Ken's Compassion Blog

Insurance Update

I wanted to let you know that I am now accepting insurance payment from with the MHN and Aetna. And I have also joined the Sutter Physicians Alliance. These are in addition to Magellan Health Services, Western Health Advantage and the California Victims of Crime (VOC) program, also known as Victim Witness Assistance program, which I joined last year.

I particularly want to note the Victim Witness Assistance Program. If you have been a victim of a crime anywhere in California, or are related to a crime victim, and there is a police report, you may qualify for Victim Witness funding for counseling and other services. Victim Witness will pay for my services or those of other registered providers.

For more information, or to seek assistance from the VOC Program, call at 1-800-777-9229, or go to their web site.

If you have any questions about my services, I invite you to visit my web site. Thanks to those of you who have made referrals, they are always appreciated.

Breathe In Breathe Out

I’ve been working with a lot of people lately who are experiencing more than the usual amount of stress and anxiety. And they’re looking for ways to stay centered during difficult times. It’s inevitable that we are going to encounter sources of stress in our lives. I’m a big proponent of mindfulness and meditation practices to help reduce stress and anxiety, and cultivate kindness and compassion – qualities we could all use more of.

Mindfulness is the practice of focusing on your experience in the present moment, without judgment – just being with what is. It’s about accepting ourselves, our feelings, our experience, and knowing that we’re okay. It’s easy to believe that just because we’re experiencing difficult feelings – anger, sadness, frustration - that something is wrong and we have to make a change.  But what if it’s alright to feel whatever we feel – pleasant or unpleasant – and we’re still okay, even if it’s uncomfortable?

More often than not, when we look around at the present moment – where we are right now – all is well. But the mind tends to wander. And it often settles on something that made us unhappy yesterday or something bad that we think may happen tomorrow – replaying past conversations to a different conclusion, or imagining what we would say when/if... Or it tells us mundane and useless things that we already know – I’m working in the yard on a hot day. It’s uncomfortable. My mind has me thinking about how hot and I’m uncomfortable I am, as if I hadn’t noticed, or as if grumbling about it in my head is going to make it easier.

But if we hold still and stay here, we will see there is nothing to fear in this moment and this is the only moment. The futures we imagine never arrive, and when they do, they’re nothing like we imagine them. And replaying the past with the fantasy of a different outcome is just a way of beating ourselves up.

In the present moment, all is well. Mindfulness helps us tap into our wellness. Sure, we have difficult circumstances and uncomfortable feelings. Grief is part of life. Mindfulness helps us to be with those circumstances and feelings. while staying balanced and centered at the same time.

Mindfulness is a simple concept, but takes a lot of practice. It’s especially hard to do in just our every day experience, or when we’re distracted. So we need to train the mind. It’s not unlike training a puppy to heel. You’re walking your new puppy. It tries to wander away. You gently, but firmly, pull it back to your side.

One simple practice is just to take a few moments during the day to focus on your breathing. If you’re feeling stressed or tense, or if you’re about to go into a situation that has you nervous, just take a few minutes, place your hand over your diaphragm, and take ten long slow deep breaths. Chances are you’ll notice the noise in your head gets quieter, or at least more manageable, and you’ll feel a little more centered. You can pause and do this as often as you like during the day, or just when you’re feeling stressed.

Meditation is also a great mindfulness practice. Meditation helps us relax and reduce stress. It makes it easier to stay in the present moment. And in doing so, it becomes easier and more natural, to bring balance, calm and a sense of centeredness to our daily activities. Meditation helps us to be with the difficulties that arise without being swept away or overwhelmed by them, and generally to be more focused.

I know, some people find the idea of meditation esoteric or intimidating. But it’s really not. It’s actually very simple. There are hundreds of ways to meditate. But here’s we’re talking about mindfulness meditation.

As I said, it is the tendency of the mind to wander. To stay in the present moment, the mind needs something to focus on – something constant. In mindfulness practice, we start by focusing on the breath. There’s nothing more constant than breathing in and breathing out.

So, to start find a comfortable place to sit with your back straight and both feet on the floor. Let your back fall into its natural curve – not so straight that it’s like you’re standing at attention. Let your hands rest in your lap or on your knees or thighs. Gently close your eyes and bring your attention to your breathing. There’s a couple of ways you can do this: You can focus on the sensation of your breath moving between your nose and your upper lip. Or you can focus on your chest or belly moving up and down as you breathe.

Your mind will wander away almost immediately, kind of like that playful puppy I mentioned earlier. When you notice that you’ve wandered off, gently, but firmly bring your attention back to your breathing. I emphasize gentleness here. Don’t get frustrated or start getting hard on yourself. An important part of this practice is learning to be kind and gentle with yourself. You may be lost in thought for a long time before you even notice it. That’s ok. When you notice your puppy mind has wandered off, just bring it back.

You can’t do this wrong. The doing it is the doing it.

Try this for ten to fifteen minutes every day. The effects are cumulative. You’ll start to feel more relaxed and centered day to day. The things that bother you won’t bother you as much. The sources of stress and anxiety may not go away. But they’ll be more manageable.

In any event, you’re here in the present moment. You’re reading this article. You’re breathing in and out. There’s nothing to fear in this moment, and this is the only moment.

 

Cutting to the Truth

A local weekly newspaper recently ran an article on teenage cutting. I was surprised and pleased, since this is a near-epidemic problem among teens and it's something nobody talks about. The article interviewed a couple of ministers and a local Rabbi, who offered good perspectives. But I felt compelled to write a letter to the editor in response. I thought I'd share it with you:

To the Editor:

I want to commend the Sacramento News & Review for its coverage of cutting and self-harm among teenagers.

As a psychotherapist working with teens for the last 11 years, I believe this problem is near epidemic. When I worked as a child and adolescent crisis intervention counselor, a large number of teens I saw had engaged in cutting or other forms of self harm. Many school administrators and counselors reported to me that the problem was rampant.

I appreciate Rabbi Alfi’s perspective and her willingness to speak out on the issue. Yet I believe the phenomenon of cutting and self-mutilation goes far deeper than “a very private way of rebelling.”

Quite often, teens who engage in cutting are in severe emotional pain. All too often, that pain is rooted in physical, sexual or emotional abuse, or some other trauma.

Over the years, I have heard many teens say they cut themselves because the physical pain was easier to take than the emotional pain. Some teens cut so they can feel something, anything, after physical, sexual, or emotional abuse has left them numb. And, as Rabbi Alfi said, some teens cut or self-mutilate because it gives them a sense of control in a world that seems frighteningly out of control.

As noted in the article, cutting and self-harm can also become compulsive behaviors. Many teens have told me how difficult it is to stop. And many have reported that once they have stopped, they are afraid to start again, despite the on-going urge, because they fear they may not be able to stop again. It’s also worth noting that while cutting is most common among adolescent girls, teen boys also cut or self-mutilate for the same reasons.

I agree, as the article stated, that spiritual interventions can be an important part of healing. But in most cases, teens who cut or self-mutilate need psychological counseling, and often family intervention, so they can find healthier ways to manage, express and heal their emotional pain, and to gain a real sense of control and mastery over their lives.

The phenomenon of teen cutting is not new. But it is only in the last few years that it has been getting the attention that it deserves.

Finally, cutting and self-mutilation are not only teen behaviors. Over the years I have worked with many adult survivors of severe childhood trauma – particularly sexual abuse. It is an unfortunate truth that cutting and self-mutilation are not unusual behaviors among this population. Many adult survivors of child abuse practice self-harm for many of the same reasons that teens do.

They key, for both teens and adults, is to heal the pain and trauma that birthed these behaviors. I believe very strongly that with the right intervention, counseling and guidance, these wounds can be healed.

Ken Siegmann
Licensed Marriage & Family Therapist
Citrus Heights, CA
ken@insight-counseling.org
www.insight-counseling.org
(916) 367-2105

A Psychotherapist's Pledge

My friend Gail Carson-Webb recently posted a Psychotherapist's Pledge on an electronic forum that we both subscribe to. It was written by her husband, Robert Webb, Ph.D.

There are various Codes of Ethics and laws that govern the practice of therapy. But until now, I have never seen an actual Pledge or Oath suggested for therapists. I was moved by Dr. Webb's pledge, because I thought it summed up the sacred trust that is placed in our hands as psychotherapists. So, I thought I would offer this Pledge to those who read this newsletter, with thanks to Robert and Gail Webb.

The Psychotherapist's Pledge

As a psychotherapist, I am privileged to know many people in depth and to help them in their efforts to resolve their emotional problems and live more fully. Often frightened, confused, and in great pain, those seeking my help must trust me to care about them and be able to provide the help which I offer.

To be worthy of their trust - -

I must be aware that psychotherapy is a relationship based on the love of one human being for another.

I must try to empathize fully with my clients so that I may better understand their problems and know their pain.

I will accept my clients totally without judging, finding fault, or condemning them for their mistakes and I will attempt to communicate with them in the clearest possible terms.

I must always be aware that I may participate in my client's struggles only as a teacher, guide, and friend, knowing that ultimately they must heal themselves.

I will encourage all of my clients to be hopeful and treat all of them with kindness and respect.

To inspire my client's trust, I will never flatter or encourage them falsely and I will always speak the truth. Though at times I must be firm, I will never be unkind.

Realizing that a psychotherapist is in a very influential position, I will guard against any desire to control others.

I will make every effort to be aware of my own values as well as my shortcomings and try not to impose them on others.

Realizing that my clients are vulnerable to me emotionally, I will avoid romantic or sexual involvement with them.

I will respect my client's right to privacy and never treat their confidences as my property.

Though I may be paid for my services, my love is freely given and I will never allow payment to become more important than my desire to help others.

I will always be aware of my client's investment in their psychotherapy of time, money, and pain. Within the constraints of doing it well, I will complete their therapy as soon as possible.

Knowing that I may become an exemplar to many of my clients, I will always strive to be authentic and to achieve my highest level of personal growth.

With an appreciation for the uniqueness of every human being, I will strive to help all my clients realize their own potential.

Recognizing my need to understand the endless and beautiful complexity of human beings, I will dedicate myself to a lifelong study of humankind.

Though I cannot be perfect as a psychotherapist I will always be conscientious in my efforts, knowing that I am privileged to have helping others as a profession.

Robert Alan Webb, Ph.D.
June, 1986

Be Kind to Yourself

I’ve been thinking lately about my friend Bob, who died during the summer of 1992.  Bob was a friend who had a marvelous capacity for figuring out how to take care of himself. During a particularly rough period that year, Bob approached me with an important message: "I came to tell you to be kind to yourself," he said. I remember thinking "but I don't know how to do that." So decided that learning to be kind to myself would be a good theme for the year.

Then, a couple of days ago, I was talking to one of my favorite people and I felt moved to repeat Bob's message. She said, "How do you do that?" I said it starts with accepting yourself. I was still thinking about that question the next day, and Bob's message. I don't claim to really know anything. I've learned some things this year about being kind to myself. Here they are:

Go to meetings as often as you need to. Stay home as often as you need to. Socialize. Spend time alone. Be nice to your body. Laugh whenever you can. Cry when you need to. Take time to breathe. Take time to sit. Pray. Meditate. Love God. Love yourself, and if you can't, act as if you can. Set and maintain your boundaries. Be nice to people, it comes back to you. Accept compliments, and just say, "thank you." Rest when you need to. Accept your feelings. Accept your fears. Enjoy your triumphs. Enjoy people. Listen to music. Hold still sometimes. Pet your cat (or dog). Smile at someone you don't know. Don't sweat the small stuff. It's all  small stuff. Remember you are worthy. Keep it simple. Dance whenever possible. Read your favorite book as often as you like. Keep your sense of humor, and use it. Say something nice to someone. Go for walks. Offer yourself the same compassion you offer everyone else.

Blues for Oscar

Blues for Oscar
    for Oscar Peterson, 1925-2007

I can hear his music
in my head - the way he
coaxed sweetness from

the keys, or pounded
like thunder Younger
Than Springtime.

The night my father
died, I sat alone and
played Smile (though

your heart is breaking)
over and over while
I wrote dad’s eulogy.

I no longer have those
words. But the memory
of Oscar is immortal.

Twelve (stress free) Ways of Christmas, Chanukah, Kwanzaa...

The holidays are fast approaching. You probably don't need me to tell you that. Personally, I enjoy the holidays. I also know many people find them stressful. So, I've put together a list of suggestions to help people enjoy the holidays without the stress and anxiety. I hope you find these suggestions helpful. Feel free to pass them on to anyone who might need them, along with my best wishes for a joyous and relaxing holiday season.

Decide Your Limits – Don’t Over Schedule
The holiday season is a time of parties and other gatherings. You don’t have to do it all. Figure out what you truly desire vs what you feel obligated to do. Do only what you truly desire to do. Your only obligation is to enjoy yourself.

Avoid Travel
But if you have to travel, pay a little extra for direct flights. You’ll avoid the stress of having to rush from one plane to the next, or having to wait around for long periods of time. If you have to have a lay over, avoid laying over in Chicago. It’s one of the busiest airports in the world, and the winter weather often creates long delays.

Limit Car Time.
I’ve heard a lot of people say that they spend too much time in the car on Thanksgiving and Christmas – driving from one gathering to the next in an effort to see everyone. This can be exhausting. Pick one or two places you truly desire to be. It’s part of setting healthy limits and keeping a reasonable schedule.

Make a Budget and Stick by It
The holidays are a time of gift giving. This can be a lot of fun. It can also be financially stressful. Make a budget and stick with it. Ask people to make a prioritized wish list. Pare down your list. You’re not obligated to get something for everyone.

Limit Your Shopping Destinations.
Make your shopping list conform to an easy schedule. One person I know spent his entire gift budget at a book store. He bought books, cards, calendars, decorative items, journals, CDs, DVDs, lots of stuff.

Shop On Line:
Point, click and all your gifts are delivered to your home wrapped. And it’s a great way to send gifts to loved ones far away. You get to avoid the crowds and long lines at the post office, and you don’t even have to leave your desk.

Keep it Simple
Even a small gift lets people know you cherish them. Bigger is not necessarily better.

Get creative:
Make gifts, instead of buying. One year, I made loaves of sweet breads and batches of cookies, and delivered them to friends for the holidays. It was fun, easy and inexpensive.

Take Care of Yourself.
Stick with healthy eating choices. Moderation is the key, especially with sweets and alcohol. You don’t have to eat or drink anything you don’t want, even if aunt Martha made her special fruit cake (or maybe aunt Martha is a special fruit cake). Drink plenty of water to remain hydrated. And you’ll get a full feeling too.

Take Time for Yourself.
Consider it a holiday gift you give to yourself. Take a break from the rushing around, the shopping, the cooking, the cleaning. Take time out to re-read your favorite book, rent your favorite movie, take a nap.

Enjoy Family
Some people find extended family time to be stressful. Do whatever you need to do to take care of yourself. Take a break from the gathering. Go for a walk. Call someone you really enjoy talking to. Take some alone time if you need it.

Don’t Forget Routine Maintenance
Get plenty of sleep. Eat regularly. Exercise. Get a massage. Meditate. Don’t forget to breathe.

Merry Christmas, Happy Chanukah, Happy Kwanzaa!

You Are Good Enough Today

I heard a story not too long ago, and I thought it was worth sharing, because it makes an important point. Thus I have heard:

Several years ago, The Dalai Lama was on his first lecture tour of the United States. He was about to speak to a group in Los Angeles, when someone approached him to ask a question. The man wanted to know why the Dalai Lama never addressed issues having to do with self esteem. The Dalai Lama didn’t know what the man was talking about, so he asked the man to explain what self esteem was and why he thought it deserved discussion.

What he heard stunned him. Apparently, it had never occurred to the Dalai Lama that people wouldn’t feel good about themselves. In fact, the very thought that large numbers of  people feel bad about themselves made him weep.

I decided to relate this story because I encounter a lot of people who struggle to feel good about themselves. Too many people believe they’re not good enough - not smart enough, too fat, too thin, too tall, too small, just plain aren’t enough.

The point is there is no point in waiting for the next thing to come along to make us feel good about ourselves. We don’t need to be thinner, fatter, smaller, taller, look different, have more of this or less of that. The point is we are good people today.

Believe it!

A Grief Story

Dave had been clean and sober for 17 years when his father died of alcoholism. He regularly attended meetings of Alcoholics Anonymous, stayed in touch with his A.A. sponsor and diligently took the necessary steps to stay sober. In fact, it had been more than ten years since Dave had felt the urge to drink or use drugs.

Dave's father was a maintenance alcoholic. He lived alone in a one-room apartment with a bed, a chair, a television and his collection of empty bottles. He drank himself to oblivion every day. Eventually, he drank himself to death.

Some friends and associates listened politely to Dave's grief, but they seemed to lose interest after a while. Others were obviously uncomfortable talking about it and urged him to "move on." Some told Dave he was "doing fine," which meant he wasn't actively grieving in front of them and making them feel uncomfortable.

In subsequent weeks Dave started to notice a familiar tug that he hadn't felt in years - the tug of his addiction. He started to have thoughts about getting high. Then he started to feel urges, which really scared him.

When I met Dave, he was at his wit's end. He was still sober, but no longer sure he could stay that way. He was scared and confused. He was still grieving.

As time went by, Dave told me about his anger over his father's alcoholism, his sadness about the course of their relationship, his sense of frustration and loss that his father had died before they had a chance to reconcile, his fear that he could end up like his father.

As Dave continued to express, honor and validate his grief, the thoughts and urges associated with his addiction began to fade. Eventually, Dave found his way to wholeness. But he found his life, and his perspectives, had changed.

Dave is not a real person. He is a composite of people I have known. The point is that grief will always find expression. We can talk about it, express it in art or writing, etc. Or we can try to ignore it, or try to "move on," in which case it is likely to come out as behavior or compulsion. In Dave's case, it came out as the urge to drink or use drugs.

There is nothing new in grief. There's just more of it. The sadness, anger, fear, sense of loss are not, in themselves, unfamiliar. They're just more intense during grief. Nonetheless, we have few, if any, tools to deal with the intensity, the preoccupation, the exhaustion that grieving entails.

Some cultures have year-long rituals associated with death and grief. We're not one of them. So, as often as not, the bereaved end up feeling alone and isolated with their grief.

That makes periods of bereavement an especially important time to take good care of ourselves - to reach out. Help is available.

Here is a link to information on grief support groups in the Sacramento area.

Or you can call my office for information at (916) 367-2105.

Insurance Update

I wanted to let you know that I am now accepting payment from with the California Victims of Crime (VOC) programs, also known as Victim Witness Assistance, in Sacramento and Placer Counties. That means if you have been a victim of a crime anywhere in California, or are related to a crime victim, and there is a police report, you may qualify for Victim Witness funding for counseling and other services. Victim Witness will pay for my services or those of other registered providers.

For more information, or to seek assistance from the VOC Program, call at 1-800-777-9229, or go to their web site.

In other insurance news, I am now registered with Integrated Health Plans. That means I am am accepting insurance from more than 1,100 PPO insurance programs. To find out if your PPO plan covers my services, call your insurance provider. Click here for a partial list of participating PPOs.

I am happy to report that I am now accepting Magellan Health Services insurance, which includes Western Health Advantage. This is my first foray into the world of HMOs.

If you or your clients have any questions about my services, I invite you to visit my web site at www.insight-counseling.org. Thanks to those of you who have made referrals, they are always appreciated.