Author Archives: Eric Stroo

Knowing Our Strengths

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One of the strengths of Samaritan is that we are available to help people in an ongoing way with the problems that inevitably arise in life. Created in 1960, with therapists who stay with us for 10, 20, and 30 years, we serve families in a variety of ways—often beginning with individual or couples therapy, sometimes including additional family members, and when it’s indicated, referring them to another therapist with specific expertise. Clients sometimes come with a specific issue that is resolved in a few sessions, but frequently they find that the issues are more complicated and they engage in deeper, longer-term work.

An example of Samaritan as an ongoing family resource is a couple in their mid-40s who came to Samaritan for the first time 10 years ago. The problem was the “out of control” behavior of their two teenagers. They wanted to know how to set limits and provide support for their adolescents, both of whom were taking risks that could have serious long-range consequences. Their therapist helped them examine and make changes in how they were parenting and, at the same time, focused on protecting and strengthening their marital relationship.

A second round of therapy occurred when one of their aging parents needed to move from home to an assisted living facility.  The loss of independence was devastating for the parent and put our clients in the position of making hard but necessary decisions while being viewed as “the bad guys.” The therapy setting created space for them to voice their grief and frustration without appearing weak or unfeeling.

Later, health issues for each of the couple coincided with the husband’s planned retirement.  It brought them face to face with questions of their own mortality and an urgent need to re-think their financial expectations.  Again, having a therapist who could listen deeply to their fears, bringing both her history with the family and her training in life transitions, helped them move forward.  The couple pulled together their considerable resources—among them their love for each other, their strong Christian faith, their experience of meeting adversity with determination, and a soul-saving sense of humor.

The belief that both the couple and the therapist held as they worked together, once again, to find a way through very difficult circumstances is what Samaritan has always offered our community. A belief in our ability to care for one another and to create positive change.

 

 

Making a Difference

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Life isn’t always easy to navigate or easy to understand. Samaritan Center exists to help people cope, rebound, and heal from the unexpected difficulties life can bring.

In the third year of pandemic-driven change, we are determined to continue to live vibrantly into that mission. No matter their ages or their circumstances, our clients tell us they are weary, worn thin by the stress of isolation, unpredictability, and the incessant troubling news. For example, there is the woman in her 70s who meets with her therapist every other week. She lives alone in low-income housing, is largely estranged from her adult children, and worries continually about her health, her finances, and the uncertainty of the future. She talks about her faith and experience of decline: ‘You’re the only one I have to talk to,” she says. “I don’t know what I would do without being able to meet with you.’

Those of you who so generously support this ministry make it possible for us to continue to be a healing presence for people who are in need of care. Without these donations from our spiritual partners – church congregations and individuals – helping those in need simply can’t be done. We pray that you will stand beside us in this difficult time. We thank you.”

Good Faith Estimate

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Good Faith Estimate

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act” which requires practitioners to provider a “Good Faith Estimate” to individuals who are uninsured or utilize self-pay. The Good Faith Estimate (referred to throughout this document as “GFE”) works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for mental health services. The estimate is based on information known at the time the estimate was created. The GFE does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new GFE should this occur. If this happens, federal law allows you to dispute (appeal) the bill if you and your provider have not previously talked about the change and you have not been given an updated GFE.

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a GFE of expected charges.

Note: The PHSA and GFE do not currently apply to any individuals who are using insurance benefits, including “out of network benefits” (i.e.., submitting superbills to insurance for reimbursement). 

Timeline requirements: Providers are required to provide a GFE of expected charges for a scheduled or requested service, including items or services that are reasonably expected to be provided in conjunction with such scheduled or requested item or service. That estimate must be provided within specified timeframes:

  • If the service is scheduled at least 3 business days before the appointment date: no later than 1 business day after the date of scheduling;
  • If the service is scheduled at least 10 business days before the appointment date: no later than 3 business days after the date of scheduling; or
  • If the uninsured or self-pay individual requests a GFE (without scheduling the service): no later than 3 business days after the date of the request. A new GFE must be provided, within the specified timeframes if the individual reschedules the requested item or service.
Samaritan Center of Puget Sound recognizes every individual’s mental health treatment journey is unique and personalized. How long you need to engage in mental health services and how often you attend sessions will be influenced by many factors, including, but not limited to:
  • Your schedule and life circumstances
  • Your provider’s availability
  • Ongoing life challenges
  • The nature of your specific challenges and how you address them
  • Personal finances

You and your provider will continually assess the appropriate frequency of services and will work together to determine when you have met your goals and are ready for discharge and/or a new “Good Faith Estimate” will be issued should your frequency or needs change.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises 

We Can Only Be Human Together

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Archbishop Desmond Tutu, who died on December 26, believed in and actively lived the South African principle of ubuntu. The word ubuntu is part of the Zulu phrase “Umuntu ngumuntu ngabantu” which literally means, “A person is a person through other people.

”In The Book of Joy, which the Archbishop wrote with the Dalai Lama and Douglas Abrams, he said: “Ubuntu says when I have a small piece of bread, it is for my benefit that I share it with you.… In a very real sense we’re meant for a very profound complementarity. It is the nature of things. You don’t have to be a believer in anything. I mean, I could not speak as I am speaking without having learned it from other human beings…. I learned to be a human being from other human beings. We belong in this delicate network. I am, because you are. It is actually quite profound.… We are bound up and can be human only together.”

At Samaritan, we are deeply aware of how foundational it is to wellbeing to have reliable, caring relationships with others.  Mind, body, spirit, and relationship are bound up together, and healing occurs as we give attention to each of these elements of our humanity and actively seek to integrate them. We are grateful for the example of those, like Desmond Tutu, who have faced adversity without losing their ability to identify with others and live, not in separation but in solidarity with them.

As the pandemic has stretched now from months to years, we all have experienced the significant, sometimes catastrophic impact that it has had on relationships. Stress that arises from multiple directions can drain away the ability to connect with one another in meaningful ways. It affects everyone, parents and their children, husbands and wives, friends, work colleagues, and casual acquaintances. Reaching out to one another in nurturing ways is sometimes simply more than we can do. In the resulting isolation, our sense of the warmth of human connectedness – ubuntu – withers.

How are we to respond to the unchosen stress of this time and the fears that arise in our mind, our body, and our spirit?  Ubuntu tells us that, as individuals and in community, we can choose to intentionally express to one another respect, dignity, reciprocity, compassion, and mutuality.

When we feel overwhelmed by circumstances, it’s hard to know what that would look like. What can just one person do?  Mindfulness suggests that, first of all, we should simply pause, taking time to acknowledge what we’re thinking and feeling. As we’re able to accept and calm our anxiety, we will see the situation more clearly. We’ll see the possibilities, where we have some control or influence and how we can use that. We’re more able to let go of the things that are beyond our control.

As our minds become quiet, refraining from worrying and judging ourselves and others, we are able to respond to the problems in more creative and confident ways. We find that we can act with the energy and compassion of ubuntu, secure in the experience of our common humanity, our interconnectedness and our responsibility to one another.

Re-entry from Covid

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And Now… How Do We Think About Re-entry?

It’s spring. We can feel the changing, evolving season. Light that lasts longer. New growth appearing. A taste of warmer days to come. People venturing out of hibernation.

It’s been a long winter, a long year, and we’ve become accustomed to the many ways in which we’ve been separated from one another. Many of us are wondering what this season of re-entry–the emerging from separation–will look like. There’s a feeling of uncertainty, a forgetting of how everyday relationship with the outside world is done. Used to be done. Should be done. Can be done.

Some of us feel the questions more intensely than others. Instead of embracing the new freedom, we look at it with a raised eyebrow. Our habits of caution outweigh our impulse to engage. That can lead us to wonder in a self-critical way–about ourselves, our resilience, our ability to adapt.

We know that distressing situations can trigger our feelings of anxiety and depression. When this happens, we do well to remind ourselves of strategies that can help manage these feelings. We may have learned some of them through Cognitive Behavioral Therapy and the practice of Mindfulness. While they’re simple skills, they’re not easy to maintain when we’re feeling stressed. Our efforts, however, can be rewarding.
Here is a reminder of some of those useful strategies:

  • Stay in the present–don’t ruminate about the past or try to predict the future
  • Focus on what you can control and set aside what you cannot
  • Appreciate those things that are going well
    Maintain healthy habits of eating, sleeping and exercising
  • Seek out pleasurable activities and meaningful connection with others
  • Extend an attitude of generosity, both to yourself and to others

It seems fortuitous that our emerging from this highly restrictive year of the pandemic coincides with our calendar’s emergence from winter into spring. Access to vaccines and lower numbers of serious illness and death from the virus are allowing us to move about more freely. Sunny days are inviting us to come outdoors, shedding our raincoats and boots and woolen scarves.

So, is there a way to step into this re-entry, this emerging from separation into reconnection, with lightness, the spirit of spring? Can we bring what we’ve learned in this past year, about ourselves and others and reality itself, to a clearer and more compassionate understanding of what life is about? Will our inner conversations and our relationships with others thrive in this warmer climate? Will our sense of gratitude and hope speak to our experiences of loss and grief? Will we agree to move forward with a smile – one that may still at times be hidden by the masks we agree to wear but will surely be visible in our eyes.

Stepping Out in Faith

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These days we are all walking on water. Beneath us, supporting us, we experience not the solid ground of our once familiar lives—predictable routines, reliable institutions, and in-person engagement—but the deeply disturbing uncertainties, the chaos of this ongoing pandemic. Or worse. Some have experienced the disease firsthand, some have lost family or friends, some have lost businesses, jobs, homes, savings. Struggling to survive, fearing to go under completely, we are walking on water.

Reportedly, Jesus made it look easy; our own experience is more like Peter’s:
Peter got out of the boat, started walking on the water, and came toward Jesus. But when he noticed the strong wind, he became frightened, and beginning to sink, he cried out, “Lord, save me!”
We try to remain confident, to take things a day at a time, but these are terribly uncertain times, and despair is not far away. The pandemic has robbed us of so much, taking lives, separating us, and punishing those most who have the least.

Yes, we have learned the practices that can help to keep us healthy: washing, masking up, maintaining distance, limiting our “bubbles.” All that is surely good. But the measures we take to guard our health have come with a cost to our well-being. Even those who are fortunate to have jobs and health must nonetheless face separation and confinement, deprived of the many ways we gather: in schools and businesses and concerts and ball fields and places of worship.

We are all walking on water these days, and it is easy to become weary of the effort. It is easy to become afraid and to lose hope as the days have turned into weeks, and the weeks have turned into months, and the months threaten to turn into years before we can reclaim the freedom and togetherness that we long for. Faith is essential. Science will ultimately offer some relief from the threat; it is a source of understanding and a guide to tactics. But meanwhile, we need something in addition to tactics; we need to resist being overwhelmed by fear and isolation.

Many years ago, speaking to a conference of clergy, Ernest Campbell said, “The reason that we seem to lack faith in our time is that we are not doing anything that requires it.” Though we certainly could wish it otherwise, our time requires it. The disciplines of our time require it: to apply the best practices dictated by science, restrictive and repetitive as they may be; to cope with the disruptions and demands of these chaotic circumstances; and to bear the losses, which continue to mount with no clear end in sight. Faith gives us a focus beyond the turbulence of today on a real and hopeful but distant horizon.

I Will Not Give Up

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It was above the timber line. The steady march of the forest had stopped as if some invisible barrier had been erected beyond which no trees dared move even in a single file. Beyond was barrenness, sheer rocks, snow patches and strong untrammeled winds. Here and there were short tufts of evergreen bushes that had somehow managed to survive despite the severe pressures under which they had to live. They were not lush, they lacked the kind of grace of the vegetation below the timer line, but they were alive and hardy.

Upon close investigation, however, it was found that these were not ordinary shrubs. The formation of needles, etc., was identical with that of the trees farther down; as a matter of fact, they looked like branches of the other trees. When one actually examined them, the astounding revelation was that they were branches. For, hugging the ground, following the shape of the terrain, were trees that could not grow upright, following the pattern of their kind. Instead, they were growing as vines grow along the ground, and what seemed to be patches of stunted shrubs were rows of branches of growing, developing trees. What must have been the tortuous frustration and stubborn battle that had finally resulted in this strange phenomenon!

It was as if the tree had said, “I am destined to reach for the skies and embrace in my arms the wind, the rain, the snow and the sun, singing my song of joy to all the heavens. But this I cannot do. I have taken root beyond the timber line, and yet I do not want to die; I must not die. I shall make a careful survey of the situation and work out a method, a way of life, that will yield growth and development for me despite the contradictions under which I must eke out my days.

In the end I may not look like the other trees, I may not be what within me cries out to be. But I will not give up. I will use to the full every resource in me and about me to answer life with life. In so doing, I shall affirm that this is the kind of universe that sustains, upon demand, the life that is in it.” I wonder if I dare to act even as the tree acts. I wonder! I wonder! Do you?

       This meditation was called to our attention by Samaritan therapist John Baumann, MDiv, LMHC, who sees clients in Seattle, Renton and Federal Way. John says: “I was introduced to Howard Thurman in 1995, some 14 years after his funeral.  Reading his biography brought a sense of wonder at the grace-filled and graceful manner in which he lived.  He spoke of offering a meditation a half hour before each Sunday service and discovering that calls for counseling began dropping.  I quickly ordered his book, Meditations of the Heart.  I find myself returning to it from time to time and each time I find a new jewel.  As always, the jewel seems to shine ever brighter as I read and reflect again and again.”

 

 

Meet Heather Macdonald

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Profile for HeatherDr. Heather Macdonald joins our clinical staff this spring, bringing with her a wealth of experience and depth of training. We are particularly excited to welcome her to our psychological testing and assessment program. Heather’s professional background includes working with young children, adolescents and adults in a variety of settings with a wide range of identified concerns. A licensed clinical psychologist since 2010, she has experience working with neurodevelopmental challenges, specific learning differences, complex developmental trauma, ADHD (in adults and children), and mood issues.

Working with Clergy. Heather also has a great deal of experience working with clergy around issues of leadership, mid-career questions, as well as pre-ordination evaluations. In her work with clergy she is careful to include perspectives on adult development and how this can impact behavior and functioning. In such work with spiritual leaders, she uses standardized and objective test batteries but focuses largely on the complicated intersections of personality structure, leadership style, spiritual calling, and social and psychological functioning.

Passionate about Assessment. Heather is committed to making the process of psychological evaluation deeply collaborative and therapeutic so that a person’s lived experience resonates with the results written in the final report. When viewed as a therapeutic intervention, assessment yields much more insightful results. The collaborative space of the assessment process necessarily includes multi-dimensional perspectives on identity and intersectionality.

She often asks, “Can psychological testing be a site of invitation, provocation, revelation, or promise? Can it be a space of apology, mourning, and forgiveness since the true suffering of the Other refuses to be put into language to begin with?”

Trained on Both Coasts. Prior to working at the Samaritan Center, Heather worked at the Danielsen Institute at Boston University and taught psychology at Lesley University in Cambridge, MA. She completed her MA degree in psychology at Seattle University and her doctorate at Pacific University in Forest Grove, Oregon. She sees clients at the Bellevue office and at the Samaritan main office in Seattle.

Alcohol Use Disorders: A Closer Look

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What would it be like for you to go 72 hours without alcohol? As part of Alcohol Awareness Month, the National Council on Addiction and Drug Dependence (NCADD) has invited all Americans to abstain from alcohol the first weekend in April (5th-7th). Taking a break from alcohol can be a great way to explore what role it plays in your life, even if you would not identify as someone who struggles with alcohol use.

As you probably know, drinking too much can harm your health. According to the World Health Organization, the harmful use of alcohol contributes to more than 200 diseases and injury conditions, most notably alcohol use disorders, liver cirrhosis, and cancers.1 An estimated 88,000 people (62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the 3rd leading cause of preventable death in the United States.2

So what does responsible alcohol use look like? It may surprise you. Both the USDA and National Institute on Alcohol Abuse and Alcoholism (NIAAA) have developed recommendations to limit the risk of alcohol-related harm, suggesting that women should consume no more than 7 standard drinks per week and men should have no more than 14.3, 4

It is important to note that these recommendations define a standard drink as: 1.5 oz of hard liquor (40% alcohol), a 5 oz. glass of wine (12% alcohol), or a 12 oz. beer (5% alcohol).5 Step foot into one of the many breweries located in Seattle, and you will notice that it is difficult to find a beer whose alcohol content is 5% or less; similarly, most cocktails contain multiple shots of hard alcohol and the alcohol content of wine can vary drastically.  All of this to say, you may be having more than “one standard drink” with every drink you consume.

In addition to the weekly guidelines highlighted above, the NIAAA recommends that daily consumption of alcohol is limited, no more than 3 drinks for women and no more than 4 for men, in order to reduce the risk of developing an alcohol use disorder.

What exactly is an alcohol use disorder? It is a clinical term describing a collection of symptoms related to alcohol use that cause significant distress and or impairment during the same 12-month period; these symptoms fall into four major categories including impaired control, social impairment, hazardous use, and pharmacological criteria (i.e. tolerance and withdrawal).  An estimated 16 million people in the United States have been diagnosed with an alcohol use disorder.6

The good news is that there is hope for recovery from an alcohol use disorder. In fact, it is estimated that between 42%-66% of people with substance use disorders achieve full remission7,8  and as many as 20 million individuals and family members are living lives in recovery from alcohol.9 Recovery is not a one-size fits all concept and it may include the use of self-help groups (i.e. AA, SMART Recovery, LifeRing, etc.) and/or formal treatment (i.e. medications, therapy); no single option is right for everyone, and treatment should reflect an individual’s unique history and hopes for their recovery.

Are you wondering if your relationship with alcohol may be problematic? Next steps might include speaking with your family, friends, or pastor; attending a self-help group; or speaking with a treatment professional in your area.

 

 

 

 

 

 

Do We Need an Alternative to Self-Esteem?

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Raising questions about the value of self-esteem can seem like modern blasphemy. So let me say up front that I am for it: Self-esteem is a positive attribute! Who has not witnessed the pain of shattered self-esteem in a friend who has lost love or a co-worker whose career has been derailed?

But the pursuit of high flying and unassailable self-esteem isn’t necessarily the golden road to mental health and happiness. Once proclaimed with certainty in schools and self-help seminars, the merits of self-esteem have been overstated. Especially when you consider the routes we take to keep a shiny and soaring self-esteem aloft: constant focus on competition, perfectionism, and narcissistic preoccupation.

There is a better way. A better model of healthy and sustainable self-regard. It is supported by research, and it is grounded in the wisdom of our faith traditions. It amounts to a practice of self-compassion as the principle for understanding and sustaining one’s worth. Failure and loss are the inevitable consequences of being human. One shares that condition with everyone else, no more and no less. And one offers oneself compassion in the unblinking awareness of that common experience of imperfection, just as one would offer compassion rather than condemnation to a friend.

A current researcher who has substantiated the claims for self-compassion is University of Texas-based psychologist Dr. Kristin Neff. Her experiments have substantiated the effectiveness of self-compassion, and she has gone further to refine tools for assessing one’s inclination to respond to one’s shortcomings with compassion rather than condemnation. Still further, she has developed a variety of ways to practice self-compassion as a route to health and healing. To get a brief intro to her work, check out her TED talk on youtube.com, https://www.youtube.com/watch?v=IvtZBUSplr4

As I have come to advocate for the value of self-compassion—in contrast to a primary focus on self-esteem—I become aware that its roots extend into the depth of my faith. I understand that we, you and I, share a common humanity and a common dignity as God’s creatures. That dignity lies not in some perfection that we have realized but in the path that we ascend together, accepting ourselves and one another with compassion.

The acceptance with which we embrace ourselves, our wonderful and flawed selves, is neither resignation nor complacency. This is crucially important: self-acceptance is realistic and hopeful, positive and not cynical. We regard ourselves with love, even as we commit ourselves to continue striving to be our best. Central to Christian faith is the exhortation to love your neighbor as yourself, and insofar as we strive to show compassion to our neighbor, we do likewise for ourselves. Success in one is inseparable from pursuit of the other.

The apostle Paul wrote in 2 Corinthians that he discovered his strength in his own weakness, his wisdom in his foolishness. This is not doormat Christianity: Paul was not strong because he was weak; he was strong because he could acknowledge and accept that he had inescapable weaknesses and failings. In his humility—in compassionate self-acceptance—he gained towering strength.

And so it is with us. In our capacity for clear-eyed humility, we find strength. In our relationship to a providential God who embraces humanity and all creation in a spirit of loving acceptance, we find a foundation for our own self-acceptance. And a greater capacity to love and be loved.