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4 considerations that may aid your therapeutic journey Taking care of your mental health is just as important as taking care of your physical health. Seeking professional help may sometimes be overwhelming, especially when considering the cost. We'll discuss the top 4 reasons why finding a therapist that takes your insurance may aid your therapeutic journey. Cost-Effective Using insurance to pay for your mental healthcare is a financial benefit that will likely save you money in the long run. Therapy sessions can be costly, averaging about $150 per session in the United States; even one session without insurance can be a significant expense. If you find a therapist that accepts your insurance, the cost per session can be significantly reduced, making it more accessible to the average person. Better Quality Care If you have insurance, you can choose from a pool of in-network therapists who have been vetted by your insurance company. It typically takes months for insurance carriers to verify a therapist’s education, training, and experience before allowing the provider in-network status. By finding a therapist paneled with your insurance company, you’ll likely save time searching for a quality provider and benefit from better care and outcomes. Long-Term Therapy Therapy is often a long-term commitment to achieve and sustain the outcomes we want. Paying out of pocket for services can add up and may be financially stressful. Finding a therapist that accepts your insurance ensures you continue receiving the treatment you need for longer without sacrificing your financial health. Consistency of Treatment The cost of each session may be a significant factor in deciding how often you see your therapist. If therapy is a financial burden, some people may skip sessions or choose to attend therapy less frequently. Attending weekly therapy sessions, however, is often crucial to the rapport-building process with your therapist, to your ongoing progress in treatment, and to successful long-term results. By finding a therapist that accepts your insurance, you may be better able to attend therapy consistently and set yourself up for therapeutic success. Overall, finding a therapist that accepts your insurance may offer financial benefits, ensure quality care, allow for longer-term therapy, and support regularity of treatment. Don't let the cost of mental healthcare prevent you from getting the help you need. Finding a therapist that accepts your insurance may be the first step to achieving your mental health goals. Reach out to your insurance company and start the journey to a healthier you today! The Resilience Center of Houston accepts many Insurance plans and provides therapy to children, teens, and adults with several locations in greater Houston.

Personal perspective: It’s OK to admit you’re not OK. Bipolar disorder can strike anyone, regardless of gender, race, education, or class, from pre-teens into our sixties. It is an equal opportunity disorder and can, at its worst, destroy lives and health, marriages and families, careers, friendships, finances, and more. Many people with bipolar disorder are not as fortunate as I was. Between 25 to 50 percent of the five million or more people with bipolar disorder in the U.S. attempt suicide at least once. Eight percent succeed in killing themselves, and the suicide rate for people with bipolar is four times higher than the general population. Although it’s not known how many active-duty military may have bipolar disorder, data suggests that some 700,000 veterans live with it. [1, 2, 3] Deciding to publicly share my bipolar disorder story is a serious matter, but something I had to do. I argue that seeking mental health treatment should be destigmatized and dealt with the same way our culture deals with cancer, diabetes, or a broken leg. With physical illnesses, we tend to recognize the symptoms, get medical help, recover, and get on with our lives. We don’t (usually) blame or shame the sick or injured person for their malady. In most cases, we love, support, and help them get well. Yet with mental illnesses, we often wait for people to fail before we get them the help they need. How is it that failure—often with permanent family, legal, social, career, or academic consequences—tends to be the first and only indicator of brain maladies? How can we change this? In my view, we need more scientific research on bipolar disorder and other mental illnesses, brain health broadly, and the “invisible wounds of war.” We must identify the genetic early warning markers, find the causes, understand the disease mechanisms, and develop preventive medications and better recovery treatments. We need earlier identification of symptoms and even potential cures. This research is vital for our society—especially, I believe, our veteran population and our serving military. Moreover, how can we accommodate people who have these maladies so they can continue their careers? There are some examples of the medical and academic professions finding ways to do so. Professor of psychiatry Kay Redfield Jamison of Johns Hopkins University, for example, has suffered from severe bipolar disorder for decades, yet figured out how to manage it and perform at a world-class level as both a psychiatrist and a scholar. Could other professions perhaps follow suit? Millions continue to suffer. Worse still, their suffering is compounded by the stigma many members of our society continue to attach to brain maladies. By some grim coincidence, I found myself finally healthy enough to begin to tell my story during the worst public health crisis of our time. But even when the pandemic is over, our mental health crisis will remain, and even appears to have worsened. What You Can Do If you or someone you love is demonstrating the warning signs of bipolar disorder or another serious mental illness, go get medical help immediately. Engage your medical professionals—understanding that bipolar is difficult to diagnose, can blend in and interweave with other brain maladies and personality traits, and can take years to properly diagnose and treat. Read, study, and learn all you can about bipolar and mental illness in general. Engage fully in this effort. Knowledge is power. Once you are prescribed medication and treatment, stick to it and maintain an informed dialogue with your doctor and therapist. Steel yourself to be compliant for life. Bipolar disorder never takes a break, and neither can you. Like me, you may find yourself in a “forever war” that you cannot quit or walk away from, without potentially disastrous results. Be strong and help stop the stigma! The good news, though, is that bipolar disorder is a treatable medical condition. With proper treatment and a determined attitude, it's possible for many people with bipolar disorder to live successful, happy lives. It takes courage and strength to admit you need help, to get it, and to walk the road to recovery. I am not ashamed or embarrassed to be a bipolar survivor and thriver. In fact, I am thankful and proud to have survived this toughest of battles—with the support of my wife, family, friends, the VA, and grace—and to be thriving once again, with the unexpected gift of a great new life. References: 1. NIH “Undiagnosed Bipolar Disorder: New Syndromes and New Treatments”, Ira D. Glick, MD. 2. NIH Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence 3. Office of Research & Development USVA Gregg F. Martin, PhD - Website - Book

A Personal Perspective: Therapy won't save you. That doesn't mean it's not worthwhile. Let me start by saying that I love therapy. I’m a therapist and was an enthusiastic therapy client for years before becoming one. For me, therapy is fun. (Whatever impression that gives you of me is probably accurate.) When I decided to become a therapist, I knew it would be challenging–and it is! But it’s a challenge I feel suited for. I enjoy sitting with people in their hardest moments. I love existential questions and feel energized by brainstorming with my clients as they grapple with life’s greatest hurdles. I believe most people could benefit from therapy, and therapists do enormous good and alleviate much suffering. Now that I’ve gotten that out of the way, here’s my less likable take: Therapy won’t save you. It won’t solve your problems, make your life easy, and keep you from ever experiencing anxiety, self-loathing, or despair. It won’t do that for me, either. That’s because therapists aren’t miracle workers. We can’t pluck you from a broken society and place you somewhere safe. We can’t make you immune to the complicated realities of being a person; the best therapists know this. If a therapist implies that therapy can solve all your issues, maybe think twice about working with them. They might be a teensy bit out of touch. It’s not that life has to be torture or that there’s no way to improve our well-being. If you’re struggling with depression, anxiety, or any other mental health symptom, I strongly encourage you to reach out to a professional. Therapy can almost certainly offer some relief. Still, no matter how much healing we do, we must live in the earthly realm. If you haven’t noticed, things have gotten pretty weird here. Most of us living in the United States have to fight almost every day to meet our basic needs. We’re lonely, overworked, and worried about the future. Many therapists are in that fight alongside their clients. Plenty of us deal with the chronic pains of prejudice, poverty, and disability. We drink unsafe water. We live in fear of guns. We keep cutting our own bangs, even though they have never once looked good. If anything, our experience engaging with the hardships of the modern era is part of what makes us good at what we do. A good therapist will draw from their own history as well as their education. They won’t try to act like they have it all figured out or are above you in some way. They won’t gaslight you into believing things make sense or that life would be easy if you just made the right choices. They will teach you to find and build community so you won’t have to lean on them alone. They’ll validate your struggles and efforts to survive because they will have struggled in some way too. They’ll assist you in accepting the bitter truths of living in a time when the sky is sometimes on fire, and many good people are having a very hard time. A good therapist will help you see that you’re not struggling because you’re weak, doomed, or a terrible person. You’re just living in a pretty tough place. They’ll help you understand your thoughts and feelings so you can embrace the power you do have to make your life more manageable and meaningful. A good therapist will get to know you. They’ll help you figure out what problems can actually be solved and which you’ll just have to live with. They’ll teach you skills that apply to your unique situation with its particular pitfalls and possibilities. They’ll help you make the most of a less-than-ideal situation and hopefully help you feel good about being alive, even now, smack dab in the middle of this wild, messy, beautiful world. Chelsea Harvey Garner, LMHP - Website - Book: A Pity Party Is Still a Party: A Feel-Good Guide to Feeling Bad

First, never forget that the decision to change is theirs alone. If there's something you wish your partner would change, think carefully about why it's important to you. Rather than complaining to your partner, let them know what your experience is. Challenge yourself to see the situation through their lens, so you have conversations that honor them. As a therapist, I tend to focus on self-empowerment. I want my clients to succeed, and by far the easiest way to succeed is to make sure your aspirational goals are 100% within your own power. That’s why I encourage my clients to quickly let go of pseudo-goals. By that, I mean goals that are actually about their partner changing. Pseudo-goals sound like “I want my partner to go to the gym, so I’ll be more attracted to them” or “I want my partner to want to have sex more often.” Goals like those aren’t goals at all; they are wishes for something outside of yourself to change, which, of course, is not within your control. Goals that are outside of your locus of control are a near-guaranteed ticket to frustration and disappointment—and a great way to irritate your partner as well. That doesn’t mean you shouldn’t have wishes or desires that may involve hoping your partner will change in some manner. It’s perfectly natural to have these feelings and thoughts! Nonetheless, for the sake of avoiding frustration and disappointment, it is very important to realize those are wishes, not actually something you can control. So what options do you have when there is something you wish your partner would change? First, think carefully about why the change is important to you. Getting clear about this will help you initiate a meaningful conversation with them in which you honestly express what you miss, wish for, or desire. Let’s imagine, for example, you notice that they spend a lot of time getting sucked into their screens. Do you miss their undivided attention? Prefer no devices at mealtime so you can experience a tech break? Or something else entirely? Think it over until you have gotten clear about what this means to you on a deeper level than merely a complaint. Plan to focus on your feelings, preferences, and desires, and then also make time and space to get curious about what they think, feel, and want about the same issue. Plan to really put yourself in their shoes and understand it from their perspective as well as express yourself to them. When you are ready, initiate a conversation. Rather than complaining about their behavior, let them know what your experience is, and why the issue feels important to you. I highly recommend being direct and non-judgmental. I also suggest focusing on what you want, rather than what you don’t want. Compare these examples: “I really miss having meals with you where we talk with one another about our days, and generally have a break from screens and devices; it gives me a really lovely feeling of connection with you, and also creates a nice still-point in my otherwise busy day.” “You know I hate it when you are on your phone during dinner; it’s so disrespectful. Why do you keep on doing that even though you know I hate it? How hard is it to just put down your phone?” These are two ways of expressing the same wish, but you can probably imagine that they’re likely to land very differently. The first frames the issue in positive terms, focusing on what the speaker really wants, and reaches out to the loving, compassionate part of the listener that really wants to connect with their partner — whereas the second version is likely to put the listener on the defensive right off the bat. The next part of the conversation involves asking what their experience of this issue is: What do they think, feel, prefer, or want? What is important to them about it? What do they want you to understand about their perspective? Really challenge yourself to see the situation through their lens, so ultimately you have had conversations that honor both of your perspectives equally. These phases of the conversation are for the purpose of getting to know one another (and yourselves) better with regard to the issue. That’s not the same as problem-solving, so slow down a bit and don’t worry about finding a solution right away. Focus on gaining an understanding of what this is all about for each of you. For instance, maybe you’ll learn that they’ve been feeling much more stressed than usual at work, and find themselves reaching reflexively for their phone as a quick and easy way to self-soothe — and then, when they start to feel your irritation that they’re looking at their phone instead of at you, it makes them feel even more stressed, and then even more likely to get sucked into the screen. Taking your time to truly understand the dynamics at play in the situation can help disarm some of the negative feelings you may both be having, and when your partner feels heard, they’re much more likely to be open to trying something different. There may even be something you want to do differently yourself. If you want to move to a problem-solving phase, I suggest you do that in a separate conversation. You might ask if they are interested in working with you to come up with a solution that works for both of you. I recommend asking before diving in because if your partner feels cornered or pressured, they are unlikely to be flexible or creative in the problem-solving process. That’s just human nature; to stretch and grow, we need to feel safe enough to get curious about possibilities that are outside of our comfort zone. Nobody does that well when they’re feeling guarded, judged, or attacked. Getting stuck in a battle of wills will most likely lead your partner to double down on the behavior you’re talking about. Here’s an idea of how you might go about having this conversation with your partner: Let go of the expectation that you will be able to control your partner’s actions. No matter how you express your request, it’s possible that your partner will just say “no.” Make your peace with that possibility; they have just as much of a right to make choices as you do. Get clear on what you’re asking. If all you can think of is a complaint, go deeper and see what’s underneath it for you. This topic is important to you for a good reason; figure out what is most important to you about it before you start talking about it with your partner. Frame it in positive terms. Talking about what you want to experience is a much better motivator for change than complaining about what pisses you off. Be open to hearing their perspective, including learning why they don’t want the same thing you do. If it turns out you have a big difference of opinion, don’t get in a fight or dig in; instead get curious. Ask questions. Learn more about what’s going on for them. Feeling heard will put your partner at ease, and you might learn that there are aspects of the issue that you hadn’t considered. You might also discover that there are ways you can help that you hadn’t realized before–and the process of thinking through the issue might give your partner a chance to reflect on what is and isn’t working for them. Release the actual decision-making to the person making the change. Remember, you can only change yourself, and your partner can only change themselves. You can inspire someone to change, and you can request someone change, but you can’t make anyone besides yourself change. Honor and appreciate one another. Engaging in deep conversations like these is an act of love, respect, and courage. Even if you haven’t entirely resolved the problem (yet), don’t forget the importance of honoring one another and the process of showing up authentically and becoming better teammates with the kinds of challenges we all face. You get major props from me for taking part in this deeply challenging yet rewarding process. Martha Kauppi, LMFT, CST-S, Website - Book: Polyamory: A Clinical Toolkit for Therapists (and Their Clients)

While each family is different, there are some common elements that can contribute to a healthy family environment. Respecting opinions and personal needs, as well as showing respect, are all part of healthy family systems. In isolation, one or more of these characteristics not being a part of your family is not in itself dysfunctional. Whenever I conduct trainings or start working with clients who are beginning their journey in recovery from family trauma, I like to go over some basic characteristics of healthy families. If we do not know what is healthy, it's difficult to identify what was unhealthy. These may sound easy to identify, but in truth, many of us are unaware of what makes a family healthy—or normal. Words like “healthy” or “unhealthy” have become so commonplace, but few of us could describe the characteristics required to use these words in relation to families. Thus, I focus on these six to give a foundational understanding to build from. Here are six common characteristics of healthy families or social systems: 1. Respecting healthy emotional and physical boundaries. Children and other family members have privacy, and all members understand and respect that. In healthy families, parents do most of the emotional work with their children by modeling empathy, self-control, and appropriate behaviors in response to emotions or stress. The role of children is to learn. 2. Seeing each family member as an individual with an opinion. Everyone is allowed to have an opinion and all family members should respect and allow those opinions to be expressed as long as they are respectful, even if adults make the final decision. In families where there is little room for differing opinions, it is common for children to grow up into adults who do not know who they are. When you are always taught how and what to think, it is normal to not know how to do this for yourself. 3. Setting consistent, fair, and age-appropriate rules and expectations. All families have rules and it would be normal to find homes with different sets, but rules that are inconsistent or not age-appropriate create an environment of confusion and chaos. Children are still growing and learning, so a caregiver’s expectations of them should not be the same as their expectations of themselves or other adults. 4. Meeting each person’s needs appropriately. All members are concerned with the health and well-being of others, but in an age-appropriate way. Parents provide emotional care for the children; not the other way around. As best as they can, other members also seek to meet their other family members' needs. 5. All members of the family feel safe and secure. Children in healthy families feel safe learning, growing, and making mistakes. They have a healthy understanding of mistakes and understand that they will not challenge or threaten their security or safety. Love is unconditional. 6. Expecting mistakes and forgiving them in a healthy way. The family members understand that we are all humans learning and growing. Conflict is handled in an appropriate and safe way, with adults modeling appropriate ways to manage disagreements and disputes. These families explore mistakes to understand and improve, instead of shaming people for them. Children understand that they will be punished for unacceptable behavior, but that they will also be forgiven for making mistakes, instead of having them held against them for years after. Take a moment to think about your family history and if you remember any of the above characteristics. Often, people who experienced family-of-origin trauma will not have these experiences. This list can just give you an idea—if none of them took place in your home, that might be a sign that things were at least somewhat unhealthy. In isolation, one or more of the above characteristics not being a part of your family of origin is not in itself dysfunctional. For example, different households might have different ideas about whether and how the children can express their opinions based on individual family dynamics, like culture, generation, and other factors. All of the above items do not have to exist together, either, for a family to be healthy. Kaytee Gillis, LCSW-BACS - June 15, 2023 - Website - Book: Invisible Bruises: How a Better Understanding of the Patterns of Domestic Violence can Help Survivors Navigate the Legal System

Cognitive restructuring can help you change your beliefs about health. People with health anxiety hold maladaptive beliefs about health and illness. Core beliefs influence how we interpret and react to symptoms and bodily sensations. Core beliefs aren't permanent; they can be changed. Cognitive restructuring is a CBT technique that can be helpful in reshaping maladaptive beliefs about health into adaptive beliefs. People with health anxiety have dysfunctional beliefs about health and illness. One common belief among health-anxious people is that they are weak and particularly vulnerable to sickness or disease. They might have the sense that their health is ‘barely hanging on by a thread.’ They are convinced that, because of their presumed weakness, any illness or disease that happens to come along will be what puts them in the grave. Now, I want to recognize that in some cases, people are actually dealing with serious or debilitating diseases and have compromised immune systems. And in those cases, of course, one may be particularly vulnerable to illness and the appropriate steps need to be taken to protect their health, as advised by their doctors. That said, many people who experience health anxiety and live with this assumption are not weak or vulnerable to disease to the extent they are assuming. And this belief causes them to live in fear of any and all diseases, naturally. Why? Because if they believe that any disease they get will be the end of their life, it is only natural to live in fear of it! Of course they are going to be startled by and concerned about any bodily sensation or symptom that pops up because they are convinced it could be the beginning of the end. The whole process can look a little like this: They hold the core belief that they are weak and vulnerable to disease, and therefore live in fear of disease because they believe they won’t stand a chance against it. This belief leads them to be hypervigilant and on high alert for any potential ‘threats’ (i.e. symptoms or bodily sensations). Any time they have a symptom or bodily sensation (even when it is neutral or benign such as due to normal body noise or anxiety), they fear it may be due to a serious disease. They then make biased interpretations of the symptoms or bodily sensations (i.e. engage in thinking errors). Their misinterpretations make them feel very unsafe and, therefore, they begin to do a bunch of things to feel safer (i.e. engage in safety behaviors like going to the doctor frequently, asking loved ones about symptoms, googling symptoms, incessantly pinching, poking or checking body parts or symptoms). So, how does one change this cycle? The goal is to recognize one's own physical strength, resilience and capability of coping with, treating or overcoming the vast majority of illnesses and diseases. This is where cognitive restructuring techniques can be helpful. Cognitive restructuring is a CBT technique that helps one to examine and challenge their thoughts and beliefs. In this case, one needs to examine the evidence of their belief, that they are weak, vulnerable and prone to sickness. This process allows them to pull out all of their assumptions (i.e. write them down) and evaluate the validity of each one. We often don’t question our beliefs but just assume they are valid. This is problematic because our beliefs are the lens through which we see the world around us. If one has illogical or faulty beliefs, they may be interpreting symptoms in a distorted and biased way without even realizing it. Challenging core beliefs When it becomes evident that a client carries this belief of being weak and vulnerable to disease, I suggest we take a few minutes to challenge it. Step 1: We write the maladaptive core belief at the top of the worksheet (I am weak, vulnerable and prone to sickness). Step 2: We then come up with a new, more adaptive belief (the goal is for them to learn to believe this more and more over time). Step 3: We assess the degree to which they believe both beliefs (0-100, with 100 being the strongest). Step 4: We make two columns, one to gather evidence for the old core belief and one to gather evidence for the new core belief. Step 5: We begin collecting evidence for the old, maladaptive core belief. Step 6: After we are finished, we go through the list of evidence and look for any potential thinking errors or inaccuracies. We write out the reframes next to each piece of evidence. Step 7: We then move to the right side to list out all the evidence that contradicts the old core belief and supports the new core belief. Step 8: As a final step, we look through all of the evidence on both sides and then assess the extent to which they believe the old core belief as well as the extent to which they believe the new one. If they believe the new core belief even a little bit more (and the old core belief a little less), even if it is only a 10-point difference, I would conclude the intervention was helpful. See the table below for a detailed example of the results of this activity. It’s important to keep a few things in mind when completing the core belief worksheet. 1. When you are identifying evidence for the old/maladaptive core belief, make sure you are including everything. Even if you know the piece of evidence is silly, you still want to write it down. You need to give yourself the opportunity to really challenge this and see how illogical it is. If you don’t, you still may carry it around in your mind as a truth, to some extent. 2. Make sure you document the extent to which you have both beliefs, before and after the intervention. This will help you to evaluate whether it was helpful. Importantly, don’t discount small changes in your belief after you do this. Even just 10 points can make a difference and mean the intervention was at least somewhat helpful. 3. You will not change your beliefs entirely during this one activity. Beliefs take time to change. Use this worksheet as a starting point. You will then work to build from there, slowly collecting evidence in your environment to support your new, healthy belief. In addition, you will want to continue to challenge any assumptions you make in your daily life that support your old belief. A few final comments There you have it! Try this activity out for yourself and see what you come up with. Cognitive restructuring can take time at first. But, as you continue to use these skills, it will take less and less time for you to come to these same conclusions. Remember this: Your thoughts and beliefs about health and illness are not facts! Evaluate their validity and try to come up with new conclusions. It takes work at first but is well worth the effort. Brittney Chesworth, PhD, LCSW - June 15, 2023 - Website