Brandon – 0:00
Before we begin this episode, I want to issue a trigger warning. This episode of Michigan voices explores various aspects of mental health, including the mentioning of substance abuse, domestic violence, and suicide. While the episode doesn’t explicitly go into detail about each subject, if you find the mentioning of these topics at all triggering to you, I encourage you to please refrain from listening to this episode. Lastly, if you are a loved one is experiencing thoughts of self-harm, or thoughts of suicide, please call the Suicide Prevention hotline at 1-800-273-8255 where help is available. To everyone, please take care. Let’s begin.
Brandon – 0:55
Now I’ll be the first one to admit, I never really took mental health seriously, at least for myself. It just wasn’t something that was really talked about as a kid. And I never really understood its importance until recent years. And honestly, I’ve had a lot of people share the same experiences around me to on a national level, I feel like mental health wasn’t really talked about until the past decade, where it’s finally been held with some importance and priority in our society, at least here in the United States. Of course. While we still have a long way to go with how we treat and cope with varying aspects of mental health, we’re at least talking about it now. And that’s the first step in the right direction. But if there was one thing that detoured the quest for achieving globally improved mental health, it was 2020 and the covid 19 pandemic
News Clips – 1:41
We do have a plan to contain the Coronavirus in the US. And we think it’s going to be handled very well. We’ve already handled it very well. There are now more than 80,000 cases worldwide and the outbreak is also sparking fears on Wall Street. The Dow plunged more than 1000 points on Monday, but one confirmed case here in Oakland County another in Wayne County majority of public Michigan colleges and universities are ending face to face classroom learning today I’m issuing a stay home stay safe executive order for all Michiganders, the US has now reported more than 100,000 cases there are now more than 1 million confirmed cases of the virus. here in the us the number of cases now surpassing 4 million The US has reached more than 8 million confirmed cases of the virus the US now leads the world with more than 13 million infections and new infections have soared past a new milestone, now topping 20 million.
Brandon – 2:39
As the COVID-19 virus began to spread within the United States, the emotional and psychological toll also began to take hold on individuals throughout the US. According to the CDC during the month of August 2020 and February 2021, the percentage of adults with recent symptoms of anxiety or depressive disorder increased from 36.4% to 41.5%. And the percentage of those reporting on an unmet mental health care need increased from 9.2% to 11.7%. Now, using data from the Kaiser Family Foundation gives us a little bit better of a perspective on these numbers. The Kaiser Family Foundation also found that there was an increase of anxiety disorder or depressive disorder symptoms in 2022, a rate of nearly 41% as we just read, but that’s up from 11%, the previous year in 2019. And additionally, much of this increased disproportionately affected communities of color as well, where non-Hispanic black adults or Hispanic adults were more than likely to report symptoms of anxiety and our depressive disorders. So, what is exactly causing these increased rates then? Well, specifically, the CDC says that the main contributors to increase anxiety and depressive disorders arise out of fear and grief associated with the covid 19 pandemic, along with social restrictions and limits on operating non-essential businesses, and other measures to reduce pandemic related mortality and morbidity, which can lead to isolation, unemployment, or underemployment, further increasing the risk for mental health problems. So, while both anxiety and depressive disorders are on the rise, with the pandemic being a key contributing factor, the COVID crisis also presents a new set of challenges to the access of care for patients in mental health facilities because of the pandemic triggering lockdowns to prevent further spread of the virus. This meant that in person services, such as in person therapy services, were also upgraded to a strictly virtual format. Since therapy is one of the main ways to help treat anxiety and depression disorders. This meant that individuals that needed the therapy services had explore other avenues of receiving the care that they need. Of course, this change can present new barriers to access to care, namely technological and insurance-based barriers. Additionally, this change to an online base format for telemedicine services for mental health, also causing the question the effectiveness of the treatment itself, as therapy is a rather experiential based service with environmental dependent factors. However, while access to care may be mediated by technological insurance bound issues if one has the capability to receive access via telemedicine services. The resources rather plentiful. leading the way for such therapy services include apps like Talkspace, or Better Health Counseling. Additionally, a patient may be able to find their own providers through providing hospital systems nearest them. To explore these telemedicine solutions. I interviewed Joseph Lempicki, a licensed and clinical psychologist who has been giving care via telemedicine services since it started the pandemic. Within the interview, we explored the effectiveness of telemedicine solutions, potential issues, their benefits, and much more. So, without further explanation, let’s explore these online therapy solutions together.
Brandon – 5:43
So before we begin today, I just want to say thank you so much for allowing me to interview you and learn from your expertise in this area. To begin, could you tell our audience a little bit about yourself and your journey throughout your career?
Lempicki – Well, thanks, Brandon, pleasure to do this for you and with you, as you know, but I’ll let everybody else know this is a second career for me. I did start out Originally, I have a double major in psychology as my undergrad degree from Wayne State University. And I never really utilized it because I was working in the commercial field or the financial field and worked my way up in management, but really had a desire to do human resource work. So, I thought about it and pondered it. And I thought, well, I have choices here. So later in life, I decided, well, maybe what I should do is just go on and seek another career. So, I found a program at Mercy College of Detroit, master’s in clinical psychology. And also, there were two tracks at that time was one was gerontology and the other was substance abuse. So, I decided to go the substance abuse route. And so, I entered into the field by being a substance abuse counselor, which I did both inpatient and outpatient for a while, and then moved into the clinical practice. And I’ve been with the same company now for I started in 87. So, it’s 34 years. And in that time, I have done substance abuse, I helped design programs for outpatient substance abuse, but I had more interest than that. And just by a fluke again, some of my colleagues were retiring out, and they were running anxiety programs. And so, I became the anxiety specialist on staff took a lot of coursework, of course, we have to maintain our licensing. So, we take coursework, and took a lot in anxiety work. And then after working with substance abuse, actually, I burned out a little bit. So, I decided to quit my full-time position as a therapist and do it part time and go into academia. So, for 20 years, then I was teaching introductory psych with some human sexuality courses at Henry Ford Community College. And doing that also, I always told people, I think being a teacher made me a better therapist and being a therapist made me a better teacher, because I had the opportunity to learn from my students and also to impart what I did know to them. So currently, I’m still working clinically, my main forte, and people that are referred to me are a lot of times for gender dysphoria clients seeking transformation surgery or trans gender affirming surgery. I’ve been dealing with that and worked on the task force with sort of educating doctors on how to treat transgender patients, but also doing a lot of work in anxiety, post-traumatic stress, male survivors of childhood sexual abuse. So we are now working, of course, remotely, which is new for us. I had my office in Dearborn for the longest time. And on a Thursday, when the pandemic struck, they had announced that they were going to close down our services. So we had to get our plate ourself out to Rochester pick up our laptops, get them programmed in for us. And actually, our clinic never missed a beat. We only closed for one day on Friday went right back to work on Monday. And we’ve been operating virtually since then. And one of the things that we talked about too, is that it was a big blow to the system. About 20% of doctors had always been doing telemedicine visits for their patients where they don’t have to come in where it might just be a review of medications or review review of systems. Sure. But the the system itself went from 20% of the staff using technology for virtual visits to like 85% within two days. So I think what we saw was a lot of system overload. They just couldn’t handle it. So we were having a lot of appointments that went bad technology wasn’t catching up to where we were at. And we are losing patience dropping calls during that kind of stuff as well too. But we’ve lived and learned, and we’ve survived it. So that’s where we’re at today doing virtual visits and having a range of patients from all different sectors.
Brandon – 10:02 – Now, you kind of already answered this question a moment ago, but were you specifically offering any virtual services before the pandemic started?
Lempicki – Personally, no, this was all brand new to us as therapists as well. Also, they had, interestingly enough, probably, I want to say at least nine months before the pandemic struck, we all did get new computers in our offices and new screens, where we were camera ready. The only thing we were really doing in any way with regards to like any virtual, we’re like connecting to supervision, meetings, those kinds of things, just like you and I are doing right now. But as far as literally seeing patients and doing it, no, we weren’t doing any of that time at all, it was all in, in house visits, not to say that we would reach out like by a telephone call for patient called us about something. But I would say that easily 98% of all the visits, were always going to be always in person. So it was a big jump for us also, to not have that proximity to people. So what were the biggest challenges that either you or your patients paced moving to a strictly virtual format, I think other than the technical challenge was the idea behind trying to convince patients that and a virtual visit is similar to an in house visit. Meaning that for example, as you and I are talking right now, we’re both in our separate residences, we’re both in rooms where we have privacy. I know, we talked about our pets being asleep right now. So that’s okay. You know, our significant others are busy with other things right now. And that’s okay. But the biggest challenge was to convince patients that this visit is not unlike you coming to see me in my office. So we had to make sure that they had a private and secure place in order to have the visit, that they were in a room where they weren’t going to get interruptions. One of our challenges now is to make sure they’re not driving their car, as they’re trying to have a visit with us, we have to demand that they pull over to the side of the road. I think I told you one time when we did talk prior to this that I had a patient when she connected with me was walking through target with her family, and thought that she was going to have a visit there. We still are under the Health Information Protection Act. So the HIPAA law says we have to protect the privacy of individuals, right. One of the challenges to at the beginning was establishing our own environments. I’m fortunate I have a little area upstairs in our house where I’ve set up my office. So it’s private, we had to make sure we had pictures of that we could supply to our management to indicate what room we were going to be in or what the room looked like the environment that we were going to be talking to our patients in. So we had to do that as well. And I think for a lot of people, the technical challenge was when you’ve got, say, a husband, a wife, and two or three kids, and everybody’s working from home, trying to find a private space for anybody to be able to conduct anything, whether or not it’s their business practice or their classroom work. But more so for the therapist, I think that was a challenge to to deal with.
Brandon – 13:19 – Has it been a challenge to have patients create their own personal environment from a distance and online to facilitate an efficient therapy session?
Lempicki – Well, and I think that’s a two-way street. I think our patients do it for us as well, too. I have a patient right now whose wife is mentally challenged; she had a brain tumor in though starting to notice some shrinkage in her brain tissue. So, she’s rather intrusive. But I can see, as I’m talking to him that he’s sitting in what looks like his family room. And He will say to me here, please let me close the door first. And that’s so that she doesn’t wander in and do things like that. A lot of times you’ll see them put their dogs in another room. Or sometimes if they do have situations, as you say, where they’re in a challenging relationship, they’ll sit in their car, so they’ll take their tablet or their phone to their car, which again, is okay for us. It’s a it’s a quiet environment, as long as they don’t have six passengers in the car. But you know, but they choose to do that, you know, so then I will have patients before a session, say when I connect with them, they’ll say, could you hold on a minute, and I can see as they’re walking through their house because they’re walking with their phone and I’m seeing their image, that they’re going to another room where they feel more comfortable or say for they’ll say, I’m going to go outside the other day a woman said I get better reception on my porch. So she went out to her porch and sat there. You know. The other benefit to that though, Brandon is the fact that we get to see their environment which we don’t see if they come into the clinic. So we don’t see things like the person who’s a hoarder or a scavenger or we don’t see people who are perhaps maybe living in environments where we might have to intervene with adult protective services or something else. And so it gives us an insight into their environment as well, too.
And sometimes to just the little telltale things I know like, as we’re talking, I see a white wall behind you, as I’m talking, I’m sitting in the living room, and you can see the drapes behind me. But oftentimes, you can see like photos or pictures, or you can see things there. So you have a little bit more sense of who they are as a person, because their environment sort of, lets us know that a little bit. So I have to say that’s been, in a way a little bit of the benefit of being able to work remotely as well too.
Brandon – 15:37 – in addition to being able to see their home environment, have there been any other advantages to a virtual therapy format that you’ve noticed? There are more. The other thing I would add to that, too, is, if you’re talking about challenging subjects, sometimes, you know, it’s like, you’ve heard the term white coat fever, you know, going into the doctor’s office, your blood pressure goes up, because you’re in the doctor’s office, you know. So is there a difference when they feel more comfortable, and they don’t feel as confined? You know, my office is not large, when I’m in Dearborn, the environment is sort of closed in from it’s not claustrophobic by any means. I mean, I have a very pleasant office with the couch and the chair, and I keep the lights dim, and I have a nice environment for my patients. But sometimes they just feel more at ease, being in their own environment, little more readily able to talk about things, there’s always, for example, to that escape that we talked about, also is that if it does get intense, they can shut their camera off for a while, you know, you can’t shut the camera off when I’m sitting across from you, because there is not, you know, yeah, but that’s one of the advantages. But it’s also a disadvantage, because in working like, for example, with substance abuse people, we could be talking to them. And if they shut their camera off, are they taking a sip of a drink? Or are they taking a joint or are they shooting a pill in their mouth, we don’t see that, which they wouldn’t be doing in the clinic, and we’d be able to see some of that behavior. We missed the body language sometimes that we would get in the clinic. You know, they always say that the therapy starts in the lobby, really. So it starts with the front line that starts with the people at the front desk. And we’ve always said to our clinical people in the front desk, you’re the frontline therapist, because they will come to you. And they may say something like, but you know, I was really upset with the the guard downstairs or this woman in the lobby and stuff too. So they’re giving us more insight into the mood, which we don’t have, because there’s nobody there before us. Sure. Um, the other benefit of working remotely is the decrease in no show appointments. When a patient has to leave where they’re at and drive into the clinic, that can be very anxiety provoking for them. For example, I had a client who worked in Ann Arbor, lived in West Bloomfield and came to see me in Dearborn, while he would come at the end of the day, but as you know, from being a Michigander, and where you live, and where you go.
Driving from Ann Arbor to anywhere during rush hour, you know, you can go from anywhere from a 20 minute drive to an hour and a half to go the same distance. So this way, they’re more at ease there. They haven’t battled with traffic, and all of those kinds of things, too. And it makes it easier for them to keep appointments because they can do it during their lunch hour, they can do it at the end of the day, they can go into a private room, they can go someplace where they feel secure, and they don’t have to take time off work and miss work and do all that stuff. And sometimes when you have people who are at jeopardy of job loss, because they’re taking too much time off, this sort of eliminates that, okay. So there’s that benefit as well, which also indicates that once things go back to our new normal,
I wouldn’t, I don’t think we’re ever going to be able to eliminate video visits again, for our patients. It would be a thing like doing a hybrid class in school, we would still like to see them occasionally in person, but it doesn’t have to be every single time, but to have them have the availability of doing that, especially for the people who drive long distances. And I did tell you once off interview also that even though my offices in Dearborn, my catchment area now is wider. I mean, I have a patient who visits me for potassium, or who visits me via the line from Grand Rapids. I have a person who’s in Ohio, because we can reciprocate our license to Ohio, who’s going to school there, if it were only in person, and they still needed the support and help for their anxiety or their stress. I don’t think anybody’s going to drive in from Petosky to see me for an hour session, it would be worthless to them. So we are able to expand our practice a little bit, but it’s also putting pressure on us as clinicians because we’re getting more and more referrals. You asked another question though, about the pandemic and I just
Lempicki – 20:00
I want to touch on that, please, as you did ask it, and that is, what have we seen any difference? You know, we’ve always treated things like anxiety, depression, bipolar disorder, you name it, we’ve treated it. I think at the onset of the pandemic, we were getting a lot of people who are just generally just scared. There is a lot of fear, a fear of loss of job, loss of income, a lot of grieving, going on with not being able to connect with family and friends and things like that as well, too. So early on, we had people who just felt lost, and they didn’t know what to do with themselves. We also had the increase in sort of when you talked about not necessarily domestic violence, but argumentation and I mean, close proximity of people one with another, you know what I mean? It was that was getting highly irritable patients, people who are dealing with frustration and anger and anger issues that they hadn’t dealt before, which were affecting their relationship. Other thing, too, that the patients didn’t realize. And going back to my example of the guy from Ann Arbor, I have to tell you, he says he loves working he, he loves working from home. And I said, Well, yes, you do, but you miss the commute. You know, like, say, for example, at the end of my day, my commute is about two minutes from when I closed on my computer upstairs and walk downstairs to the first floor, I have no time to unwind from my day, my day ends, and I’m here, as opposed to stay at 30 minute or 20 minute drive from my office to my home, it gives me time to decompress. So we were noticing that was an issue for patients who had no decompression time, we also had to assert ourselves with things like take your computer out of your bedroom and put it in another room, your bedroom should be only for sleep, you can’t, you know, or I have clients who literally I have taught them to throw a blanket over their computer when they’re done with their work day, just so they don’t have a visual connection that work is home and homeless work. So we’ve seen that a lot also, we’ve seen a lot of the anxiety increasing also. And then the anxiety increased with the idea of, Okay, we’re, we’re going to ease things up. Now we’re not that we’re going to them we’re not. And since no one really knew how long this was going to last, you have to remember, anxiety is also very much triggered by anticipation, and the unknown. So even in our own clinic, when we would say things like, So when are you legally able to come back to the office? And I’ll use right now they’ll say, well, not April? Well, not April doesn’t tell me anything. It just tells me it’s not during that month, but not April could mean not April, but maybe December or not April, maybe next June or not April, you know. So the clients, we’re dealing with a lot of that ambivalence, you know, or we’re gonna have you back in the office, but, and then we did have a fair amount of people who were just really fearful about going into their office, because a lot of their management, people weren’t taking the necessary precautions, and they were afraid to go there. There were some that just had the general worry, that was real. And then they, some people were just getting very paranoid and the paranoia was taking over a lot, too. So we saw an increase in that. And I think that’s what’s prompted as busy a business as we have now. I mean, we’ve got more work now than we did before. Because of that very reason, pandemic has created a subset of people that are in the old AIDS epidemic, we called the worried Well, you know, they’re not just the worried well.
Brandon – 23:46 – So would you say that telemedicine mental health services are for anyone that has the ability to access them and not a specific type of person?
Lempicki – Well, yeah, and I would put, I would put a disclaimer on that, because one of the things we are finding, and we just talked about this in one of our team meetings the other day, is that there are some insurances that will allow for virtual visit, but not telephone visits. We just recently had one of our clinicians say that the insurance for her patient would only approve a telephone visit and not a virtual visit. We still have a lot run by the insurance companies. And one of the interesting things that I could go back on this when the pandemic first struck, the corporations were having problems getting reimbursement for insurance companies, because the insurance company said we pay for in person visits. And we had to say, well, we understand that and we’re we would love to have in person visits except we can’t. So can you deny somebody something they can’t get because it doesn’t exist. So in essence, like saying yes, that patient wants to come in and see me but that is not one of their options at this point. The only option they have is to do it via virtual visits. So, if you’re saying that if the benefit is that they can have a visit with a therapist, it has to be allowed to be a virtual visit, if that’s the only type of visit that they’re allowed to have at this point, okay. Similarly to our telephone only patients, we do have telemedicine rooms set up at the clinic I work at. So now if they eliminate, because insurance companies are looking to that, that audio visits are not permissible, they do want face to face contact with, excuse me, the patient, we can book them into a telemedicine office so they can literally come to the clinic, I physically will not be there. But there will be a medical assistant or someone else who will get them into a room, get them hooked up to a virtual visit. So, you know, again, I think, yes, anybody can do a virtual visit. But unfortunately, some of them are still driven by the insurance companies. And of course, the depends on who you work for. And who you work with. I was on the board of directors for a new clinic at one point and until we got approval, we could not see like Blue Cross patients until we got one of the we became a Blue Cross provider, or we couldn’t do it if we weren’t you, Miss provider, you know. So you had to make sure that the service matched. But to answer it another way to Yeah, anybody can avail themselves of telemedicine telemedicine services, if they want to, um, sometimes maybe an out-of-pocket expense, but if they’re willing to it’s there for them.
Brandon – 26:40 – So because of this increased reliance on technology, have you seen any increase in younger patients seeking out therapy services?
Lempicki – Well, we have, but I don’t know whether it’s driven just by the technology. There are so many people, I have high school, I don’t normally do adolescents, so I don’t normally see people under the age of 18. Okay, how though however, I am referred a lot of them on occasion because of other issues they may have. So I do have some high school students, I have some early college students and stuff too. And I have to say that what’s driving them to seek services. One, they don’t have the proximity of a campus, so they don’t have campus counseling available to them. And if they do, it’s via zoom the same way. Sure. But the number of people that even though they’re technologically savvy, do not like doing long distance learning I have had, I’ve had at least I would say in the last couple of months, maybe four or five clients who they want to go back to college, but they’re not going back until they can go into a classroom. They, they’ve tried it, they just don’t like it, you know. And then of course, I’ve got the others who absolutely love it. But you know, those are the people that we’re seeing in therapy because they want to graduate, they want to get their degree, they want to complete their college career, and they feel they’re being held back by it. So they’re getting depressed, and they’re getting highly anxious, you know, when will I be able to go back into the classroom? When will I be able to do that? You know? So we’re seeing a lot of that right now. Sure, sure. That social, that social connection with people is so important that they don’t realize how important that is until it’s not there anymore. So even if you go into a classroom, and you don’t have your new BFF in that room, or you don’t have somebody that you’ve really bonded to, it’s just being around other people, it’s just the idea of being in that environment, that seems to be conducive to good learning. So, you know, just being at home, without having that becomes very difficult. Sure. So those, those are the younger people that we’re seeing coming in, they are technologically more advanced, that is true. You know, like I always tell my older colleagues, I said, and my older patients, I said, if you’re having problems connecting this, if you have a six year old niece, nephew or grandchild, please have them come back because they can probably get it hooked up for you. Which is true because they were raised with computers, whereas my generation we were not, you know, right. So, you know, we’re seeing them and we’re seeing more of them because of the fact that they are struggling with this at home learning type of thing. And we didn’t see them early on in the pandemic, but as it increased a little bit, we got to see more and more of them.
Brandon – 29:30 – Do you see this virtual format, attracting new patients just because of the convenience of online access? Yeah, I think that when, you know, doctors have always referred to us or EAP is ever referred to us or employers have referred to us. And I think that the referrals now in the follow through on the referrals is better than it was before also. And I think it’s again for that very same reason. You know what I mean? You know, if you’re having a problem with me as a therapist, you know, you would feel a little intimidated by getting up and walking out of my office. But if you have, if you’re online, you can disconnect from me. You know what I mean? Sure, and you don’t have to deal with the embarrassment or all that stuff. So I do think that they feel a little more protected by that as well, too. Um, so I think there, there is something to that, you know? And especially to if you got people with social anxiety, you know, this helps them as well, too. Sure. Sure. Yeah. So I think the access does allow us to get more referrals and more people following through because they feel more comfortable in this format. You know, going back to what I said earlier, I don’t have to leave or I don’t have to get all dressed up to go there, I can be comfortable in my own house. You know, as an aside to that, our big boss, the director of our programs, said, she has seen more colorful pajamas and bathrobes since we’ve gone through virtual than she ever has in her lifetime. And then she also said, The only problem with working virtually is I’m closer to my refrigerator, when I’m at home. So we’ve seen a lot of that too. And that’s been another issue that people are presented the lack of motivation. I mean, they’re not exercising, they’re not walking to the cafeteria, they’re losing that a lot of them too, are putting on weight. Now, with regards to that as well, too.
You know, so it was adapting to being in an environment where you’re too distracted. You know, like, if I’m at the office, and I’m thinking I have a load of laundry to do, I can dismiss that thought immediately, because there’s nothing I can do about it. Right. But if I’m upstairs and I’m thinking I have a load of laundry to do, then I get more anxious about it, because I can just walk downstairs and throw it in, right? Yep. Yeah. So there’s something about a fair point. There’s something about, you know, I always said, Brandon, there’s an oxymoron, it says I’m going to stay at home and relax, staying at home and relaxing, don’t go together as a phrase, because the minute you’re at home, you’re thinking, Oh, I should be doing laundry, I should be cleaning the stove, I should be mowing the lawn, I should be washing you know. But when you’re not at home, you don’t have that. So to relax your home, the best way to relax is to say, let’s get out for a while. Yeah. And even in a coupled relationship, you have to say things like, let’s go for a walk in the park, or let’s go out for a stroll, or let’s go get a dairy queen or do whatever, even though it may not be the thing you want to do. But you know, if you don’t break away from the environment, the anxiety goes up. So if you think of that, tying in to what we said earlier, the anxiety for patients has increased. But that is also another factor for it. They’re too close to environments, which sort of percolate their anxiety, you know, read, know, if they’re doing virtual work from home, but the phone rings at the house. If they have a landline. They’re wondering who that was. But if they were at work, and that self-same phone rang, they wouldn’t have that, you know, right? Mm hmm.
Brandon – 33:05 – Do you have any advice or recommendations for someone hesitant about trying out therapy for the first time?
Lempicki – Yeah, we’re not scary people. Um, you know, and that the only thing that they should fear is the in compatibility with the person that they might have been assigned to.
I want I’m one who thoroughly believes in recommendations. But if you put it this way, let’s say for example, I recommend a restaurant to you, I might think it’s the best thing in the world. But if it’s not the flavor you like, or the seasonings you like, you’re not going to like it no matter how much I do. So one of the things about therapists is what the public needs to know is that especially those of us that work in clinic, it atmospheres, meaning we’re working for operations, like I do with the hospital system, or larger clinics are interested interest is in you getting better, not in you liking us, not in you getting along with us. So if I get a patient, and this does happen, who says I don’t think I can work with you. I’m not going to get upset about it because I get paid. Whether because I work for a clinic, I get paid, whether I see them or not. Right? It has to be a fit, you have to have somebody that you feel comfortable talking with, that they feel comfortable with you as well, too. And so always for people seeking therapy. I say number one, don’t be afraid of therapy and understand something, you’re hiring somebody to help you. You become the employer, they become the employee. So don’t feel bad about asking questions about what style they use, or what you know what their focus is or what they believe. Because that’s going to be crucial. No, no, you can’t share things with people that you don’t feel comfortable with, or that you don’t feel are going to listen or be in your best interest. As a therapist, I have to tell people I’ve not worked with people like that and passed. And there have been occasions where I’ve had to as a therapist, we have to take ethical standards as part of our licensing procedure. I’ve had patients where I’ve had to go to my boss and said, I just can’t work with them, we have to reassign the case. So if people are seeking therapy, just remember something we all need somebody to talk to, you know, and sometimes talking to people that are close to you, it’s difficult, because the fact that as you address say, for example, even yourself from myself, as you address, address your significant other or your, your, your parent, or anybody else or a sibling, you’re watching their expressions and works when their eyes get teary, you stop, when they get a little bit agitated, you stop. And as therapists we’re trained to, if the tears have to be there, let’s talk about them. Let’s work through them. If you have to be angry, let’s work through it, we’re not going to abandon you, we’re not going to ask you to stop talking, you know. And, you know, there are things that people say to us, that make us very uncomfortable. But the phrase that I use in all therapy is very simple. I will give you my acceptance, I will always accept you for who you are, I don’t have to approve of you. But I do have to accept you. My job on the world is not to approve them, it’s to accept them. So if you as a as a person seeking therapy, you want to make sure that whatever your issues are, that you can see the acceptance in the eyes of the therapist, that they will accept you for those issues. training new therapists, I always say you learn about your patients, you don’t learn from your patients. So, if there’s something that you don’t know, and I have to tell you, I have researched many, many things in my life, certain disorders that have never heard of certain religious backgrounds that I’ve never heard of, for example, the term now binary sexuality, I’ve had to research it to find out what it is it’s not my job to ask my patients. What do you mean by that? It’s my job to know what that means, you know, so long way of answering your question, but I don’t think anybody should ever be shy of therapy. And there have been occasions I’ve tell you very honestly, Brandon, where you meet somebody now. And it’s the first time they’re talking about something, and you have one visit with them, and then they cancel out the next two, because they’re scared. But that’s okay. As long as you stay steadfast, I’ve had patients come back to me again, because they know they felt safe, it was just scary for them, and really scared to share those things. You know, it’s not an easy thing for people to spit out, especially when they’ve been holding secrets, their whole life going back to post traumatic and a lot of issues as well, too. Sometimes we’re the first person they’ve ever said something to, and we have to respect that. And that’s the other thing, too, that people should understand about therapists is that we have just to throw this out to you, there’s only a rule called the federal duty to WARN Act. And this was imposed a long time ago, we are not allowed to discuss anything about our clients with any other person or individual with the exception of three areas, the threat of homicide, if we know that somebody threatens somebody else’s life, and they have actual intent, and to do it, suicide, where we have fear of them taking their own life, and we have indication that they’ve prepared for it any abandonment, abuse or neglect of a minor under the age of 18, we have a federal mandate that we have to report that. So, we have to call Protective Services, we have to hospitalized or we have to notify authorities in those situations. And the reason for that if we don’t and something happens, we are held accountable by the same standard. So, for example, if the therapist knew that somebody was going to commit suicide and the person or homicide and they do, the therapist is charged with murder the same way they are. So, the the Privacy Act in working for a hospital system under the Health Information Act, it goes through all clinical people. So even in my own life, I mean, I can talk about a patient, but whether or not I’m giving you the full demographics, you know, are they 23? Are they 28 as a male or a female? Do they have two kids or four kids? I can’t be that specific so that there’s any identifier that would tell you what I’m talking about. So, we can still discuss clinical cases, the only ones we discuss it intimately with our team members or our supervisors. But we have to be very protective of that.
Brandon – 39:29 – So as we wrap up this interview, are there any final thoughts you might like to give to our listeners?
Lempicki – Yeah, I think that people need to learn something. And that is very basic, to the fact that it’s okay to feel it’s okay to have emotions, it’s okay to have feelings. It’s not okay to not deal with them. So, part of it too, is if people are scared, they should be able to say they’re scared. Um, one of the definitions that I’d like to impart to anybody that listens to this too, is that as therapists we define a phrase. And a word and that’s the word intimacy. intimacy is not anything to do with what normal people would think it is. intimacy, by psychological standards is the ability to feel with little or no threat. So, to be intimate with somebody is to be able to express their feeling without feeling threatened by that feeling. So, for example, if you were to say, No, I don’t want to go, I’m depressed. And if I weren’t in an intimate relationship with you, it would be a thing like, Okay, fine. Well, if you’re depressed, then I’m never going to call you again, a very threatening statement. Or if you’re depressed, fine, just sit at home, you don’t have to do anything. I’m not respecting your emotion. intimacy is defined by the fact of, if you’re feeling depressed, and you don’t want to go someplace, then if I have an intimate relationship with you, the response would be, I’m sorry, you feel that way? I’m going out with some friends. But would you mind if I called you later? Or would it be better if I came by and sat with you for a while? You know, and you know, I’m not going to go to a group of friends of ours and say, Well, yeah, Brandon, competencies really depressed right now. I’m not going to throw you under the bus. So, intimacy is based on accepting feelings as being feelings and not threatening a person, like if you’re starting written down and leave you type of situation. But here’s the kicker. The kicker is it starts with self-intimacy, and not to be punishing to yourself for feeling a certain way. And how many times do people say, Oh, I feel stupid, I shouldn’t be feeling this way. Or I’m scared. I don’t know why I’m scared. This is stupid to feel this way. Why are you threatening yourself? It’s a real feeling. So self-intimacy is important. And also, that intimacy of being able to feel is very important, and especially during the pandemic. To express that feeling. It’s okay to be scared, it’s okay to be nervous. It’s alright to be upset, it’s okay to be frustrated. It’s not okay to not do anything about.
Brandon – 42:01 – As vaccinations continue to get distributed. With everyone keeping up the safety and health protocols put into place, we should hopefully return to a new normal here soon. However, while COVID-19 may begin to subside, the importance of mental health should not and luckily, it doesn’t have to. With plentiful technological resources and the return of in person medical services. Help will be available with whatever method one may choose.
And for that person curious about trying out therapy for their first time. Give it a shot. It just might improve your life.
Brandon – 42:34 – My name is Brandon McLeod, and this has been the conclusion of Michigan voices season two, conversation nation, we want to express our greatest appreciation for lending us both your time and your ears for this season. This season was a purely collaborative effort between everybody, including Stella, Hope, Maddie, Jonathan, Owen, Jack, Mia, Elyssa, Sarah, Julia, Olivia, Noah, Nicklas, Cooper, myself, and our Professor T Hetzel. We also want to extend a big thank you to Brad Gurwin and Stone Zhang for this season’s theme music. You can find more information about them in our show notes. Lastly, we’d also like to extend the biggest thanks of all to our guests on this season’s episodes as well. This season would have not been possible without you. To find more information about Michigan voices, including episode show notes, episode transcriptions, producer information, and much more. You can visit our website at: courses.lsa.umich.edu/Michigan-voices/. Or alternatively, you can google ‘Michigan Voices Podcast’ to find more that way. And once again, thank you so much for listening. Stay safe, and we’ll see you next time.
