Counselling Can Be Expensive

Now that is a truism. Sometimes I tell my clients that I can’t even afford me! (I am never sure how they take that.)

But how you feel about the expense of counselling depends a lot on what you get out of it.

My fee is $180 per hour. Carole’s fee is $160 per hour and David’s fee is about $50-75 per hour. I usually see someone for about 10, 1-hour sessions, so the total is about $1800 over several months. That is a lot of money, perhaps what you pay on car insurance. And then you take that car in for a tune-up (actually they don’t tune up anymore – they download computer upgrades) or sign up for a course at Capilano U.

Here is what I do about fees:
• I charge $20 per hour less than the going rate for Psychologists ($200 as of January, 2012). I want to give back to you.
• Many of you can have your fees covered under an employee assistance plan or an insurance program. Make sure that you check your coverage for “Psychologists” before you visit with me. By the way, Carole’s fees as a Registered Clinical Counsellor may be covered under your plan as well.
• Here is something interesting: if both you and your partner are both covered under your EAP or insurance program it may mean that you have twice the number of appointments for couple counselling. Imagine how many family appointments you can have if you have 10 kids!
• Keep your receipts for your income tax – some of it may be reimbursable. Ask an accountant.
• I also create my own assistance plan with your church or community group. You pay a portion (about a third) of the fee and they pay about a third, and I will reduce my fee to correspond. And this for a maximum of 10 sessions.

I am happy to say that most of my client-friends consider therapy to be good value and many recommend their family and friends. Counselling can be a valuable investment and worth much more than it costs.

(Updated in September, 2018)

 

[You can respond to this blog or anything else you see on my web site by emailing life@theducklows.ca.]

Fighting: We See Things as We Are

Anais Nin commented that “we don’t see things as they are, we see things as we are.”

Acknowledging this – that our life and especially our pain, skews our seeing and our thinking – is the first step in mediation and conflict resolution.

If the psychologist observes this when two parties are deeply stuck and viciously divided, she challenges her client-friend’s way of being in the world, his world view.

The second step is to appreciate the other’s point of view – to see that it has merit.

The third step in mediation is to find an agreed upon goal that both parties can strive towards. This is popularly known as a ‘win-win’ solution and puts the combatants on the same side.

These 3 steps result in a ‘success’ that is seldom better than 70%; in other words, neither party gets the perfection they think they are due.

Acknowledging, then appreciating and finally agreeing. And that seems right to me.

Is My Marriage Worth It?

Conflict and relationships go together. A conflict-free marriage is an oxymoron.

Why? People mature at different rates; they have different values (some they don’t even know they have); and people see and experience the world differently. And all of this leads to tension that can result in conflict. And sometimes we wonder if marriage is worth it.

These are the kinds of issues my clients bring to couple therapy. Think about these questions for you and your marriage.

• If you had to create a short list of people you could spend the day with, would your spouse be on that list? Do you genuinely enjoy each other’s company? Do you laugh when you’re together?
• Do you have the same or similar values, goals and interests? Do you and your spouse enjoy doing some or lots of things together? Do the two of you want the same things out of life?
• Do you express a lot of affection and appreciation for each other? Or is there mostly indifference, negativity and hostility in your relationship?
• Do you feel understood when you are talking with your partner? Does your spouse try to see your point of view? When discussing things, does your husband or wife listen to what you have to say?
• Is your relationship usually based on fairness? Does your spouse see you as an equal? Do you feel you are treated with respect? Or do you feel used, exploited, or taken for granted?
Do you feel that your spouse will be there for you in a time of need? Can you count on your spouse for help when the going gets tough?
• Do you feel comfortable sharing your private thoughts with your spouse? How easy is it for you to talk to your spouse about sensitive issues?
• When you disagree with each other, do the two of you work together and try to resolve your differences? Or is there a lot of hostility, disregard and contempt when disagreements arise?
• Does your spouse care for you sexually? Do you make love pretty regularly? Or are you disappointed or frustrated with your affection?

The pain can be huge. This happens when conflict spikes and shared pleasures plummet. And even at these times, working on your marriage is always worth it.

Mental Illness: A Parent’s Journey (Stu Ducklow)

Stella_Ducklow

The following article was written by my brother about his daughter. Both have given permission for this to be re-posted on my blog. Stu said it was okay “as long as Stella gets all the credit” — that’s like my brother.

I have previously posted about Stella’s depression and struggle with mental illness (please see below).


Like most parents, we thought our first-born child was extraordinary, and we hovered over her as much as any helicopter parent.

She seemed to need more attention than most. When she nearly died of anaphylactic shock at age 4, we sought help from specialists ranging from a pediatric immunologist to Reiki practitioners. When eczema kept her from sleeping, we covered her with creams and dosed her with prescription meds.  When she was hospitalized for asthma, we gave away our four cats.

When she had trouble in Grade 1, we enrolled her in a private school where students were expected to learn to read via the ‘whole language’ process which spurned phonics and spelling. When she still couldn’t read, we took her to an after-school program that drilled her in the very same phonics and spelling that we were paying the other school to avoid. Stella was reading above grade level in a few months.

But we couldn’t come up with a solution for the all-day crying jags, cutting and constant dieting that began at about the age of 16. We turned to the provincial mental health system for help. We had a lot to learn. While mental health professionals are nearly always kind and well-meaning, the system they work for seems designed to serve administrators more than the patients.

For example, Stella was confined to her unit during one short stay because staff was thinking of moving her to another unit and they wanted her available at short notice. This meant that our daily one-hour drive around Halifax, the high point of her day, was forbidden. Fortunately a good-hearted nurse bent the rules when I promised to deliver her within ten minutes of a call to my cell phone.

Over the next ten years we got used to waiting up to 16 hours in emergency wards when Stella felt suicidal or overcome with anxiety or depression. In contrast, she was seen immediately for a fractured ankle, though broken bones aren’t nearly as harmful as suicidal thoughts.

She was admitted at least ten times for short stays of about a week. Though she saw many psychiatrists, they confined themselves to adjusting her meds. Requests for some form of psychotherapy were met with blank stares. She was given a regular outpatient worker who she met with for about a year but that person was hostile to us as parents and dismissive of Stella’s chances of recovery once she was diagnosed with borderline personality disorder. 

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The Wisdom of Tenderness

In October 2007, Krista Tippett interviewed Jean Vanier, the founder of L’Arche. Tippett is the host of “Speaking of Faith” on American Public Media, one of my favourite blog sites and a source of great spiritual-theological gain for me.

Of all of Tippett’s interviews, this interview with Jean Vanier is spectacular — I would say life transforming!

The 90 minute video is a much better investment than watching another edition of “House” (also a favourite of mine!) and you can also download an abbreviated version for your iPod so you can listen to Vanier’s “wisdom of tenderness” while walking or working out at the gym.

Find the interview at http://vimeo.com/462130.

What Motivates You? (Our Triple-A “Drivers”)

We are driven by needs. Many think that we are motivated by values and many of us are some of the time. But all of us are motivated by pressing needs or “drivers.” Consider these drivers in your marriage or family, or in your business or church.

Acceptance (to be counted in). Who gets to be “in?” This is the issue here. Some attend a church for years without essentially being counted in. They feel like “strangers in a strange land.” And acceptance is pretty easy; just treat people like people you don’t know and would like to, and say “hello and welcome.”

Acknowledgement (to be known). Once you are accepted (or at least feel accepted) you will want someone to know your name and remember it when you return. The simple saying of your name and perhaps attaching some affection to it is the motivator called “acknowledgement.”

Affirmation (to succeed). We all want to feel that we have succeeded in who we are and what we do. When we are affirmed we feel that we “fit” – like a key for a lock. We know our strengths and gifts and work out of them. Success is easy then; it is who we are.

These triple-A drivers are motivators for all of us. Of the three, what motivates you the most?

Would You Like to Super-Size That?

Size matters in emotions. Some spouses bark, bully, blame and belittle with the noisier suppressing the other by volume and spite. Others may coerce their partners and kids to “submit” thinking they have some theological “right to respect” (which they clearly don’t!). Kids up-turn power into tantrums and tyranny. And then lots of families “tiptoe” their lives, waiting for the next tsunami. Yes, size matters especially the size of noise and especially again the noise of coercion. It is as if we “super-size” our emotions, pumping up insanity to defeat an enemy that used to be friends and family.

“I don’t know why you’ve got to be angry all the time,” she said to her husband of 7 years, clients of mine for several months. As I write this, I am listening to Tim McGraw singing “Angry All the Time” and that comment is the refrain: “I don’t know why you’ve got to be angry all the time.” (You can hear / watch this on You Tube. This is a tiptoe marriage, like my client friends, with super-sized emotions.

I have come from a week of super-sized emotions; watching super-sized partners push and prod while their tiptoe spouses lose voice, hiding and hoping for anything else. You know of course, that it is not either men or women who coerce – in some families it is both.

I want to tell you about a conflict questionnaire that I have used over the years in my teaching and consulting. I would love it if you became an expert in understanding conflict (not necessarily doing it!). The “Thomas Kilmann Conflict Inventory” is resourceful for people who want to understand conflict and why it perpetuates.

I can provide this assessment for you. Please contact me.

Parents and Teens: A Few More Comments (Part 2)

I think a big part of parenting teenagers is self-control as in controlling oneself, not trying to control one’s near adult. If I can be more resilient as a parent then maybe I can parent more effectively. Psychologists call this “differentiation” and it is the ability to separate emotions from thoughts. When  thinking becomes clouded by emotional responses, we become undifferentiated. Families with lots of emotionally reactive reasoning used to be called “undifferentiated ego mass.” Lovely description of a family isn’t it?

Back to some comments about parenting teens with an understanding that no one does this perfectly. So first,

— Give up on being a perfect parent or having a perfect kid. Reality is more helpful than perfectionism.

— Don’t push your power, your age or your wisdom. Just because you own the mortgage on the home does not mean that you have the right to coerce or pummel your teens into compliance.

— Believe in your teen’s hyperbole. Exaggeration and overstatement is a favourite in adolescent communication. You don’t need to correct her. Anyway, she might just be the best Math student on the planet.

— You don’t have to be your kids’ friend. Accept yourself as a parent and learn to be good at it.

— Value what he or she has to say even when you disagree or have a different opinion.

— Speak quietly especially when the tension is rising. Tension goes up, voices go quieter and everybody listens more intently.

— Be careful of quick decisions. Quick conclusions are soon problems.

— Admit when you don’t know something. This is easier to do than you think. And your kid will appreciate your incompetence and see it as common ground.

So you might ask, “Did you do all these things?” Uh, no. I just did my best like you. But I wish that someone told me some of this while I was an undifferentiated ego mass.

Parents and Teens — Some Comments (Part 1)

For 5 years when I first started my work as a Psychologist, I worked for Family Services in West Vancouver where I focused on dysfunctional families referred through the public school system, police and probation.

I thought of these kids as “BC’s best” and mostly they were hopeful, resilient, and crafty and making the best out of some tough and tense circumstances at home and at school. They were also hard to handle – it was easy for me to talk with them as they got to skip school to “go see the shrink.” I remember one parent who asked if I knew of a monastery in Africa where he could send his 16-year old son. (Didn’t know of one.)

Some of the parents were excellent in loving and guiding their kids and some were clearly working out their own difficulties in marriage and life through their offspring. Some of these kids became the “Identified Problems” of the greater family tension.

Along the way, I worked up some principles for parents living with teens. These days I am having a resurgence of parents seeking help with their kids and I thought this list might make some sense to some. If nothing else, it might help parents remember what they hoped for when they were teens.

So for parents, in random order as it occurs to me…

— Be careful about criticism of anything. Even when you think you are only making a comment, it may well be experienced as another of a long list of judgments.

— Focus on your teen’s emotions. Kids “naturally” emotionally reason and this can seem illogical to you as a parent.

— Think about what depression looks like in a teen. Sometimes it is in withdrawal and sometimes it is in acting out aggressively. When your child is acting hurt and harmed, wonder about how his inner life is going.

— Say as little as possible and especially about your own experience, unless asked. When kids talk they want to talk and not listen to your thoughts.

— Don’t believe in “teachable” moments. Let your kid talk without your interruption.

— Ask questions that can be answered. Questions like, “Do you want to suggest with me 3 or 4 ideas from which you can choose?”

— Experiment in thinking in non-absolutes. If you have a 70% good relationship with your kids, then celebrate that. Don’t overly prod and provoke the 30% that is not the best.

Okay, that’s enough for today. In fact, that’s probably enough for a few days. I will post a few other ideas in a bit.

My Arms Tell My Story (Stella Marcia Ducklow)

This article is written by my lovely niece Stella Ducklow on osted in MindVine and it speaks of the bodily geography of self harm. Stella is my older brother’s daughter from Halifax. I don’t get to see her much but I think that we usually “click” in spite of my middle-classness. You see Stella is edgy, a tattoo canvas, an artist and writer, a former student at Nova Scotia College of Art and Design in photography, an advocate for the mentally ill, a roller derby player — not middle class at all. Initially, photography was a hobby and a way to get closer to her father who is also a photographer. It quickly became Stella’s medium for expressing her struggles with mental illness, for helping others through teaching photography and for raising awareness.Here is the piece she wrote for Ontario’s MindVine:

I recently had an awkward experience where my cafe manager caught a glimpse of my forearms and thought I had been in a recent accident. She held my wrist and glanced at the row of keloid scars and said ‘my dear, did you scratch yourself?’ I just  shrugged and  responded ‘no, those have always been there’ and went to fix the milk stand. I think we were both kind of embarrassed.

There isn’t really a social etiquette for this type of thing yet, it’s like goiters and nose jobs, the unwritten code is that although you can see it is not proper to address it.

It’s not a secret whatsoever that I’ve had a long battle with self harm. My arms tell that story. Too often I let the scars speak for me, because it’s easier to have people accept or reject me upon appearance than it is to actually risk talking about it. Because, like everyone else: I am afraid. I have cultivated a well honed persona that makes me appear outgoing, braised, and unaffected by stares of others. However, to this day I cannot utter the words ‘cutter’ ‘self harm’ or ‘stitches’ without having my stomach drop with shame.

To read more of this article click here and to read more of Stella click here.

Thanks Stella for writing. I admire you dear one. (Uncle Paddy)