Waves of Emotions

During these uncertain times it is not unusual for my patients to feel different emotions in very short periods of time. I hear mostly of anxiety. However, I also hear of sadness and feelings of loss and grief. Even as my patients stay healthy physically the emotional toll the COVID-19 Pandemic has inflicted is quite high. We mourn for the people who have died. We mourn for the families who have been inflicted with economic hardship. I know some of my patients will sail through this seemingly unaffected and others who will be deeply affected for a long time. Each patient is dealing with this differently. I have to listen and meet my patient wherever she is.

Create your  immediate future

Dealing with different emotions can be scary and exhausting. Because the future is so uncertain it is important to create the future we need in this moment. If there is a picture that needs to be painted get out the paints and start painting. If that yarn has been sitting in the bag since it was purchased get those needles going. If there is a book you have been wanting to write start writing. If my patient is feeling helpless she can take back some control. Life will feel less helpless if she can determine even the immediate future.

Staying Connected Matters

I am seeing all of my patients each week via Telehealth. I am happy that the hour they come we can stay connected. Staying connected is so important right now. If you are not already in therapy, it can start now. If you feel alone it can help you feel that someone is there for you week after week.  Relationships are what will help us get through this emotionally.

I’m your Venus

 Take good care of yourselves. On another note, if you look at the evening sky in Portland, Maine Venus is very bright tonight. I think this is symbolic for the brightness that needs to shine over all of us right now. Be well, stay safe and stay home!

How are you doing?

We are now about two weeks into the COVID-19 Pandemic. Maybe longer but I’m not paying attention to the actual date it was decided this is a pandemic. I am doing this out of self preservation. I try to listen to news once per day and  not too close to when I go to sleep for the night. I have moved my practice to Telehealth and telephone. Thankfully the insurers have agreed to cover both. In the beginning there were some adjustments but it seems to be running quite smoothly.

Homeschooling is not my forte

Taking care of ourselves will be most important as this unfolds. I ordered new visual journals for myself and my son. I will be curious to see what comes out creatively at a time of great anxiety and uncertainty. My son who is 15 is now homeschooling. He told me he is not worried about getting COVID-19 at all. I guess that’s good. I don’t want him to be afraid at such a young age. I do encourage good eating, sleep and exercise for him. He seems pretty happy and we can both still laugh a lot despite the City of Portland stay at home order. I have seen very funny video clips about mother’s who “are not home schooler types.” I would have to say, it is not my forte either. I am lucky he is in high school and can get into his Google classroom on his own. I am also lucky he can help with our chickens.

Start a virtual community

There are many ways to deal with the stress from this strange new way of living. Meditate daily even if it is for ten minutes. Get creative through art, clay or other mediums if you can. Start planning a garden. Exercise outside. Now that temps are in the fifties it feels glorious! Watch movies or shows on Netflix. Start virtual communities for things like knitting. Have a virtual dance party. Staying socially distant doesn’t mean complete isolation. Take good care of yourselves and stay safe! 

Stay Calm and Keep Your Distance

I made the difficult decision to increase social distancing in my private practice. As a whole, we must do this to flatten the curve of new infections from the coronavirus. Right now, if we don’t our health care system and workers will be over whelmed. I felt I needed to do my part and have moved my practice to a HIPPA compliant video tele-health platform. If this creates a hardship for anyone in my practice I am asking you to call me and we will come up with an alternative plan. My hope is this will be short and we will resume our face to face meetings once things have settled down.

Worrying Increases Cortisol Levels

Staying calm is something you can do to boost your immune system.  Stress and anxiety increase cortisol levels and is not good for our immune systems.  Good self care is very important right now.  Meditate, knit, bake, paint or watch movies. If you can, stay connected with loved ones.  If watching the news heightens your anxiety-turn it off!  Stay calm and wash your hands!

 

COVID-19 Guidelines for Established Patients

Today at around 3:45 p.m. President Trump declared a national emergency. He has restricted any laws that would not allow me to provide Tele-Psychiatry to all of my patients. I am currently giving my patients the choice to see me via HIPPA COMPLIANT video platforms. If patients still want to come to the office they may  only come  if they do not have any of the following symptoms: fever, cough, runny nose, difficulty breathing.  They may also not come  if they believe they have been exposed to the Coronavirus within the last 14 days. I will continue to  reassess the situation over the next two days to determine if I will move to Tele-Psychiatry entirely.

This is not Fake News

 

This is very big news and thankfully it lets me continue to provide the best care to my patients during this very difficult time.  If you are a current patient and have any questions or concerns, or are unsure if you should come to the office,  please call me or contact me via the contact page

Stay Tuned!

High Anxiety

Sometimes in life, we can get very anxious about things. I try not to worry about things that have not happened yet, but how do we do this when every day on the news we are hearing of a potentially fatal virus?! I have no idea of how this whole COVID-19 (aka Coronavirus) will go. I have no idea who will get sick or how sick they will get. What I do know is I have to breathe and do the best I can to take good care of myself and my family. In my practice I speak often about trait vs. state anxiety. Trait anxiety is when it is in the background all the time. State anxiety as in what is  going on with this whole COVID-19 business.

Surprisingly no one is talking about it

Oddly, not many of my patients are talking about it. It was the same thing with 911. My patients seemed to continue to focus on their lives. It got me thinking about being in therapy helps when there is something big going on in the world or even locally. Is there something protective about  already being in psychotherapy? Therapy helps you to feel cared for in so many ways. Just knowing that someone shows up for you week after week is comforting. There is so much more to being in therapy than solving problems. It truly is about the relationship. Many years ago I gave a talk about psychotherapy to a large group of mental health professionals. I described the various types and how they differed. At then end of my talk I said that the most important thing was the relationship with the therapist and not so much the type of therapy being done in the office. Much to my surprise I received an evaluation that said I was reckless and basically a crappy Psychiatrist because everyone knew that this one type of therapy (I will leave nameless) was the best blah, blah blah. The person also said I was irresponsible because there were students in the audience and how could I teach such garbage?! I still to this day believe what I said many years ago at that presentation. The bottom line is the relationship between therapist and patient. So many of my patients felt uncared for growing up. I do care about them and their lives. How could I not?

Preparing for distance therapy

Another issue that may arise is I may have to see my patients via Tele-Psychiatry. I have done it before, like during snowstorms and it works just about the same as face to face. So I am here and I know my patients feel a sense of relief knowing we have a plan in place if it should move to that. My hope is that if it  should come to this that there is no disruption in our work. We will get through this. My other hope is it passes quickly and we can all resume worrying about other things in life like whether Tom Brady is coming back to to New England!

Wash your hands and don’t touch your face!

Too Little, Too Late?

Closed Sign

At the end of a very long day I sat down to read the local newspaper online. I was disappointed to see a major provider of mental health services in the area  is closing leaving 170 patients to find services. The agency had provided care in the form of case management for 27 years. A little longer than me being back in Portland.    I am disappointed  each week when I read of more  and more agencies having to close their doors.  I actually have as much work as I feel I can safely provide.  This work is very strenuous at times so I know my limits. I do feel badly when a colleague will want me to see a patient and I just don’t have the time to take the patient on.  Sometimes things will open up briefly in my practice, but those appointment times  fill quickly.  I also don’t want to take on a new referral if I could not give appropriate followup appointments in a timely manner. Could I add a day a week to my schedule, sure, but then my own self care would be compromised.  In my opinion, no one would benefit from an over tired doctor/therapist. I am adding to my psychotherapy practice but that type of work is weekly for a 50 minute hour and I get to know my patients very well. Although it can be strenuous at times, it is entirely different from working in community mental health. Patient’s have to be much more independent and able to manage symptoms with little involvement from me outside of the office.

I would say that 90 percent of my practice is providing therapy.  It is the work I truly love and why I went into Psychiatry in the first place.   While there is a part of me that feels helpless when I see another agency close. I know that I am only one small piece of the puzzle.  I never quite understand why the “bigger players” don’t step in.  

I hope that reimbursement improves which seems to be the driving force behind the closures. That would mean that the State would have to allocate dollars toward caring for these patients and I know it has been an uphill battle the last eight years. I am hopeful things will improve over time. I just hope it’s not too little too late!