I officially started my tenure as President of our association on January 1, but the gavel was passed at our annual meeting on January 21. As I listened to John Preston, Ph.D. talk about Managing Resistances in Psychotherapy, I was reminded of the uniqueness [struck again by] of our profession. He mentioned the incubation chambers of ancient times, when a person in emotional pain, turmoil, or grief would go into a darkened chamber with a Holy Person for three days. The idea being that when one is in despair, healing comes by being with the feelings, and allowing the feelings to be present. In our psychotherapy offices, we often re-create such a chamber, a container for those feelings to be expressed as we listen deeply. When someone is suffering, the willingness to go into the dark with them as they express and move through their feelings is a large part of what we do as psychologists.
What do we do in our offices to help alleviate the pain our clients come to us with? There is a plethora of wisdom that comes through the ages to guide us. Rumi stated it well:
College is a Rite of PassageAnd Carl Jung wrote: “Your vision will become clear only when you can look into your own heart… Who looks outside, dream; who looks inside, awakes.
In this time of evidence-based therapies, we are often pressured to keep our clients from experiencing painful emotions, by suggesting alternative cognitions, or practices that will alleviate their discontent. We think about outcomes, often with an imaginary HMO adjuster sitting in the room as we work. I have been fortunate over the years to have a practice that does not rely on insurance panels. But it was not always that way.
When I left California Pacific Medical Center in San Francisco to start my private practice, I joined most insurance panel as a PPO provider. That was over twenty years ago. Those were the days when PPO had just come into being, and they were good to us. We were allowed to charge fees much higher than HMOs and Medicare, currently, allow psychologists to charge. It was before managed care. It was the time when psychologists fought for hospital admitting privileges, and to be allowed membership to Psychoanalytic Institutes. Both of which we got only to find out that the times-were-a changing, and while we were able to admit patients to inpatient hospitals, we were to learn that we would collect little if any reimbursement. I know because I did get admitting privileges at Walnut Creek Hospital. And then the bottom fell out of the inpatient market. Psychiatric hospitals were closing and many psychiatrists were leaving hospital-based practices as well.
Psychologists (with the aid of our professional organizations, The California Psychological Association and The American Psychological Association(CPA and APA) waged a battle to gain access to Psychoanalytic Institutes. Just as we were granted admittance to these elite institutes, the demand for long-term psychoanalytic therapy was on the wane. Once again, the timing was not with us. Cognitive therapy had arrived on the scene with a wham.
There have been many other changes, exciting and innovative. We have learned more about brain function with FMRI. Our understanding of neurobiology is beginning to guide our work. The evolving knowledge of the effects of techniques such as Mindfulness, EMDR, and evidence-based therapies such as DBT, MBCT, ACT and Emotionally Focused Therapy are pervasive in the culture.
These and other numerous developments make our profession an interesting and growing one. I think about the direction our field is taking now, I see a limitless future. Many are working for less income that in previous years, but the possibilities for a fulfilling practice continue to grow. As a profession, we will continue to use evidenced-based therapies, while we help our clients to ride the waves of their emotional lives, helping to bring them from darkness to light.
It is an honor to accept the responsibility of the position of President of this association. In doing so, I become the newest link in a chain of psychologists who have served as president before me, psychologists who have generously given their time, energy and creativity to serve the membership of our organization.
We are a diverse membership. Geographically, we span Contra Costa County from Antioch to Orinda, and from San Ramon to Martinez. We represent a diverse economic area as well. Our membership ranges in age from newly licensed psychologists to the many old-timers, the group to which I now belong.
Those of you who have been around that long – and you know who you are—will remember that Dr. Beth Hall created a website for our organization that displayed each member’s names, a photo, and a description of their practices. Over the years, that evolved into an Information and Referral page, as the website was reconfigured. The I & R became a marketing tool for its members as well as a resource for the public to get referrals to members on the I&R, and information regarding low fee clinics and other support organizations.
Originally published as President’s Message January 28, 2011
couples counseling, and Mindfulness-based therapies in the San Francisco Bay Area for over 20 years.
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