Suicide is not painless

Far too many of our LGBT brothers and sisters contemplate, attempt, and complete suicide.

Here are some statistics, according to the Trevor Project (www.thetrevorproject.org/pages/facts-about-suicide):

• The rate of suicide attempts is 4 times greater for LGB youth and 2 times greater for questioning youth than that of straight youth.
• Suicide attempts by LGB youth and questioning youth are 4 to 6 times more likely to result in injury, poisoning, or overdose that requires treatment from a doctor or nurse, compared to their straight peers
• In a national study, 40% of transgender adults reported having made a suicide attempt. 92% of these individuals reported having attempted suicide before the age of 25.
• LGB youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGB peers who reported no or low levels of family rejection
• Each episode of LGBT victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times on average.


We have made so much progress in recent years towards greater equality and acceptance, that I hope we will start to see these numbers go down. However, at the moment it continues to be a significant mental health concern. You can't read news or look at Facebook without seeing stories dripping with hate towards LGBT folks. This hate is what pushes individuals to consider suicide, when they question their own self-worth because of some vitriol someone is spouting off.

Those of us who are fortunate enough to be resilient against the onslaught of hate must be clear that life can indeed get better. We know that acceptance for LGBT individuals, couples, and issues has swelled over recent years, and this will definitely help. However, we must continue to fight against those who continue to try to push us down, to call out the hatred for exactly what it is. Our voices of love and support must drown out the screeches of hate.

In 2013, Amy Bleuel established Project Semicolon 10 years after the death of her father by suicide. The idea is both simple and elegant. Writers use a semicolon when they could end a sentence but choose not to. The main thrust of the project is suicide prevention by folks getting a tattoo of a semicolon. The idea is that we could choose to end our life, but we make the choice to keep going. Here is the semicolon tattoo I recently got:

Sadly, Amy Bleuel took her own life recently. That was part of what prompted me to go ahead and get the tattoo. She worked hard for many years to help people stay alive, and ultimately she succumbed to her demons. I don't know the details, but I do know that we must continue to fight, continue to counter hate with love, continue to survive.

If you know, or even suspect, that someone is struggling with suicide, urge them to get help. There are many counselors out there who can help. There are many suicide hotlines folks can use to reach out and find someone to listen. People kill themselves when they believe that they have no other option to overcome the pain they are experiencing. We must exemplify hope as we fight, and love, and survive.

National Suicide Hotline: 1-800-273-8255

Insurance Update

When I started my private practice almost 2 years ago, I didn't fool with getting on insurance panels - I knew it would be a headache and decided to just use a sliding scale. However, when I went full-time with the practice, I knew I needed to go ahead and get on some insurance panels. I started the process months ago, and it has definitely been a headache. Here is where things stand.

Magellan: I have a contract and am finalizing a few details, but basically ready to bill.

Cigna: I have a contract but before I can start billing they have to check my credentials. They say it won't be more than a month (I'm not holding my breath).

Blue Cross Blue Shield: I have submitted all the documentation that I am aware of and am waiting on a decision. I do think this decision will be favorable, but don't know how much longer it will take.

Humana: They denied my initial application, but I appealed it and I think they are going to offer me a contract. Again, not sure of the timeline.

Aetna: I have submitted the initial application but haven't heard anything from them.

United: Initially they stated they are not contracting with any more psychologists in this area. I have appealed it but haven't gotten an answer.

Amerigroup: Will submit my initial application once I have a Medicaid number - they require that before they will consider an application.

Medicare: I have submitted all the paperwork and am waiting on the answer.

Medicaid: I have submitted all the paperwork here as well, so just waiting.

At the moment I think this covers it. As contracts become real I will notify folks.

When did we invent gender identities?

I found this quote on Facebook. Lately we've been hearing about all of the "new" gender identities, as if we are suddenly creating all of them. Fact is, they've existed since we've existed, but it's only now that we are recognizing that gender is more than man/woman or even trans/cis. At this point there are quite a few gender identities that are being used, and sometimes I get a little confused trying to understand exactly how an identity is different from all of the others.

The diagram above shows some of the most common ones, but there are lots of others. I'm not going to try to explain them all here, but I did want to share the initial quote and give a bit of an explanation. I do think it is important to acknowledge that gender is (and has always been) so much broader than was recognized; now we just have the language to describe it.

Religion and Psychotherapy

We live in a time where religion/spirituality is sometimes seen as not belonging. We are likely aware of the frequent disagreement about the role of religion in our government. Controversies around laws with religious content are very common at the moment. However, this isn't primarily a political blog, it is a blog about psychology. Another question we sometimes have to deal with is the role of religion/spirituality in the therapy room.

To be completely transparent, I am a Christian. I was raised in the United Methodist Church, and I continue to identify with that denomination today. Recently I have also been incorporating some additional spirituality into my life, meditation practices that could be considered more a part of Buddhist thought. Thus, religion and spirituality are important parts of my personal life.

As important as religion and spirituality are to me personally, when I am working with a client, my beliefs are not relevant. Early in my work with an individual I will ask them about their personal religious/spiritual beliefs. If they do have beliefs that are important in their life, I need to know so that our work can include their beliefs (as relevant). If they don't have specific beliefs, then our work won't include a spiritual component.

Living in the South, religion (Christianity) is a very visible part of the landscape. We don't have to go far to see multiple churches of varying denominations. However, there are folks who are not interested in religion, possibly because it has never been a part of their life, and possibly because they have been hurt by the religious beliefs of others. For these individuals it is inappropriate to expect psychotherapy to include religion; it is unethical for a therapist to try to include religious beliefs when the client does not want that.

Religious beliefs/spirituality are very personal endeavors. If you are contemplating therapy and want religion to be included, make that known to the therapist. If you do not want religious thought to inform your therapy, make that known as well. It is appropriate for you to ask your therapist how they utilize religion in the therapy room, and if their response isn't comfortable for you, then that therapist is not a good fit for you.

Mindfulness - It really is a thing

We live in a very complex, active society. So much so that we spend the vast majority of our time responding/reacting to our environment, which leaves us little time to pay any attention to ourselves. If we are lucky we do find time to relax, spend time with people we enjoy, or focus on hobbies that are meaningful for us. However, these activities are not the same as really focusing on ourselves.

Most of the time our focus is either on the future or the past. We plan for all of the things we need to take care of or get ready for, or we perseverate on things from the past that we wish we had differently but we can't change now. What we don't focus on is the here and now, the present moment as it is, the one thing we can actually experience. We have memories from the past and hopes (or worries) for the future, but this moment is our reality, if we can turn our attention to it. The only way to change the future is to be present in the moment, to cultivate intimacy with things as they actually are, and we aren't typically very good at this. We maintain high levels of stress as we react to the world around us, instead of taking charge and living fully in the present.

Mindfulness is awareness that arises in the present moment. It is not a state of the mind, but instead is a state of being. It is seeing yourself as you are, and accepting yourself as you are in this moment. Mindfulness is a dignified act of love that we can give to ourselves, but we can't give to anyone else, nor can anyone give to us. We must take the time to give ourselves this gift, so we can be fully present and fully ourselves. Mindfulness means we are fully awake. It is a shift from doing to being.

Over the next few posts I am going to explore various ways that we can be more mindful in our lives. I imagine when you think of mindfulness you think of meditation, which is a fair connection to make. You may envision someone sitting in the full lotus position, eyes closed, softly humming "ommm" to themselves.

This is meditation, absolutely, but it isn't the only way to accomplish it. It is true that some people meditate for long periods of time, but there doesn't have to be a huge commitment of time to be more mindful. In addition to classic meditation, a number of other practices include mindfulness: yoga, some martial arts (like Tai Chi), biofeedback, using mantras, and short mindfulness/meditation exercises (as short as a few minutes) to reconnect with ourselves in meaningful ways. There are also psychotherapies that utilize mindfulness: mindfulness cognitive therapy, mindfulness-based stress reduction, and hypnotherapy. I am learning about all of these practices myself (for both personal and professional reasons) and I will share what I learn with you all here. Mindfulness really is a thing, and it is a thing we could all use more of.