The State of Therapy: Why Therapists Feel Trapped by Insurance: The Power and Control Wheel, Reframed

Like that is part of my job.

but to like open up your email and say like, we're trying to fast track licensing for AI doctors.

And you just go like, did I just, I must've misread that.

Like I must be misreading that.

Like what is happening right now? And then again, we're like, we're still on the, on the, the other pieces of, you know, AI therapists.

If, if they're ready to give a physician a license to an AI physician, then why, I don't say like, what are we but like in the in the pecking order that shouldn't be there, but the pecking order that is in our society in the system, like, oh, are they even going to require a license? Like, what are we it's just been wild.

I don't feel like there's a day that I haven't opened up my email or open up my tick tock.

And there isn't something big that's happening that feels important that feels like something that like, well, people need to know that, but then there's also this space of like, or do they, is it creating more fear? Is it creating less action? Is it just this overwhelm that becomes too much heaviness to carry? Like, what is the, what is it? You know, I don't know.

And then I, you know, this aspect of the constant re-traumatization or, um, exposure to really challenging and world events and things happening you had this idea of applying the power and control wheel right to what's happening in our country's health care insurance system and i think about you and i both come from working in domestic violence um That was my training and my internships and things.

And you and I both ran groups and all sorts of stuff.

And we're very familiar with this wheel.

And thinking about like when people are in situations of oppression and constant abuse, you know.

where does the laughter go so i i you know looking at this wheel it's like okay that balance of we're in a situation that's that is abusive and we're still trying to create a life with levity and enjoyment and connection it's challenging yeah

It's really, really challenging.

I think that's the piece that I was always struck by in the work, in that part of the clinical work, was the space of...

A, how the how that cycle of violence, the like tension building and then there's this explosion, then it sort of goes into this like sort of honeymoon period and then back into the tension building and then the explosion and the honeymoon and then over time.

Maybe it speeds up a little bit more.

Maybe the honeymoons get shorter.

And how when you're in the midst of that, bouncing back and forth, it becomes so much just about survival.

It's really, it's hard to step back and to see the cycle.

It's hard to have the energy to make sense of what's going on because it's just about safety, right? And I think when we started, like, it's not that this is new to be looking at it from this perspective, but when we started actually, like, going, like, wedge by wedge in the power and control wheel and looking at the, well, how does this show up? in the way that things are happening in the insurance industry, it got really uncomfortable really quickly.

Like, really, really uncomfortable.

And it so connected in with what we're hearing from therapists, I think especially in the United States.

Like, what's happening in insurance, I'm not seeing it in other countries, especially countries with single-payer health care.

This is not a thing.