Latest / The Trauma Therapist / When Something Happens to You with Robyn Miller, Ph.D

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When Something Happens to You with Robyn Miller, Ph.D · The Trauma Therapist

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  Speaker 1: Trauma Thepist Podcast Plus listeners can listen to episodes early
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  Speaker 1: and ad free right now. Become a Plus listener by
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  Speaker 1: going to Apple Podcasts, searching for the Trauma Thepist podcast
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  Speaker 1: and signing up today. Welcome to the Trauma neverst Podcast,
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  Speaker 1: a show about the incredible people dedicated to helping those
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  Speaker 1: who experienced trauma. My name is got macpherson, and my
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  Speaker 1: mission is to raise awareness of trauma and to inspire
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  Speaker 1: each of us to help those around us. Robin, you
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  Speaker 1: ready to do it?
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  Speaker 2: I'm ready?
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  Speaker 1: Okay, So five four, three, two and one, our folks,
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  Speaker 1: welcome back to the podcast. Very excited to have as
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  Speaker 1: my guest today, doctor Robin Miller. Robin welcome, Thanks so
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  Speaker 1: much for having me.
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  Speaker 3: Awesome so.
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  Speaker 1: Robin is a licensed clinical psychologist and the founder of
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  Speaker 1: therap Closure, the first therapist professional executor service. Robin has
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  Speaker 1: been in private practice in Bethesda, Maryland since two thousand
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  Speaker 1: and two. She received a BA in child study from
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  Speaker 1: Tufts and a PhD in clinical psychology from the University
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  Speaker 1: of Rochester. She completed a pre doc internship at Harvard
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  Speaker 1: Medical School, Mass Masssachusetts Mental Health Center and a post
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  Speaker 1: doc fellowship at Harvard University Health Services and Ober twenty
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  Speaker 1: years of clinical practice, Robin has provided training, supervision, coverage,
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  Speaker 1: and professional will and practice, executive consultation and services, and
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  Speaker 1: she's written on the topic. Awesome, Thanks so much for
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  Speaker 1: being here. Before we dive in, I'm really excited to
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  Speaker 1: dive in because I know very little about what we're
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  Speaker 1: going to be diving in to today. But before we do,
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  Speaker 1: share with the listeners where you're from originally and where
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  Speaker 1: you are currently.
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  Speaker 2: Sure, I am from nearby Bethesda, Maryland, and found my
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  Speaker 2: way back here after a lot of time, you know,
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  Speaker 2: in other places, and have been back here practicing for
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  Speaker 2: almost twenty five years. So yeah, all.
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  Speaker 1: Right, So let's move into the topic of today. But
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  Speaker 1: before we do, how did you get into this field
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  Speaker 1: rawly in the first place?
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  Speaker 2: Sure? Well, when I was twelve, I said I wanted
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  Speaker 2: to be Chief Justice of the Supreme Court, and that
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  Speaker 2: didn't happen. By the time I was in college, I
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  Speaker 2: was very curious about how we came to be who
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  Speaker 2: we are and went into child study, and from there
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  Speaker 2: went into psychology and thought I would be a professor,
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  Speaker 2: but then loved the work of psychotherapy and so moved
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  Speaker 2: straight from there into this art and science of connecting
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  Speaker 2: with people and trying to help them kind of get
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  Speaker 2: to the heart of what's going on with them and
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  Speaker 2: what they want.
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  Speaker 1: You you mentioned becoming a chief justice. Did you like
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  Speaker 1: pursue that or was that just some whim thing here?
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  Speaker 2: Yeah? No, that was my twelve year old self when
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  Speaker 2: you asked kind of here, it's like, I don't know,
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  Speaker 2: I don't know. Yeah, yeah, we're going to go and
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  Speaker 2: we're kids.
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  Speaker 1: Well, yeah, I mean it's really interesting because you know,
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  Speaker 1: a lot of therapists in this field, there are there
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  Speaker 1: are kind of bread crumbs that you can follow, you know.
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  Speaker 1: They they have that innate ability need want to connect
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  Speaker 1: with people or and or listen to people.
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  Speaker 3: So you start to pursue this. Uh, you went to school,
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  Speaker 3: you got your degree. What was it about.
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  Speaker 1: Let's go back to when you first started seeing clients,
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  Speaker 1: even even in your training, what was it about that
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  Speaker 1: that interaction you mentioned finding out like what's going on?
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  Speaker 1: Talk to us about that?
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  Speaker 2: Yeah, I just love kind of that electric experience when
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  Speaker 2: you are really looking at someone and they are looking
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  Speaker 2: at you and they want to be seen, or even
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  Speaker 2: when they don't want to be seen. Some of My
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  Speaker 2: most favorite people to work with are people who initially
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  Speaker 2: did not want to be seen and kind of put
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  Speaker 2: put their hands up, but then you know, really just
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  Speaker 2: finding a way to see each other in the room,
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  Speaker 2: and you know, being I think my most authentic self
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  Speaker 2: in the room with people is a really nice experience
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  Speaker 2: for me to be there in a way that I
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  Speaker 2: think sometimes is more vulnerable than I'm able to be
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  Speaker 2: in my regular life, and it allows for kind of
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  Speaker 2: a really special way of connecting, and I think that
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  Speaker 2: gives people a taste of intimacy or a kind of
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  Speaker 2: way of relating that can be very healing and very powerful.
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  Speaker 1: And to get to that point where you understand the
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  Speaker 1: importance of being your authentic self, right, I mean, was
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  Speaker 1: that a no brainer for you?
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  Speaker 3: Did you just ease into that or.
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  Speaker 1: For many of us it's I mean for a lot
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  Speaker 1: of us, it's hard to be our authentic selves a therapists.
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  Speaker 1: What was that learning process like for you and how
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  Speaker 1: did you realize that that was key and elemental to
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  Speaker 1: the work.
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  Speaker 2: Yeah, it's an interesting question. I mean, certainly my own
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  Speaker 2: experiences over time with therapy and how important and meaningful
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  Speaker 2: it's been in my life, and that way of relating
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  Speaker 2: I think informed a lot of what I do and
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  Speaker 2: how I say with people. But I think definitely for
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  Speaker 2: a long time, I was maybe a little more rigid
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  Speaker 2: around my way of sitting, more formal, maybe boundaried, and
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  Speaker 2: I still consider myself pretty conservative as far as boundaries go,
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  Speaker 2: but there's a difference in sort of being really open
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  Speaker 2: about how I'm feeling and what's happening in the moment
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  Speaker 2: with people. And that's that's what I really cherish.
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  Speaker 3: People connect with, that we need a human being.
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  Speaker 1: I've told this story before, but recently, like a year
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  Speaker 1: and a half ago, I wanted to get back into therapy.
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  Speaker 1: I just moved here to Bend from Oakland, and I
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  Speaker 1: reached out to my therapist. She was no longer seeing anybody,
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  Speaker 1: but she had referrals. So three referrals, I call them all,
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  Speaker 1: and I'm sure they were all competent, but one of
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  Speaker 1: them in particular, spent the whole time telling me about
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  Speaker 1: the modality and that they were going to use and
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  Speaker 1: this was this, And I was like, I need a
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  Speaker 1: human being who you know what I'm saying, I don't
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  Speaker 1: need to know your personal intimate details, but what exactly
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  Speaker 1: what you're talking about is what I feel a lot
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  Speaker 1: of us need. And it's oftentimes the exact opposite, I
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  Speaker 1: mean of what people experience when they're traumatized. Right, They're
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  Speaker 1: not seen, they're not respected, they're not heard. But anyway,
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  Speaker 1: I love it.
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  Speaker 3: Okay, So.
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  Speaker 1: You start to get into this work, talk to us
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  Speaker 1: about this whole specialization.
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  Speaker 3: That you work in, and when did that become on
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  Speaker 3: your radar?
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  Speaker 2: So it was a big surprise, and it happened about
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  Speaker 2: six years ago when my very closest therapist friend and
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  Speaker 2: supervision partner, we had met weekly for seventeen years, oh
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  Speaker 2: my god, a long time, she suddenly had a terminal
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  Speaker 2: illness that went very, very rapidly, and I stepped in
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  Speaker 2: for her practice and for her, and through the course
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  Speaker 2: of that very painful and tragic circumstance, I learned so
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  Speaker 2: much about what it takes and realized that in our
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  Speaker 2: training we are never really prepared for that. What is
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  Speaker 2: there is very superficial and administratively focused. Might here make
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  Speaker 2: a will. It's your professional ethical duty to plan for
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  Speaker 2: the well being of your patients in the event of
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  Speaker 2: an incapacitation or death, or planned for what happens to
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  Speaker 2: the confidentiality of your medical records, and it's prescribed, you know,
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  Speaker 2: name someone and you know sign on the dot in line.
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  Speaker 2: And I think that's as far as people really ever
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  Speaker 2: think about it, if they think that far, which I
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  Speaker 2: think most don't. I did a survey recently and thirty
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  Speaker 2: one percent said that they have a professional will. But
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  Speaker 2: I think that was kind of a skewed cool. I
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  Speaker 2: think it's much lower than that. Even so, I learned
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  Speaker 2: about what it takes to do the job, what's required.
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  Speaker 2: I wrote a paper about it because it really was
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  Speaker 2: the most wrenching experience for me, having to grieve my
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  Speaker 2: friend and at the same time put my feelings to
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  Speaker 2: the side and have to be present to inform all
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  Speaker 2: of her patients and help them with referrals and take
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  Speaker 2: care of so many things that I could say more
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  Speaker 2: about in a minute. But the process of doing that
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  Speaker 2: while greeting and having my own full time practice and
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  Speaker 2: young children and all of those things was really excruciating.
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  Speaker 2: So then I wrote a paper to try to process
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  Speaker 2: my grief about that.
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  Speaker 3: And got what was the paper called? What was it?
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  Speaker 3: This was a topic?
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  Speaker 2: Sure, so it uh was called I don't know if
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  Speaker 2: I'll even get it exactly right anyway professional wills, and
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  Speaker 2: it was grief and the dismantling of a practice as
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  Speaker 2: the practice executor, So it was really trying to convey
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  Speaker 2: you know, I'm a you know, psychodynamic and relationally oriented therapist,
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  Speaker 2: so as my friend from that perspective, we looked at
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  Speaker 2: grief and the loss of the attachment real therapeutic relationship
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  Speaker 2: as a potential trauma for each patient that was going
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  Speaker 2: to be told this person you relied on for however long,
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  Speaker 2: you're not going to see them again. It was it
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  Speaker 2: was that abrupt, that drastic, and you know, the consequences
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  Speaker 2: were really devastating, and then how to handle what people
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  Speaker 2: were going through and provide for them became, you know,
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  Speaker 2: the mission and became the preoccupation for my friend of
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  Speaker 2: her remaining weeks. It was very short, but her being
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  Speaker 2: alive for those weeks really informed and taught me about
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  Speaker 2: what needs to happen because she was there saying, this
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  Speaker 2: is what I want you to do, and this is
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  Speaker 2: what this patient needs, and this is what that patient needs,
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  Speaker 2: and here's how I want you to handle this. And
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  Speaker 2: so it became this really detailed, comprehensive way of assuming
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  Speaker 2: kind of the needs of all these patients, very differently
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  Speaker 2: than from what I think typically happens, even if someone
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  Speaker 2: has named a professional executor, and especially if they haven't,
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  Speaker 2: where a colleague puts a note on your door and says,
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  Speaker 2: ex therapist is not available. Call doctor so and so
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  Speaker 2: for information. And then they might call and they might
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  Speaker 2: be oh, I'm sorry to tell you this happened, and
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  Speaker 2: here's a list of ten referrals.
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  Speaker 3: Good luck.
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  Speaker 2: That's really minimum. And that's what happens, I think a
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  Speaker 2: lot of times for patients. And I had the experience
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  Speaker 2: of way before this even happened with my friend of
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  Speaker 2: telling someone I had seen an obituary of a colleague
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  Speaker 2: who had passed away, and I knew one of my
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  Speaker 2: own patient's fathers saw this colleague for therapy and he
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  Speaker 2: had told me how amazing the therapist was and how wonderful,
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  Speaker 2: and I didn't know if he knew about it, And
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  Speaker 2: so that was my very first entree where I called
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  Speaker 2: him and said, this isn't about your son. You don't
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  Speaker 2: need to worry, but I have something to share with you.
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  Speaker 2: And I informed him and he said he had gone
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  Speaker 2: to the office the week before saw a note on
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  Speaker 2: the door, never called the because he thought, oh, she's
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  Speaker 2: just an emergency, I'll go again. And you know, my
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  Speaker 2: telling him, he was obviously devastated, sobbing on the phone
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  Speaker 2: talking about what an amazing, amazing impact this person had
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  Speaker 2: had on his life. So I had that experience before
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  Speaker 2: my friend kimssed, and then I had her teaching me
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  Speaker 2: what I needed to do and which like the opposite
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  Speaker 2: end of things.
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  Speaker 1: Let me jump in here, so you use the word executor,
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  Speaker 1: is is the executor in this context the person who
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  Speaker 1: manages the clients or takes over and begins to see
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  Speaker 1: the clients.
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  Speaker 2: No, so the executor is the person who fulfills the
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  Speaker 2: wishes of the therapist. The therapist sets in a professional
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  Speaker 2: will what they want done, how they want their patients notified,
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  Speaker 2: who they might be referred to, Where you're going to
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  Speaker 2: find the access information to get your patient's contact information,
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  Speaker 2: where your records are kept, how you do your billing,
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  Speaker 2: all the details of a practice, and you name typically
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  Speaker 2: a colleague, an attorney will tell you this could be
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  Speaker 2: that an administrative person. Sometimes people leave it to a
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  Speaker 2: family member, but our ethical code is to leave it
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  Speaker 2: with someone who is qualified, not only to interact with
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  Speaker 2: your patients directly in a clinically oriented manner, but also
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  Speaker 2: qualified in being aware of ethical obligations and the legal
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  Speaker 2: obligations around confidentiality and the security of medical records and
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  Speaker 2: compliance of all of that personal health information. So really,
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  Speaker 2: it needs to be a colleague at minimum who then
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  Speaker 2: depths in to fulfill your wishes. And that does not
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  Speaker 2: mean taking on your caseload. It's impossible to take.
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  Speaker 3: On this two separate things.
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  Speaker 1: Okay, let me just remind everyone I'm speaking with doctor
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  Speaker 1: Robin Miller. She's the founder of their Closure, the first
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  Speaker 1: Therapist Professional Executors service. Okay, so, man, this is this
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  Speaker 1: is intense and there's no two ways about it. And
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  Speaker 1: your experience in particular, she was very intense. Was it
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  Speaker 1: after that that you founded their Closure? Talk to us
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  Speaker 1: a little bit about that, and then let's get into
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  Speaker 1: the specifics of what you do there.
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  Speaker 2: Sure. No, it took me a while to get here.
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  Speaker 2: I did this for my one friend and then sadly
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  Speaker 2: I had to do it a second time for another
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  Speaker 2: friend who had a crisis, and I stepped in to
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  Speaker 2: do this for her practice. She thankfully returned to her
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  Speaker 2: practice a number of months later. But in the meantime
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  Speaker 2: I had that as well, and so then I started
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  Speaker 2: doing trainings. And when I did trainings the Maryland Psychological
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  Speaker 2: Association last fall or last winter, the reactions I got
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  Speaker 2: for people were like, whoa, you are stressing me out here.
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  Speaker 2: I never thought about this. I never heard about that.
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  Speaker 2: Or the person that I named, you know, twenty years ago,
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  Speaker 2: has since retired. I don't have close enough colleagues to
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  Speaker 2: ask to do this, you know. People were so overwhelmed,
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  Speaker 2: and so that was the spark from starting therap closure.
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  Speaker 2: I was like, we need a better solution to this problem.
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  Speaker 2: People don't know what to do and that's why they
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  Speaker 2: don't do it. So that was my inspiration.
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  Speaker 1: Now is this specifically for if a therapist is going
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  Speaker 1: dies or is it if they leave and have to
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  Speaker 1: just leave the profession?
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  Speaker 2: So it is for incapacitation.
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  Speaker 3: Or incapacitation Okay, if.
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  Speaker 2: Something were to happen to you severe enough tragic enough
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  Speaker 2: that you don't have at minimum kind of the mental
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  Speaker 2: faculties to call yourself to your colleague and say, hey,
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  Speaker 2: I need coverage because I got to take a month off.
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  Speaker 2: If you can do that, then you got to do
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  Speaker 2: that if you can't do that because something terrible has
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  Speaker 2: happened and you are distraught and unable to function in
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  Speaker 2: the therapeutic role, or if it's a physical incapacitation or death,
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  Speaker 2: you are not able to be your psychological professional self,
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  Speaker 2: then that is when a personal representative, someone that you
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  Speaker 2: name to notify us, would contact us and tell us
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  Speaker 2: something happened to you, and then we would step in
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  Speaker 2: to take care of everything that you have already communicated
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  Speaker 2: to us that you would want done for your patient.
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  Speaker 1: So you folks are acting as that person or that okay, okay.
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  Speaker 2: We take that on so that you don't have to
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  Speaker 2: ask a colleague make this awkward arrangement with a colleague.
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  Speaker 2: Sometimes people pay their colleagues, But the problem with that
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  Speaker 2: is colleagues think, and it'll take two or three hours
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  Speaker 2: to you know, wrap up somebody's practice. It's so so
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  Speaker 2: overwhelming to it takes multiple hours per patient. You're going
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  Speaker 2: to talk to them many times. You're going to have
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  Speaker 2: hours of you know, searching for available therapists who will
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  Speaker 2: be good matches for these people. You know, think how
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  Speaker 2: hard it is these days to find a referral right right, Well,
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  Speaker 2: you have to you know, so all of this it
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  Speaker 2: takes hours and hours and hours. And if you name
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  Speaker 2: a colleague and if you say, oh, my estate will
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  Speaker 2: pay you your hourly rate to take care of this.
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  Speaker 2: You know, for a practice of twenty patients a week
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  Speaker 2: plus you know your records for all your past patients,
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  Speaker 2: and a state could end up with a ten thousand
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  Speaker 2: dollars bill completely unexpected. If the arrangement was my estate
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  Speaker 2: will pay my colleague to do this. The other is,
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  Speaker 2: you know, either it's voluntary, which mine was, and my
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  Speaker 2: heart was happy to you know, be able to be
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  Speaker 2: of use to my friends and do this was to
• 19:27
  Speaker 2: do this for them was in many ways a privilege,
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  Speaker 2: but it also was a tremendous heartbreak and burden at
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  Speaker 2: the same time that I wouldn't wish on anyone. So
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  Speaker 2: I've learned through this process that it's really not the
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  Speaker 2: best idea to have a close colleague do this for you,
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  Speaker 2: and that it's really something we have not as a
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  Speaker 2: field figured out how to make more efficient, cost effective,
• 19:58
  Speaker 2: palatable even for therapists to take care of this. So
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  Speaker 2: during the pandemic and after when so many of us
• 20:06
  Speaker 2: switch to electronic health records, you no longer need it
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  Speaker 2: to be your colleague who's in the office next door
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  Speaker 2: to go into your office and find your paper calendar
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  Speaker 2: and see who you're supposed to see and get the
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  Speaker 2: paper records. We now have the possibility of outsourcing this
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  Speaker 2: like we do with so many other parts of practice.
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  Speaker 2: So that's where the idea came, like, this doesn't need
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  Speaker 2: to be someone who's going to be in the throes
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  Speaker 2: of grief themselves and overburdened. This can be someone who
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  Speaker 2: you know. We certainly don't want it to be a stranger.
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  Speaker 2: We don't want it to be totally a corporate impersonal thing.
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  Speaker 2: But the model that I have developed is we people
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  Speaker 2: who want to make this much easier on themselves and
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  Speaker 2: cross off because I think a lot of people the
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  Speaker 2: feedback I've gotten is I know I should do it,
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  Speaker 2: I know I mean to keep intending to, I'm just
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  Speaker 2: putting it off and on all of that. In order
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  Speaker 2: to solve that and unburden yourself of that weight that
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  Speaker 2: so many people carry, we have created the system where
• 21:16
  Speaker 2: if you want to sign up, we meet for a
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  Speaker 2: really intensive consultation where we try to get to know
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  Speaker 2: you and your practice and how you work, what your
• 21:26
  Speaker 2: orientation is what kind of patients you see, you see them,
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  Speaker 2: how you interact with them, your general style. I want
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  Speaker 2: to get to know the details of how you run
• 21:36
  Speaker 2: your practice, how where your records are, how you keep
• 21:40
  Speaker 2: your schedule, and then we come up with you with
• 21:44
  Speaker 2: a personalized plan of if something happened to you, how
• 21:47
  Speaker 2: would we access that like immediately, so we could reach
• 21:51
  Speaker 2: out immediately to your current patients and let them know
• 21:55
  Speaker 2: in as sensitive and caring away as possible. You know
• 22:00
  Speaker 2: that you would not want the end to be this way,
• 22:08
  Speaker 2: and that you have put together a really caring and
• 22:16
  Speaker 2: compassionate plan for how to take care of your practice
• 22:20
  Speaker 2: and your patients in the event of the unexpected, which
• 22:23
  Speaker 2: sadly has happened. You know, if we're making this phone
• 22:28
  Speaker 2: call to people.
• 22:29
  Speaker 3: Robin, excuse me, so who is this for?
• 22:35
  Speaker 2: It is for all therapists of all disciplines, social workers,
• 22:39
  Speaker 2: licensed marriage and family therapists, counselors, psychologists, it's for psychiatrists too,
• 22:45
  Speaker 2: but for their psychotherapy patients in particular. All across the disciplines,
• 22:51
  Speaker 2: therapists have this ethical obligation. If you go and look
• 22:56
  Speaker 2: in your ethics code, you're going to find it there,
• 22:59
  Speaker 2: even though you probably don't remember ever having heard about
• 23:02
  Speaker 2: it or talked about it, it's there and more.
• 23:07
  Speaker 1: Than something that's nice to do, nice to have checked off.
• 23:12
  Speaker 1: As a therapist, you're ethically responsible, yes, to take care
• 23:18
  Speaker 1: of this, to manage this, you are well.
• 23:22
  Speaker 2: And that is to help mitigate the effects of traumatic
• 23:28
  Speaker 2: loss on vulnerable people who rely on us and trust us.
• 23:34
  Speaker 2: Going back to the start of our conversation, that really intimate,
• 23:38
  Speaker 2: you know, meaningful relationship and for so many people with trauma,
• 23:43
  Speaker 2: what you're working on in therapy is the attachment relationship
• 23:47
  Speaker 2: and can you ever feel secure with someone? Can you
• 23:51
  Speaker 2: ever feel safe? Can you ever be yourself? Are you
• 23:54
  Speaker 2: going to be rejected or abandoned or harmed? And so
• 23:57
  Speaker 2: of course, you know the loss of a therapist in
• 24:01
  Speaker 2: a tragic and sudden means is going to be painful.
• 24:06
  Speaker 2: I mean there's no way around that. I can't prevent that,
• 24:08
  Speaker 2: and you know nobody can. But you can mitigate that
• 24:13
  Speaker 2: loss by communicating to the patients as I did for
• 24:19
  Speaker 2: my friend Kim. You know, I would call after call
• 24:22
  Speaker 2: after call to these people and say, you know, I
• 24:25
  Speaker 2: am the psychologist covering for Kim's practice. I have some
• 24:32
  Speaker 2: really upsetting news. I need to talk with you about.
• 24:35
  Speaker 2: Are you in a private place? Do you have supports
• 24:38
  Speaker 2: available to you? Kim wish she could tell you this herself,
• 24:43
  Speaker 2: but she is unable. She has been diagnosed with And
• 24:47
  Speaker 2: then people decide. My friend wanted it to be excruciatingly
• 24:53
  Speaker 2: plain and direct, so she wanted me to say she's
• 24:58
  Speaker 2: diagnosed with terminal pancreatic cancer and she is unable to
• 25:02
  Speaker 2: be available to her patients anymore. That's what she wanted.
• 25:06
  Speaker 2: Other people will want something different, but it's communicating to people.
• 25:11
  Speaker 2: Then your therapist not only is not available to you,
• 25:16
  Speaker 2: and that's really sad, And I'm here to kind of
• 25:19
  Speaker 2: help you through this immediate reaction and shock and help
• 25:25
  Speaker 2: you with resources so that you're not falling through the cracks.
• 25:29
  Speaker 2: That's really the intent. But also the important part of
• 25:36
  Speaker 2: approaching it this way is to preserve the new secure
• 25:42
  Speaker 2: attachment or the therapeutic alliance, whatever you want to call it,
• 25:46
  Speaker 2: as best as possible, so that it is a loss
• 25:49
  Speaker 2: no matter what we do. But it doesn't necessarily have
• 25:54
  Speaker 2: to be an abandonment. It doesn't have to be a trauma,
• 26:00
  Speaker 2: and you know it can it can be a loss
• 26:03
  Speaker 2: where people understand, Wow, my therapist really cared about me.
• 26:06
  Speaker 2: They did everything in their power to make sure that
• 26:11
  Speaker 2: someone would be there to help me if they were
• 26:15
  Speaker 2: not able to be there for me, and.
• 26:17
  Speaker 1: Not only managing the incredible, obvious, traumatic emotional aspect of this,
• 26:24
  Speaker 1: but also the logistics which you have to be handled,
• 26:28
  Speaker 1: the nuts and bolts of Okay, how do we move
• 26:30
  Speaker 1: on from here? There are these referrals yeah wow. I
• 26:38
  Speaker 1: mean as first of all, as you were talking and
• 26:41
  Speaker 1: you're talking about your own experience with your friend, I
• 26:44
  Speaker 1: was thinking, Okay, how common is this? But then you're like,
• 26:49
  Speaker 1: and then it happened again, so and you can I mean,
• 26:53
  Speaker 1: I can see why a lot of people don't even
• 26:56
  Speaker 1: want to go near this is this is hard stuff
• 26:58
  Speaker 1: to do. Even trauma in and of itself people don't
• 27:01
  Speaker 1: want to talk about. But this is like you're talking
• 27:03
  Speaker 1: about your own incapacitation. You know, you could see what
• 27:07
  Speaker 1: people don't. They want to avoid this.
• 27:11
  Speaker 2: People want to avoid it. And I've been presenting recently
• 27:15
  Speaker 2: at psych associations and trying to tell people about fair closure,
• 27:19
  Speaker 2: this new option, this new way to say, hey, I'm
• 27:22
  Speaker 2: going to spend an hour and a half, and I'm
• 27:23
  Speaker 2: going to spend a little money. It's a subscription service.
• 27:26
  Speaker 2: I'm going to spend maybe two sessions worth of my
• 27:30
  Speaker 2: pay a year to have and an hour and a
• 27:34
  Speaker 2: half of my time only once to be able to
• 27:38
  Speaker 2: outsource this whole thing and know I did the right
• 27:41
  Speaker 2: thing for my patients, for my family, nobody for my colleagues,
• 27:45
  Speaker 2: you know, Otherwise, families are the ones fielding the questions
• 27:49
  Speaker 2: around wait, where are my records? And how do I
• 27:52
  Speaker 2: find things? And patients are showing up in the waiting room,
• 27:55
  Speaker 2: and your colleagues have to tell them that something happened
• 27:58
  Speaker 2: to you. You know, I spoke with a psychologist just
• 28:03
  Speaker 2: this past weekend who told me that twenty five years ago,
• 28:07
  Speaker 2: her therapist died and she was not notified for two
• 28:12
  Speaker 2: months after she had gone repeatedly to the door for
• 28:16
  Speaker 2: her sessions, banging out where is she? And twenty five
• 28:21
  Speaker 2: years later, she's still accessing the emotion of that, both
• 28:25
  Speaker 2: the anger and the hurt in feeling abandoned, and now,
• 28:29
  Speaker 2: you know, wants to do everything she can to be
• 28:31
  Speaker 2: sure that that never happens to her own patients.
• 28:34
  Speaker 1: So when someone contacts you perspective client of the service
• 28:41
  Speaker 1: contacts you and after the initial information gathering, Now into
• 28:47
  Speaker 1: what degree are they in touch with you? Mentioned service
• 28:51
  Speaker 1: or subscription rather.
• 28:52
  Speaker 2: Yeah, sure. So what we do is we create a will,
• 28:58
  Speaker 2: very personalized as as I said, We figure out with
• 29:01
  Speaker 2: you what makes sense for your practice and how we're
• 29:04
  Speaker 2: going to do it, and we document that and it's
• 29:07
  Speaker 2: been legally approved and reviewed. We have a template, and
• 29:11
  Speaker 2: we make sure everything is in accordance with the regulations
• 29:15
  Speaker 2: of each state regarding record retention and notification requirements and
• 29:21
  Speaker 2: so forth. And you sign that will, and you notify
• 29:26
  Speaker 2: your personal representative that you want us to do this thing,
• 29:29
  Speaker 2: and they're in charge of if something ever happens letting
• 29:33
  Speaker 2: us know. We have different ways of different options around
• 29:39
  Speaker 2: how we would access your information. We have a password
• 29:45
  Speaker 2: manager option that you can use to allow us access
• 29:50
  Speaker 2: only in the event of an emergency. We don't want
• 29:53
  Speaker 2: access to your private things any other time, and then
• 29:58
  Speaker 2: we're on call. Essentially, we don't. We send you reminders
• 30:04
  Speaker 2: a couple times a year to update any information you
• 30:08
  Speaker 2: can leave. Part of the conversation is do you want
• 30:12
  Speaker 2: to leave specific instructions for particular patients you know, we
• 30:18
  Speaker 2: all well know the folks who would really struggle the
• 30:23
  Speaker 2: most and be most risk if something were to happen.
• 30:26
  Speaker 2: Do you have a special plan for them? Do they
• 30:28
  Speaker 2: need to be notified in a certain way? Are they
• 30:31
  Speaker 2: going to be at risk for harm to self? Does
• 30:35
  Speaker 2: the person call them need to have other backup in
• 30:38
  Speaker 2: place already before you notify them. You can update that
• 30:42
  Speaker 2: information as your caseload changes, as you know you maybe
• 30:46
  Speaker 2: your colleagues and change. We can refer patients to people
• 30:52
  Speaker 2: you chip choose. We can find referrals ourselves. Usually people
• 30:57
  Speaker 2: will say I want you to call my friend and
• 31:00
  Speaker 2: see if they could take one of my patients. But
• 31:02
  Speaker 2: if they can't because they're too busy, then you find someone.
• 31:06
  Speaker 2: We take on that responsibility. We notify your licensing board,
• 31:11
  Speaker 2: your malepractice insurance. We take custody of the records and
• 31:15
  Speaker 2: notify all your past patients so that if they're looking
• 31:18
  Speaker 2: for their records and they find practice is closed, they
• 31:21
  Speaker 2: know we go to get their records and we take
• 31:23
  Speaker 2: care of all of that. And there's no additional cost
• 31:26
  Speaker 2: to the estate. So your estate is not going to
• 31:29
  Speaker 2: wake up one day and have a ten thousand dollars bill.
• 31:34
  Speaker 2: You are taking care of that in your planning by
• 31:37
  Speaker 2: paying the modest fee each year to keep us on retainer.
• 31:40
  Speaker 2: And it is a gamble. I mean, for any one
• 31:42
  Speaker 2: of us generally healthy folks in our forties and fifties,
• 31:47
  Speaker 2: it's maybe like one in a thousand that this is
• 31:50
  Speaker 2: going to happen too. But I can tell you it
• 31:51
  Speaker 2: happened to two of my healthy female friends in their forties.
• 31:57
  Speaker 2: And so you know, you just want to do the
• 32:01
  Speaker 2: right thing and want to be relieved of that burden.
• 32:05
  Speaker 1: Yeah, yeah, Well, you know, like I said, I haven't
• 32:09
  Speaker 1: spoken with anyone else on this podcast about this topic,
• 32:12
  Speaker 1: and you're the only person I know who's doing this.
• 32:15
  Speaker 1: But I'm glad you're doing it. You're obviously someone who's
• 32:22
  Speaker 1: very compassionate and invested in this in this work, Robin,
• 32:27
  Speaker 1: How do people get in touch with you and learn
• 32:30
  Speaker 1: more about this?
• 32:32
  Speaker 2: Thanks? Yeah, please come and find us and read a
• 32:36
  Speaker 2: whole lot about us on the Closure dot com. That
• 32:42
  Speaker 2: is the best way you can find me on LinkedIn,
• 32:46
  Speaker 2: but checking out our website. We offer a free informational
• 32:49
  Speaker 2: meeting to talk with you about how and whether we
• 32:53
  Speaker 2: can be helpful and and then you know, there's also
• 32:57
  Speaker 2: the option of enrolling and secure this care with such
• 33:02
  Speaker 2: minimal effort on your part. We know nobody wants to
• 33:04
  Speaker 2: think about it, but you can do it. For an
• 33:05
  Speaker 2: hour and a half, you can. You can face this
• 33:08
  Speaker 2: and and really feel like you and know because ethics
• 33:11
  Speaker 2: is so important in our field and we all train
• 33:14
  Speaker 2: so hard and invest so much in doing the right
• 33:17
  Speaker 2: thing by our patients. Here's here's one more thing, don't
• 33:20
  Speaker 2: don't forget.
• 33:22
  Speaker 1: We'll have this linked up here at the show notes
• 33:24
  Speaker 1: page at the Trauma Papers podcast dot com. Once again,
• 33:26
  Speaker 1: that's their closure dot com.
• 33:30
  Speaker 3: Robin, thank you. Love to have you back at later
• 33:33
  Speaker 3: date talk more. I really appreciate you being here.
• 33:36
  Speaker 2: Thanks so much. I'd love to tell you. There's so
• 33:38
  Speaker 2: much people need to know.
• 33:40
  Speaker 4: Okay, take care, Okay boyd bye e domany Com