3 Reasons to Be Tired

#1.
I can tell I am getting tired.  It seeps into my body, my mind and my soul.  This is part of getting ready for vacation, which now is just a week away. To go on vacation it is necessary to be tired.  A vacation should be earned.  For me, it is difficult to just walk away because you can; you have to be tired.

So I am getting tired.

#2
It seems like many of my colleagues are tired also, and a bit scared.  They can see that the landscape is changing.  This whole health care delivery discussion makes everyone wonder what's going to happen.  It is reasonable to assume that those who will be making the decisions will have no idea what they are really talking about -- on a therapist to patient level.  The decisions will be based on money.  Those of us who still bill insurance companies for our services have already seen that the way insurance companies will cut costs is to pay us less. 

The other way will be to not pay us at all.  The model that most psychotherapists use, seeing people in their office for about 50 minutes at a time, once a week, was created about a hundred years ago.  It hardly fits today's world.  Two things are happening.  Well trained, Ph.D, or M.D. therapists are being replaced by Master's level people who are paid less.   Also, technology will enter into the mix.  People will be treated by text messages and Tweets. How much does it matter?  I think it does, but it is very difficult to demonstrate. I am the best therapist in the world and I only help about 62.347% of the people I see.

All of this makes everyone discouraged, and tired.

#3
When I'm rested and on the top of my game, doing therapy is challenging and fascinating. When I begin to get tired I can feel the resistance.  I can still deal with it, but it is there.  What happens is I feel badly when I open the can of worms and really see what's in it.  Today I was working with a guy I have been seeing for about six weeks. I like him.  He is bright, interesting and came to me for anxiety problems.  I am good with anxiety problems, especially if they are , you know, anxiety problems.  But they are not always just anxiety problems, very often they are more than that. It can take a while to find out.

Today, I was doing what I do, which is when someone with anxiety is still just as anxious even after I have sprinkled the first wave of magic dust on them, I probe a bit to find out what' s going on. Now, this is a guy I really like, as it is with most of the people I see.  When I like them I don't want them to be too fucked up.  But I still have to look under the rocks and see what's ticking.  So today, I looked under the rock and found out the the guys isn't just anxious, he's full of self-loathing and has cut himself.

I was tired.  I didn't want to find this out.  I want him to be OK.  I wanted it to be easy.  I can handle it, but then I'll go on vacation.  Now I have to do things to make sure he's OK.

It's not that I'm complaining, because this is what my job is.  It's just that I'm.......
complaining.