Resolutions: A New Year is Upon Us

What do we make of New Year's resolutions?  Do we even bother making them anymore? Many of us still do and several of us set ourselves up with grand plans of losing mega weight, making mega bucks, or some other far reaching goal with little planning or thought of how to go about getting there.  So today let's talk about thinking our goals through and planning for success. Don't make a huge list, start with one or two goals at a time.  

First: Let's start with identifying your expectations for the year and the resolution you are making:
How will your goal benefit you? Identify your goals and address these expectations and define your objectives. Setting a timeline for yourself at the outset is important; now keep this realistic.  However, remain open to setbacks and work them into the process.  If you need help ask for it.

Second: After you know what your goals are and are sure of your timeline you should be feeling confident about yourself, your plan, and feel ready to begin your process.   Resolutions need not start on January 1st, although planning for them can begin soon after. But this is where the majority of your  action and enthusiasm drive your momentum, and desire to get started, so take advantage of the extra enthusiasm.  Again, don't be afraid or frustrated with setbacks, we all experience them from time to time.  Just get back on course as quickly as you can and again if you need help don't be afraid to ask for help.

Third: As you continue to build on your momentum you may find that you need additional support.  Friends will be supportive, but you may feel alone in your accomplishment.  You may want to re-examine your objectives and being flexible and not feeling frustrated or let down by the speed of the process.  Like all skills, your new skills were learned over the course of months, so be flexible and forgiving of yourself as you may slip from time to time, so seek out support where it is available to you.

Once you have followed this more systematic way of meeting your goals you should feel a sense of accomplishment, but if you don't feel fulfilled, re-evaluate your initial goals and expectations, and if you want more support feel free to call me to set up a consultation.

As always, I hope you found this helpful and informative.  Feel free to call for a consultation.

All the Best to you and yours this Holiday Season.

Dr Kevin
www.DrKevinOBrien.com

Being Prepared for the Holidays: Don't Sweat the Small Stuff

Holidays are a time of high emotion, powered not only by nostalgia but unrealized expectations that can leave us feeling unfulfilled. If you are feeling frazzled, consider making time for yourself. Doing so can be an effective way to avoid getting caught up in the folly of the overstressed gift exchanges, and social media displays of status and achievement. It may be completely out of character for you to take time out for yourself but you will feel less exhausted and more present at the events you do attend.  So, give it a try: grab a hot chocolate and rest your feet, catch up on a phone call, or something else that helps you feel that you are re-energizing yourself.   

Going into the family gathering with the expectation that relatives will be on their best behavior can be a set up for disappointment. Remember that friends and family will not be any different, and you will be in a much better mind set.  Arrive prepared for this and you won't get "plugged in" to their incipient behavior. You'll get along with Uncle Fred and his excessive drinking and bombastic stories, and accept them for what they are and from whom they are coming.   You will have survived a holiday gathering unscathed and with little emotional cost to yourself or your ego. 

Not sweating the small stuff goes a long way when it comes to family and work especially during the holidays. Generally during the holidays, family and folks are so caught up in their own folly that rarely do they take the needs of others into consideration. People will let us down at times, but when we apply these life lessons about not sweating the small stuff, we realize it is rarely with any real malfeasance or malice.

This major attitude adjustment does take practice, so be patient and start with yourself.  For instance Uncle Fred is drunk again, is he your responsibility personally? NO. Is he the family's responsibility? Maybe. Or is he responsible for himself? Yes. Uncle Fred, his partner and the rest of the family may need to discuss the emotional costs of his drinking, and the benefits of seeking help. If they are unwilling to, you may wish to discuss this with your therapist so you can learn to let Fred live his own life as he chooses until he decides he wants to change it. You may decide that it's most constructive to limit your contact with your your uncle for the time being.  

As always I hope you found this helpful and informative, Feel free to call on me for a consultation.

All the Best,

Dr Kevin.

www.DrKevinOBrien.com

  

Managed care and "Out of Network" Therapy

There appears to be a lot of confusion about managed care, and with confusion comes inertia. We see it playing out on a National level so of course it is effecting us on a local level. The reality is that not much has really changed in the scope of things.  Insurance companies still reimburse for "out of network" service although the deductibles have begun to vary greatly over the years from one provider to the next.  

Finding a therapist on a list is similar to looking in a phone book these days and can be quite daunting.  The other difference is that "in network" reimbursement rates have declined dramatically in the last few years as well; which partially explains the exodus of medical and psychiatric providers from many high profile insurance panels. Not to mention that finding a therapist on a list is similar to looking in a phone book these days and can be quite daunting.

These are two primary reasons, along with practice freedom that many doctors choose not to deal with the bureaucracy and unnecessary oversight of having to justify every medical or psychiatric decision by disclosing patient confidential information repeatedly to insurance companies.  

Another unfortunate problem is the language regarding out of pocket expenses; co-pays -vs- co-insurance payments, as well as deductibles.  Until there is a universal deductible for mental health the confusion and rate  wars will continue.  Speaking for myself, as an "out of network provider" I charge a fair market rate that clients either find agreeable or not.  It is lower than many of the in network practitioners charge the insurance companies, but they balance it out once their rate drops following the client meets the insurance deductible.  

However, on a personal note, I do not reveal (without your permission) your reasons for treatment and your notes to your insurance company for any reason.  I release the minimum amount of information necessary for you to be reimbursed for your costs, if you want to be reimbursed.  Many clients prefer remaining confidential in their treatment and choose not to be reimbursed.    

Not everyone can afford not to be reimbursed however, so, confidentiality remains a major sticking point between "in network" vs "out of network."  Confidentiality is less secure when you work on a panel because the insurance company can audit your file when they feel fit to do so.  So one of the benefits you are paying for is the luxury of privacy with an "out of network" provider.  You are able to feel confident that your information is kept private and not shared with your insurance company, unless you want it to be.  

A bargain is not always the best or wisest course of action.  It does work for many, but many "out of network" providers have sliding scales to work with clients and make "out of network"treatment more accessible to more people.  Don't be afraid to try to negotiate a rate with a provider, It can't hurt and may help you get a better therapist in the long run.  

As always I hope you found this helpful and informative.  Feel free to contact me for consultations.

All the Best,

Dr Kevin

www.DrKevinOBrien.com

What Do We Do With What We Learn In Therapy?

What do we do with all the knowledge we learn in therapy?  Hopefully, you are applying it to your everyday life experiences, or at least trying to.  As much as people tend to want to believe that therapy is about the past, it is more about understanding the past so you don't repeat it.  We all have developed positive and negative patterns of thinking and behaving. So you are not alone.

It is understanding how these ingrained thoughts and behaviors "get in the way," or even benefit us that help to optimize our lives.  It is easy to say I live in the "here and now" and I don't need therapy. Understanding that your "here and now" is nothing less than an amalgamation of past experiences, both good and bad and even in between is what therapy helps to uncover.  In other words, it allows for you to finally be more in charge of your "Here and Now."

Of course this is not resolved in 12 easy steps, it is a process that requires an ongoing commitment of both therapist and client.  It often implies that there are setbacks and is not a linear process.  Developing trust with a therapist takes time, feeling safe enough to explore secrets requires trust and both of these take time to develop in any relationship, including a therapeutic one.  

Band-Aids have their purpose in the medicine cabinet, but if you need sutures see a doctor. So don't fall prey to the easy fix, it does work temporarily on the specific issue in question, but it is not modeled to help you understand causality (the reasons under the behavior in the first place) and the primary reason they are only "short term fixes" to long term problems.  Understanding the reasons why we repeat self sabotaging behaviors, helps offset new thinking and behaviors that help us make clearer choices and less damaging ones.

Self help is wonderful, and helpful to millions of folks, and that is often all they require or want out of their programs.  Some however, seek more answers to the questions and a deeper understanding that comes with growing mentally and emotionally stable in their particular self help program.  It is these individuals that seek outside guidance for deeper understanding of their questions and lead to a healthier lifestyle.  Therapy is an excellent option to helping explore those esoteric questions that are sometimes to complex for the self help route, or even the rooms.  

Again, what do we do with what we learn in therapy?  We apply it to live healthier and happier lives as more self actualized people that better understand what motivates their thoughts and actions.  Living in the present "here and now" as fully as possible, no longer prisoners of our past memories, behaviors, self destructive desires. This is what therapy can offer anyone seeking a happier life that is patient enough to work a little toward their goals to truly experience the moments in their life as they unfold in the "Here and Now." As always I hope you found this helpful and informative.  Feel free to contact me for consultations.  

All the Best,

Dr Kevin
www.DrKevinOBrien.com