1. A client who uses mental health benefits decides to open his or her own business and must buy private insurance. If they answer the insurance questionnaire honestly,they will be denied private insurance for health, life and disability because they have seen a provider for depression..or they will be charged an exorbitant premium.

2. The legislature of Georgia decides to allow Blue Cross to be run as a for-profit business licensed to Wellpoint and the non-profit coop is dissolved. Over the years, the mental health side of the plan is targeted to lowered reimbursements for providers. Because mental health treatments can lead to stigma, the patients are afraid to fight this within their companies. The reimbursement for me as a doctoral level expert psychologist with 20 years of experience is dropped from July’s rate (112 per hour) to August’s rate (78 per hour) in 2007 and I have to leave the plan as I cannot pay overhead and earn a living at that rate. Meanwhile, the CEO of Wellpoint is the highest paid CEO in Indiana, earning 14 million in one year. The clients are the ones who are hit hardest as their costs rise for the treatment they need.

3. At the same time I get the notice of my change in payment, I also receive a threatening letter stating that I tend to see Blue Cross patients for 16 visits while the average number of visits should be 4. Because of my tendency to see patients for a longer time, I will be subject to in-office audits where the charts of my patients will be reviewed and assessed for the appropriateness of my treatment.

4. Approximately 50% of all claims paid directly to me are full of errors and the error always results in a lower payment than I am due. The errors are predictable: a visit in a series of visits is left off; the code is entered incorrectly; I am deemed to be in the network when I am not; the usual and customary fee for that service is not at all realistic, etc. I am rarely able to get the errors corrected without spending an hour on the phone or paying an assistant to do this.

I am clear that the health insurance industry is rife with abuses that harm clients and the providers but currently there is not another alternative. I would like to see a 3 tiered program for our needs: A private corporate option for those who are well-employed and can afford it; a set of non-profit cooperatives for the self-employed and those who cannot afford the private corporate tier; and a government safety net plan for those with life-changing medical problems, unemployed and unable to afford the others. There are numerous debates about health care and reform but the industry has created its own difficulties as they attempt to maximize profits and minimize care and reimbursements. Even with these caveats, it is better to use your benefit if this is the only way to afford treatment as the decision to forego mental health treatment has many negative effects.

On another note, I am starting my women and money ongoing group this fall. This is a group for women only as all the research and my personal experience leads me to believe that women work best on subjects that are considered “Male-expert” (math, computers, finance) in small same sex groups. This is an ongoing group that follows after two years of offering one day workshops. I feel the one day workshop format does not work as well to sustain ongoing changes as the open-ended group. The group will meet 2 times monthly on wed evenings from 6:30 to 8:00 and is both educational and psychotherapeutic in nature. This is unusual but I think it will be a powerful combination and is modelled on the program at Onsite. The charge for the group is 65 per session and the initial committment is for 6 groups

. The group will be diverse in nature and is appropriate for a variety of issues and ages. Some referrals may be for younger women who want to prevent the problems they see in others; some will be women who have money but are afraid to invest it or use it; some may be for women who are afraid to negotiate or market on their own behalf; some may be for overspending problems, some may be for women who are in partnerships where there is severe conflict about money, etc. If you have a colleague, partner or client or client’s spouse that you believe is a good fit for this program, please have them contact me

If you are concerned about your or your partners use of substances, please feel free to call the office at 404-320-6510 for a consultation.

Or click here to send an email: mg@doctorgresham.com.

Dr. Mary Gresham

One possible source for this is the relationship research of Dr. John Gottman. He observed couples for 25 years and then noted the characteristics of happy and unhappy couples. His work has been published for the general public and is easily available in paperbacks. Knowing the skills we need is only the first step. The hardest part is learning to change old ways or develop the skills to begin with. This is the work …often uncomfortable and awkward at first…and without feedback hard to know if we have mastered it. If you are lucky enough to have a partner that you want to stay with, it would be best if both of you read the book and used the same theory. If you are still seeking a partner, you can practice these skills on close friendships and family relationships as they can apply to any intimate relationship.

Most of the skills have to do with how you talk to someone. If you have an issue with someone, learn how to bring it up “softly” rather than harshly. If you wait to bring up issues until you are furious and you use sarcasm and blame, this will be more difficult. You will not get a good response and are likely to get a defensive reaction, not a true listening and understanding. If you bring up issues based on your feelings and how you felt about something and are not acting in a superior manner in your presentation, you are likely to get a more positive response. It is hard to learn how to bring up things that are bothering you. Many people are afraid of hurting someone’s feelings.

There are different kinds of “hurt.” A negative type of hurt is done simply to punish someone or put them down..the useful kind of hurt is done to help the relationship, help someone become aware of themselves and helps them grow as a person. Try hard to practice what you want to say before you say it and imagine how you would feel if this were said to you. Then get your courage and arrange a special time to talk remembering that often the most feared words in a relationship are “we need to talk” and that sensitivities will be high. Assure your partner that you do not want to hurt them, you want to have a better relationship.

Then read Dr. Gottman again and again until it begins to feel more natural.

Psychologists are finally beginning to study and do research on the experience of happiness. Happiness is defined as a feeling of “subjective well-being”, meaning that only we can decide if we are happy or not and that it will change from person to person. Most people would include in their definition of happiness being able to experience a number of positive emotions like joy, affection, contentment, hope, and gratitude. Is it possible to be too happy?

Yes it does seem that it is not good to be too happy. When the happiness scores of thousands of people from 1 to 10 were tabulated and followed over time, those who rated themselves about an 8 on the scale had better life outcomes that those who said they we 10 on the happiness scale. Chronic euphoria is not the best outcome. Negative emotions do serve a real purpose in life, especially in moderate doses. Occasional guilt,worry, anger and sadness are necessary to help us know what we need to change to improve our lives. Without them, the people in the studies seem to drift.

Another important aspect of happiness is a measure called life satisfaction. For most of us, life satisfaction depends on doing well in areas that are important to us….relationships, health, work, leisure, spirituality and income. We are operating in sync with our values and our goals. There is another factor in happiness that is called “flourishing”. This is the assessment that our lives have meaning and purpose, that we are good people, that we get the social support we need , that our everyday lives are interesting and that we have an absence of addictions.

The formula developed by Dr. Ed Diener, one of the foremost happiness researchers in psychology is as follow: Happiness = positive feelings minus negative feelings + life satisfaction + flourishing. If you are interested in learning more about the research on happiness, you may want to read Dr. Diener’s book, Happiness: Unlocking the Mysteries of Psychological Wealth.

The Iowa Youth and Family Study project was started during the period when many families were not able to keep the family farm ( late 80’s) and had to weather a serious economic downturn. 500 7th grade students were followed over a period of 20 years, making this one of the most comprehensive studies of family life done. What do you imagine caused these teens the most trouble? The emotional distress of their parents!!! They were able to adapt to the changes in circumstance but if the parents were irritable, depressed , withdrawn, fighting with each other, etc. , these teens did worse than the teens whose families pulled together and weathered the changes with greater acceptance and calmness.

See also the current February issue of Money magazine for an interview with me that talks further about helping teens through this time.

Money losses are very painful. In fact the money research shows that we feel significantly more pain ( about twice as much) over money loss than we feel pleasure about money gain. This means that loss is a feeling that we are motivated to avoid at all costs. Unfortunately, no one can avoid the experience of money loss in the current situation. For many people, the money represents the years and time spent working and so they also feel as though they have wasted their time and energy.

Coping with money losses requires a strong and flexible approach. It is important not to berate and beat yourself up..the loss itself is enough of a negative consequence. It is also important to feel creative in dealing with the twists and turns in your money life. Creativity lets you see other ways to live and thrive besides what you had planned. One of the most important images that comes up for me and helps me during times when I am coping with money downturns is a memory I have a patient I worked with years ago. She was a middle-aged homemaker who was going through a divorce that would greatly reduce her standard of living and put her back in the workforce unexpectedly. As we were talking about the moments of her day that brought her the most pleasure, she described taking a hot bath and sipping a cup of tea. She then realized that those moments would be available to her no matter where she lived and how she spent her daytime hours.

There are often suicidal thoughts and feelings that go along with money losses. The basic challenge here is to be flexible and see how to live differently than you have in the recent past. When you can see no other acceptable way to live, it is easy to conclude it is better to die than to live another way. People who get through this period are often surprised to find out that their new life has unexpected pleasures that there was no way to anticipate.

The mindset that will help is to use the model of grief …..as if you had lost a family member. Mourn your losses and after an appropriate period of time get back to living and accepting the loss.