Author Archives: Ann Becker-Schutte, Ph.D.

About Ann Becker-Schutte, Ph.D.

Dr. Ann Becker-Schutte is a licensed counseling psychologist in Kansas City, MO. Her practice specialty is providing support to patients and caregivers facing serious illness--offering help at the intersection of physical and emotional health.

MedPsych Hiatus

Hi folks. Susan and I want to thank everyone who has participated in #MedPsych so far.  We have an amazing community, and there is a lot of energy here toward improving and integrating our healthcare system.

At the moment, Susan and I are facing a good news/bad news issue.  The good news is that we both have a lot going in in our private practices, which is keeping us very occupied.  The bad news is that everything happening in our businesses and families means that the two of us have had to push #MedPsych to a back burner in the past few months.

We both believe that this community and our goals deserve a lot more than a last-minute chat topic.  And we are trying to figure out what steps would ensure that “more” takes place.  We will be continuing to talk, however, until we get some answers figured out, #MedPsych is going to take a break.

We will be available to group members on Twitter and in the Google+ community, and the hashtag will remain active.  We just won’t be conducting a weekly chat on Tuesday nights.  While we are on hiatus, please continue to connect and share in our group spaces (Twitter & G+).  Please connect with the #hcldr chat (health care leadership), the #healthdoers chat (people actively working toward health), the #MHStigma chat (mental health stigma), the #hchlitss chat (health care, health literacy & social science), or others.

Susan and I will be continuing to work towards whole person healthcare, with brain and body integration.  We’ll let you know more as we know it.

Thanks again for everything.  You are amazing and we look forward to continuing to rabblerouse with you!

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Mission Statement Building

When the #MedPsych community formed, over a year ago, it was driven by a desire to truly change healthcare.  Over the last year, we have had a wonderful core group form.  And now, we recognize that changing healthcare is going to require action. And action needs a plan. So, during our January 13th chat, Dr. Giurleo and I invited the community to brainstorm a mission statement.  This post is the summary of the wonderful ideas that were generated.  Actually, this post is the next step in building our mission statement into a tool that can power forward action.  So let’s start with a list of some of community’s thoughts:

  • If we can get rockets to fly, we can integrate health care. — Susan Giurleo
  • We pledge to be an inclusive community together working towards holistic health- mind, body & spirit. We connect to each other. — Gia Sison
  • Nike had the best mission statement ever. Just Do It. Mission statements tend to be so long these days they can become meaningless.  — Scott Strange
  • Maybe what we need more operationally is a clear goal. Let’s brainstorm one clear goal for our work in the coming months. — Susan Giurleo
  • Healthcare should connect brain & body. Connection shouldn’t be only patient’s responsibility. Let’s not reinvent the wheel. — Ann Becker-Schutte
  • Increase awareness on both sides of the HCP/PT relationship to facilitate open communication. — Laurel Ann Whitlock
  • Impress upon all stakeholders the interconnectedness of mental health to physical well-being. — Laurel Ann Whitlock
  • Increase provider and patient demand for whole health care. — April Foreman
  • Create resources and open channels for information – increase awareness through education. — Laurel Ann Whitlock
  • Increase provider and patient awareness that whole person healthcare EXISTS and MATTERS. — Laurel Ann Whitlock
  • We are all in this together to collaborate, problem solve, heal and create #wholepersonhealthcare. — Sean Erreger
  • We are bringing together all county safety nets to collaborate on uninsured pts w/high ER admissions: community-centerered-health-home. — Jen Platt
  • Need to educate people about the benefits of shifting to #wholepersonhealthcare . Spread the word.  — Sean Erreger
  • I think a huge practical goal is to get people to bring forth personal anecdotes re: how combining mental/physical health worked. –Laurel Ann Whitlock
  • A piece around how integrated care leads to better health outcomes AND cost savings. — Susan Giurleo
  • Breaking down Tx silo’s benefits all stakeholders. — Sean Erreger
  • Seems like the goals I’m hearing are that #MedPsych should be a clearinghouse for best practices in #wholepersonhealthcare (or #wphc).  — Ryan Lucas

Okay folks. There’s the summary.  What happens next is that we try to consolidate this impressive list into a few clear points, so that we have a mission that can be explained quickly and easily understood.  We will also be working on identifying a series of action steps.

As part of this process, I’ll be sharing this as an editable document in our Google + Community.  Stop on in and add your thoughts.

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Voting and Brain Health

This post was originally shared on Dr. Becker-Schutte’s practice blog.

What on earth does voting have to do with mental health? That’s a fair question. Bear with me.

This is new territory for me (kind of). In the four years that I have been writing this blog, I have never addressed politics here. There are good reasons for that. The first is that therapy is a safe and neutral space. People are welcome in therapy regardless of their background or beliefs, and each person’s background and beliefs is given room to be valid. That’s still true. The second is that part of my job in therapy is to nurture that safe and neutral space–and talking politics makes it hard for lots of people to stay neutral, so I don’t talk politics.

And actually, I am not going to talk politics today either.

But the fact that tomorrow is election day did get me thinking. One of the topics that I cover with my clients extensively is the issue of choosing to take action in the areas that you actually have some control. Because life is full of things that you can’t control, and it is easy to focus on those things. It is easy to let your depression or anxiety feed on the awareness of what is not under your control.

I don’t have a magic formula that takes away the out-of-control pieces of life. But I can remind my clients (and you) that you still have plenty of places where control is possible. Where your choice makes a difference. And growing towards health includes noticing those chances and making choices.

So, in that context, voting matters for mental health. Voting is a space where any citizen in good standing over the age of 18 can have their own moment of control. And I know that people will argue that they don’t believe that their votes matter. Sometimes, in a district with a deep political identity, that might seem true. But the reality is that voting matters to each of us on an individual level. It means that we get to say, no matter the outcome, that we were active participants in the process.

Being an active participant in your life is an incredibly healthy choice.

So, I would strongly encourage you to vote tomorrow. And after that, make another choice. Then another one.

Change happens one choice at a time.

Not sure what issues you have to vote on? Not sure who the candidates are? Don’t worry, there are tons of nonpartisan voting guides out there. Here are just a few:

Project Vote Smart
Voter’s Edge
Vote411
On The Issues

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Healthy Doesn’t Equal Superhuman

I started to touch on this point last week in my post about honoring vulnerability. And we’ve had some great discussions about the issue of vulnerability and health over the past few weeks in #MedPsych chat (check out the transcripts here).  And there have been comments made during this entire year of the #MedPsych chat that have led to this topic.

Being healthy (in body and mind) doesn’t equal being superhuman.

I think that if I said that to the average person on the street, they would agree with me.  But, the truth is, we kind of expect superhuman–from ourselves, from our patients/clients, and from our healthcare providers.

  • We expect that we will never fall ill.
  • We expect that we will perfectly manage our chronic health conditions.
  • We expect that we will always communicate our needs well.
  • We expect that we will intuitively choose healthy habits.
  • We expect that we will never need to restart our healthy choices.
  • We expect that clients will keep appointments, even when their lives are in chaos.
  • We expect that patients can make behavior changes, even without education and support.
  • We expect that clients and patients can communicate their needs on our timeline.
  • We expect that our healthcare providers will be completely up to date on current research.
  • We expect that our healthcare providers will start all appointments on time.
  • We expect that our healthcare providers will take as much time with us as we need.
  • We expect that our healthcare providers will be able to connect empathetically with us as fellow human beings.
  • We expect that our healthcare providers will have good enough boundaries not to burden us with their struggles.

And that’s just a tiny sampling of the expectations that we have–for ourselves and for our healthcare providers–when it comes to health.  Laid out like that, it becomes pretty easy to understand why we often feel blamed and judged in healthcare, on all sides of the treatment equation.

It seems clear to me that all of these threads: countering stigma, honoring vulnerability, and acknowledging human-ness are essential components of building a healthcare system that truly honors and integrates support for whole people (body, brain, relationships).

I think one area to start changing our expectations is in our training systems.  We need systems where students who set healthy boundaries are respected, not judged.  We need training systems where mistakes are treated as opportunities to learn, not moments of public shaming (or a rush to risk management).  We need training that give us permission and tools to consider our work as part of an integrated system, not isolated silos of expertise.

And sometimes, we just need to pause, and honor the fact that being human is a process of learning and relearning, of connecting, of struggling–a process, not a destination.

 

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Honoring Vulnerability

This post was originally posted on Dr. Becker-Schutte’s home blog.

 

This year, I had the chance to participate in two fantastic panels at Stanford’s Medicine X conference. You can see the video of the panel on chronic illness and depression here:
The video for the second panel will be available later this fall. The great thing about panels is that you get an authentic discussion, a give and take that is really valuable. The tough thing about panels is that you often think about the things you wish you had said later on (maybe that’s just me).

So, this post is about those things. The things I wish I had said–in both panels. Because at the heart of all of the work I do with my clients, the advocacy I do online, and the writing I share in this blog is this conviction: We are all unique, fascinating, fallible, fragile, resilient human beings. In spite of marketing that suggests that we should never be sad, never feel pain, never experience illness-each of those experiences is a part of being human. In spite of a culture that demands invulnerability and infallibility, we are both vulnerable and prone to mistakes.

So, I wish I had said these things:

  • We need to give our doctors and other health care providers permission to experience and claim their own pain, fear, sadness and vulnerability.
  • We need to talk about the amazing learning potential in our mistakes.
  • We need safe space (in our heads, in our workplaces, in our training environments) to have moments of vulnerability.
  • We need to counter shame and unrealistic expectations.
  • We need to challenge the damaging perfectionism that pervades our healthcare system.
  • We need to respect the courage it takes to admit when you are hurting, or scared, or depressed, or anxious.
  • We need to support one another’s humanity more and better.

The statement I made that was tweeted the most was about the need to decrease stigma around depression and other brain health struggles–both in medical patients and in medical providers. In order to decrease stigma, we need to increase our understanding that vulnerability is a fundamental human experience AND our compassion and empathy for the pain and difficulty that vulnerability can bring.

I’ve been having a conversation about vulnerability with the #MedPsych tweetchat community over the past week. We’re continuing that conversation tonight at 9:30 pm ET. You are welcome to join us.

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Medicine X and the Sneaky Impact of Stigma

Ten days ago, I had the privilege of joining the participants at Standford’s 2014 Medicine X conference.  I’ve written about this conference on my practice blog before, and it is a gathering with lofty aims.  The conference was initially envisioned as a space to explore how health and emerging technology support one another.  Over the three years it has been running, Medicine X has become the leader among healthcare conferences at integrating patient voices into the planning and narrative of the experience.  This year, Medicine X invited some discussion of brain health related issues.  One panel focused on the interaction between chronic illness and depression, and another focused on how brain health issues cut across diagnoses to be a “missing link” in whole person healthcare. I was thrilled to participate in both of these panels, and advocate for an issue that I believe is essential as we move into the future of healthcare.

Participating in these panels was a joy–I shared the stage with some courageous advocates whose stories are very powerful.  However, my participation also reminded me of a critical topic.

Stigma is the elephant in the room when we are talking about integrating brain health more fully into healthcare. 

I have written a bit about healthy privilege and the stigma of illness, so I won’t repeat that here.  There is also a great deal of powerful writing about the more obvious ways that brain health issues are stigmatized.  One of my favorite reminders of this is a pointed cartoon:


This cartoon cuts to the heart of the most obvious brain health stigma–which seems to be founded on the idea that brain health can be improved just by “adjusting your attitude” or “trying harder.” That piece of stigma is very real. So is the piece of stigma that has cost individuals facing brain health challenges their jobs or their relationships.

However, what I saw at Medicine X this year was a more challenging and subtle component of stigma. I saw an assumption that brain health issues are something that patients deal with, not a challenge that confronts health care professionals. People were willing to talk about providers who were burned out. They were much less willing to talk about providers who might be facing depression, anxiety, unsustainable stress levels, etc. That language still seemed taboo. And that’s a problem. As long as brain health challenges are something that “they” experience, stigma will continue. As long as it is not acceptable for a medical student to own that the intense demands of their training are difficult emotionally as well as practically, stigma will continue.

I also saw brain health discussed as something “other.” Medical students talked about not knowing how to approach a referral for brain health services without upsetting their patients. Until a referral for a brain health consultation is as automatic as a referral to an endocrinologist, stigma is still at play.  Until we are trained to think about the brain and our social functioning as a vital component of health that we wouldn’t dream of ignoring, stigma will still be an issue.

I don’t want this post to be construed as pessimistic.  At Medicine X, I heard medical students ask questions that showed they truly want to be part of this conversation.  I saw patients who discussed their depression  as a medical challenge on the same stage with diabetes or autoimmune disorders.  I saw that there is so much hope and potential for the future.

I also saw that we have work to do.  Let’s keep the conversation going. Shining a light is how we challenge the grip of stigma.

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Behavior Change–Easier to Say Than to Do

In recent #InnoPsy chats, we have talked a lot about the fact that many healthy choices (from regular movement to taking insulin) are actually behaviors.  So, helping people make healthy choices is, at the root of things, helping people choose or change behaviors that support their health.

The truth of the matter is, behavior change is complicated.

It sounds simple on paper.  Do this more. Do this less.

In fact, it sounds so simple on paper (or on the screen, or in the exam room) that we expect people to be able to hear about a beneficial behavior change and immediately begin implementing that change.

But that expectation ignores the reality of human behavior.  Behavior is so much more than a simple set of choices.  Instead, behavior is a reflection of your experiences and patterns throughout a lifetime.  Behavior has triggers and rewards (some of which don’t make great sense).  Behavior has emotional components.  Shaping behavior is challenging.  Just ask anyone who has ever tried to get a two-year old to behave in a way that the child didn’t choose.

We all have an inner two-year old.  That part of ourselves that is unwilling to make a change.  That part of ourselves that might be willing to throw a tantrum to avoid having to engage with change–even healthy change.

What we know as psychologists is this.  Behavior change is hard AND behavior change is possible.  Honoring and respecting the challenge is part of how we navigate through it.

In fact, during tonight’s chat, we are going to invite our community to take part in some real-time behavior change.  We hope that you’ll join us.  We hope you’ll feel free to share your responses.  And we hope you’ll come along with us as we practice walking our own talk.

–Ann & Susan

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Can We Talk about Brain Health?

If you’ve read some of the earlier posts in this blog, you know that InnoPsy co-founder Susan Giurleo and I started this project to give psychologists and other mental health specialists a platform.  Our profession has been marginalized in the health care system.  I think that is partly because there is stigma about the conditions we treat.  I think it is partly because some folks trained in a medical model view psychology as a “soft science.”  I think it is partly because our profession hasn’t done a fantastic job of educating other health professionals and the general public about how much impact we can have on health and social function.

But around here, just acknowledging the problem isn’t going to be enough. The goal of InnoPsy is to change the status quo. To make a difference.

We had a really interesting discussion during chat a few weeks ago. We were talking about the link between physical and mental health.  And we started to ask, “If there is so much stigma attached to the words “mental health,” why not change the words?”

Because really, it makes more sense on some level to talk about brain health.  All of our emotions and cognitive processes originate in our brain.  The brain is the recipient and interpreter of our internal and external neural feedback.  And, in terms of helping other health professionals understand what we do, starting with a recognized organ and body system seems like a good idea.

Right now, if you do a web search on the phrase “brain health” you will find lots of advertising for sites like Lumosity, which provide “brain training,” or for organizations dedicated to Alzheimer’s support and research.  Go ahead, give it a try.

However, you won’t find anything (in the first few pages of search, anyhow) that references cognitive dysfunction, depression, anxiety, stress management or any of the other issues typically treated by psychologists.

And that makes me wonder–how did we get this disconnected?  How did we take so many of our brain’s functions and just push them off to the side?

And why aren’t we using the phrase brain health to describe these issues?

What do you think?

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Come on In, The Water’s Fine!

I believe psychologists have an important role to play in bringing about health care change. And I am so very excited to be partnering with innovative thinker and psychologist Dr. Susan Giurleo to begin exploring how that might happen.

After a discussion in which several psychologists were sharing frustration over our wish to contribute more and our sense that our voices aren’t heard in other spaces, we realized that we could do something about that. We could build a space and reach out to others from that platform. I talked about this a bit more in my post “Why #InnoPsy?

Now it’s time to actually get it started.

The Medicine and Psychology Tweetchat started January 7th 2014 as the #InnoPsy chat, and continues every Tuesday at 9 pm ET/6 pm PT. Why a Tweetchat? Because Twitter is a platform that allows for global conversations–and it’s where I met most of the innovators that I admire and respect.

You’ve never participated in a Tweetchat, you say? No problem. First of all, you need a Twitter account. They are free and easy to establish. If you’re starting your first account, you’ll be prompted to follow some folks. You could start with Susan Giurleo (@SusanGiurleo) and I (@DrBeckerSchutte). You can also follow the @MedPsychChat account for chat topics and moderation.

Once you have your Twitter account up and running, I would recommend using another tool to participate in the chat. My favorites are Tweetchat or T.chat. Either of these tools allows you to enter a hashtag (ours is #MedPsych) and you will see the chat in a full screen window, which makes it easy to follow along.

So, if you want to join a #MedPsych chat, then pull up your device of choice at 9:30 pm ET on a Tuesday night.  Open your Tweetchat, T.chat, or other Twitter interaction tool.  Type the #MedPsych hashtag into the search bar, and jump on into the conversation.  We’ll ask for introductions, and then be off and running on our topic of the night.

Not a psychologist or a doctor? No problem! #MedPsych is open to all stakeholders (and if you live in a body, you are a healthcare stakeholder).  We believe that a big-tent community is how we will truly find solutions to the challenges that we face in healthcare.

The first chat included some community brainstorming about topics we wanted to explore in a discussion about innovation in psychology.  Now, we’ll introduce a new topic each week.

I hope we see you there! I’m excited to explore new ideas in psychology, medicine, and integrated healthcare.

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Why #InnoPsy?

BootsI have mentioned a time or two (or ten) that it is very important for me to walk my talk. I can’t talk to my clients about healthy choices if I am not making healthy choices. I can’t encourage my clients to do the tough emotional work if I am not doing it myself. That authenticity is part of what makes me a good psychologist. It’s a quality that I try to protect and nurture.

Keep that whole walking my talk thing in mind. It’s important for the story.

Earlier this month, I found myself talking with a group of psychologists about how our voice feels absent in the larger healthcare leadership discussion. This has been a theme for me ever since the Stanford Medicine X conference. I wrote here that:

The mental health field has so much to bring to the table in this effort to change and improve health care. I heard many attendees talking about the value of patient stories–mental health is centered on the story. I heard speakers talk about the critical lesson of asking if they “got it right” when summarizing patient experience. This person-centered reflection has been part of introductory therapy training for decades. In addition, when we aren’t talking about the impact of mental health factors on patient education and health decision-making, we’re missing a huge part of the picture.

I’ve been talking with folks since September about how to get more psychologists to the table. We are doctoral level professionals–we’ve had extensive training not just in patient-centered care, but in brain-based understanding of human behavior.

And so, in this discussion, someone (Dr. Susan Giurleo, to be specific) said, “Why don’t we have a tweetchat where we are discussing these issues?” And that led to even more questions. Why aren’t psychologists being more assertive about our potential to add to the discussion? Where is the public education that says, “There are folks who could help with this!”? And finally, why are we waiting for someone else to invite us to the table? Why not create our own table?

And there’s where the whole walking your talk thing came in.

And the #InnoPsy chat was born. Because, at the end of the day, a significant part of the health crisis in the United States today is a mental health crisis. And psychologists are the folks best trained to lead the discussion about that crisis. Public leadership isn’t a familiar role for many of us. I know that I, at least, am most comfortable confronting the mental health crisis in my office–one client at a time. But if I am going to walk my talk, then it is time to show up. Psychologists have a great deal to contribute to the larger conversation. And I’m ready to do my part. I’m showing up.

And I hope that you will show up with me. The #InnoPsy tweetchat had an opening discussion today, about healthy coping in the face of the Newtown shooting anniversary. But we’ll be chatting weekly on Tuesday nights at 9 pm ET/6 pm PT on the #InnoPsy tag. I hope I see you there. We can walk our talk together.


Cross-posted on http://www.drannbeckerschutte.com

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