Practice Empathy in Three Ways: Cognitively, Emotionally, and Somatically

You must first take off your own shoes to put yourself in someone else's shoes.

We stretch our hearts and minds beyond our own experiences, viewpoints, and feelings in order to imagine what it's like to be inside someone else's head. We employ imagination, creativity, and instinct to envision what life is like for them.

Listening with empathy is a fundamental component of coming from curiosity and care, as well as the foundation of discussion. Here are three strategies to start practicing incorporating more empathy into your daily life that integrate living purposefully and empathetically.

PRACTICE: Empathy

It's important to remember that practicing this doesn't have to be limited to situations in which you are the center of attention. Its easier to feel for others when you aren't being attacked. Remember that empathy isn't something you put into words; it's a quality of presence in your heart. Aim to comprehend the other person's situation and let the conversation unfold organically.

SILENT EMPATHIC PRESENCE: Practice listening completely, with the heartfelt intention to understand and "feel into" what the other person is saying. How is this issue for them?

PARAPHRASE: After listening, summarize the gist of what you've heard. What are the key features of what they've said? It's also possible that repeating just a few words will be enough.

EMPATHIC REFLECTION: After listening, check that you understand by reflecting what you hear is most important to them. This may include how they feel and/or what they need. What's at the heart of this individual's narrative? What can you do to assist them to feel understood? Remember to phrase your reflections as questions and double-check that you're correct.

There are other methods for conveying compassion. We may convey empathy by giving a kind word, with a loving touch, or by describing how we're feeling in response to what we've heard. By expressing interest with open-ended questions like "Tell me more," "What else?"

As an example, my daughter's friend a freshman who is usually cheerful and bubbly, began showing up early to practice. I struck up a conversation and realized how much she was struggling. This friend was saying, "I don't want to go to this school anymore," and was thinking about dropping out. I noticed the impulse to go into problem-solving mode, an old habit of mine. Having just finished another book on empathy, I paused and decided to try listening instead. "Tell me more. What's going on?"

She began to open up. She was being bullied. She felt sad, alone, and depressed. Every time I noticed the urge to fix or solve, I attended to feeling the weight of my body and my feet on the floor, and resisted the temptation to offer solutions. I focused my attention on what she was feeling and reflected what I was hearing. She began to cry, oscillating between speaking, sobbing, and awkwardly making eye contact as if to check whether all of this was okay. There were a lot of tears, tissues, and long moments in which I simply held her gaze.

She spoke more about her feelings of sadness, loneliness, and not feeling valued. "I've felt like this since first grade," she mentioned. "Was that the first time you felt so sad and alone?" I inquired. No, it started when she was three, when her dad left. They looked at each other, realizing they'd hit the root of her pain. Eventually they explored what she might need at school. They came up with some strategies to address the bullying. She decided to stay in school and to make a public art piece for the classroom about depression.

This is the power of which empathy may help us. With a listening spirit, we can absorb each statement made, each emotion felt. Healing and change are possible if we come from a place of curiosity and care rather than our usual mode of behavior.

PRINCIPLES

People are more likely to be willing to listen when they feel heard. To build understanding, reflect before you respond.

KEY POINTS

The desire to comprehend is frequently expressed through listening, which entails putting away our own ideas, emotions, opinions, and views temporarily.

We can listen in many ways:

• With complete, wholehearted presence

• To the content of what someone says

• To the feelings and needs beneath the content

Staying connected in conversation helps us build understanding and

collaborate:

DON'T LET THE CALL DROP: Seek to establish and maintain connection in conversation.

REFLECT BEFORE YOU RESPOND: Confirm that you're hearing each other accurately before moving on. This "completes a cycle' of communication.

At the heart of listening is empathy, which includes:

• Cognitive empathy: seeing things from another's perspective

• Affective empathy: feeling another's emotions

• Somatic empathy: sensing another's embodied experience

Q & A

Q: What if someone wants advice? Is that ever okay?

Of course. When someone asks for advice, you might try offering empathy

first. I'll often say, I'm happy to share some of my ideas, but first I just want

to take in what you've said. I'll follow that with an empathic reflection of

what I'm hearing and check if I've understood. This can help the other

person process their experience and clarify what matters. I then circle back

to inquire if they still want advice; sometimes it's no longer relevant.

If the tables are turned and you want to give someone advice, check

first. Let them know: "I have an idea that I think might be helpful. Are you

open to some advice?" This honors their autonomy, minimizes the chances

that your input will be disempowering, and guards against giving advice

as a way of soothing your own anxiety.

Q: I've been exploring these empathy tools with close friends and family

and my new approach creates a lot of awkwardness. What do you do

when others expect you to communicate in a certain way?

It can be confusing when our attempts to create more connection backfire.

Part of what you are experiencing is the relational dimension of communication habits. They occur in a dynamic, so when we shift it affects others.

It also may simply be the learning curve; it takes time to find an authentic

voice with these tools.

Let go of the form and focus on your genuine intention to connect.

What would help this person to feel heard? If someone is used to us

showing care by asking questions or agreeing and we respond by reflecting

their needs, that may throw them off. Try to tune in to what they want.

When all else fails, let people know that you're trying something new that

you hope will bring you closer. Ask them to humor you while you learn.

Empowering Couples to Communicate Compassionately~ Using Non-Violent Communication (NVC)

The process of non-violent communication (NVC) was developed by Marshall B. Rosenberg and encourages us to connect with others in a more heartfelt and empathetic manner. NVC emphasizes the significance of language in our day-to-day encounters, calling for conscious responses, instead of reactions, based on perceptions, feelings, needs, and visions for what we DO want to see happen.

The Four Components of NVC

There are four basic components to NVC that include observations, feelings, needs, and requests. What actions are we seeing around us that have an impact on our well-being? How do we feel based on what we've seen or heard? What need, desire, or value sparked those feelings? All negative feelings are unmet needs. Finally, how may we make positive requests of others that will improve our lives? These elements all work together to create NVC's foundation.

Our Language Shapes Our Thinking

Sometimes our thoughts sabotage our needs. It is helpful to gather more data and not just react from our triggers or automatic thoughts. Our thoughts produce the way we feel. Negative thoughts point to an unmet need. If I don't know what I need and react from the story that I tell myself, a lot of bad habits can form from this bad habit. Instead, I can gather more data, not just from thoughts but I want to drop down and gather more data from my feelings, where my feelings live somatically in my body, and what needs I have. When I discover my needs, I am in a powerful position to get my needs met. If I do not know what I need in real time, I may react and sabotage my needs which disconnects us from ourselves and other people in our lives.

All attacks are unskilled ways of trying to get a need met. Attacks create disconnect and defensiveness. Using NVC helps us accept influence and stay connected even through some of the most difficult conversations.

NVC not only challenges us to change the way we talk to one another, it also challenges us to change the way we think and perceive the world around us. In other words, NVC is not just a process of communication where words are simply exchanged. We must reframe our thinking so that we are able to genuinely express ourselves and be empathetic to what others are observing, feeling, needing, and requesting. NVC is truly an amazing process that empowers us to connect with one another in a compassionate way.

How to Calm The Jackal and Put on Your Giraffe Ears

Marshall Rosenberg conceptualized our tendency toward aggression and dominance as a jackal, while our more compassionate side he imagined as a giraffe (since giraffes have the largest hearts of all land mammals). When we listen with Jackal ears, we hear complaints as criticisms and requests as demands. When faced with a demand, collaboration isn’t possible. You either submit or you rebel which disconnects us and neither feels good, nor works well in a long-term relationship.

Conversely, when we put on our Giraffe ears, we listen with more empathy and compassion. We are more likely to hear the feelings and the needs behind what someone is saying. We’re more likely to see those needs as being understandable and reasonable, and not in competition with our own needs. When we understand and empathize, compromise and collaboration become feasible.

Nonviolent Communication in Couples Therapy

With couples, NVC bridges the gap in understanding between each partner and helps counter the judgmental negative stories that may build up about the other person:

“They’re lazy.”

“They’re not putting in as much work as I am.”

“They don’t love and care about my feelings.”

These interpretations or evaluations discourage us from being vulnerable and trusting the other person, and they prevent us from making needed changes. When we choose to replace those judgmental stories with greater understanding, more connection is possible.

NVC may challenge our preconceived notions about others and the world, which can help us to appreciate one another and live more freely. When the guy who is cutting me off in traffic stops being a jerk and becomes a person going through something terrible in their own life, I am able to let go of my anger. When I recognize that my difficulties in keeping my home clean aren't "laziness" but rather a battle for motivation or a desire for "rest and recuperation," the self-compassion I gain not only lessens my suffering, but it also increases the likelihood that I will be able to satisfy that need AND keep my house clean.

Whether you’re looking for Couples Therapy or Individual Counseling, Nonviolent Communication (NVC) can help you create the life you want to live together as a team.

Defensiveness & Emotional Flooding: Understanding Our Nervous Systems

DEFENSIVENESS

At its core, defensiveness is a way to protect our ego and a fragile self-esteem. Our research team member Ellen Alley explains that our self-esteem is considered fragile when our failures, mistakes, and imperfections decrease our self-worth. In our work, the opposite of a fragile self-esteem is grounded confidence. With grounded confidence, we accept our imperfections and they don’t diminish our self-worth. It makes sense that defensive-ness occurs in areas of our lives where we have fragile self-esteem, or across several areas of our lives if the fragility is more general. Any perceived call-out of our weakness is experienced as an attack on our worth, so we fight hard to defend ourselves against it.

In order to try to limit our exposure to information that differs from how we think of ourselves, we get defensive and overjustify, make excuses, minimize, blame, discredit, discount, refute, and reinterpret. Defensiveness blocks us from hearing feedback and evaluating if we want to make meaningful changes in our thinking or behavior based on input from others.

In our Dare to Lead training, we work with participants to figure out what defensiveness looks like for them, what it feels like, and whether there are some situations that are more likely to trigger it than others. To increase self-awareness, we ask folks to think back to a time when they received difficult feedback and try to remember what their bodies were doing, what thoughts were coming up, and what emotions they were feeling. The vast majority of people struggle to remember the exact thoughts and feelings, which makes sense, given that many of us go into fight-or-flight mode in these situations.

However, for the most part, people can remember their physical responses: Folding their arms over their chest, shoving their hands into their pockets, getting tunnel vision, feeling their heart race, looking down, and getting dry mouth are just a few. It’s worth thinking about the physical cues that show up for you when experiencing defensiveness and devising a strategy that can help pull you back into the present moment.

When I get defensive, I often get tunnel vision and start planning what I’m going to say instead of listening. But I have found some ways to disarm my defensiveness. My strategy is to subtly open my palms, even if my hands are just hanging by my side or on my lap, and actually say, “I’m sorry. Can you say that again? I really want to understand.” It’s pretty effective. If I’m having a really hard time, I might say, “I’m sorry. I’m feeling overwhelmed. I’m going to get a glass of water. Can we sit down in ten minutes and start again?”

FLOODING

This seems like the perfect place to talk about the concept of flooding. The body can become overwhelmed when it senses danger, and for a lot of us, a difficult conversation, hard feedback, or an argument is enough to send our body into overdrive. We can feel overwhelmed, attacked, and confused. According to the Gottman Institute, flooding is “a sensation of feeling psychologically and physically overwhelmed during conflict, making it virtually impossible to have a productive, problem-solving discussion.”

In his book Why Marriages Succeed or Fail: And How You Can Make Yours Last, John Gottman explains, “We each have a sort of built-in meter that measures how much negativity accumulates during such interactions. When the level gets too high for you, the needle starts going haywire and flooding begins. Just how readily people become flooded is individual.” He also shares that flooding is affected by how much stress you have going on in your life. The more pressure we’re under, the more likely we are to be easily flooded.

One of the worst patterns that I brought to my marriage from my family was “Get back in here and fight with me!” Growing up, we didn’t take breaks during fights. No one ever said, “This is no longer productive and we should take a time-out before someone gets their feelings hurt.” Our strategy was get louder and meaner until you win or someone else is crying. When I first married Steve, in the middle of a heated argument he would say, “Let’s stop and take a break.” I was like, “What are you talking about?”

At some point, I realized that stopping scared me. Fighting together seemed less painful than hurting alone. Looking back, I just didn’t know how to do it. I had never been taught or seen it modeled. Gottman’s work helped me understand the mechanics behind “Okay, can we circle back in twenty minutes?” or “Okay, how much time do you need?” Knowing that we’re coming back to finish the discussion, and when, reassures me in some way.

This research also helped me realize that it wasn’t just Steve who was getting overwhelmed. I get overwhelmed too. The difference is our strategies. He shuts down; I lash out. Disastrous.

Now when I feel flooded, I’m as likely to say “Time-out” as he is. This is a good thing because, according to Gottman, chronic flooding sets us up to dread communicating. Gottman discusses this effect in the context of marriages and partnerships, but I’ve seen the same thing in organizations. I’ve interviewed many research participants who experience chronic flooding with their bosses, so much so that every time they’re called into the office, they’re already on the path to overwhelm.

There’s only so much our bodies and nervous systems can stand before they flip the survival switch and stop communicating and start protecting or attacking. Looking back, I’ve never once regretted calling a time-out at home or work. Not once. I’ve never experienced a little time and space being a bad thing, but I have plenty of regrets the other way around.

Excerpted from Atlas of the Heart by Brené Brown. Copyright © 2021 by Brené Brown.

Couples Counseling South Tampa: Couples Reveal What They Have Learned In Therapy

As a marriage and family therapist in Tampa, Florida, I have received feedback from several different clients. I combine some of the most powerful approaches utilizing Internal Family Systems, Compassionate Communication and Non-Violent Communication, The Gottman Method, Emotion Focused Therapy, Holistic Psychology, CBT, and DBT.

Here are the 10 best lessons couples learned from therapy.

1. Go to therapy sooner rather than later.

   It is best to go to a counselor before sh*t hits the fan. This way, you can start to develop conflict resolution and communication skills before resentment builds. Establishing a therapeutic relationship with a counselor early on can be beneficial when and if you find yourselves in a rut. Having an unbiased and supportive counselor can help you and your partner maintain a healthy relationship when and if you need support along your relationship journey.

2. You are on the same team.

   There is no winning and you don’t need to fight against each other. Therapy is a great tool and safe space to really work through things together. Meeting both of our needs, growing, and thriving together is the goal. We often ask ourselves, are you trying to listen to understand or are you trying to be right?

3. Play and have fun together.

   Unstructured quality time to just be living purely in the moment increases connection, creativity, and releases negativity. A couple that plays together stays together!

4. Unfinished business of childhood can show up in adulthood.

   Continuing to work on intrinsic positive change is a lifelong learning process. Insight and empathy can help partners understand conflict in a whole new light. When we create an awareness of patterns and habits we are able to create awareness regarding intentional choices in real time. If we are not aware, we keep reacting. Responding intentionally knowing what is happening is being awake to our inner experiences. Self-witnessing is a tremendous tool that can be used in so many facets of our lives. Practicing compassion for our partner's story, and becoming more empathetic to each other, we could actually help our partner heal from their painful childhood experiences.

5. It is not about changing the issue, it is about understanding.

   We have learned so much about communication and the ways to really listen to understand one another. Most people listen to try to change the other person’s perspective. When we get into trying to change the other person, defensiveness comes into the game. When defensiveness shows up, it creates disconnect. Communication either connects us and helps us get needs met or it disconnects us and sabotages our needs. We feel all sorts of negative feelings when our needs are not being met. However, we are in homeostasis when our needs are met and feel positive emotions. Our feelings are always signals to pay attention to which provide data about whether our needs are being met or not. When we know what we need, we are in a powerful position to get the needs met intentionally. When we do not know what we need, we will probably be in autopilot, reactionary-mode. Tune into your inner worlds so that you can understand yourself. When we understand, we can communicate honestly about what is happening internally.

6. Our thoughts are the root cause of anger.

   Anger masks more vulnerable feelings like hurt, disappointment, and sadness. It's helpful when both partners understand that the words or behavior hurts their partner, even when their partner tends to react with anger or stonewalling. Therapy can help couples connect — which includes learning how to get calmer and go slower rather than to lay out their arguments about who's "right".

7. Hear your partner out before letting emotions get in the way.

   Getting guidance from a therapist around how to listen to each other without being emotionally charged about the topic can help couples stay engaged in the conversation, to accept influence from one another, and compromise based on needs. This is huge! We can stay curious about what is actually happening in the moment. When our partners feel heard and understood, they are in a better position to hear us too. Listen to each other without reacting! This sounds so simple but bad habits can be hard to break and its beneficial to have a therapist as a sounding board to make neutral observations.

8. Conflict is normal, you will have different perspectives at times, and disagreements are inevitable in every relationship.

   There will be different stages throughout life and couples will never stop getting to know one another. The most important thing is that you listen, respect, and acknowledge each other's viewpoints. Many times, people listen to respond and not to understand — which is one of the biggest reasons why many relationships fail. Attending couples therapy, can help partners communicate feelings, emotions, and concerns more effectively. Counseling equips couples with valuable skills that will be instrumental throughout their lifetime and once they become parents.

9. Marriage therapy taught us how to communicate about our needs and desires without hurting the other person.

   When we are emotionally and intimately disconnected, it is challenging to help each other to feel heard and understood. The way we deal with conflict is directly correlated to intimacy. Change the way we fight, change the way we love. When we trust each other more and give each other the benefit of the doubt, we're less hurt when the other person isn't in the same place as us in the moment, We may still have issues and hurt feelings from time to time, but we're better equipped to handle those problems when they come up.

10. Psycho-education and therapy helped couples identify patterns.

    One partner was pretty direct and the other partner tended to be more thoughtful in the way he delivered information. One partner said the thing that stuck with her the most was that the therapist was able to reframe and articulate her partner's concerns in a way that he couldn't — which then helped her to understand him better. Therapy can help couples become aware of how reactions to difficult situations can be unhelpful. Attempting to respond in a way that is more productive for the relationship can feel very different. Psycho-education can be of tremendous value when co-morbidity plays a role in relationships. Trauma informed therapy can help partners empathize, respond to each others needs, and heal together. It is advantageous to the relationship when partners learn about mental health together.

To learn more about how therapy can help you, please text or call Dr. Mahaney directly 813-240-3237 or book an initial consultation: www.SouthTampaCounselor.com/BookAppointment

9 Tips for Successful Compromise

Have you ever found yourself in the middle of a conflict with someone and it feels like nothing is getting resolved? When people have different desires, they'll often try to compromise. But sometimes when we compromise, we don't actually focus on what we NEED. In this article I'm going to share some tips on how you can successfully negotiate compromises so that both parties needs are met.

First of all, it's important to remember that compromise doesn't mean both people will get exactly what they want. Both parties need to be willing to make changes in order for the negotiation process to work out well. If someone isn't open-minded enough about making compromises then you'll just end up fighting over who gets their way and nothing will get resolved. According to John Gottman, two opposing forces creates gridlocked issues. The main point of compromise is that you'll be happy with the final result, even if it's not exactly what either party originally wanted.

Here are 9 tips for successfully negotiating compromises:

Tip #01: Know what you want. This may seem like a no-brainer, but it's important to be clear about what you want in any situation. If both parties know exactly what their needs are then it'll be easier to brainstorm collaboratively to come up with a solution that works for everyone.

Tip #02: Continue to create clarity to ask for what you want. Just as importantly, don't be afraid to ask the other person for what they want. This will help create an open dialogue and show that both parties are willing to work together.

Tip #03: Stay Attuned and present. Don't make assumptions about what the other person needs. We often make assumptions about what the other person wants, and this can lead to misunderstandings. It's important to clarify what the other person is asking for so that there isn't any confusion.

Tip #04: Take responsibility for your part in the conflict. Don't be defensive. As soon as you become defensive, it becomes very difficult to negotiate anything. Try to stay calm and open-minded, even if the other person is being difficult. The antidote to defensiveness is taking some responsibility and accepting influence from others.

Tip #05: Soften your start-up and begin the conversation from a neutral standpoint. Don't be confrontational. This goes along with Tip #04 - don't try to force the other person to see things your way. It's important to maintain a positive and constructive dialogue, even if it's challenging at times. Continually regulate your emotions and self sooth during the conversation to avoid becoming emotionally flooded.

Tip #06: Listen actively. This is one of the most important things you can do in any negotiation. If you're not actively listening to what the other person is saying, then you won't be able to understand their perspective and come up with a resolution that works for everyone.

Tip #07: Listen without interrupting. Along the same lines, don't interrupt the other person while they're speaking. This will make it difficult for the conversation to move forward in a constructive way.

Tip #08: Hold space and try to simply understand your partner. Don't feel like you have to be right all of the time. If both people are open-minded about change, then there's no reason why you can't find an appropriate solution that works for both parties.

Tip #09: Be flexible and willing to compromise. When you're negotiating compromises, remember that if one person is inflexible the negotiation process won't work out well for anyone. Being open-minded about making changes will help resolve conflicts quickly so everyone can get needs met.

Why I Only Accept 50% of Insurance Clientele & 50% Self-Pay In My Private Practice (50/50/❤️ MODEL)

WHY I ONLY ACCEPT A FEW NEW INITIAL INTAKE INSURANCE APPOINTMENTS

USING MY MORAL COMPASS AND COMPASSION FOR HUMANITY, I’M CHOOSING TO CREATE A 50/50/❤️ MODEL:

50/50/ ❤️= 50% SELF PAY 50% INSURANCE ❤️SLIDING SCALE FEE

Sliding Scale Fees help advocate for affordable mental health care and create an opportunity for highly qualified INTERNS to co-counsel clients in need. I interview interns extensively, decide selectively, and supervise very closely and yet very trustingly. I will be an active participant in each session.

I initially started accepting insurance 15 years ago when I felt a strong need to support my community, who needed financial support, to get consistent help. Despite hearing horror stories from colleagues about insurance paperwork and clawbacks, I joined a few insurance panels. I loved every minute of being a therapist! I hated everything about the administrative process when it came to dealing with insurance companies. Don’t get me wrong, I love my insurance peeps! We have connected over the years and I will continue to support my clients who choose to use insurance as they should!

I too, have health insurance. I get it, we have health insurance for a reason, pay high monthly premiums, and should be able to use insurance when we need it!

Regardless, I will show-up powerfully for ALL of my clients.

I feel good about my choice to create a 50/50/ ❤️BALANCE in my Private Practice!

As a healthcare member and a private practice provider, I’ve had the unique experience of seeing both perspectives of the healthcare system in the US.

As my specialty has continuously evolved, I have realized that mainly accepting insurance no longer make sense for the advanced work that I do. Ultimately, my decision came down to acting with integrity and practicing what I preach to my clients.

Here are some key points to help you understand my decision to create this model for my Practice:

LACK OF PRIVACY & CONFIDENTIALITY

When insurance companies pay for your treatment, it also means that their employees (clinicians or not) will audit my treatment plans and read what we talked about in my session notes. These employees are paid to save the insurance company money by searching for fraud and determining whether you're overusing your insurance coverage. In turn, the insurance company may decline authorization of additional sessions because you're not progressing fast enough; our work in psychotherapy does not qualify as "a medical necessity": or because my treatment approach isn't recognized by the insurance company as an "evidence-based treatment" (that's code for short-term, as in 6-8 sessions).

Hell, some insurance providers don't reimburse for 60-minute sessions anymore!

This doesn’t seem right.

I recently got audited by an insurance company. This audit took me countless hours, staying up late at night, time away from my family, unnecessary stress and scrutiny to provide tedious paperwork and specific details to prove that my clients needed the services provided. This is just not okay in my book. I totally understand documentation for integrity but demanding extra proof during a pandemic when I am already submitting the necessary information and feel overwhelmed and overworked helped me create the awareness and opportunity for me to reflect on MY CHOICE to accept insurance.

At first, I reactively felt angry resulting in thoughts and hopes that the insurance company would fire me! However, when I pause and feel to respond intentionally, I honestly and truly feel honored to hold space and care for ALL of my clients and I would feel disappointed if I were unable to offer insurance as an option.

In conclusion, I believe that everyone has a right to confidentiality of your medical records. You also have the liberty to progress through treatment at a pace that's best for YOU - one that allows you sufficient time to process everything that you're experiencing. Things unfold differently for each person, especially when our world seems chaotic (Global Pandemic)! If the insurance company fires me, they rip the therapeutic relationship apart that my clients and I have securely built over the years. Emotional injuries and attachment issues can be easily re-traumatized within seconds.

DIAGNOSIS OF ILLNESS

Insurance companies operate on a medical model, which means they require a diagnosis to establish that you have "a medical necessity" to seek services in order to pay providers. To justify that you have a "medical necessity" I have to assign you a diagnosis to be reimbursed for our work together when there may not be one that really fits what you're going through. The vast majority of insurance companies don't consider relationship issues like couples or family therapy, developmental/attachment trauma, existential issues, life-transitions, personal development, or self-improvement as "medical necessities" because there are no diagnoses for these in the DSM-V.

And even if there are appropriate diagnoses, there are some diagnoses that insurance companies don't consider debilitating enough to pay for. So, if I know what diagnoses are and are not paid for, l'd have to label you with a more severe diagnosis they will pay for, but one that may not really reflect your situation. I am not ok with this either!

You're probably wondering, "What's the harm in that? A little truth-bending never hurt anyone." Well, that's just it - it can. It can come back to bite my clients in the ass... your medical record. While that might not be such a big deal right now, it may become one later on if you want to: get life insurance, work in the financial sector managing other's assets, regularly handle firearms, or seek employment in any sector in which your decision-making might be called into question due to your emotional state. Call me crazy, but I feel that people should get the help they need without fear, stigma, or reprisal for making their mental health and personal growth a priority.

FRAUD

If I engaged in the aforementioned truth- bending, I'd essentially be committing insurance fraud. There are providers out there that are willing to walk this fine line and take this risk. In my opinion, the penalties and professional consequences of insurance fraud are huge, and frankly, not worth it. I have a strong need for peace of mind that comes with integrity.

LOW RATES

In order to be "in- network" with an insurance company, I have to agree to accept a lower fee in exchange for the insurance company listing my practice in their directory of providers and sending me referrals. In the spirit of transparency, most of my clients find me through friends, family and through searching online. And each year, insurance companies continue to cut the rates they pay therapists for their work.

Here's an example with real numbers and real circumstances of how this happens: My fee is $170 per session. But I joined XYZ Insurance Co.'s network because I had a client in need of services. I chose to help and chose to agree to the insurance reimbursement rate of $60 per session. My client would also be responsible for a co-pay of $0-$40 per session depending on his plan, bringing the total to $60-$100 per session. That means I'm waiving at LEAST $70-$110 for each session. As a healthcare professional, I want to help! I have made these types of choices for the 20 years that I have been in private practice. I will keep choosing to advocate for my clients who have insurance because I also have insurance for myself and my family.

Would you be willing to forgo ~65% of your salary?:-/

I will also continue to set boundaries with ALL of my clients and companies that I choose to work with. If you no-show as a self pay or insurance client, I will treat you the same and ban you from being able to book an appointment until we have a meeting. I get it. I want to understand one another and use empathy. Life happens. I want to turn toward these curveballs

Additionally, insurance companies have been increasing their members' premiums, deductibles, and co-pays in the last few years claiming rising costs of care. You'd think that that would translate to higher reimbursement rates to care providers, but it doesn't...at least not in the mental health fields. In fact, insurance reimbursement rates have actually decreased over the same period of time. You're probably wondering, "How do the therapists and psychologists that take insurance afford to?

For such insurance-based practices, taking on more clients than is clinically prudent is the only way to make up the difference and keep their doors open. This then leads to another problem...

BURNOUT & EXHAUSTION

Here's the reality, many providers that accept insurance overbook their schedules in order to turn a modest profit after rent, utilities, malpractice, and other expenses.

Additionally, these providers often only offer a 30-50-minute session to maximize the number of clients in a day (10 vs 8) and the chances of insurance reimbursement (remember, most insurance companies don't pay for 60-minute sessions anymore). Also, if you use the 60 min codes, you are flagged for audits which take hours and hours to complete.

DELAYED (OR NON) PAYMENTS

Despite the insurance companies agreeing to a set reimbursement rate, these companies require therapists to jump through a bunch of hoops to get paid. It is common practice for most insurance companies to reject submitted paperwork to delay payments. When they're not seeing clients, these therapists are drowning in insurance paperwork and resubmitting billing claims in order to get paid, or spending hours on the phone contesting unpaid claims.

On average, it takes an additional 1.5 hours of UNPAID work outside of the session to get paid for sessions. And remember, the therapist is already making less by agreeing to take insurance. (In my previous example, it would cost $255 of my time ($170x1.5) to get paid my $60 reimbursement rate from XYZ Insurance Co.)

The alternative is to pay a medical billing company 8-10% of the claims' costs to do the aforementioned, but that increases expenses and cuts into that modest profit I mentioned before. But let's say that I or my medical billing admin ARE able to see the claim through the labyrinthine insurance payment process, the payment will finally arrive in my bank account anywhere between 3-6 months after the session took place IF everything goes smoothly.

RETROACTIVE CLAIM DENIALS (AKA CLAW BACKS)

Now imagine that, after all that trouble, that insurance company asked you to give the money back, even years later. Yep, this really happens and, unfortunately, it's a common practice among insurance companies. They'll audit your claims and paperwork for several years back. If they find any mistakes or inconsistencies in the therapist's paperwork they missed when they originally approved the therapist's claim, the insurance company will request that the therapist return the fees she was paid.

Pretend that your employer sent you a bill requesting that you repay the income you'd earned 3 years ago. Would that seem fair to you? I didn't think so. Claw backs can amount to thousands of dollars that can bankrupt a small business like a private practice. Many insurance- based clinicians live in fear of such retroactive audits.

Before reflecting and reassessing the insurance-based private practice I founded, I recently heard from a friend and colleague that a major insurance company requested thousands of dollars be returned by the end of the month. Talk about stressful!

All together that's a recipe for a tired, overworked, and stressed out therapist.

This may have been the problem if you've ever been to therapy that you felt didn't "work" with a provider from your insurance company. I should know. I started to experience the symptoms of burnout after two years of insurance-based practice. And that's when I realized, "Crap! I'm doing the things I tell my clients not to do!" Talk about incongruence!

So I changed my business model for the sake of the well-being of myself and my team to preserve the quality of care we want to provide every client. It breaks my heart to REDUCE ACCESS to care for people in need, but I realized early on that we can't help anyone if we're stressed/burned out or have to close our doors. I am choosing the 50/50/❤️ MODEL to advocate for mental health and well-being for all!

This makes sense to me!

WHAT ARE THE BENEFITS OF PRIVATE SELF-PAY AND/OR A 50/50/❤️MODEL FOR MENTAL HEALTH CARE?

No Labeling - You don't have to carry an unnecessary diagnosis on your medical record. Although, if you’d like to create awareness and assess for diagnostic criteria, I would invite this curiosity and self exploration.

Confidentiality & Privacy - You and your psychotherapist are the only people that will know you're in therapy. You get to choose who you disclose this information to. Session notes are private records so there won't be intimate details to “prove medical necessity/ diagnosis info”.

I am highly confidential and keep minimal notes. I naturally remember our sessions together because I truly care and our therapeutic relationship is genuinely important to me.

Self-Determination - You get to work with a psychotherapist that is free to use the best therapeutic approach to help YOU meet YOUR goals. You and your psychotherapist are the only people involved in the decision about the length of your care. You won't have to seek additional authorization to continue your work or return to psychotherapy, if you have new goals you'd like to explore.

Quality Care & Attention - You'll get a psychotherapist that's alert and engaged during your session, remembering the details of previous conversations. You'll have the help of a professional that's invested in your process of growth because they've taken the time to do the same for themselves. She will be able to use the healing methods that are most appropriate for you.

You might be thinking that this is just one therapist's rant against insurance companies. Don't take my word for it. Feel free to do your own research!

If you tried psychotherapy and were disappointed with the results or the treatment didn't seem to "fit" after working with a provider from your insurance company, I hope you have a better understanding of what might have been happening behind the scenes. We urge you to reconsider getting some support now that you do. There are great providers in the healing professions on both sides of the insurance divide that can help you.

I HOPE YOU HAVE A BETTER UNDERSTANDING ABOUT WHY I HAVE DECIDED TO CHOOSE THE 50/50/❤️ MODEL!

50/50/ ❤️= 50% SELF PAY 50% INSURANCE ❤️SLIDING SCALE FEE

Call or TEXT with any questions:

📱#813-240-3237 or ***Book Now: —> ❤️

Nonviolent Communication Skills in Intimate Relationships

“NVC requires us to be continually conscious of the beauty within ourselves and other people. ”

– Marshall B. Rosenberg, PhD.

The connection between Nonviolent Communication and Intimate Relationships is strong and vital — and perhaps not obvious to those unfamiliar with NVC.

For those of us with NVC skills who are also in intimate relationships, we can’t imagine being in a relationship without NVC!

Intimate relationships are some of the most meaningful connections with the people who are most important to us.

This is why when disconnection happens it can be more painful than in other types of relationships.

In intimate relationships the stakes are higher, in part because our emotional investment is greater.

For all these reasons and more, learning NVC skills to prevent and resolve misunderstandings and conflicts in intimate relationships can help us deepen and enjoy those relationships more fully!

The Importance of Communication in Intimate Relationships

An intimate relationship without communication is like a bird without wings, or a tree without leaves. Communication is one of the primary mediums for connection, and without connection how intimate can a relationship be?

The importance of communication in intimate relationships — now, today —can be summed up by the proverb: “dig your well before you’re thirsty.”

What does this mean?

In this metaphor, thirst is the need for connection, for mutual understanding, for the trust and good will that take us to mutually satisfying ways of living. The well would be access to NVC tools and the practice to become skillful with them.

Your NVC skills can take you to mutual understanding and deeper connection — consistently!

However — there is a big difference between having a tool and being skillful with it.

Can you understand why it might serve NOT to wait until you’re in a full-blown conflict to decide that you want to develop your communication skills?

Communication helps us each know where we’re at, what we’re each feeling, what’s important to us, and what we would like.

There’s another apt proverb here: “An ounce of prevention equals a pound of cure.”

The importance of communication in intimate relationships goes way beyond resolving conflicts.

As you develop your skills you begin to prevent misunderstandings and conflicts. And this allows you to conserve mental and emotional energy, and prevent angst and suffering.

Beyond misunderstandings and conflicts, the importance of communication in intimate relationship is that it contributes to an ongoing deepening of your most important connections.

Common Communication Problems in Relationships

There are many common communication problems in relationships.

Fortunately, NVC has principles, insights, and tools that address every one of them!

One of the most common communication problems in relationships is when we listen to respond rather than to understand.

When you are present, and listening to understand, you will still have a chance to respond later! But first, help the other person experience being understood. This is not the same as agreement; simply understanding.

When the other person feels understood they are much more open to hearing you out! And the dynamic of hearing each other deeply as each person reveals vulnerably, allows the conversation to deepen to a place of authentic connection in which conflicts often resolve themselves.

Sometimes you might be in a conversation that is going just fine, and a little while into it you and the other person find yourselves in a very uncomfortable place — a disagreement, a disconnection, or even a full-blown conflict — and you’re wondering, how did we get here?

This is actually quite a common experience, and is related to the previous communication problem. Sometimes there is even a slight miscommunication — for example one person says red and the other hears blue — and nobody notices.

These situations easily lead to misunderstandings which can lead to conflicts.

A true-life example: a woman said to her male partner, “I don’t want to be so wifey.”

What she meant: “I don’t want to be the only one doing the housework.”

What he heard: “I don’t want to be married to you anymore.”

This couple ended up divorcing — true story — and is an example of a small miscommunication that can spiral out of control quickly if we don’t catch it. So slowing down, listening to understand, and asking clarifying questions can save us all a lot of heartbreak! (In the example of the couple above, their large group of friends also went through a form of heartbreak.)

Another common communication problem in relationships is rushing to a solution in a way that skips the connection. Often the person who does this has positive intentions of wanting to resolve an issue or fix a problem.

However, when we skip the connection the other person rarely feels included in the solution. Furthermore, we have little guarantee that the solution will meet their needs because we haven’t taken the time to find out what they are! NVC encourages us to connect first — get clear on each person’s observations, feelings, needs, and requests — and then, once the needs are clear and there is mutual understanding, together arrive at a strategy that meets all or most of the needs.

Connection before solution!

Nonviolent Communication is also known as life-connected, life-serving communication. As such, it has its opposite: life-disconnected, life-alienating communication, which is defined as the type of thinking and language which takes us away from the quality of connection for which we are seeking.

Most of the common communication problems in relationships can be identified in this life-disconnected thinking and language. These include:

Diagnosing others: This includes judgments, name-calling, and criticism. Diagnoses also include assuming we know what another person is thinking, feeling, or needing. (“You’re obviously very angry about that!”) And they include any static language that would explain why someone is acting the way they are (the problem with you is you are [an egomaniac; an Aries; a troubled soul; a rebel, etc.]).

Denying responsibility: This includes any language that implies that we lack choice. I had to. I had no choice. You made me. I can’t. This does not mean that we always like the options of which we’re aware. Sometimes we dislike every option, and yet, within that we still have choice. And sometimes we’re not aware of other possibilities because we are in a “crisis of imagination.” Rather than owning our choices we act as if we are powerless. I have no choice, it’s (the law, company policy, superiors’ orders). Accusatory blame would fit in this category.

Placing demands on others: In NVC we take responsibility for what we are wanting by expressing clear requests. In a request, the other person’s needs matter too, and so no is an option. In a demand, ‘no’ is not an option. In a demand, by definition, the other person’s needs do not matter equally to the person issuing the demand. The reason this hurts relationships is that, if I am on the receiving end of demands it communicates that my needs don’t matter. This, in turn, leads to resentment and disconnection. Over time, it is quite likely that the needs of the person placing the demands cease to matter to the person on the receiving end.

Life-alienated motivations: The key insight here can be summarized by a phrase often emphasized by Dr. Marshall Rosenberg, creator of NVC: The energy with which we do anything for each other is just as important as the action itself. Life-alienated motivations include fear, guilt, shame, duty/obligation, to obtain an extrinsic reward, to avoid punishment, or acting out of “shoulds” or have-tos.” When we do something for each other out of these motivations, it creates disconnection, resentment, and serves to break down trust. We want to do things for each other when we are connected to how it serves life, how it also contributes to our needs.

Using Compassionate Communication in Relationships

The key to using Compassionate Communication in relationships consists of remembering three things: Purpose, Intention, and Attention.

It’s extremely helpful to remember that the purpose of Compassionate Communication (another name for NVC) is to create a high quality of connection out of which people naturally and spontaneously enjoy contributing to one another’s well-being. This is how we find win-win or mutually satisfying outcomes: out of the connection.

The purpose is not to get others to do what you want, or to get your way, or to get a particular thing to happen!

So when you enter a conversation or are in an interaction, remember that the purpose is first to connect.

And so it helps if this is our intention.

When connecting with another, check your intention. What do I want here? Is my intention to be right? Am I willing to let go of being right and my preferred outcome in order to connect first? Do I trust that once we connect we can together find a mutually agreeable outcome?

And one of the outcomes of developing in NVC is skillful deployment of your attention.

Using Compassionate Communication in relationships means being able to put our attention on feelings and needs, rather than on who’s right and who’s wrong. It means putting our attention on our own, and the other person’s, humanity in order to connect and find a way of being with each other that is mutually fulfilling.

This is how using Compassionate Communication in relationships teaches us to use purpose, intention, and attention to create deeper and more satisfying relationships.

Using NVC to Improve Communication in a Relationship

Using compassionate communication in relationships is simple, though it is not necessarily easy.

The reason is that it helps us become aware of and re-configure old, unconscious patterns that get in the way of the quality of connection we’re looking for. Sometimes discovering these old patterns is painful, and shifting them can take time.

The good news is that as you get better at it, it becomes more fluid and takes less time.

How do we do it?

First, a clarification. We can think about communication in intimate relationships as consisting of a spectrum:

In this simple diagram, we can see that informal NVC could be indistinguishable from a normal conversation. That’s because connection is happening — which after all is the purpose of NVC.

At the other end of the spectrum we see “formal” NVC, which has certain key differentiations and follows a particular structure and syntax. Formal NVC keeps our communication extra clear, and helps us keep the key differentiations clear in our mind.

The dance of connection refers to the steps we take to move toward connection. A simple mnemonic device is ABABAB, referring to person “A” and person “B.”

Here’s how “the dance of connection” works:

1) Person A speaks with honesty from the heart.

2) Person B reflects back their understanding of what Person A said.

3) Person A confirms they were heard accurately.

4) Person B speaks with honesty from the heart.

5) Person A reflects back their understanding of what Person B said.

6) Person B confirms they were heard accurately.

7) Return to the top, to #1. This process is continued until the two people feel connected and they trust that they are understood by the other. Then they can proceed to brainstorm or propose strategies and/or solutions.

Though somewhat of an oversimplification, this illustrates the process we undergo to allow a conversation to wind deeper and deeper, until there is a high quality of connection out of which people co-create mutually satisfying outcomes.

Dr. Marshall Rosenberg on Nonviolent Communication Skills in Relationships

There is so much we can learn from Dr. Marshall Rosenberg on Nonviolent Communication Skills in relationships.

He knew that intimate relationships are some of the most important relationships — and sometimes some of the most challenging ones.

Dr. Rosenberg explained that if you meet your needs at the expense of another, your needs will also not be met. Anytime you create a win-lose, you also lose — because we are all interconnected, interrelated, and interdependent.

When we coerce others or place demands on them, the quality of the connection suffers.

When we can let go of being right and put our attention on making life more wonderful, then we can create a high quality of connection out of which it’s easy to explore outcomes, solutions, and ways of living that are mutually satisfying.

Content by PuddleDancer Press. Use of content okay with attribution. Please visitwww.nonviolentcommunication.comto learn more about Nonviolent Communication.

Listening Accurately Worksheet

Non Violent Communication and Listening Accurately. Let’s listen to understand, instead of listening to change the way the other person feels.