Individual and Couple Therapy
in Tacoma and Seattle

Tacoma Office near Proctor District

35th & N. Cheyenne St

Ample Free Parking

Tacoma Detailed Directions

 

Seattle Office on Greenlake

Greenlake Wellness Group

7900 East Green Lake Drive North, Suite 202

Free Convenient Parking

Greenlake Office Detailed Directions

 

(253) 304-1411

parke@parkeburgess.com



Click the appropriate button below to see what appointments are currently available. Please contact me by email or phone before scheduling a first appointment. I am unable to see new clients without some preliminary discussion. Thank you.

TACOMA APPOINTMENTS

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MUSINGS BLOG

Saturday
Dec282013

Class Registration Now Open

I will be offering my class on love twice in the first half of 2014. Registration is now open for the class on Saturday, February 15 (9:00 am to noon). Based on the Hold Me Tight: Conversations for Connection program developed by Dr. Sue Johnson, I will be talking about the emerging Science of Love. The class is divided into three sections: exploring the myths versus the science of love; finding out what goes wrong when relationships become distressed; and learning the steps to repairing your relationship.

Tuesday
Nov262013

New Study of Emotionally Focused Couple Therapy

This is one of those rare empirical studies that you can read in its entirety for free online. The researchers, including Susan Johnson, the originator of EFT, used fMRI brain scans to test the quality of romantic attachments in real time. They conclude: "The present study provides evidence consistent with the suggestion that EFT can alter the way the brain encodes and responds to threats in the presence of a romantic partner."

Read the study here.

Wednesday
Nov062013

Is Psychotherapy a Medical Procedure?

I think if you asked almost anyone on the street whether psychotherapy is a medical procedure, the great majority would think that a very strange idea. Frankly, the same is true among legions of psychotherapists and counselors. It’s a goofy notion.

But a whole branch of our field has dedicated itself unceasingly to promoting this very idea. Why? In part, these professionals worry that therapy doesn’t have the respect among the general public and, worst of all, other healthcare providers that it should. But mostly, it’s because this field wants to have access to health insurance coverage.

Health insurance carriers only cover medical procedures, so if therapy is not a medical procedure it is not covered. Simple as that. Therefore, therapy must be a medical procedure, right? Wrong.

I could go on at great length about how poorly therapy fits the medical model once you really think about it. Maybe another time. What matters here is that trying to pretend that therapy is a medical procedure involves twisting everything inside out and doesn’t serve anyone very well.

So, yes, I am saying it: psychotherapy should not be covered by conventional health insurance, as long as the insurer subscribes exclusively to a medical model.

But am I saying that psychotherapy should not be covered by some kind of insurance? Absolutely not. Indeed, the same case that argues for coverage of medical procedures applies equally well to therapeutic work; it’s just that these are two different kinds of thing. Auto insurance and flood insurance, for example, may both make a lot of sense, but it wouldn’t make sense to pretend that they are the same thing and should be covered under the same policy.

Psychotherapy should be covered because it’s a human right. We as a society know how to alleviate emotional pain and have trained and licensed professionals qualified to do it. Everyone should have access to that, just as we believe everyone should have access to healthcare for physical pain—it’s a basic right.

And psychotherapy should be covered because the social costs of excluding people from this benefit are much greater than the costs of including them. The social costs of crime and violence, substance abuse, lost productivity—not to mention the unfathomable human and social costs of passing depression or abuse down from generation to generation—can be measured in the billions of dollars per year.

What would make far more sense than no insurance for therapy or our current medical insurance for therapy is a separate psychotherapy insurance. Medications would still be covered under health insurance, but this insurance would cover therapeutic office visits and residential (in-patient) programs.

As long as we’re dreaming, let’s throw out a few numbers. The standard policy would provide 24 hours of individual psychotherapy per year at 100% and an additional 24 hours at 80%; it would cover couple therapy for ten 75-minute sessions per year at 100% and another ten at 80%; and for families with children, it would cover ten 90-minute family therapy sessions per year at 100% and another ten at 80%. The plan would have, say, a $400 deductible.

Although I made these numbers out of whole cloth, they represent what I would consider adequate coverage for those in need of out-patient therapeutic support. The relatively scanty coverage of current plans reflects “parity” with medical coverage but not the well documented realities of actual psychotherapeutic work. With support such as I have proposed, people in need might actually be able to get the help that would dramatically improve their own lives, the lives of those who depend on them, and the society that they help comprise.

Thursday
Oct172013

"What Is Our Deepest Desire?"

A fellow EFT practitioner shared this gorgeous poem with me, a poem by Miriam Pederson. It is the most deep and wise piece of writing I have seen in a long time!

To be held this way in our mother’s arms,
to be nestled deep in the warmth
of her body, her gaze,
to be adored, to overwhelm her
with our sweetness.
This is what we seek in chocolate,
in the food and drink and drugs
that stun the senses, that fill the veins
with the rich cream of well being.
What we take for lust—can it be, perhaps,
a heavy pang of longing to be swaddled,
close, close to the heartbeat of our mother?
No bucket seats, Jaccuzi, or even a lover’s embrace
can duplicate this luxuriance,
this centered place on the roiling planet.

When the old woman, small and light,
can be carried in the arms of her son,
he, at first, holds her tentatively,
a foreign doll,
but gradually, as the pool loses its ripples,
he sees his face in hers
and draws her to him,
rocking to the rhythm of her breathing.
This is the way to enter and leave the world.

"What Is Our Deepest Desire?" by Miriam Pederson, from New Poems from the Third Coast: Contemporary Michigan Poetry, edited by Conrad Hilberry, Josie Kearns, Michael Delp and Donald Hall. © Wayne State University Press, 2000.
Friday
Sep062013

Review: Broucek on Shame and the Self

Broucek, F. J. (1991). Shame and the self. New York: Guilford Press.

This is an extraordinary, broadly scoped, and passionately argued book. Broucek founds his conception of shame on the development of the self. Broucek locates the beginning of shame as a problem at the time when the child begins to recognize herself as an object in the field of the other. The key developmental moment, then, involves the acquisition of what Broucek calls "objective self-awareness:"

The acquisition of objective self-awareness requires that the child grasp that he is visible to others in the same way that others are visible to him, that is, that he has an exterior on which others can have a perspective that he can never share, except in a very limited fashion (pp. 37-38, emphasis original).

In general, this objective self-awareness is not a constant state of being, but one we move into and out of. We experience it more often than not suddenly, unexpectedly, and have a sharp feeling of uncomfortable exposure. Broucek importantly observes that we cannot simultaneously maintain both a sense of self from the inside (that is, self as subject) and the sense of self as seen by the other (as object), so this sudden experience of exposure is disorienting and disorganizing, requiring a dramatic shift in brain state. This kind of visibility suddenly and forcibly takes us out of ourselves, which Broucek takes to be an elemental feature of shame.

I think this is an enormously important contribution to our understanding of shame (and Broucek makes wonderful hay of it in his critique of modern society), but it seems to miss a crucial distinction. I want to say: being visible to the other is not necessarily like that, but only is like that under certain conditions. The gaze of the other does not necessarily compel us to regard ourselves as an object; there is something specific to the circumstances of the gaze and, more importantly, the quality of the other's regard of us that feels objectifying and therefore changes how we regard ourselves.

Many theories, like Broucek's, rest heavily on the idea that exposure brings shame. But these theories all seem to miss that it is only unwanted exposure that induces shame--namely, it is when we are visible to the other so that they might (or do) reject us. Exposure is not the main issue (though it is closely proximate to the main issue). Rejection is the main issue. Gershon Kaufman indicates this clearly when he speaks of the sundering of the "interpersonal bridge," and Silvan Tomkins points to the same dynamic, albeit indirectly, when he speaks of the sudden diminishment of excitement or interest.

This distinction, I think, is immensely important. Deep down we want nothing more than to be exposed--that is, to feel free to be open, transparent, and vulnerable: and loved all the more for it. This is the state of early infancy (at least for a securely attached child), and it is the state to which we all yearn to return. Moreover, it is this very state of innocence that we lose with the onset of shame, and that shame, when consistently over-utilized and under-repaired, banishes to the nether regions of implicit memory. We long for exposure, but shame renders it perilous, so we resist being exposed. Herein lies the real tragedy of shame.

Couple therapy, to give one highly significant example, aims to create a zone of safety for the partners to be exposed to one another and, at long last, to feel loved all the more for it. When this can occur, a seismic shift of the psyche usually follows, as though an enormous weight has suddenly been lifted.