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Episode 4: Shenanigans of the day · Clinically Chaotic

• 0:07
  SPEAKER_01: Welcome back to the Clinically Chaotic podcast with Tara and Erica.
• 0:14
  SPEAKER_01: Happy to have you here.
• 0:15
  SPEAKER_00: Thank you, which is not the proper response to that question.
• 0:19
  SPEAKER_00: Apologies.
• 0:19
  SPEAKER_00: That's good.
• 0:20
  SPEAKER_00: You're doing great.
• 0:21
  SPEAKER_00: Not a question either.
• 0:22
  SPEAKER_00: Okay.
• 0:22
  SPEAKER_00: I am there mentally, I swear.
• 0:25
  SPEAKER_00: I wanted to bring you an interesting thought.
• 0:27
  SPEAKER_00: How do you feel specifically about therapists on social media and also clients finding you on social media?
• 0:36
  SPEAKER_02: Oof.
• 0:38
  SPEAKER_02: That is a tricky one because I know myself personally.
• 0:44
  SPEAKER_02: Anytime I am going to meet with someone new, whether it's in a professional setting or not, I feel like I am the person to kind of creep and look.
• 0:55
  SPEAKER_02: My current therapist that I see now, I did Google his name.
• 0:59
  SPEAKER_02: I don't think I've ever gone as far as like looking up social media profiles.
• 1:03
  SPEAKER_02: So I think there does have to be some line.
• 1:06
  SPEAKER_02: I don't necessarily know that I would want to know my therapist's personal life and what they're posting on social media.
• 1:13
  SPEAKER_02: And I think in terms of population, because I work with children and families, I am very mindful about making sure that my social media accounts are locked and not visible to the public.
• 1:28
  SPEAKER_02: I think just naturally in the day and age that we live in, there's so much information and content that is on social media or on the internet that people can find fairly easily.
• 1:43
  SPEAKER_02: And so I think it's just like a constant, you know, level of being mindful about what you're putting out there.
• 1:49
  SPEAKER_02: But also with that, like I will say I don't ever want to like fake it or have my social media accounts outline kind of like a hindered version of who I am.
• 2:02
  SPEAKER_02: Part of that is because I am firm around not having my clients on my social media.
• 2:09
  SPEAKER_02: But I guess that is kind of like a gray area for some people in this field.
• 2:15
  SPEAKER_00: Oh man, I feel like I'm a hard pass.
• 2:17
  SPEAKER_00: Like all of my social media is private.
• 2:20
  SPEAKER_00: I hope that they don't look me up.
• 2:22
  SPEAKER_00: I don't look them up.
• 2:23
  SPEAKER_00: I feel like that's your business if you want to tell me about it.
• 2:26
  SPEAKER_00: Sometimes I like, maybe this is not wise on my part, will post where I'm at on my social media, is private, but I just don't want people to know that about me.
• 2:36
  SPEAKER_00: That risks this really awkward moment of running into clients in person who may or may not want to talk to in that moment, which I know can happen organically, but I think sometimes interacting on social media or allowing them to friend you or follow you really can blur those lines for them.
• 2:58
  SPEAKER_02: Yeah.
• 2:59
  SPEAKER_02: I can't really think of a situation in my life where I would kind of like loosen that boundary around letting clients or past clients onto my social media because that just like gives away a certain level of information to my clients and families that I work with that I'm not really open to sharing, to be honest.
• 3:24
  SPEAKER_02: My social media isn't always the most appropriate or yeah, that's fair.
• 3:30
  SPEAKER_02: You know, there there's no um there's no filter that that goes over my social media.
• 3:36
  SPEAKER_02: Like anyone, you want freedom to to post freely and then what you want.
• 3:41
  SPEAKER_02: And by choosing the people who you have on your social media, you're kind of allowing them into that space.
• 3:48
  SPEAKER_02: I think for the most part, I do not allow any of my clients to be a part of that space, rightfully so.
• 3:55
  SPEAKER_00: That poses an interesting thought of past clients.
• 3:58
  SPEAKER_00: Because I know ethically there's nothing that talks about being friends with clients post termination.
• 4:05
  SPEAKER_00: I wholeheartedly it's not for me.
• 4:08
  SPEAKER_00: I think that is a weird power dynamic.
• 4:11
  SPEAKER_00: I feel like I can just see it, even if the person's not intending it to be this way, that you're just gonna be there now free therapist, because it's hard to change that.
• 4:21
  SPEAKER_00: I think it is inherently human to want to know about people who you spent so much time with.
• 4:27
  SPEAKER_00: And so I always tell clients, if you want to stay connected to me, you can always send an update to my email, which is hard because I also have been like, I might move practices though at some point in time.
• 4:39
  SPEAKER_00: So you are welcome if you'd like to Google my name.
• 4:42
  SPEAKER_00: There's only one of me, unfortunately.
• 4:44
  SPEAKER_00: And you can send that update to whatever email based on the practice that you can find on the internet.
• 4:49
  SPEAKER_02: I have said that before for clients.
• 4:51
  SPEAKER_02: If all else fails and you're not able to locate support in wherever you're at in your life journey, if nothing else, Google my name and find me wherever I'm at.
• 5:02
  SPEAKER_02: Are you the only one?
• 5:03
  SPEAKER_02: I am the only one.
• 5:05
  SPEAKER_02: Yeah, I am the only one.
• 5:07
  SPEAKER_02: It is kind of nice for us because we do have the ability to tell our clients if all else fails, you know, Google our names or something, which I feel that's I don't know, a little bit more keeps us protected in in some other way.
• 5:20
  SPEAKER_00: I think so.
• 5:21
  SPEAKER_00: The one thing that our clinical director right now is really good at is telling you to Google yourself regularly to make sure that your address is not on the internet.
• 5:30
  SPEAKER_00: Because sites will just post it in ways that you don't know.
• 5:34
  SPEAKER_00: Which is interesting.
• 5:35
  SPEAKER_00: Sites that you've never heard of, all kinds of things come up.
• 5:37
  SPEAKER_00: Like somebody will buy a website from someone else, and then they are allowed to do whatever they want with the information.
• 5:44
  SPEAKER_00: Right.
• 5:44
  SPEAKER_00: So just a mindful thing that I think we should all be aware of.
• 5:48
  SPEAKER_00: Absolutely.
• 5:49
  SPEAKER_02: Specifically when I'm working with kids, to be honest, kids, when you're a kid, you are still learning boundaries and how to uphold boundaries and maybe like dynamics within professional relationships.
• 6:02
  SPEAKER_02: Of course, we do our best to explain to kids like the limitations with within the therapeutic relationship, but that doesn't mean that after their discharge or after I'm no longer working with them, that when they're a teenager, they still haven't fully comprehended what it means to uphold a therapeutic boundary or professional boundary.
• 6:22
  SPEAKER_02: And so it also could be harmful to our clients if they're trying to add us on social media and they see that I'm not accepting them on my Instagram or my TikTok.
• 6:33
  SPEAKER_02: That could be, you know, for them, I could see how they could misinterpret that to wow, this person at some point was such a consistent support to me.
• 6:42
  SPEAKER_02: And now all of a sudden it's like they're ghosting me or ignoring me or something, which for adults, maybe that's not the case, maybe it is, but I could see how for children and adolescents that could get a little confusing for them.
• 6:56
  SPEAKER_00: I think it also plays into the narrative that we face all the time of like they're only here for the money.
• 7:02
  SPEAKER_00: So once I'm no longer paying them, they don't care about me.
• 7:05
  SPEAKER_00: Right.
• 7:06
  SPEAKER_00: I would like to say, no therapist ever is here for the money.
• 7:09
  SPEAKER_00: Right.
• 7:10
  SPEAKER_00: That does not exist in this field.
• 7:12
  SPEAKER_00: I think we all entered grad school thinking that we would get paid like psychiatrists, and we do not.
• 7:18
  SPEAKER_02: Such a good point because you're spot on.
• 7:20
  SPEAKER_02: When I was in grad school, I would think to myself, all I need is this master's degree, and suddenly I am gonna be able to pay my bills and afford life, the way that life is set up for us right now.
• 7:33
  SPEAKER_02: That is just like so far from the truth, even though it appears maybe differently.
• 7:38
  SPEAKER_00: Definitely.
• 7:39
  SPEAKER_00: And I think in a way it can elevate us.
• 7:41
  SPEAKER_00: Maybe we're no longer eating cereal for every meal.
• 7:44
  SPEAKER_00: Right.
• 7:44
  SPEAKER_00: But in general, I hope that clients know and understand if your therapist is not accepting you on social media, it's not because they don't like you or they're trying to abandon you.
• 7:55
  SPEAKER_00: It's an ethical issue, yeah, entirely.
• 7:59
  SPEAKER_02: There's also a piece of the therapists in this setting really doing their job in prompting clients and letting them know in the beginning of the ra relationship and when services are coming to an end or the relation the therapeutic relationship is ending, kind of reminding your client that in the future you might be able to access me, but there are certain ways in which you can access me and certain ways in which you cannot access me.
• 8:25
  SPEAKER_00: Definitely.
• 8:26
  SPEAKER_00: On that tidbit, have you ever run into a client in person?
• 8:30
  SPEAKER_00: Um I should reframe that.
• 8:32
  SPEAKER_00: Obviously, yes, all the time in a work setting.
• 8:34
  SPEAKER_00: Out and about in the wild.
• 8:37
  SPEAKER_02: Oh my gosh.
• 8:38
  SPEAKER_02: You know, now that I think about it, which like knock on wood, I'm gonna like, you know, show up to Costco tomorrow and see all my clients or something.
• 8:45
  SPEAKER_02: But weirdly enough, I have not had that experience of running into clients out and about.
• 8:52
  SPEAKER_02: I will say, obviously, I worked in a big city at my last few jobs.
• 8:57
  SPEAKER_02: So maybe it was less likely that I run into clients.
• 9:00
  SPEAKER_02: I live in a much smaller city now.
• 9:02
  SPEAKER_02: Um, I do remember there was one time I was walking around in old Navy, and I noticed out of the corner of my eye, there was a parent that I had previously worked with.
• 9:13
  SPEAKER_00: Good relationship or bad relationship?
• 9:15
  SPEAKER_02: It was a good relationship, and it was from my current job, which I will say in my current job, I am a short-term therapist.
• 9:22
  SPEAKER_02: I don't work with my clients for longer than about 60 days, and even that is a stretch most of the time.
• 9:29
  SPEAKER_02: My job is to help the client stabilize their safety and then transfer them into higher, lower, lowered level of care.
• 9:36
  SPEAKER_00: So hopefully this person wasn't holding a personal vendetta.
• 9:38
  SPEAKER_00: Time to form one in 60 days.
• 9:40
  SPEAKER_02: Right.
• 9:41
  SPEAKER_02: That is part of kind of a perk of my job right now is that I am always discharging and bringing in new clients.
• 9:48
  SPEAKER_02: It's it's a constant cycle that's going for me.
• 9:50
  SPEAKER_02: And so any client that I work with in my current job, uh, it is short term.
• 9:54
  SPEAKER_02: I'm act as kind of a bridge to get them to wherever they need to go.
• 9:58
  SPEAKER_02: So I do remember like a brief interaction where I saw my client's caregiver, and I remember just kind of having an urge to make myself not be seen.
• 10:09
  SPEAKER_02: I think that my initial reaction would be to kind of take myself out of the space, just like remove myself, walk to an area where they aren't.
• 10:19
  SPEAKER_02: So, no, I guess I don't have a ton of experience with running into clients.
• 10:23
  SPEAKER_00: It's probably a good thing.
• 10:24
  SPEAKER_00: Gosh, I do everything I can to adamantly avoid it because I just feel like it's uncomfortable.
• 10:30
  SPEAKER_00: It's uncomfortable for them, it's uncomfortable for me, they're trying to live their life.
• 10:35
  SPEAKER_00: Maybe they didn't want to share that with me.
• 10:37
  SPEAKER_00: I had a nightmare story.
• 10:38
  SPEAKER_00: Ooh.
• 10:39
  SPEAKER_00: I was at WSU.
• 10:42
  SPEAKER_00: For people who don't know, I guess Washington State University is a party school in the state of Washington where I attended my undergrad and have a couple of close friends who went there.
• 10:52
  SPEAKER_00: We were on a girls' trip for a football game.
• 10:54
  SPEAKER_00: Ooh.
• 10:54
  SPEAKER_00: The football game occurred in the afternoon.
• 10:56
  SPEAKER_00: So we were eating afterwards at a bar type location.
• 11:01
  SPEAKER_00: We had fully participated in all of the shenanigans of the day.
• 11:06
  SPEAKER_00: And I'm sitting there, and all of a sudden, it's like direct eye contact, like that moment that you don't want to have of like, oh no, but you're so um not present because you're gently intoxicated from partaking in the day.
• 11:23
  SPEAKER_00: Key word gently.
• 11:24
  SPEAKER_00: Uh-huh.
• 11:25
  SPEAKER_00: Definitely gently.
• 11:26
  SPEAKER_00: That in my brain, I was like, just put your sunglasses on.
• 11:29
  SPEAKER_00: So as my friends are talking to me, because they have no idea this is occurring, I just put them down over my eyes and they both look at me like, what's wrong with you?
• 11:37
  SPEAKER_00: And I was like, nothing.
• 11:38
  SPEAKER_00: And they were like, Well, it's not sunny out.
• 11:40
  SPEAKER_00: Some something's wrong with you.
• 11:42
  SPEAKER_00: And I was like, No, I'm good.
• 11:43
  SPEAKER_00: You just can't recognize me now.
• 11:45
  SPEAKER_00: And they were like, Nope, just looks like you with sunglasses.
• 11:49
  SPEAKER_00: Wow.
• 11:49
  SPEAKER_00: Honestly, it worked.
• 11:51
  SPEAKER_00: It was like a weird thing where they moved on and I moved on.
• 11:54
  SPEAKER_00: So maybe that sent the signal of we don't have to acknowledge one another because they looked like they also did not want me to look at them in that moment.
• 12:02
  SPEAKER_02: And I think that goes back to population.
• 12:04
  SPEAKER_02: Cause if I was to see, like in that example at Old Navy, like care caregiver might not have any desire to be interacting with me or acknowledging me.
• 12:14
  SPEAKER_02: Whereas sometimes I have little kids that they don't really understand the professional dynamics uh or confidentiality within the dynamic of like if you see your therapist out, you can choose to pretend like you don't know them.
• 12:29
  SPEAKER_02: That is kind of part of the therapeutic relationship.
• 12:32
  SPEAKER_02: Well, it's very much a part of it.
• 12:33
  SPEAKER_02: For a six-year-old, if they saw me out and about, they would just be excited that they see a familiar face or, you know, someone that they've connected or bonded with in some type of setting.
• 12:45
  SPEAKER_02: Now they're seeing me in a different setting.
• 12:48
  SPEAKER_02: I go back to like, I am not a robot.
• 12:52
  SPEAKER_02: If I saw one of my clients out and they had some type of desire to be interacting with me in a public setting, then I think I would be open to that.
• 13:02
  SPEAKER_02: I can't really think of a situation where I wouldn't be.
• 13:04
  SPEAKER_02: But kind of your like your story that you explained, if I wasn't in a state of mind to be interacting, I could see that cause me some type of like discomfort or anxiety.
• 13:15
  SPEAKER_00: It was awkward.
• 13:16
  SPEAKER_00: Yeah.
• 13:17
  SPEAKER_00: And I mean, I moved on.
• 13:18
  SPEAKER_00: It was never referenced and it was fine.
• 13:21
  SPEAKER_00: I've like run into clients at the grocery store before and they'll like nod at me and I'll nod back.
• 13:26
  SPEAKER_00: That's a good level of interaction for me.
• 13:27
  SPEAKER_00: It's such a delicate area where if you want to come talk to me, I'm fully present and can make myself available because you do care about people.
• 13:35
  SPEAKER_00: And simultaneously, maybe we already spend time together and you live your life, I'll live mine, and you decide if you want to share this or not with me.
• 13:43
  SPEAKER_02: Absolutely.
• 13:44
  SPEAKER_02: Well, I guess I've been maybe a little lucky in not having those experiences out and about, but then also having some level of awareness that it's a small world and you're right into people at some point or another.
• 13:57
  SPEAKER_00: I want to take you on a full U-turn though.
• 13:59
  SPEAKER_00: Love it.
• 13:59
  SPEAKER_00: Can we talk about therapists in the media specifically fictionally portrayed?
• 14:05
  SPEAKER_00: Oh.
• 14:07
  SPEAKER_00: Can you give me an example?
• 14:09
  SPEAKER_00: I hate it.
• 14:10
  SPEAKER_00: Anytime anybody sees something that has a therapist in it, they're like, you should see this.
• 14:16
  SPEAKER_00: I'll suddenly love this character just because they're a therapist, but almost every single time therapists in media, A, so incredibly unethical, and B oftentimes like weirdly sexualized in a way that honestly just makes me uncomfortable when I watch the media.
• 14:32
  SPEAKER_00: I guess my mind went to like social media.
• 14:36
  SPEAKER_02: What is kind of being portrayed on there?
• 14:38
  SPEAKER_02: Do you watch uh I think it's on Hulu?
• 14:40
  SPEAKER_02: It's called Couples Therapists.
• 14:42
  SPEAKER_02: No.
• 14:43
  SPEAKER_02: Really?
• 14:43
  SPEAKER_02: Maybe it's not on Hulu.
• 14:45
  SPEAKER_02: Maybe it's more peacock vibes.
• 14:46
  SPEAKER_02: It's reality.
• 14:47
  SPEAKER_02: So you are actually getting to see a therapist do like couples therapy.
• 14:51
  SPEAKER_02: I remember watching that show, and it is very interesting.
• 14:55
  SPEAKER_02: I'm not a couples therapist.
• 14:56
  SPEAKER_02: So I remember watching being like, whoa, like there's two clients in the session.
• 15:01
  SPEAKER_02: How do people do that?
• 15:02
  SPEAKER_02: Because that's just like a foreign language to me.
• 15:04
  SPEAKER_02: There was something that was like, it was very glorified.
• 15:08
  SPEAKER_02: I remember wondering, are we seeing like an increase for people who've watched the show?
• 15:12
  SPEAKER_02: Are people more willing, or have we normalized being in the setting by throwing a reality show on Peacock about couples therapy?
• 15:20
  SPEAKER_02: One hand I was like, this could be helpful, beneficial.
• 15:23
  SPEAKER_02: But then there's this other hand of the media portraying therapy in a way that's it solves all the problems, or it always works.
• 15:32
  SPEAKER_02: Or, you know, you walk into therapy and suddenly you have the perfect therapist sitting in front of you that you bond with and connect with when it typically doesn't go like that.
• 15:42
  SPEAKER_00: I feel like most people have to try out several before they find a good fit, and I think that's really normal.
• 15:47
  SPEAKER_00: And I wish more people knew about it and talked about it because it's just not the reality when you walk into a space.
• 15:54
  SPEAKER_00: Have you ever seen the show shrinking?
• 15:56
  SPEAKER_00: I have not.
• 15:57
  SPEAKER_00: Oh, it's really cute.
• 15:58
  SPEAKER_00: I uh always mix every actor's name up, so apologies and bear with me.
• 16:04
  SPEAKER_00: I want to say it's Harrison Ford.
• 16:06
  SPEAKER_00: Okay.
• 16:07
  SPEAKER_00: And maybe Jason Segal.
• 16:10
  SPEAKER_00: Sure.
• 16:10
  SPEAKER_00: That sounds right.
• 16:11
  SPEAKER_00: Let's go with there, but they sound great.
• 16:13
  SPEAKER_00: You're unfamiliar with Harrison Ford?
• 16:15
  SPEAKER_00: I'm really bad with names.
• 16:16
  SPEAKER_00: Maybe if you put a picture in front of Indiana Jones.
• 16:19
  SPEAKER_00: Oh, okay.
• 16:19
  SPEAKER_00: Uh old now.
• 16:21
  SPEAKER_00: Got it.
• 16:21
  SPEAKER_00: It's still very uh dashing.
• 16:23
  SPEAKER_00: Lovely.
• 16:24
  SPEAKER_00: I have 15 people that I knew personally recommend this show to me.
• 16:29
  SPEAKER_00: I think it was all out of really gentle care.
• 16:32
  SPEAKER_00: And I think if you're not a therapist, you could watch the show and be like, yay, great.
• 16:37
  SPEAKER_00: And I do like it.
• 16:38
  SPEAKER_00: I want to say that it is very funny, it is very relatable.
• 16:43
  SPEAKER_00: The thing about the show is that I think it voices out loud a lot of the inside thoughts that we have that we should and ethically are responsible to keep internal.
• 16:54
  SPEAKER_00: So it's hard to stomach sometimes.
• 16:56
  SPEAKER_02: Okay.
• 16:56
  SPEAKER_02: As you were speaking about that, my mind went to have you seen the movie Freaky Friday with Lindsay Lohan.
• 17:04
  SPEAKER_02: So when I first decided that I was going to become a therapist, I remember having this visual in my head that I was going to be Jamie Lee Curtis.
• 17:14
  SPEAKER_02: You know how she shows up in her blazer and work pants, and she has that one client who consistently shows up every day to her office that she's sitting there taking notes on a notepad.
• 17:26
  SPEAKER_02: Like it's all just so cookie-cutter.
• 17:28
  SPEAKER_02: That's what being a therapist did.
• 17:30
  SPEAKER_02: And I remember thinking, like, okay, I'm gonna be Jamie Lee Curtis.
• 17:34
  SPEAKER_02: I'm gonna sit in a fancy leather black chair.
• 17:36
  SPEAKER_02: I'm gonna have a notepad on my lap and I'm gonna take notes and nod my head at, you know, everything my client says, probably while they're laying down.
• 17:45
  SPEAKER_02: Because I feel like they're always laying down in media.
• 17:47
  SPEAKER_00: Yeah, they're always laying down.
• 17:49
  SPEAKER_00: I've never seen a client lay down in what a recession.
• 17:52
  SPEAKER_00: I've had people be like, shut up.
• 17:53
  SPEAKER_00: You don't have to, but you can if you'd like to, right?
• 17:57
  SPEAKER_02: This image that the media puts out of like what it should be.
• 18:00
  SPEAKER_02: And then obviously, as I have done the work and gone through the schooling and have become a therapist, in some situations, sure, it could look like that, but it's based on the individual who's providing the therapy.
• 18:12
  SPEAKER_02: Some people are gonna provide therapy like that, and then others is gonna look just so unbelievably different than that.
• 18:20
  SPEAKER_00: I think most of us are gonna look different than that.
• 18:22
  SPEAKER_00: Right.
• 18:22
  SPEAKER_00: It really sets the tone that we all come across the same way.
• 18:25
  SPEAKER_00: I think another part that uh gives me a little bit of an ick is the thought that we're kind of like hypersexualized as a career in the way that like nurses are sometimes.
• 18:38
  SPEAKER_00: A lot of media portrays therapists sleeping with their clients.
• 18:43
  SPEAKER_00: Right.
• 18:43
  SPEAKER_00: I cannot think of anything in life I would rather do less.
• 18:47
  SPEAKER_00: Like anything at all.
• 18:49
  SPEAKER_00: Maybe I catch a little less of that just working with kids.
• 18:53
  SPEAKER_00: That's fair.
• 18:54
  SPEAKER_00: I think that would be more along the trope of like the parent being attracted to.
• 18:58
  SPEAKER_02: That is still alarming in its own way.
• 19:01
  SPEAKER_02: Just catastrophic to think about kind of like how clinicians can be sexualized.
• 19:06
  SPEAKER_02: I don't know what kind of example of this is.
• 19:08
  SPEAKER_02: But when you're going through training and learning how um to kind of conceptualize your clients and hold the boundaries and things like that, I think about the younger, maybe female therapists who are working with older men who again have kind of played into this dynamic of older men are showing up and and looking at the younger individuals saying, Here, here's my problems, fix me.
• 19:35
  SPEAKER_02: You know, how do we make this work?
• 19:38
  SPEAKER_02: Which already kind of sets us up in a space where we are here to give.
• 19:44
  SPEAKER_02: And I'm not saying it just has to be like a younger woman and an older um male individual.
• 19:49
  SPEAKER_02: The dynams can definitely be flip-flopped where it's a younger male therapist and an older individual or everything in between.
• 19:56
  SPEAKER_02: There's also this added layer of pressure that you have a service that you are trying to provide to this person.
• 20:03
  SPEAKER_02: People have interesting ways of how they think we might help or fix.
• 20:08
  SPEAKER_00: I touching on that.
• 20:09
  SPEAKER_00: The idea you're giving constantly in this space.
• 20:12
  SPEAKER_00: And for a lot of people, they're like, it feels really good to be heard.
• 20:16
  SPEAKER_00: And feeling heard and validated is not the same as feeling romantically connected to someone.
• 20:22
  SPEAKER_00: And when you think about it, I hope that all clients do.
• 20:26
  SPEAKER_00: I get why they feel romantic feelings for therapists sometimes.
• 20:29
  SPEAKER_00: Totally.
• 20:30
  SPEAKER_00: You have somebody who's fully available to you at all times when you are scheduled to be there.
• 20:37
  SPEAKER_00: That's not reality for partners.
• 20:39
  SPEAKER_00: So I don't think it's a fair expectation.
• 20:41
  SPEAKER_00: And you know almost nothing about this person.
• 20:44
  SPEAKER_00: Yeah.
• 20:44
  SPEAKER_00: You're attracted to the fact that they're mentally available for you at all times.
• 20:50
  SPEAKER_02: Right.
• 20:50
  SPEAKER_02: There's not a mutual exchange of information.
• 20:53
  SPEAKER_02: So at some point, I'm sure that I've experienced it in my own clinical setting with my own therapist, is sometimes you kind of ride that high of like, wow, somebody's listening to me, somebody's validating me, somebody's having compassion and empathy for me and building me up when I'm dragging myself down.
• 21:12
  SPEAKER_02: There's just like so much that goes into it that of course it feels fair to kind of give clients the space and grace that sometimes those lines are gonna feel like they they blur for some people, this added layer of responsibility to continuously reiterate to people that this is not a mutual exchange of information and compassion and empathy.
• 21:35
  SPEAKER_02: This is a one-way street.
• 21:36
  SPEAKER_00: Definitely.
• 21:37
  SPEAKER_00: And I think in reverse, and I don't want to like put shame on anybody because I'm sure there are therapists who have been attracted to clients before.
• 21:44
  SPEAKER_00: Absolutely.
• 21:45
  SPEAKER_00: I'm sure ethically they were further out.
• 21:47
  SPEAKER_00: Right.
• 21:47
  SPEAKER_00: Not only is my brain not there in any capacity, I think what occurs to me is that this is a power dynamic in a way that being a teacher or a doctor would be.
• 22:00
  SPEAKER_00: Utilizing that or abusing that power is so fundamentally wrong.
• 22:05
  SPEAKER_00: On top of that, do you want to be a caregiver all the time in relationships?
• 22:09
  SPEAKER_00: Because if you could shove past all of these really awful ethical dilemmas, because technically our code of ethics only says it's a two-year gap, correct?
• 22:19
  SPEAKER_00: Yeah.
• 22:20
  SPEAKER_00: That you can have any kind of sexual relationship you want with clients after two years of termination, which seems insane to me.
• 22:28
  SPEAKER_00: That dynamic still occurs no matter what.
• 22:30
  SPEAKER_00: I think the only reality that it would exist for that I could see as like, okay, is if uh the therapist suddenly develops amnesia, maybe, or they both develop amnesia simultaneously and they have no idea that that relationship existed.
• 22:47
  SPEAKER_00: Such a weird thought.
• 22:48
  SPEAKER_00: And I love that we have rule books to really like keep people being mindful about power dynamics.
• 22:55
  SPEAKER_00: It's uh an extensive rulebook.
• 22:58
  SPEAKER_00: Is there anything in our code of ethics that you find difficult to stomach?
• 23:06
  SPEAKER_02: Difficult to stomach.
• 23:08
  SPEAKER_02: One of the only things that comes to mind right off the bat is in my work setting, we are required when we bring in a client through intake, I could know that client for five minutes or an hour.
• 23:22
  SPEAKER_02: And I'm still required in order to get them in my note-taking system, I'm required to be diagnosing them.
• 23:29
  SPEAKER_02: Um, like pinning a diagnosis, which I don't exactly remember how it works for outpatient.
• 23:34
  SPEAKER_02: I know in my internship, I would get a new client, they would upload their file.
• 23:38
  SPEAKER_02: And for insurance purposes, you would have to kind of stick a diagnosis in their treatment box.
• 23:44
  SPEAKER_02: Yeah, no matter what.
• 23:46
  SPEAKER_02: Which I don't know.
• 23:47
  SPEAKER_02: To me, I understand insurance is needing specific information, but also I guess I have just never understood how on earth we are labeling or pinning diagnoses on clients that we have not worked with.
• 24:05
  SPEAKER_02: Yeah, that's fair.
• 24:06
  SPEAKER_02: So I don't even really know if that goes into like our code of ethics, but it always is one of those things where it feels like I'm doing something that has weight to it and I don't really believe in this thing I'm doing, but I am doing it because it's a requirement of working with this individual.
• 24:23
  SPEAKER_00: I think that occurs for all of us at some point in time or another.
• 24:26
  SPEAKER_00: Uh, I'm a big fan of an adjustment disorder until you have enough time to really figure out what's going on.
• 24:32
  SPEAKER_00: Right.
• 24:33
  SPEAKER_00: Because it can be not so straightforward sometimes.
• 24:38
  SPEAKER_00: Is there something that comes up in your mind, like code of ethics-wise?
• 24:41
  SPEAKER_00: What there's a section on gifts, which I think is really interesting because it's kind of a gray area, right?
• 24:47
  SPEAKER_00: It's like you're not allowed to accept gifts over a certain value, but it doesn't tell you what that value is.
• 24:53
  SPEAKER_00: It's up to you to decipher if it's ethical or not.
• 24:57
  SPEAKER_00: In my experience, working with people occasionally, they want to bring you something or make you something, or if they are like really cool creators, they want to bring that to you.
• 25:08
  SPEAKER_01: Right.
• 25:08
  SPEAKER_00: And it's a really awkward place where you're like, let me judge the monetary value of this item that someone's giving to me.
• 25:15
  SPEAKER_00: Because I want to say, yes, if you made something for me, I think that's the kindest thing of all time.
• 25:21
  SPEAKER_00: I do treasure these things and I do have like an area in my home office where I keep a bunch of these things, obviously, not with any kind of identifying client information on it.
• 25:31
  SPEAKER_00: It's really sweet.
• 25:33
  SPEAKER_00: And I haven't been in a place yet where I've had to be like, no, thank you, because I can't.
• 25:39
  SPEAKER_00: But I can't imagine how awkward that would be.
• 25:43
  SPEAKER_02: Maybe that is one of the code of ethics that I am a little bit more flexible on.
• 25:46
  SPEAKER_02: A large portion of it has to do with I work with kids.
• 25:49
  SPEAKER_02: And so when they bring me their artwork or their half-eaten bag of goldfish or whatever, I am absolutely accepting it.
• 25:57
  SPEAKER_02: First and foremost, my job as a therapist is do no harm.
• 26:00
  SPEAKER_02: And I come back to that constantly.
• 26:02
  SPEAKER_02: If in some way I'm gonna create harm by telling this client, hi, I can't take this$10 Starbucks gift card, or I can't take this little thing, that little plant that you brought me.
• 26:13
  SPEAKER_02: I just know there's no part of me that is going to cause that weird chance of harming, especially because gift giving is a form of connection.
• 26:23
  SPEAKER_02: So it's like, sure, gift giving is not really my personal love language.
• 26:28
  SPEAKER_02: It's not really something that helps me feel connected to someone more.
• 26:32
  SPEAKER_02: But there's a lot of people in this world.
• 26:35
  SPEAKER_02: There is some level of mindfulness about the power dynamic.
• 26:38
  SPEAKER_02: I can't have my client gifting me an Apple Watch.
• 26:41
  SPEAKER_02: But I think naturally, as therapists, you have some gauge of like if my client was to hand me a gift that was about$10 versus a gift that was$100, I genuinely trust that in my body, if that client was giving me something that was, you know,$100 or just something that was not appropriate for the setting, that I would notice that in my body and then be able to kind of take a pause and and talk to my client about why I'm not able to accept this, because I think that would cause some weird issues around the power dynamic.
• 27:17
  SPEAKER_00: Definitely.
• 27:18
  SPEAKER_00: It could be a romantic issue.
• 27:19
  SPEAKER_00: I also think about it from like a legal issue of is there a chance that there's gonna be any legal repercussions of this action as somebody giving me an extravagant gift that I maybe haven't worked with for very long in an attempt to maybe make me feel obligated to lean into whatever ethical or legal concern that they have.
• 27:40
  SPEAKER_00: Yeah.
• 27:40
  SPEAKER_00: And I don't accept extravagant gifts for that reason and definitely not from people that I haven't known very long.
• 27:46
  SPEAKER_00: I love a good hand-drawn photo from a kid.
• 27:48
  SPEAKER_00: Like I was talking about uh my plant in my office.
• 27:52
  SPEAKER_00: A lot of it is they're filled with teeny tiny trinkets from people who wanted to leave them there or got excited.
• 27:59
  SPEAKER_00: And I think it's a very sweet building block, especially for child clients, to be able to thank somebody who's done a lot of help for them.
• 28:09
  SPEAKER_00: That's not the right way to say that, but you know what I mean.
• 28:12
  SPEAKER_02: Yeah.
• 28:12
  SPEAKER_02: When I was an intern, I remember I had a client who on our last day, she brought me a little box that had some stickers.
• 28:22
  SPEAKER_02: It had a bath bomb, a little card that said thank you for all the support.
• 28:28
  SPEAKER_02: And I think there was like a little body spray or something like that.
• 28:33
  SPEAKER_02: I can just remember this sweet girl was so excited to sit there and watch me like open my card and like the stickers.
• 28:40
  SPEAKER_02: She's like, I I handpicked those stickers for you.
• 28:43
  SPEAKER_02: Like she had really put in the time and energy into like creating this gift.
• 28:48
  SPEAKER_02: This client actually even asked me, like the session before, am I allowed to gift you something small?
• 28:54
  SPEAKER_02: I would really like that.
• 28:55
  SPEAKER_02: There's absolutely no obligation.
• 28:57
  SPEAKER_02: I don't think one way or different of you if you don't.
• 29:00
  SPEAKER_02: Whatever you feel like is comfortable, we can go with that.
• 29:03
  SPEAKER_00: I think it's sweet.
• 29:04
  SPEAKER_00: I think whenever you're terminating a long-term relationship with anybody who's helped you, it's a thoughtful thing to do.
• 29:11
  SPEAKER_00: I always think about like growing up on teacher appreciation, right?
• 29:14
  SPEAKER_00: Yeah.
• 29:15
  SPEAKER_00: You bring your teacher something or write them a note if they were great or bring them a coffee.
• 29:20
  SPEAKER_00: Because we're not robots at the end of the day.
• 29:23
  SPEAKER_02: We're humans, we're people.
• 29:24
  SPEAKER_02: Sure, it would cause me discomfort to get something that was proportionately not appropriate for the setting, but also it makes me feel good after, you know, working hard with someone and putting in my own time and energy with them that they want to take a moment to acknowledge the relationship in in a way that feels good or sacred for them.
• 29:43
  SPEAKER_00: Who am I to, you know, shut that down?
• 29:45
  SPEAKER_00: I think no provider is ever sad if you want to make them a piece of artwork or write them a note.
• 29:50
  SPEAKER_00: Totally.
• 29:50
  SPEAKER_00: Always an appropriate way to end a relationship, should it feel right to you?
• 29:54
  SPEAKER_00: That's thought the thought that counts.
• 29:56
  SPEAKER_00: On those lines, I'm not taking a complete turn this time.
• 29:59
  SPEAKER_00: Okay.
• 30:00
  SPEAKER_00: In termination, when you think about that, I know that sometimes this comes up a lot.
• 30:05
  SPEAKER_00: When is the proper time to terminate?
• 30:07
  SPEAKER_00: I have also heard of clients feeling mixed reviews about bringing that up because they're afraid of hurting your feelings.
• 30:14
  SPEAKER_00: Right.
• 30:14
  SPEAKER_00: What are your thoughts around termination?
• 30:16
  SPEAKER_00: Having both a private practice knowledge and also currently.
• 30:20
  SPEAKER_02: Termination is tricky because in my current job, it's a state-funded program.
• 30:26
  SPEAKER_02: So honestly, the state kind of gets to decide depending on what insurance my client has.
• 30:31
  SPEAKER_02: If they have private insurance, they get a little longer.
• 30:33
  SPEAKER_02: If they have state, it's a little shorter.
• 30:35
  SPEAKER_02: In terms of termination, I totally get people feeling hesitant to speak up on when they think they're ready to be done versus when their therapist might think that.
• 30:48
  SPEAKER_02: It's tricky because I don't know.
• 30:51
  SPEAKER_02: I too have felt the pressure of maybe not always being honest or super forthcoming or direct about my thoughts with my own personal therapist.
• 30:59
  SPEAKER_02: Then when I'm in session with my clients, I feel like I'm constantly reminding them, I don't care one way or another.
• 31:05
  SPEAKER_02: As long as you're getting what you need, it doesn't matter to me if we work for six more months or six more years together.
• 31:11
  SPEAKER_02: As long as we have this open line of communication.
• 31:14
  SPEAKER_02: It's this slippery slope of just constantly having this open line of communication with your client.
• 31:21
  SPEAKER_02: And not only that, like things change.
• 31:25
  SPEAKER_02: I could have a client where I feel like they're ready to discharge and terminate services, and the following week happens and they experience a tragic event or something happens and comes up in their life that maybe might change kind of the plan that was made around services being terminated.
• 31:45
  SPEAKER_02: It's different when you work in private practice and you are being compensated, which I could be wrong about this, but you're being compensated per client.
• 31:54
  SPEAKER_02: That is correct, yeah.
• 31:55
  SPEAKER_02: Right.
• 31:55
  SPEAKER_02: And so if you have clients that aren't really engaging or maybe aren't as consistent, maybe aren't needing to see weekly, needing to do like an every other week thing, then you have to kind of be mindful about the rest of your caseload and filling time and making sure that your schedule works for you.
• 32:13
  SPEAKER_02: Whereas I work in a setting where I'm paid on a salary wage.
• 32:18
  SPEAKER_02: So I could see one client a day or I could see five clients a day.
• 32:21
  SPEAKER_02: So I think working in private practice, you have to have kind of a different level of mindfulness around keeping the balance, you know, making sure that your client's treatment journey is fitting for them and is what they need, but also makes sense for your schedule and what works for you.
• 32:39
  SPEAKER_00: I think so.
• 32:40
  SPEAKER_00: I mean, obviously my setting's a little bit different, but I feel personally excited when somebody's ready for termination.
• 32:48
  SPEAKER_00: I'm of course sad because I get to know them and they're funny and I genuinely enjoy spending time with them.
• 32:54
  SPEAKER_00: But I tell people pretty early on, because this question does come up frequently.
• 32:59
  SPEAKER_00: My whole job is to get you to a place where you don't need me or you need me infrequently.
• 33:06
  SPEAKER_00: And I want you to get there genuinely.
• 33:09
  SPEAKER_01: Yeah.
• 33:10
  SPEAKER_00: I know the entire time we're working together through all the hard stuff that I'm setting you up in a place, hopefully, if I'm doing my job, to be able to tackle it yourself or with a new circle of people who support you or in whatever way you might need to.
• 33:28
  SPEAKER_00: And so I'm not sad.
• 33:30
  SPEAKER_00: I genuinely feel happier for them than I feel like stressed or sad about how do I fill my schedule, what comes next for me, especially given uh the ratio of therapists to people who exist.
• 33:41
  SPEAKER_00: Yeah.
• 33:42
  SPEAKER_00: There will be other people that I can go on and help and find purpose.
• 33:45
  SPEAKER_00: And I don't have to like sit there and be sad and anxious.
• 33:51
  SPEAKER_00: Oh yeah, no.
• 33:52
  SPEAKER_00: I don't think I've ever felt sad about closing, discharging a client.
• 33:56
  SPEAKER_02: And if anything, that's an accomplishment.
• 33:58
  SPEAKER_02: That means, you know, we've done something right and we've gotten somewhere.
• 34:01
  SPEAKER_02: Of course, there are clients that I'll miss because we have a good bond.
• 34:05
  SPEAKER_02: But in my mind, there is always someone right around the corner waiting for the spot on my caseload, waiting for some level of support.
• 34:13
  SPEAKER_02: I'm definitely quick to discharge clients.
• 34:16
  SPEAKER_02: I affirm in as soon as we start seeing change, then I'm quick to mesh them out because there's somebody else that needs to start that cycle always.
• 34:26
  SPEAKER_00: And as you brought up, we also have that conflicting obligation, right?
• 34:29
  SPEAKER_00: Of if I'm billing insurance, I have to be billing it authentically.
• 34:34
  SPEAKER_00: You can't be committing fraud in that space.
• 34:36
  SPEAKER_00: Right.
• 34:36
  SPEAKER_00: So if you don't have a medical necessity for attending therapy, unfortunately, that does mean you need to be self-pay or I have to close the case.
• 34:49
  SPEAKER_02: Right.
• 34:49
  SPEAKER_02: Tricky situation.
• 34:50
  SPEAKER_02: It just goes back to the setting and what's expected because in your type of work setting, it is a little more expected that clients can stay there until they're ready to transition.
• 35:00
  SPEAKER_02: Whereas in my setting, you're on a timeline and you know, your insurance is gonna kick you out of the program one way or another.
• 35:06
  SPEAKER_02: There's a crunch of having to be super solution focused and kind of speed things up so that you can get what you need in the the short time frame that I have.
• 35:16
  SPEAKER_00: Sometimes I do see this in a different way, and I think it's wild when I see this.
• 35:19
  SPEAKER_00: I realize this is probably more normative in your field, but it'll be insurances that are like 10 sessions approved.
• 35:26
  SPEAKER_00: And I'm like, wow, right.
• 35:28
  SPEAKER_00: 10 sessions feels like nothing.
• 35:30
  SPEAKER_00: I realize that is something, right?
• 35:32
  SPEAKER_00: Some support is better than a support at all.
• 35:34
  SPEAKER_00: Yeah.
• 35:35
  SPEAKER_00: But I guess when I see that, it's just the signal of like identify the problem, be really solution focused, give them as many resources so that they can look into them when you're not around.
• 35:45
  SPEAKER_02: The approach and how you engage in the treatment setting is completely shifted when there's some sort of timeline presented, which both I think serve a purpose in their own way.
• 35:57
  SPEAKER_02: We need both settings.
• 35:59
  SPEAKER_00: Oh, constantly trying to navigate and jump through hoops of every single expectation possible and meet everything and document it all in a timely manner, because of course, all of my documentation is always done within 24 hours.
• 36:12
  SPEAKER_00: Absolutely, as it should be.
• 36:14
  SPEAKER_00: Shifting gears.
• 36:16
  SPEAKER_00: Can you tell me something that you're looking forward to in the upcoming month?
• 36:21
  SPEAKER_02: Hmm, looking forward to so this is a little far out, but my sister is getting married.
• 36:30
  SPEAKER_02: We just found out she's having destination weddings.
• 36:33
  SPEAKER_02: So Father's Day next year.
• 36:35
  SPEAKER_02: I think we will be in Mexico somewhere.
• 36:38
  SPEAKER_02: I get to see my sister get married in Mexico with all of our friends and family.
• 36:43
  SPEAKER_02: Even though it's not till next June, my type B brain is like, oh gosh, I should probably pay attention to this now because these things require planning and structure and taking off time of work and saving money.
• 36:57
  SPEAKER_02: So recently I've been thinking a lot about how next summer I'm gonna be in Mexico's, you know, watching my sister get married, which is so exciting.
• 37:05
  SPEAKER_00: I love that.
• 37:07
  SPEAKER_00: That is hard.
• 37:08
  SPEAKER_00: I think a destination wedding sometimes is amazing and sometimes is a lot of boofing pieces.
• 37:13
  SPEAKER_02: I'm not a part of the planning portion.
• 37:15
  SPEAKER_02: It sounds like just in the first initial weeks of planning, it's been chaotic.
• 37:21
  SPEAKER_00: That's a good way to sum it up.
• 37:23
  SPEAKER_00: Oh, I love that.
• 37:24
  SPEAKER_00: Well, and I think anyway, you can kind of just focus on the happy things.
• 37:28
  SPEAKER_00: Totally.
• 37:28
  SPEAKER_00: What about you?
• 37:29
  SPEAKER_00: Looking forward to anything.
• 37:31
  SPEAKER_00: Ooh, uh, my happy thing, I think, is just Halloween and all things related to the fall, aside from pumpkin spice, obviously.
• 37:40
  SPEAKER_00: Given that I'm deathly allergic, it means I'm gonna avoid every coffee shop for the next month.
• 37:44
  SPEAKER_02: But you're allergic to pumpkin?
• 37:46
  SPEAKER_00: To cinnamon.
• 37:47
  SPEAKER_00: Oh, to cinnamon, that's right.
• 37:49
  SPEAKER_00: I thought you meant pumpkin, and I'm like, whoa, I didn't know this.
• 37:51
  SPEAKER_00: No, that'd be a tragedy.
• 37:52
  SPEAKER_00: Yeah, that would no terrible.
• 37:54
  SPEAKER_00: I make a version of pumpkin pie that is arguably slightly less good.
• 37:57
  SPEAKER_00: You still make it work.
• 37:58
  SPEAKER_00: So no cinnamon dolce lattes from Starbucks?
• 38:01
  SPEAKER_00: No Starbucks at all.
• 38:03
  SPEAKER_00: From August through January, because you've got pumpkin spice and then into gingerbread.
• 38:10
  SPEAKER_02: Okay, because I was gonna say, I've definitely seen you with the Starbucks before.
• 38:13
  SPEAKER_00: Yeah, it exists.
• 38:14
  SPEAKER_00: I just avoid during those months.
• 38:17
  SPEAKER_00: And the summer months are great.
• 38:18
  SPEAKER_00: Everything fruity, I'm all about it.
• 38:20
  SPEAKER_00: But I'm specifically excited.
• 38:22
  SPEAKER_00: There is a haunted farmer's market that they put on in Tacoma every year that I've been wanting to go to for forever.
• 38:29
  SPEAKER_00: So I finally found a time to squeeze that in.
• 38:32
  SPEAKER_00: And we're growing pumpkins in our garden this year.
• 38:35
  SPEAKER_00: Ooh.
• 38:36
  SPEAKER_00: Yeah.
• 38:36
  SPEAKER_00: So I'm extra excited.
• 38:38
  SPEAKER_00: I took my hand at gardening for the first time ever, and I'm mediocre at best, but trying.
• 38:44
  SPEAKER_00: And I'm just excited to see how it all plays out.
• 38:47
  SPEAKER_00: Is it gonna be horrendous?
• 38:49
  SPEAKER_00: Maybe, but it's my best shot.
• 38:52
  SPEAKER_00: I'm a pumpkin painter, not a carver.
• 38:54
  SPEAKER_00: I think you can fix any perfection with a little bit of paint, and it still will not be great, but it'll be my best.
• 39:00
  SPEAKER_00: Cute.
• 39:01
  SPEAKER_00: I like that.
• 39:02
  SPEAKER_00: Yeah.
• 39:03
  SPEAKER_00: Well, I think it's time.
• 39:04
  SPEAKER_00: It is what it is.
• 39:05
  SPEAKER_00: It is what it is.
• 39:06
  SPEAKER_00: Thanks for being here.
• 39:07
  SPEAKER_00: Until next time.