investment on your part. It can be expensive (though perhaps not as much as you fear…many couples require surprisingly few sessions). But you really do get what you pay for.

Like This Article? Please Bookmark It!

This is a post about a small thing, but also an important thing. It’s about how you sign your emails and other communications. If you’re like a lot of people, you are pretty informal and may not use any signature line. But chances are you might start an email string this way:

Dear Mr. President,
Great to talk with you today. Thanks for the invitation to what promises to be a great state dinner. See you there.
Take care,
–Stephen

If I’m doing a long back-and-forth email string, at some point I’ll ditch the “take care” and just respond more casually:

Barack,
No, I’m right-handed, so it doesn’t matter where they seat me. But next to you or Michelle would of course be great. Tell Malia I love the shoes!
–S

But these days I’ve been ditching “take care” entirely, replacing it with (drum roll) “Only good things.” I got it from our favorite dog trainer, a skilled professional who uses completely non-violent methods in her training programs. I’ve assumed all these years that she uses that signature line because it fits best with her general philosophy of life. It certainly fits with her work training dogs: no punishment, no nastiness, only treats for good behaviors and an understanding that dogs learn best when the training is positive and thoroughly non-violent.

But I had another reason for switching my signature line. I recently attended a workshop on conflict resolution, and the workshop leader mentioned that telling people to “take care” is actually problematic. Taking care of oneself seems like a perfectly good thing, right? Except sometimes the healthier choice is to take a calculated risk, or make yourself intentionally vulnerable. I know from years of working with people on relationships that self-protection is never enough to ensure a healthy union. If I’m 100% safe, I’m probably only 0-50% intimate with my spouse or partner. Relationships are about both risk and safety.

So I suppose I could sign emails, “Take care—and take risks!” But that’s clunky, and corny. And as a therapist I don’t need any help being clunky and corny. So I decided our dog trainer has it right: I wish you only good things. I don’t wish you badness, malice, or suffering. You may suffer if you take the healthy risks I wish you would take, but that’s different: that is the suffering of growth, so in a backwards way it too is a good thing.

Some of you may think all of this is silly. It’s an email signature line, what’s the big deal? Well…it’s not necessarily a huge deal. But it is one of those everyday things that can gradually have a significant influence over you, day by day. Now that I sign emails “only good things,” I’m reminding myself daily that a well-lived life isn’t only about safety, and there are good things to be had when we do something brave, or move outside of our comfort zone…when we stop just “taking care.”

Only good things,

Stephen

Like This Article? Please Bookmark It!

This week we have painters in our house, and they’re doing a major facelift, from front to back, painting all the rooms you’d see if you came over for dinner. Exciting! But stressful. I’ve been managing two dogs who love to bolt, shepherding them from bedroom to basement, or just bringing them with me on errands and appointments. Life continues in the midst of this mayhem… it doesn’t stop just because half our possessions are under a tarp and the other half are overloading the two rooms (and dungeon-like basement) we can still use.

I’m not whining. (Okay, I’m whining a little.) I say all this (more importantly) because I’ve noticed something while spending so much more time with our puppy dogs, Stella and Hoku ala. Whenever they can—that is, whenever I can provide a place for them to do it—they just, you know, lie around.

Of course they do, you’re saying. They’re dogs. Big deal. But it is a big deal. It’s one of those obvious things in front of our noses that we too often ignore: the fact that all the other mammals on this planet, after finding food, satisfying today’s procreative needs, and securing shelter, just…lie around. They don’t have to do anything. Only the benighted humans have created a world in which they have to do things, do more things, do so many things that their sense of self-worth is caught up in all the things they do, or can’t do.

Why don’t we all do something unusual today: after we’ve taken care of the basics, why don’t we all just lie around? I’m going to give it a try.

Hoku ala enjoying the simple experience of being an earthling with nothing to do.

Like This Article? Please Bookmark It!

Lots of times clients sound a little bit like, well, me. They say things like, “I just need to get my life back into balance.” Or, “I’ve never been in balance. I’d like to balance all the different things in my life.” And I say—both to them and internally to myself—

Nah. Don’t bother.

Here’s why: life is not about balance. Don’t believe any counselor who tells you otherwise. You think you’re focusing “too much” on career and not enough on your relationships? Says who? Maybe your career is your lovely baby, the beautiful thing you’re giving birth to in the the world. Your clients or customers or care recipients don’t think your career-focused life is out of balance. And that’s probably not only because they know your so-called “workaholicism” brings benefits to them. It’s also because they know that what you do is valuable. It’s a force for good in the world. Does that make you a bad girlfriend? Maybe. But maybe that’s okay. (And yeah, maybe you should be honest with your partner about that.)

Or maybe you’re going through a time in your life when you’re doing, well, everything. Kids, jobs, grad school, pets, family visits, volunteer work, friends…everything except rest and relaxation. This is unhealthy? Says who? Maybe this is a time of immense growth and development and change in your life. Maybe you’re young enough and energetic enough to do all of these things, and do all of them rightthissecondnow. Sounds good to me. You’ll have time for yoga and meditative silence in a year or two.

Having said all that, you may decide that your life is out of balance, but in a way you don’t want it to be. You want it to be out of balance in another way. That’s fine. But it can be very freeing to let go of the idea of “perfect” balance. And I’ll close with a little nugget on the word “perfect.” A friend of mine who studied Latin told me that the English “perfect” comes from the Latin per fecare, which does not mean to “do something flawlessly.” It means to do something thoroughly.

In your out-of-balance, crazytown life, are you doing what you love, and doing it thoroughly? If so, good on ya.

Like This Article? Please Bookmark It!

I am now a certified practitioner of the Myers-Briggs Type Indicator, which is a well-researched and versatile tool that helps you understand your innate preferences, and how you use those preferences (or not) in your daily life and work.

You can take the MBTI assessment online by yourself and come in for a 1.5-hour session with me to interpret it, or you could come in as a couple for a 2-hour session. (For couples, both of you would take the online assessment separately.) I’m also available to work with larger groups such as your work team. The online assessment will generate a detailed report personalized for you, based on your answers to 144 short questions about your personality preferences.

MBTI focuses on two basic human activities: the way we take in information (and the kind of information we tend to trust), and the way we make decisions. The first activity—taking in information—is about whether 1) you prefer to pay attention to the many here-and-now details and facts that you get from your five senses, or 2) whether you like to see broad patterns and tend to trust your ideas and hunches.

The second activity—the way we make decisions—is about whether 1) you prefer to make decisions using logic and a critical, principled method; or 2) you prefer to make decisions by listening to your values and your concerns about the impact of the decision on the people involved.

MBTI also helps you decide whether you put most of your energy out into the external world (extraversion) or whether you prefer to direct most of your energy inward, cultivating a rich inner life (introversion). Finally, MBTI helps you decide whether your attitude toward the external world is marked by a desire to be organized with lots of closure and certainty or a desire to be open-ended with lots of room for discussion and uncertainty.

All of this is intended to be useful in practical ways. You can use MBTI to understand how you behave in conflict, how you communicate with others, how you manage change, how your preferences affect your marriage/partnership, and more.

Again, you can take the assessment by yourself and come in for a 1.5-hour session with me to interpret it, or you could come in as a couple for a 2-hour session. I’m also available to work with larger groups such as your work team. Think about it, and stay tuned for more information about this useful tool.

Like This Article? Please Bookmark It!

It was four Labor Days ago, in early September 2007, when I opened this counseling practice and began seeing clients as a private practitioner. Each year has been both challenging and rewarding…and more successful, in various ways. I have truly enjoyed specializing in relationship counseling, both for individuals and couples.

For the nine years I worked as a therapist before opening my own business, I worked with hundreds of clients on a host of different issues, and since then it’s been great to focus my work on the relationships in people’s lives—not just their romantic/spouse/partner relationships, but their friendships, family relationships, and even co-worker relationships—and how we all can learn so much about ourselves when we take a close look at the many ways (for good and ill) that we relate to others.

In the coming year, I am planning a few changes to develop my practice and expand its scope. I’m working this month toward certification as a Myers-Briggs Typology Indicator practitioner, which means I’ll be working with individuals, couples, and groups on their personality types, using the MBTI as a lens that reveals where we focus our energy, how we perceive information about the world, how we make decisions, and how we relate to the outer world. I’m very excited about this. Exploring my own type has been a great way to learn how I function, and also how I run into conflicts with others…and it’s also helped me understand how others are different, and how those differences are gifts and strengths that other people bring to the world, and to my own life.

I’ll also be setting up new ways to schedule appointments, plan your course of treatment, and reflect on how our time together was helpful for you. And I expect that after another four years, I may be in a new location! (But let’s not get ahead of ourselves.)

Happy Labor Day, and may this day be an opportunity for you to celebrate the contributions we make to the world through our labor, and to hold in our consciousness those who are unemployed and underemployed during these difficult times.

See you soon!

Like This Article? Please Bookmark It!