Blog Posts by Dr. Beverly Pedroche

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 5 Lessons I Learned From My Dog

My dog is awesome-sauce! But in addition to being man's, or in my case, woman's best friend, he is an incredible teacher of some pretty valuable life lessons. From Baxter, I have learned:

1. Communicate your needs. Make requests of others.When Baxter wants a walk, he growls at the front door. When he wants a treat, he stares at the treat jar and licks his lips (yes, I googled it. Dogs have lips...well, lip-like structures). When he wants to be petted, he nudges me with his cold, wet nose. Yet we "sophisticated" human beings stink at asking for what we want. Instead we expect others to know what we want. I, as a therapist, see this communication style in couples therapy. "He should know I want flowers for our anniversary." "By now, she should know that I don't like to drive long distances. I want her to drive." Ultimately those sessions end with someone frustratedly saying, "How would I know that? You never told me that." Avoid disappointment and communicate your needs.2. Get enough sleep!Our society loves to glorify busyness. We seem to think that being busy means we're being productive and productive means we're succeeding. The problem is (well, there are many problems with this thinking but I will stick to the topic) that there are only 24 hours in a day and if you do not prioritize rest, you will crash. Baxter has never complained to me about burnout or exhaustion. Do you know why? Yep, that boy is a napping-champion. Sleep and rest help us to recover from mental and physical exertion. Insufficient sleep increases the risk of chronic health problems and leaves you more vulnerable to mental health issues such as depression and anxiety.3. Show your love, now.No matter how long I have been gone, an hour, 8 hours, a week, Baxter is always so excited to see me and love on me. It feels so good! We humans need to do a better job of this. It's good for the giver and for the recipient. Don't wait until you see them in person. Don't think it's awkward. Just do it! Tell people what you like and appreciate about them. Tell people you are grateful for them. Express your love through words and behaviors.4. Eat the damn treat!Baxter enjoys his milk bones and we should too. I mean, we probably shouldn't be gnashing on milk bones, but we need to relax and enjoy the treats in life - dessert, a good book, time with a friend, a warm cup of tea. Slow down and mindfully enjoy the treats. By mindfully, I mean - be present for whatever treat you are enjoying. Be aware of the pleasure. Don't judge it. 5. Be enthusiastic. Wag your tail. Dogs and children are good at this. When Baxter plays with his 4-legged friends, he gets so excited! He wags his tail, spins, and pulls on his leash. Have you seen a child open a gift they love? That! That reaction! You need to find some of that enthusiasm. Tell yourself you are awesome after completing a hard or dreaded workout. Jump up and down when you pay off that credit card. We tend to dilute enthusiasm and diminish accomplishments with statements such as, "Yea, I did the workout but I did not get a personal best." Stop that! Enthusiasm is infectious, motivating, and energizing. Experience it and show it.Related BlogsIf you found this blog post helpful, I suggest these blog posts, also written by yours truly: The Darkside of Therapy, I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy, and 10 Tips for Mental Wellness During COVID-19.Learn More About Dr. Pedroche
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 The Darkside of Therapy“Go see a therapist,” they said. “You’ll feel better,” they said. Well, take it from a therapist (who has been in therapy), there’s more to the story… If you think you’re going to go to a therapist, tell them your problems, get some quick answers that solve all your life problems, and walk out feeling better, you’re wrong. Here’s what actually happens in those “therapeutic safe spaces.” 

You’re Going To Feel Like Crap! Yep, it’s true. Therapy is exhausting. You’re Going To Look Like Crap, Too! Forget the eye make-up. Bring your jade roller for those puffy eyes instead. Those damn therapists find a way to get the waterworks going. It’s some kind of weird therapists sorcery. You walk in with some pep-in-your-step ready to talk about your new car and you leave looking like a hot mess.It’s Like Being Back In School. Homework? Seriously? I just gave you $150 and you’re telling me that the “growth” happens outside of session. You’re Going to Get Called Out On Your Bullshit.So, about the aforementioned homework that you didn’t do for three consecutive weeks because, well, life. “You didn’t do your homework because you didn’t have time? Let’s explore this further. Tell me again, how much time did you spend on social media this week. In what other ways is your poor time management causing problems in your life?” Grrr! 

It Takes Time. Not only does it take more than one, or a few, sessions, the therapist won’t even give you a definitive answer. When I take my car in for servicing, I’m told a pretty specific (albeit not always accurate), time frame, “It’ll be ready at noon.” Great! Thanks! Therapy, nope. You Don’t Get Concrete Answers. What is up with that? You go in with a specific question, “Should I break-up with my boyfriend?” Do you get a yes or no? Of course not. Those therapists love to respond to questions with questions. “What do you think you should do?” Come on! If I knew, would I be asking you? BUT, keep reading…

It’s not all bad. In fact, if you stick with it, therapy can be life-changing and, in some cases life-saving. The truth about therapy is that everyone’s experience is uniquely their own. It’s different for everyone. Will you feel like crap? first. But you already do! That’s why you are considering therapy or are in therapy already. Discussing feelings and life-experiences can leave you feeling vulnerable, ashamed, raw. You might wake up the next morning with an emotional hangover. But therapy can help you better understand why you feel the way you feel and why you behave the way you do. And then the magic…how to make healthy, positive changes. You’ll learn healthy ways of coping with the crap that life throws your way. You’ll change your perspective of self and the world. In summary, the crappy feeling passes and you wind up feeling stronger, more capable, and confident. Will you look like crap? Ok, maybe that’s dramatic. But you may cry and there’s nothing wrong with that. Crying can be cathartic. Crying can come from pain but also joy, relief, and closure. Yes, there is sometimes homework (all important growth requires more than an hour per week of effort). You can’t expect to go running for an hour per week and then run a marathon. Without homework, without practicing and implementing skills outside of session, you won’t have long-term results. You need to practice your new skills, your new language, in order to become proficient. Yes, there may be gentle confrontation but it’s not judgmental. It’s an effort to help you understand your own self-sabotaging behaviors.  How long will this take, you ask. Well, it’s not forever. I know, that’s not the answer you were seeking. It depends on so many variables. I can say, however, that my goal is never for my patients to need me forever. 


Finally, why don’t we give direct answers. Well, I do sometimes but see above. I want you to learn how to problem solve and come up with answers on your own. Also, honestly, I don’t have all the answers, but I will work with you to find solutions.Just Do It...If you're reading this, you're at least considering therapy. Just do it. You have done and can do hard things. You deserve it!Related BlogsIf you found this blog post helpful, I suggest these blog posts, also written by yours truly: Yet Another Blog Post about Gratitude (Read this One), I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy, and 10 Tips for Mental Wellness During COVID-19.Learn More About Dr. Pedroche
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10 Tips for Mental Wellness During COVID-19 The outbreak of COVID-19 is causing an increase in emotional distress including anxiety, depression, and feelings of powerlessness. Here are some actions that you can take to take care of your mental health during this time of uncertainty: 1. Get Moving!  I see you there...on your couch...for the upteenth hour this week. This tip is for YOU! When you exercise, the brain releases feel good chemicals called endorphins. Who doesn't want more feel good chemicals??? Research has proved that exercise reduces depression and anxiety, improves self-esteem, and serves as stress relief. It's freaking science people! Get moving and feel better! You don't have to run a marathon of buy a state-of-the-art home gym. Do something you enjoy. Take a long walk with Fido, stretch while listening to your favorite tunes, jump on the trampoline with the kids, or challenge your best friend to a virtual competition of who can do the most body weight squats in three minutes. Get creative and have fun! 2.  Hangout With Friends...Virtually. Most of us have more free time now than usual. Use that time to virtually connect with friends. Schedule a virtual happy hour with cocktails and appetizers or spend some time in the kitchen teaching one another new recipes. Bonus - you don't have to change out of your pajamas! 3.  Try A New Hobby. If you're like me, you have a long list of interests but don't have (or prioritize) the time to invest in learning something new. Now is the perfect time! Interested in knitting? YouTube has an endless supply of how-to videos. Intrigued by the benefits of yoga? Connect with a yogi and take some virtual classes. Bought that DSL-R camera and it's still in the box? Unpack it and join a Facebook group of other amateur photographers. Or make some extra money by selling items on Ebay or another online market place. The options are endless. 4. Read Something New. It doesn't have to be a novel. Pick up a magazine from that stack you have on the end table and read an article. Pull that dusty book of poetry off the shelf and read a poem. Go online and read a blog. If you find your new read interesting, be sure to recommend it to friends. 5. Do Something For Someone Else. Research indicates that the act of doing for others can lower blood pressure, combat depression and loneliness, and reduce chronic pain and stress, all of which help to boost the immune system, fight of disease, and promote longer life. "Helpers High" is a term used for the uplifting feeling that people get after doing a good deed or act of kindness. So, doing for others feels good and is good for you. Get the whole family involved in brainstorming ways to help others while practicing social distancing. Surprise your neighbor by raking their leaves. Cook an extra dozen muffins and leave them on your friend's porch. Support a local restaurant and have a meal delivered to essential personnel who are still working. Have each member of your family or social group come up with an idea each month and keep this action going after COVID-19. 6.  Clean Out Your Closet. Stay with me here...clean out your closet, your pantry, your garage with the intention of donating things you don't or rarely use to someone in need. Get the kids involved - have them clean out their closets and toy boxes. This is a good opportunity to teach them about both decluttering and donating to those who have less. 7. Have An Attitude Of Gratitude. Look, let's be honest. It's an anxiety provoking time. A lot of us are worried not just about our physical health but also our financial health. The news seems full of negativity. One way to counter all the negativity is with gratitude. Make a gratitude list and keep adding to it. Or, my favorite, take a meditative gratitude walk. Create a mental gratitude list while walking (Yay! 2-for-1....exercise and gratitude). From a psychologist perspective, the efficacy of gratitude practices lie in the ability to retrain the brain. By intentionally thinking grateful thoughts, even and especially when you aren't feeling particularly positive, you have the power to change your emotions. So, you shift from identifying good things to be grateful for to realizing that the act of being grateful makes things good. 8. Write A Letter. Each day pick a person and write them an old fashioned letter. In your letter, express your appreciation for that person. Identify what it is that you like and love about them. Recall a happy or funny memory you have with them. This is also a great activity for children and teens. Have fun with pretty stationary, stickers, and colored pens. Think outside the box. It doesn't have to be just friends and family. How about a letter to the helpful office staff at your doctors office or the veterinary technician who helps calm your pet during routine visits? For the cost of a stamp (or less), you have the ability to make someone's day. 9. Don’t Neglect Self-care.   Self-care isn’t just about pedicures and massages.  Self-care is anything you do to “fill up your gas tank.”  Daily tasks require gas from our human (emotional and physical) gas tank.  Like a car, if you don’t refuel, you’ll stall out.  Self-care is subjective.  What you do to refuel could be very different from what I do.  And self-care doesn’t have to cost money.  A long walk, a nap, or reading a book are forms of self-care.  Self-care is also about what you do not do. Do not watch an excessive amount of television, don't spend hours at a time on social media, and don't drink too many Quarantinis.  10. Therapy. Depression, anxiety, loneliness, drug and alcohol use are currently increasing. There are many therapists who are offering teletherapy (psychotherapy by video or even phone). More insurance providers are covering this form of treatment. Don't have insurance? There are some therapists who are offering reduced priced services. Don't hesitate to ask.  Related Blogs If you found this blog post helpful, I suggest these blog posts, also written by yours truly: Yet Another Blog Post about Gratitude (Read this One), I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy, The Dark Side of Therapy, and What is Psychotherapy?       Learn More About Dr. Pedroche
Overcoming The Mental Illness Stigma 5 Ways You Can Help One in five Americans, according to the National Alliance on Mental Illness (NAMI), experiences a mental illness in their lifetime and one in twenty-five experiences a a serious mental illness that interferes with or limits one or more life functions. Despite these numbers, according to, only 44% of adults with a diagnosable mental illness and less than 20% of children and adolescents receive treatment. While there are many reasons for this gap in care, one of the most commonly reported reasons for not receiving treatment is the stigma.  What Is Mental Illness Stigma? Mental illness stigma occurs when someone views a person in a negative way because they have a mental health disorder. It is a mark of disgrace that differentiates one from others, a negative belief system and negative behaviors that creates a prejudice which leads to damaging actions and discrimination. Stigma has been described as a feeling of shame or judgment from others. Stigma, however, can also be internally based, a personal belief that mental illness is due to weakness or is self-induced. Harmful Effects Of Stigma Include: Lack of willingness to obtain treatment (which can exacerbate the mental illness/condition) Lack of understanding/support from family, friends, coworkers, etc. and a subsequent feeling of isolation Bullying or harassment Discrimination in housing, employment, education A negative impact on self-esteem, self-confidence Feelings of shame and hopelessness Myths About Mental Illness Part of the reason that mental health stigma is so prevalent is due to the lack of knowledge.  Myth:  Mental illness is rare. Truth:  According to Mental Health America (MHA), 43.7 million Americans struggle with a mental health condition annually. If you are not one of those people, I can assure you that you know someone who is. Myth:  People with mental illness are violent and dangerous. Truth:  Most people with serious mental illness are never violent. In fact, people with serious mental illness are far more likely to be victims of violence that the perpetrators of violence. According to the U.S. Department of Health and Human Services, those with severe mental illness are over 10 times more likely to be the victims of violence than the general population. Myth: People with mental illness are weak, damaged, or different. Truth: Mental illness is not the fault of the person who has the condition. It is caused by a complex interplay of genetics, biology, social and environmental factors.  Myth: You can tell when someone has a mental illness. Truth:  People with mental illness can be just as functional and productive as those without. Many suffer in silence. The symptoms of mental illness are not always visible to others. There are many highly successful people who have achieved despite their illness including singer, Demi Lovato (bipolar disorder, anorexia, addiction), actress, Emma Stone (anxiety), and Novel Prize Winner in Mathematics, John Nash (schizophrenia). 5 Ways You Can Help Diminish The Stigma On Mental Health Speak out against stigma and educate others. Talk openly about mental health. Consider sharing your knowledge at local events, via  a lecture at a local high school or library, or open up a dialogue at your own dining room table. Educate your family. Explore their questions and misconceptions. Part of a book club? Select a book that addresses mental illness or features a character with mental illness. Share accurate articles about mental health on your social media. Be aware of your own slang. People often use mental health diagnoses as pejorative descriptors that can be hurtful to those with mental illness. "My ex is totally schizo," "The weather is so bipolar, " I'm so OCD about my clothes matching." If you are guilty of this habit, be cognizant of your language and make a change. If you're in the presence of someone who inaccurately uses these terms, educate them in a caring and compassionate manner.  Act! Be part of a community organization. Participate in local mental health advocacy and/or fund-raising opportunities. Local and national groups, such as the National Alliance on Mental Illness (NAMI) are often seeking volunteers for an array of tasks. Show compassion for those with mental illness. See the person, not the condition. If someone you know or love is experiencing a mental illness, don't try to "fix" them. What is not helpful are phrases such as, "Just look on the bright side," "You have such a good life," or "You have no reason to be depressed." Instead, inquire about how you can help. Sometimes just being present and demonstrating a non-judgmental approach, listening, and offering support is beneficial. Should the person ask for further help, you can assist them with connecting with resources. Perhaps aid them with scheduling an appointment with a psychologist or psychiatrist, offer to drive them to an appointment, help them research local mental health support groups, or offer a weekly "coffee date" so that they feel less isolated. Model self-care. Be kind to yourself and engage in self-care. Whether you have a mental illness or are supporting someone with one, self-care in imperative to mental health. Self-care is anything that "fills up your gas tank" and can be as simple as taking time to read a book to saying "no" to something that feels overwhelming. Mental health stigma almost always stems from a lack of understanding. Make the decision to make a difference by helping educate someone today! Related Blogs If you found this blog post helpful, I suggest reading my recent blog posts: The Dark Side of Therapy, What Is Psychotherapy and Reasons NOT to Use Your Insurance For Psychotherapy. Learn More About Dr. Beverly Pedroche 
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Sober And Still Unhappy You admitted that you have a problem, that you were powerless and all that jazz. You survived the physical detox process that, by the way, was not a mere "7 to 10 days." You're feeling like a crazy person. You're not exactly sure what serenity feels like, but this definitely is not it. Your emotions are all over the place. You can't cope with the slightest discomfort. Everything is stressing you out. Reading this article is stressing you out and you're ready for me to just get to the point, right? So, What Exactly Is Wrong With You? Dual Diagnosis...Maybe... When an individual suffers from both addiction and a mental disorder (such as depression or anxiety), it is called a dual diagnosis. The risk of relapse is high for those who are dually diagnosed unless the individual seeks treatment for both the substance abuse and the mental illness. According to Oltmanns and Emery (2007), approximately 40% of people with alcoholism have experienced a major depressive episode at some point in their lives. The authors also state that "people with anxiety disorder are about three times more likely too have an alcohol use disorder than are people without an anxiety disorder" (Oltmanns & Emery, 2007, 188). Unfortunately, people who are dally diagnosed experience more life problems than people with addiction alone including homelessness, criminal behavior, and suicide (Knowlton, 1995). Doesn't it make sense that if you have a dual diagnosis, that you seek dual recovery? Not Dually Diagnosed? So, you don't meet criteria for a mental illness, but you're still miserable. Maybe you're angry at yourself...or the world. Pity party - check. Your relationships (the ones that are left) are riddled with mistrust, resentments, and anger. Perhaps you're unemployed, dealing with the financial repercussions of your addiction, or you have legal problems. You stopped using, but your problems didn't disappear. In fact, they seem worse than ever! Ok! Ok! Now What? Even if you achieve physical sobriety, without learning how to cope with life, you place yourself at high risk of relapse. It's possible, and even likely, that you were experiencing all those negative emotions before you started using. Many people use to cope with uncomfortable emotions. Drugs and alcohol serve as numbing agents. And now that you've lost that anesthetic, all those feelings have come rushing back with a vengeance, accompanied by some new problems. You don't have to figure out if you are dually diagnosed or not. A mental health professional, such as a psychologist who is experienced in the area of addiction, can assess for a mental illness. Let them figure that part out. In therapy, you will learn ways to cope with your mood, stress, anger, anxiety, feelings of worthlessness, and resentments. It's imperative to your sobriety that you resist the urge to run away from or avoid emotions. You want to be able to experience and cope with your feelings and not become paralyzed by emotions. You will also explore what led to your addiction and you will hone your relapse prevention skills. You might include loved ones in therapy sessions in order to take steps towards improving your relationships. Therapy is also an opportunity for them to learn more about the disease of addiction and how to best support your recovery. Good News! You're completely normal (whatever that means). The disappointing truth is that getting sober does not immediately result in your life getting better. But being sober is empowering. You now have the power to take action and make your life better. You are no longer completely powerless. If you're going the same things over and over again, you're going to get the same results. It's time to try something different. A psychologist, educated and experienced in the area of addictions, is a professional who has heard stories like yours and who can help you cope more effectively, rebuild and repair relationships, and prevent relapse. Related Blogs If you found this blog post helpful, I also suggest reading my recent blog posts The Dark Side of Therapy, What is Psychotherapy and Reasons To Consider NOT Using Your Insurance for Psychotherapy. Learn more about Dr. Beverly Pedroche
I Don't Have Time For Therapy... And Other Reasons to Consider Online Therapy So, you're interested in obtaining psychotherapy but don't want to take off hours from work to drive to a therapist's office, meander around searching for parking, and then drive back to work after an emotionally-laden session. I don't blame you. Wouldn't it be nice if your therapist could just come to you? Well, I've got good news. Keep reading. What is Telepsychology? Telepsychology is one term used to describe psychotherapy services offered via phone, interactive video, email, or text messaging. You may have heard these services referred to as distance therapy, e-therapy, virtual therapy, or web therapy. In this blog, I will be speaking of telepsychology services that are provided real-time via on-line video. Reasons to Consider Online Video Therapy: Confidentiality. Unfortunately, it is not unusual for clients to worry about the stigma of seeing a therapist. Telepsychology offers a degree of anonymity that helps reduce stigma-related fears. Many of my clients who are professionals, worry that they will encounter their own patients or clients in my waiting room. These apprehensions can be alleviated with telepsychology. Efficiency. Efficiency is one of the primary reasons my clients utilize telepsychology services. A 45-minute sessions takes up 45-minutes of their time. No more leaving work early to sit in traffic for their session. They can complete a therapy session during their lunch hour and still have time for a sandwich. Convenience. No sitter? No transportation? Got the sniffles? You can still have your therapy session, as long as you have internet access. Comfort. Many people find that being in their own "space" is more comfortable and some find it easier to share revealing, personal information if they are in the comfort of their own home. Furthermore, I have had clients say that having their pet or their favorite pillow by their side during virtual therapy is an additional source of comfort that is not available in my office. Access. Telepsychology can be especially beneficial for clients who live in rural areas or underserved communities where there is a shortage of therapists or a lack of specialized providers. Online video therapy allows the client access to more clinicians and specialists who may not be within a reasonable driving distance. How Does Online Video Therapy Work? There are some differences among the various telehealth platforms, but typically you will click on a link that is received in a confirmation Email or log in to the website. There may be a few-second download the first time the service is used. You then, usually, enter a virtual waiting room. Ta Da! It's that simple. Both video and audio should be on. Headsets/earbuds provide additional privacy and are recommended. You should discuss with the therapist what the plan is if connectivity is lost. My backup plan A for these situations is to complete the session by phone. For the most part, however, if your device can stream services like Netflix, you shouldn't have any significant problems using online video therapy. The experience is similar to using Skype or FaceTime. The Questions You Should Ask: Does My Insurance Cover Telepsychology?  While more and more insurance companies are now covering telepsychology services, not all are. You'll want to call your insurance company directly and ask about whether or not telehealth services are a covered service. Is It Safe? Confidential? One of the reasons that psychotherapy is effective is because the psychologist ensures that you have a safe and private space to share your thoughts and feelings. An online video session should also feel like and be a safe space. You should ask is the service is HIPAA compliant, indicating that your privacy is maintained.  Where Is The Provider Licensed? While there are a few exceptions, psychologists must be licensed in the state where you are located to order to offer therapy services. Need Help? Get It! According to the National Alliance of Mental Illness, one in five Americans struggle with mental illness. Yet, only one third of these people obtain treatment for various reasons. Some of these barriers can be alleviated with telepsychology. Telepsychology is rapidly growing. Despite all the benefits, however, telepsychology is not for everyone. If you contact a therapist who provides telepsychology services, they will ask you several questions to assess your appropriateness. Furthermore, you may find that face-to-face treatment is more effective for you. If you need help, get it...via whatever modality is beneficial for you. Related Blogs If you found this blog post helpful, I also suggest reading my recent blog posts, The Dark Side of Therapy, Reasons to Consider NOT Using Your Insurance for Psychotherapy and What Is Psychotherapy. Learn More About Dr. Beverly Pedroche
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Reasons NOT to Use Your Insurance for Psychotherapy So, you're interested in getting some therapy and you have insurance. Perhaps you've even selected a therapist. What else is there to think about other than scheduling, right? Well, keep reading... A Psychologists' Perspective I believe that they duration of treatment (number of sessions), what is addressed in treatment, and the type of treatment provided should not be dictated by your insurance company (people who have never met you and may not even be medical professionals). These decisions should be made jointly by you and your therapist. Unfortunately, insurance can become a hindrance to obtaining effective, specialized mental health treatment. A Clients' Perspective As the recipient of therapy, here are just some of the reasons to consider not using your insurance for therapy: Control of Treatment You may choose the professional who you believe is the most competent to treat you. If you use your insurance, you are often restricted to seeing providers on the insurance company's list, many of whom have long wait lists. Additionally, insurance will often dictate your number of sessions and even what specifically can be treated. By not utilizing your insurance, you and your therapist can make these decisions together, based upon your individual needs. Avoid Interruptions to Treatment When visits are preauthorized by insurance companies, often only a few sessions are granted at a time. When these sessions have been used, your therapist must justify the need for continued treatment and this process can lead to an interruption in your treatment. There are times when additional sessions are not authorized, leading to unexpected out-of-pocket expenses for you or an end to the treatment, even if goals have not been met.  Increased Confidentiality Your insurance company may request details about your treatment, and can even request the entire medical record. Your treatment becomes part of your permanent medical record. In summary, you lose control of your information, who accesses it, and how it will be used.  Not Carrying a Mental Health Diagnosis on Your Medical Record Insurance companies typically require a mental health diagnosis in order to receive reimbursement. Psychiatric diagnosis can negatively impact you (i.e., denial of insurance when apply for disability or life insurance, higher deductibles and copays, etc.). Furthermore, you may wish to address non-psychiatric issues such as improving communication skills or coping with the stress of a new job. These non-diagnosable issues are not usually reimbursable.  Other Options to Paying Out-of-Pocket If you can not afford the full out-of-pocket cost of a therapist, another possibility is to explore options for reduced-rate or sliding scale fee therapy. Many therapists have a select number of "slots" for individuals who want therapy but can not afford the full rate. Don't hesitate to ask. Another possibility is to utilize pre-tax money, such as Flexible Spending or Health Savings Accounts to pay for therapy. Finally, most counties have a community mental health center and some universities offer more affordable psychotherapy that is provided by interns or post-doctoral students who are supervised. If You Need Help, Get It! If utilizing your insurance benefit is the only way to obtain therapy, by all means do so! I am certainly not proposing to never use your insurance for treatment. I am simply encouraging you to consider all options and make an informed decision that is right for you given the information I have shared. Related Blogs If you found this blog post helpful, you might enjoy other blog posts by yours truly: The Dark Side of Therapy, Yet Another Blog Post about Gratitude (Read this One), and I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy. Learn More about Dr. Beverly Pedroche
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Yet Another Blog Post about Gratitude (Read this One) It’s that time of year where every other blog post is about gratitude.  ‘Tis the season, right?  According to David Steindl-Rast, a Catholic Benedictine monk, scholar, and author, who has inspired generations with his inspirational messages about finding gratitude in every moment of life, "The root of joy is gratefulness."  Well, who doesn't want joy?  But how does one do about becoming more grateful? The Stack of Blank Gratitude Journals Most people have heard of a gratitude journal.  Oprah kept one daily for a decade and recommended that we all follow suit.  But if you can barely remember or find time to brush your teeth before bedtime, you may find it hard to consistently keep a gratitude journal.  Don’t get me wrong, it’s a great idea with many benefits. I have a collection of lovely journals including several attractive ones with motivational quotes on the cover that I just had to have. Unfortunately, none of those quotes were motivating enough to keep me journaling beyond a couple of weeks. Mornings Suck I don’t like mornings.  Well, I didn’t.  This is relevant…stick with me. I would begrudgingly drag myself out-of-bed after being startled awake by sounds similar to that of a fire alarm because waking up to Enya just isn’t effective for me.  After completing my basic hygiene routine, I’d leash up the dog and head out for his first walk of the day.  During this walk, I found myself complaining (possibly out loud at times) about anything.  “It’s so early.” “It’s so hot.”  “Geez! It’s too cold.” “The dog is taking so long to poop.  Hurry up pup!” “Why did I schedule my first patient so early?” “Why did I schedule myself to work today? Lots of people are off on Mondays.” You get the idea. My Alternative to The Gratitude Journal Needless to say, mornings were miserable.  Or, more accurately, I made mornings miserable for myself (and possibly for those around me for the first few hours of my day as well). I made a decision, and I wasn’t sure what would come of it, that starting on January 1, 2016, I would create a mental gratitude list while walking Fido each morning.  The premise was to shift my mental focus from all that was wrong to that which is good.  Let me be candid.  I did not spring out of bed on the first morning (ok, I still don’t spring out of bed and I’ve been doing this for years).  I completed my usual hygiene routine, headed out with my fur-kid, and assuredly started my mental gratitude list while walking.  “I’m grateful for my life, my health and my house. I’m grateful for my family and friends. I’m grateful for my dog, my job, the food in my fridge.” I blew through about 20 things that I am grateful for.  Piece of cake, I thought. I then realized that I was only about 6 feet from my front door and, you guessed it, the dog hadn’t pooped yet.  The negative thoughts quickly popped to the surface of my consciousness. “This crap doesn’t work.” “It’s cold.  Why is it cold in Florida?” But I redirected myself back to my plan – create a mental gratitude list. Keep going.  And I did. The longer the walk, the more frequently I became distracted and the more difficult it was to find things to be grateful for.  I later learned that it was at that very point…the point where I really had to think about the good in my life…where the magic happened.  I started to reframe negative thoughts into positive thoughts.  Instead of thinking, “Ugh, I am so busy today,” I thought, “Wow! That’s great. Lots of people see the benefit of therapy and I am grateful and humbled that they are working with me.” Instead of, “I feel like crap today. My throat is so sore,” I thought, “I don’t feel great, but I’m grateful that I feel well enough to take this walk and have lunch with my friend.”  While my new-found attitude of gratitude didn’t change the fact that my throat hurt, it did change the way that I feel about the situation. The Magic I don’t know exactly when it happened, but it happened.  My complaints and negative thoughts became more easily reframed into positive thoughts.  My mood improved as my thoughts improved. I was doing Cognitive Behavioral Therapy on myself.  By changing my thoughts, I changed my feelings.  And by changing my feelings in the morning, my tone for the day was more positive and more calm. Other Alternatives to The Gratitude Journal So, if the gratitude journal and walking gratitude walk aren’t for you, there are other options.  When your alarm clock goes off, hit snooze. Yep, you read right.  But don’t go back to sleep.  Spend those minutes creating a mental gratitude list.  It’s a version of my exercise but without the dog and the outdoors.  Another option – create a gratitude photo album.  If you’re thinking circa 2005 scrap books, don’t panic.  Consider creating an album on your smart phone with photos that you take daily of things that you are grateful for.  Set a minimum number and snap away.  Review the album when you’re feeling down or irritable.  Another option – digital gratitude! Tweet or post or text someone with a positive message daily.  Get creative and find what works for you. Your Brain on Gratitude From a psychologist perspective, the efficacy of gratitude practices lie in the ability to retrain the brain. By intentionally thinking grateful thoughts, even and especially when you aren’t feeling particularly positive, you have the power the change your emotions. So, you shift from identifying good things to be grateful for to realizing that the act of being grateful makes things good. I practice Cognitive Behavioral Therapy (CBT) and the (very simplified) premise behind CBT, a scientifically validated for of psychotherapy, is that by changing thoughts, you change feelings.  Gratitude exercises, over time, have the ability to do just that.  We can become increasingly aware of the positive in our life and, furthermore, we learn to reframe (a technique taught in CBT) our negative and unhelpful thoughts into optimistic and productive thoughts. Related Blogs If you found this blog post helpful, stay tuned for these upcoming blog posts by yours truly: The Dark Side of Therapy and I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy. Learn more about Dr. Beverly Pedroche
‘Tis The Season To Be…Stressed!5 Tips for Coping with Holiday Stress If buying the perfect gift that’s likely out of your budget, baking an exquisite dessert that can could compete with those made by Martha Stewart, attending drunk Uncle’s holiday party, decorating your home to look like a photo straight out of Town and Country magazine, all while managing your usual daily responsibilities leaves you feeling overwhelmed, you aren’t alone.  Stress, anxiety, and depression can crush your holiday spirit and be detrimental to your physical and mental health.  Here are some practical tips to help you fend off the holiday blues:  1. Just Say No.  I recently heard a quote that is my new favorite:  By saying yes to one thing, you’re saying no to something else.  I tried to find the original author, but it appears that many people are taking credit for this brilliant thought.  By agreeing to participate in a 3rd Secret Santa, are you taking an hour away from snuggle time with your kids or giving Fido his much-needed bath?  I know that it can be hard to say no and even harder to rescind an offer once you agreed to do something.  However, learning to say no can prevent burnout or even resentment.  If you’re unsure, it’s okay to ask for time to think about it. You can also negotiate and make an offer that’s do-able for you.  For example, “Susie, I do not have time to bake a dessert, but I would be happy to pick up a cake from the grocery store.  Would you like for me to do that?”  And if you just don’t want to do something, you could say, “Thanks for asking, but I do not have the time” or “I’m not available to help out this year.” Remember, there are only 24 hours in the day; how do you want to spend your 24 hours? 2. Don’t Neglect Self-care.  Self-care isn’t just about pedicures and massages.  Self-care is anything you do to “fill up your gas tank.”  Daily tasks require gas from our human (emotional and physical) gas tank.  Like a car, if you don’t refuel, you’ll stall out.  Self-care is subjective.  What you do to refuel could be very different from what I do.  And self-care doesn’t have to cost money.  A long walk, a nap, or reading a book are forms of self-care.  Self-care is also about what you do not do.  Saying no and setting boundaries are a form of self-care (See above). 3. Set Realistic Expectations. Pinterest can be great for ideas, but you probably don’t have time to arm-knit chunky blankets for twenty of your closest friends.  Be kind to yourself.  Don’t strive for perfection.  Things will go wrong.  You’ll run out of time.  And then…it’ll all be over.  Don’t let your goal of perfection take away from your experiences with family and friends. 4. Avoid Overspending. Set a budget and stick to it.  Suggest a family or office gift exchange to decrease the number of gifts you have to purchase.  Better yet, give gifts from the heart like baked goods delivered on a re-usable platter or a “coupon” for your neighbor to walk her dog.    5. Feel. The holidays aren’t merry for all.  If you’re missing a loved one or just feeling like Scrooge, allow yourself to experience those emotions.  But don’t isolate.  Seek professional help if needed.  You aren’t alone if you need extra support during this time of year. Related Blogs If you found this blog post helpful, I suggest these blog posts, also written by yours truly: The Dark Side of Therapy and I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy. Learn more about Dr. Pedroche
What is Psychotherapy? Good news!  You don’t have to lie on a couch and blame your mother for all life’s problems. Psychotherapy is the process of meeting with a therapist, if it’s with me – a psychologist, to resolve problematic issues through talk-therapy. Through therapy, you will gain improved understanding of your own thoughts, feelings and behaviors, learn skills to cope with your difficulties, and obtain guidance.  It’s different from just talking to a friend because therapists are trained to utilize scientifically validated techniques to help you live a healthier and more content life.  It’s an interactive process and depending on the therapists’ orientation (a fancy term for the way the therapist understands and treats your problems), both you and the therapist will be talking to some extent.  For many people, just having a place to share their feelings openly, without fear of judgment, is helpful.  What To Expect in a Psychotherapy Session Your first session with the therapist is often longer than typical sessions.  During this session, the therapist will ask you many questions such as why you are seeking therapy and what your goals are for therapy.  Just do your best to answer questions thoroughly.  The therapist will review rules regarding confidentiality and their policies regarding cancellations, payments, etc. You, too, should ask questions.  Think about this first meeting as an interview…you are interviewing the therapist to assess whether or not they have what you are looking for.  So, what are you looking for?  You want a therapist who has experience treating your specific problem.  You may also want to ask them about their schedule if you need specific appointment hours such as evenings or weekends.  You’ll want to discuss fees (although you should probably make this inquiry when you call to set up the appointment).  You shouldn’t feel pressured at the end of the session to make an appointment.  If you need some time to think about it, or to interview other therapists, that’s completely acceptable.  What Therapy is Like with Me as Your Therapist I have a waiting room that I share with other mental health providers.  It’s like other waiting rooms – it has dated music playing and a stack of boring magazines that need to be purged.  If you’ve forgotten your phone in the car or at home, you’ll pretend to read said magazines.  But, I digress… During the first meeting, I ask lots of questions to help me get to know you better and figure out if I’m the right person to help you.  You should ask questions too and then we decide how to proceed.  The options are: (1) you elect to not schedule a follow-up at that time or elect not to proceed with me at all (2) I don’t feel like I am a good fit for you so I refer you elsewhere or make other suggestions or (3) we both feel comfortable with proceeding and schedule a 45-minute follow up (some therapists schedule 60-minutes). Depending on how you’re functioning, we may meet as frequently as twice per week or as infrequently as a few times a year.  Typically, however, clients start with weekly to biweekly sessions.  During these sessions, I inquire about how you are “functioning.”  By functioning, I want to know…how is your mood, are you taking care of yourself physically and emotionally, have you engaged in social events, are you able to concentrate at work, how are you managing stress, etc. I use cognitive-behavioral therapy, so my clients learn new ways of thinking, behaving, and managing their emotions.  One of my goals is that my clients learn coping skills that they can apply to other problems in the future.  As my clients improve, together we decide upon the right time to decrease the frequency of sessions and eventually terminate therapy. Related Blog Posts If you found this blog post helpful, I suggest these blog posts, also written by yours truly: , and The Dark Side of Therapy, I Don't Have Time for Therapy...And Other Reasons to Consider Online Therapy, and Yet Another Blog Post about Gratitude (Read this One).  Learn More about Dr. Beverly Pedroche
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