Tele-Psych with Paddy and Carole (Video-Counselling with Doxy.me)

For the coming weeks, Paddy and Carole will be counselling, cajoling and comforting over Doxy.me, a hyper-secure teleconferencing system. (Did you see the pun? “Doc-see-me.”) If you have made in-person appointments with me or Carole, these will be changed to tele-psych appointments over Doxy unless you email me. I don’t recommend longer than an hour, so longer appointments might be abbreviated as needed.

Using Doxy, you don’t need to download anything — you just get an email from me on the time you have booked. Click that and you are in.

To go directly to Carole’s Doxy waiting room, click here.

To go directly to Paddy’s Doxy waiting, click here.

We are moving from Skype and FaceTime to something that is simpler and more secure. You can look up Doxy.me here. It will take you a couple of minutes to orient, but it is pretty basic and easy to use.

Having said this, if you need to visit us at our office, this can be arranged for exceptional circumstances (“What! You don’t have a webcam or a smartphone?!”). In this case, please read my blog “Current Covid-19 Concerns.” This will explain our approach to minimizing contact and thwarting this disease should you visit our home office.

Prior to starting video-counselling, I want to go over a few things with you. Here is my list.

  • There are obvious benefits to video-counselling. If you are out of the Vancouver area or if you have some sickness. Some busy business folk who are trapped in meetings video-call me from their offices and cars!
  • There are some risks too. We are using technology (and wires and stuff, that I don’t know much about) to make this work. This is why we are switching to Doxy.me. It is just more secure.
  • Confidentiality still applies to all telepsychology services.
  • We will not record our sessions and I can’t see why we would wish a recording – so we won’t record. We hope that you won’t either.
  • Note that you need to use a webcam or smartphone during the session. Otherwise, it is much more difficult with simply voice.
  • It is important to be in a quiet, private space that is free of distractions (including a cell phone or other devices) during the session. Kids can be a problem too.
  • It is important to use a secure internet connection rather than public/free Wi-Fi (eg Starbucks).
  • It is important to be on time. If you need to cancel or change your tele-appointment, you must notify us in advance by phone or email. Can you give us a day or so? Sure helps us.
  • We need a back-up plan (e.g., a phone number where you can be reached) to restart the session or to reschedule it, in the event of technical problems. Make sure we have your phone number.
  • You should confirm with your insurance company that the video sessions will be reimbursed; if they are not reimbursed, you are responsible for the payment.
  • As your psychologist, I may determine that due to certain circumstances, telepsychology is no longer appropriate and that we should resume our sessions in-person.
  • Get your coffee or pour your tea and let’s get going. Connect with Doxy.me.

 

Best to you all and stay healthy.

Paddy and Carole

A+B=C (The Upward Slope)

Please read the earlier blog first. It is entitled, A+B=C (The Downward Slope).

I think you have the idea. Our belief systems orient us to outcome or consequence. We can have a positive effect on our circumstances and experiences if our belief systems are working more consistently with reality. if we keep blaming the activating event or trigger, we will not grow. We will repeatedly suffer the consequences of our faulty beliefs. This, in large measure, is why people keep repeating the same mistakes.

A young woman visited me bi-weekly for several months. The sessions were intense and she worked hard to confront her belief system. Growing up she saw herself as pudgy, not particularly confident and remembers being coerced sexually by her brothers and their friends. She believed that she was not deserving of anyone and her only hope was to find a man who would take care of her. She complained that her mother smothered her with unhelpful advice and told her that when she got married to a good man, he would think for her as she couldn’t think for herself.

A+B=C

The activating event for “Shauna” was the continuous judgment from her growing up family. There were many diminishments throughout her childhood and adolescence. She felt empty, cheap and dumb, and acted in a way that invited the sexual exploits of others.

Shauna had to decide if her beliefs concerning herself were true-to-life. She could see the activating events (A) but she avoided thinking about them because they caused her such pain. It was much harder for her to see the beliefs (B) that produced such a chaotic and depressing life (C).

Here are a few of her beliefs: “I am dumb,” “I am worth nothing,” “I am depressed all the time,” “I can’t talk to my parents or my family without crying,” “I have fu_ked so many men that no decent man would want me,” “I can’t get a job that pays more than minimum wage,” “I can’t be happy on my own.” She was hospitalized for major depressive disorder.

It is laborious to examine and interrupt the cascade of harmful events and beliefs that precedes depression. Shauna studied the A’s of her life — her dysfunctional family of origin, the fears she enfolded into her soul, the triangles of emotions in her chaotic family. She measured the B’s she had incorporated. She challenged the beliefs that were untrue and harmful and she unearthed some hidden beliefs that were hopeful and clever.

I think of therapeutic change as being a 5% shift. She created an upward slope to a better life. Shauna made a 5% shift and her consequences improved. And she observes her A+B=C as a morning and evening ritual. It is the content of her journal and the structure of her thinking.

Recently she met a man she quite liked. Rather than becoming inebriated and travelling a downward slope, she asked him questions and interacted with his answers. She decided that she was a pretty good thinker and that she could figure out her next steps.

A+B=C (The Downward Slope)

This is an old psychology formula that makes good sense. “A” is the Activating event or the trigger that gets stuff rolling. “B” is the Belief system or judgment(s) that makes things worse (or possibly better, depending on your beliefs). “C” is the Consequence or outcomes.

This is how the formula works. Mostly the A or activating event (the thing that triggers you) just happens. You can’t control most circumstances and you are not immune to being hurt or upset. It is the B or belief system that produces the C or consequence.

Here is an example from a couple I saw a couple of weeks ago. The male partner was enraged for what he experienced the weekend just prior. This is the A – what he thought his wife did to him. He accused her of shaming him in front of his friends at a really fun party. This is the B – that he felt judged and that he should not be. The C was his rage and hurt and his spiteful behaviour for days following.

This is what went on: she asked him not to drink any more beer that night. He was getting pretty loud and acting “drunk-ish,” she said. She was worried by his disinhibition: flirting, bragging, over-laughing. She asked him quietly to stop the beer, she said. He thinks she publicly shamed him.

A bit later in the session, I asked about his thought processes and what triggered him. “I don’t need her to control me. She is not so perfect. I like to loosen up with my friends. She is so uptight.” That is the B or the belief systems that fueled his fire.

The B (or belief system) produced the C (or consequence) of several days of his swearing and anger, and spitefully threatening a divorce. Her C was to disappear from his sight, visit with her friends in the evenings, make him a Nespresso in the morning.

Here is what I said: “Your problem might be beer – I don’t know that – but it certainly is your belief system. You think that your partner is ruining your life. Where did you get that idea from?”

It still surprises me how hard we hold on to our unhelpful convictions. He needed to be right. He needed her to be wrong. He needed me to validate his narrative.

And then he saw it, reluctantly and thoroughly. He said, “I guess if I didn’t feel ‘small’ with her, I could have handled this differently. Maybe not right away but certainly within a couple of hours.” He apologized to her. She gladly accepted.

Now the therapy begins. He has to sort through his bloated belief system and find out something truer about himself and his partner. (More to come.)

[You are invited to make any comment you wish on this post or anything else on my site by emailing me at life@theducklows.ca. Thanks.]

Never-Ending Problems: Like Dandelions in the Grass

I like solving problems – always have. I like to think triangularly, question appreciatively, figure out what has not worked before and suggest something that I think is brilliant, create a plan for real change, and measure the anticipated success. I was taught all this in grad school, some of my female friends tell me that this is such a “man thing,” but I have lived this as far back as I can remember – when I was 8 years old I tried marriage counselling with my folks! I think I did pretty good.

Now John Gottman comes along as a marital researcher and says that about two-thirds of relational problems are perpetual, like dandelions in the grass. Some troubles are unsolvable he says, and lots of arguments never accomplish a thing other than rehearsing for the next squabble. Never-ending — sounds discouraging.

Carole and I have a bunch of unsolvable problems, mostly the same ones we had when we were first married. No matter what I do to “persuade” (coerce) her to do what I want (or she me), the problems keep flowering. The solvable ones delude us into thinking that we are pretty good at conflict solving, and it’s true that we’ve had some dramatic successes. It is the unsolvable ones that really bug me.

Here are some perpetual problems that you are probably familiar with:

Personality or “your way in the world”: Who is the most introverted in the dyad and who is the most extroverted? This probably doesn’t change much. Neither does the tension between the one that is most emotionally intuitive with the one that is perseveringly logical. And some people are emotional stuffers (always have been) while their devoted other is pretty much a feeling gusher (always has been).

History: You can’t change a person’s history. The times in which you were born, and the ways in which you were raised, or dynamics in your family of origin – this is set in history. The goodness of your connection has a lot to do with how winsomely you accept each other’s life before you met.

Sensitivities: How do you react to failure, or criticism, or loneliness, or unpredictability, or being excluded from a group? This is well-wired by the time a child becomes an early teen.

Some things change really slowly. Things like your view of what success or failure means in life, or what a worldview might be. Our relationship to money, emotions, work, conflict are hard to change, but change they do.

Habits change slowly as well. If you are an early-to-bed kind of person and you are married to a late night email addict, this too can change. Savers always seem to marry spenders – at least in my practice. Maybe that is why they come to therapy. Habits change – slowly.

I have discovered that unsolvable problems require different strategies than solvable ones. First off, you need to be willing to distinguish solvable from unsolvable problems. Make two lists of your problems. What can be negotiated (solvable) and what cannot (unsolvable)? What is most important to you (grade this 1-3)? What can you let go?

Secondly, focus 80% of your resources towards the good things that you already do well. Show a little “benevolent disinterest” (differentiation) towards the problem areas. It is not a moral failure to take a break from working on faults while you celebrate the good stuff you do now. Over-focusing on problems (many of which you can’t solve anyway) is a serious waste of good humour and friendly faith.

 

[You are welcome to comment on this blog or anything else you see on my website. Please suggest improvements or ideas, or just dialogue. Contact me at life@theducklows. Hear from you soon. Thanks.]