Your Therapist Needs Therapy 99 - Q&A

The internet has therapy related questions, and I offer some answers! 

Jeremy has all his practice info at Wellness with Jer, and you can find him on Instagram and YouTube. To show your love for the show you can pick up some merch! We appreciate support from likes, follows, and shares as well!

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Podcasts about therapy do not replace actual therapy, and listening to a podcast about therapy does not signify a therapeutic relationship.

If you or someone you know is in crisis please call or text the nationwide crisis line at 988, or text HELLO to 741741. The Trevor Project has a crisis line for LGBTQ+ young people that can be reached by texting 678678.

Transcript

Transcript

Jeremy Schumacher: Hello and welcome to another edition of Your I'm your host Jeremy Shimacher, licensed marriage and family therapist. We are here this week with I don't know if it's a special episode. We're doing a Q&A. Thanks Interwebs to lovely people who traverse the wilds of the internet. it was episode 99. I don't understand how or why. the podcast here was a complex solution to a relatively simple problem, which is that I don't like networking and so a complicated solution to it's weird to email people out of the blue and ask if they want to meet

Jeremy Schumacher: I did that by asking them if they wanted to meet and record our conversation and here I am 98 episodes later and we're doing a Q&A because I don't need to schedule a guest because I think there are things as a mental health provider be because it's my day job and I do it all the time and don't really think about it.  Not that I don't think about it, but there are aspects of it that become so routine. I thought it'd be good to put it out to the socials and various places where people can ask questions. And I have made a list of questions and I've pulled some questions from other social media stuff with other therapists, Reddit AMAs with therapists and stuff.

Jeremy Schumacher: So, got a little bit of a list of questions for mental health providers that I'm going to work through and hopefully that's interesting. And I like these things because I like to talk about mental health and it is a passion of mine and again because you do it every day, you sort of like I don't know can get lost in some of the things that might be interesting or relevant for other people. yeah, and then next week I have a special edition for episode 100 lined up, which I'm excited about. So, here we go. Q& A. Let's hit it. How do I know if I need therapy or if I'm just being dramatic? Everybody needs therapy is the short answer.

Jeremy Schumacher: yeah, I mean having a trained professional who has extensively studied a topic and ideally has a great deal of experience working in that topic. Tailor make a helpful approach for you and your life is awesome, that sounds lovely.  Take a coach, take a mentor, take a expert quote unquote, a very extensively trained human on a topic and they get to just meet with you and talk about how all the things they know and experience and have read research on and studied and experienced themselves. What does that look like for you personally? Love it. That sounds great. And that's what therapy is.

Jeremy Schumacher: So, it doesn't matter if you're being dramatic or not. Therapy is helpful for everyone. I think everyone would benefit from therapy. I don't think everyone needs to be in therapy all the time. I think if we're struggling with pretty much anything, there's probably a specialist out there. There's probably a therapist who can help you in some way, shape, or form. You don't need to justify having a good reason to go to therapy.  That being said, even this question implies like, "Hey, a therapist could probably help with this. Am I being too dramatic? Who's that mean? What's too dramatic according to you, according to your mom, according to your significant other? who gets to decide that?" And therapy can help sort of untangle some of those existential questions and get you to a point where you're maybe not second guessing so much or you feel like you have a good decision-making tree on how to answer that question yourself.

Jeremy Schumacher: And yeah, it can be really when done I think really empowering thing that helps people across the board. Great question. Why do I feel worse after therapy sometimes? Yeah. Yeah. couple reasons. I think first and I say this in my informed consent for people when they're starting informed consent is sort of this conversation we have before we jump into things just so we're all on the same page and know what we're getting into. And as a licensed marriage and family therapist, I say this mostly to my couples, but it's not unusual that things get better before they get worse. When you start working on something, sometimes you have to take it apart a little bit, a small example, for vacuum cleaners, not new fancy ones.

00:05:00

Jeremy Schumacher: I'm dating myself here with my but stand up vacuum cleaners, they have a band that sort of goes around and whatever. it comes off sometimes, And so if you're using your standup vacuum on a carpet, maybe this band is not even the right word. It is a band, but I'm sure there's an engineering term for it. you have to take the vacuum cleaner a little bit apart to get the band put back on and then put it back together and then it works again. I have long hair so does my partner and my children's hair is kind of long and we have dogs and our basement is carpeted so we have to set that setting for it's not like shag carpeting but whatever.

Jeremy Schumacher: and so this band of the vacuum cleaner comes off every once in a while. And so you have to unscrew the bottom of the vacuum cleaner, take a piece off, and then put the band back on. So the wheel or I don't know, the brush, the comb sort of part of the vacuum cleaner can rotate. And you got to untangle it, whatever. in my case, usually cut human hair off of it. and then it's gross. I hate it. This is a task that I detest.  And it's good to have a clean basement cuz I don't like spiders more than I dislike human hair that's not connected to a body, which I dislike a lot. That's just how much I dislike spiders. Anyway, you have to take the vacuum cleaner apart more to fix it before you it works again. So, I think sometimes, especially with mental health in general, but definitely with couples, there's some st there's some bad habits that they get into.

Jeremy Schumacher: there are some behaviors that they've learned over time that are unhelpful and you sort of have to take those apart before you can put it back together in a way that works again. So, sometimes things get worse before they get better because that's just part of the process of fixing something. sometimes it's just a part of healing. When you have a broken bone, we need to set that bone that might be very painful, that might be deeply unpleasant and that helps the healing process.  And I think therapy also can make you feel worse. Not just because of that structural piece, but also therapy is hard. working on emotional stuff, dealing with trauma, unpacking old stuff, trying to train your brain to respond to things differently, to process things differently, to reprocess old stuff. Like that is energy that requires resources and effort.

Jeremy Schumacher: so therapy can be really tiring, especially when I'm doing trauma work with folks. I sort of let them know "Hey, you're going to be tired later today." pencil in an early bedtime. Make sure we hydrate. Maybe take a nap, put on your comfort shows this afternoon. don't go hard after something. Don't get out of therapy when we're processing trauma from your childhood and Unless your mom's not related to the trauma and she's really lovely. so often times I tell people like to rest and recover especially with that heavy trauma type work. It's exhausting. It requires resources in the same way that running a 10K requires resources from your physical body. Our brain is part of our physical body too. Mental health isn't drawing from different resources. It's the same number of resources that our brain has. So I think it's tiring. It can be exhausting. It can be painful.

Jeremy Schumacher: I've been working with some folks around rejection sensitivity dysphoria and how that interplays with neurode divergence. And I think again sometimes our brain is wired in such a way where emotional pain gets wired as our brain interprets an emotional threat as a physical threat to our safety. So there's a lot of quirks that go into mental health. brain as one of the most complex machines we're aware of. we keep trying to replicate it, So, yeah, that's why the idea of therapy is that stuff does get better. if you go to therapy every single week and feel bad after or feel worse after, that's a good thing to process with your therapist. Your therapist might be aware, maybe you're new in therapy or maybe you've recently started working on something different that's very difficult.

Jeremy Schumacher: And so they should be able to sort of process that with you and ideally have some sort of game plan. Again, we're not doing labbotoies with an ice pick and just sort of shrugging and hope this works. therapists again have a lot of training. They have a philosophical background mostly. good therapists should to what they're doing, how it works, what school of thought they're coming from.  And there's an idea, there's a rough outline. It's really hard to predict what therapy is going to look like for any one particular person, but there's a blueprint for what it can look like. So, I think having that conversation with your therapist is really great. I don't like this question. Is it normal to trauma bond with your therapist? That's not what trauma bond means. Is why I don't like this question.

00:10:00

Jeremy Schumacher: This is one of those cultural zeitgeist it means something different in pop psychology than it means to us professionals. a trauma bond is formed in highly high crisis situations or repeated patterns over and over again. So therapy ideally is a safe space.  It might be a challenging space but it's a safe space and you might be working through trauma but ideally therapy is not in and of itself traumatizing maybe triggering maybe u but we try and be careful with that. We try not to retraumatize people like that's a big goal of not doing harm. so I think it's not a trauma bond. Is it normal to bond with your therapist? Yeah, absolutely.

Jeremy Schumacher: the one common point of successful therapy across different types of therapy with all different types of people is the therapeutic relationship that clients can relate to and form some sort of working relationship with their therapist. somebody who has your best interest at heart and is invested in you doing well. Yeah, absolutely. it doesn't need the extra level of a trauma bond. You're not surviving a bank heist together where you've been taken hostage. You're not going to war together. this is another human who sees you as a fellow human and wants to be helpful. It's normal to bond with them. we don't need to make it popsych nonsense. do we have to be careful of what that bond looks like? Yeah.

Jeremy Schumacher: And I'm going to say that's a lot of the therapist's responsibility. Again, we are trained in how to work with that and be aware of and work with and work through transference, which is a fancy word for our clients feel feelings about us. and sometimes that's good feelings, sometimes it's bad feelings, whatever. sometimes we're representing the authority or we're representing their parent or their sibling or whatever. So, sometimes that's a thing we have to work with and work through.  Sometimes it's just like you're a cool human. I bet we'd be friends outside therapy. And maybe, a lot of my clients think very highly of me and assume we'd be friends outside of therapy. And I show up pretty authentically in therapy. So I think at this point in my career, that's probably true in the sense that the people who want to work with me are generally self- selecting. they're good fits for who I want to work with.

Jeremy Schumacher: early in my career I'm just helpful, you want to stay married and I'm helping you salvage your marriage. the fact that you feel some sort of positive way towards me is not a surprise. That doesn't mean we're buds. so it's normal to form a bond with your therapist. Arguably that is helpful and there's a range in which that is healthy and there's some ranges where that becomes unhealthy and we have to sort of be aware of it.  But what if I think my therapist is judging me? It's a podcast, so you can't see it, but I shrugged. so that's not a helpful response. we're probably objectively judging the people in your life that you talk to us about. We think your parents could have done better.

Jeremy Schumacher: we think your coworker is an ass hat. We think your boss is misogynistic. whatever, when you come in and tell us about the stuff that's going on in your life, we are holding space specifically to help you. And so we're probably going to be more judgy in a way that is protective of you, but isn't parentifying ourselves and making you that child or always in your corner necessarily no matter what. Again, we're not your friends.  We're going to look at things objectively and try to be helpful. we do want to have your best interest in mind, but therapy is different than a friendship in that like we can say some stuff that might hurt your feelings or might challenge you or push you. You might not like to hear because we don't have to worry about being friends at the end of therapy. We don't have to maintain that relationship. So, yeah, I don't know.

00:15:00

Jeremy Schumacher: And I've seen some clients do some questionable things. I've had thoughts about getting back together with the ex. I've had thoughts about that piercing or that tattoo. And again, some of those are like, "f*** yeah, that's awesome." Some others are like, "I really hope that works out well for you." and it's not so much judging as I don't know that that's the decision I would have recommended to you had you asked. But again, good therapy isn't that we're trying to live your lives for you or that you have to check everything with us. So, I had a client once who I said "Hey, this is toxic. We should be looking at divorce." And, I worked on some boundaries for what that could look like with the divorce. And they ignored what I said and they helped each other.

Jeremy Schumacher: move into their new place and they end up Getting together outside of my help with therapy, it was like who helps the person move who's divorcing them and like that was because they ignored my advice on boundaries. they got back together. So that's my one example in 16 years of doing therapy where somebody out and out ignoring what I said worked out better for them. And it's not like I'm always right.  is just saying that's a rare occurrence. And the reason I can pull that example so readily is because it's the one that exists as a clear-cut example like that. Not saying what your therapist says is always right. It's a process of making sense of things and why it works, but yeah, we're not judging you in the way that other people out and about in your day-to-day life or out in the real world are judging you.

Jeremy Schumacher: It's different. I got a couple questions about Ax religious oaks. how do I stop feeling guilty for leaving my faith? that's a really great question and that's a big question. I could do a whole podcast about that. the guilt that we feel is a conditioned response around black and white thinking dogmatic thinking right and wrong thinking. A lot of religion is based around a control model in which there is u a problem and the religious leaders whatever is the solution.

Jeremy Schumacher: And so you're breaking that sort of social contract that almost exists that religion relies on working. You need to feel like you are sinful. You need to feel you need a savior. You need to feel like you need to repent whatever. you need to do more good things to earn that next level of spiritual awakening and nirvana or whatever there's always something that you need to be doing when you sort of say "Nah, I'm good. Peace out." dogmatic doctrine. you're just sort of saying No, that's not true." And so, while I am somebody who is atheist, like that's not where everybody lands. So, it's not so much like that's right.

Jeremy Schumacher: although I would say that's probably a correct stance. that is a logical place to land is what I will say and that guilt is that conditioned response. Again religion requires there to be a better option. And if you are not picking the religion's better option then you are in some form or fashion transgressing. And that's something that you're taught to do. that response of no I've done something wrong is a conditioned response. We are taught that. We learn it through the environment that we're in. and so yeah it's one of those things where I think it's a conditioned response. yeah. Yeah.

Jeremy Schumacher: And to there's some sometimes guilt is a helpful emotion in the sense that we've done something that goes against our ethics. we have lied to our partner. We have betrayed someone's confidence. We have done something to a friend or a family member that isn't in alignment with our value system. Guilt can be helpful. what is unhelpful is shame is really like that self-defeating thing. It's like a dog tucking its tail between its legs and going off to hide in the corner. doesn't accomplish anything. It just makes you feel bad and then you don't learn or grow and you end up sort of perpetuating the same cycle. So guilt can be a helpful marker. So I'm sort of shifting this question to say how do I stop feeling shame's unhelpful. guilt is like we do have to sort of interrogate. Okay, this emotion is going off in me. I'm feeling a thing.

00:20:00

Jeremy Schumacher: What is that thing telling me? What is this signaling? If we look at all emotions are neutral. They're neither good nor bad of themselves. They're signals of something or our brain is responding to some sort of stimuli. what is it signaling? I feel guilty about leaving the church, but the church taught me that I'm sinful and need Jesus to be my savior, but I don't believe that Jesus existed, and I don't believe that sin is anything other than a man-made construct.  So feeling guilty about leaving something that I don't believe in anymore. that doesn't make any sense. So we can sort of interrogate that guilt process and see what it's based on. And then it's learning some regulation techniques and some self soothing. I'm personally a big fan of DBT work for that stuff. I just think it travels really well.

Jeremy Schumacher: not to bismerch and I've bismerched it before so I don't know I'm caveatting adding a caveat but you go to EMDR you go see your EMDR therapist and they're great for trauma but you can't pull out that setup right like I get that EMDR therapy the goal is not that you have to do EMDR for the rest of your life but where DBT is just it's breath work it's using our senses to ground it's using body based stuff because our body is always with us it travels really well wherever we're going we're  taking our body with us and so it's using some of our brain and it's using a lot of our body to be able to regulate our system to self soothe to gather resources.

Jeremy Schumacher: So, if that guilt is not signaling anything other than we've been conditioned to feel that guilt, then we learn how to regulate and self soothe and that diminishes over time. So, we can progressively grow from there so that we're not having to deal with that stuff all the time. Is questioning my faith the same as losing it? How fundamentalist were you raised? no and I have a brother-in-law who's a pastor and when I was sort of in my deconstruction he was angsty about the questions I was asking regarding what I've been taught in my religion.

Jeremy Schumacher: which seemed very odd to me because I was raised evangelical Lutheran and I was a pretty big proponent of Paul's work when I was back as a Christian. and I'm not anymore obviously neither a proponent of Paul's work or a Christian. but to test the spirits. Paul says to compare what we're hearing preachers say to what the scriptures we are we're supposed to do that.

Jeremy Schumacher: We are supposed to engage with the topic. And I would tend to lean towards that's good and healthy. Not because Paul said so, but because interrogating our beliefs is an important process that leads to growth that if we are aligned with our beliefs like that leads to more affirmation and more self-confidence around those things. So interrogating isn't always a path to unbelief. It is sometimes a path to strengthening things.

Jeremy Schumacher: So yeah, Questioning your faith in pick a noun is great. we should pick up some rocks and turn them over in our lives and look at what's underneath them. And I think that That's a gardening metaphor. I skipped some steps in explaining it. how do I deal with still loving people who are in toxic religious spaces? Great question.

Jeremy Schumacher: poof I don't want to punt in this question in and Q&A episode but how do I deal with still people who are in talks it's such a case by case basis it's really hard to give a blanket answer to that I think if they are respectful of you as a person if they are respectful of your belief systems then more power to it I ascribed to that concept of chosen  and family that the people who are family are not necessarily who we're biologically related to, but who treats us how we want to be treated. who treats us like we want family to treat us, however we define that, So, yeah, there'll be people who show up for you and maintain that relationship and that's great and we can invest in those relationships and relationships that build us up. Great.

00:25:00

Jeremy Schumacher: even if we have different belief systems, let's continue to put energy in that because it's a edifying thing. it's an uplifting thing. if their toxicity spills over into a toxic dynamic in your relationship where they're either trying to proitize or reconvert you or you're trying to, save them from the toxic space they're in. know. I don't love that. I grew up evangelical where you're taught that you're responsible for everybody else's soul. You have to save other people. and that's just colonization, that's deeply disrespectful to other people's autonomy. so even if I think I'm correct in my belief systems, I'm wary about trying to get other people to join.

Jeremy Schumacher: I hold space for community building and mutual love and respect. More power to it. I go out of my way to find people who do have values and beliefs that are aligned with mine. I think that's helpful. I think we require community to be healthy and I think we heal in community. but that's finding people who are there already or who are doing their work to get there or who have been there already and are waiting for me to join them or whatever that looks like. I'm not some wise old man on top of the mountain. My journey continues as well. But, that's different than trying to get someone to be there or force them or pull them with you or rescue them or save them.

Jeremy Schumacher: I think a lot of evangelical folks, especially evangelicals, leave the church and then bring the procilitizing structures with them into atheism or wikah or wherever they land that they're still trying to convert other people. And I'm just deeply skeptical of that. I don't think that's a respectful behavior. I don't think that's a way to treat another human that you're respectful of.  So, a bit of a punt. It's a case- by case basis. it really does depend on some of the surrounding circumstances of that relationship. Yeah. we got some questions on the neurode divergence side of things. I work with religious trauma. I work with neurode divergence and I'm a relationship therapist.

Jeremy Schumacher: So, let's look at can you be autistic and outgoing? Yeah, absolutely. some questions about burnout. What's the difference between ADHD and burnout? I don't understand that question. Those are not the same thing. So, I'm confused as to how somebody gets to a point where they think they're the same thing and are wondering what the difference is. they're just different things. What's the difference between a pig and a horse?  It's like They're two different animals. Sometimes they're on farms together? I don't know. do ADHD people get burned out? Yeah, absolutely. At probably a higher rate Not everyone else than people who don't have ADHD. I don't know. that's not even true, just so at this point in my career, I'm so skeptical of the idea of neurotypical that there is some group of people out there who's just got the right wiring.

Jeremy Schumacher: Nah. I don't believe in that. So, does dealing with ADHD have a correlation to feeling burnt out? Yes, we exist in a society that was not designed with neurode divergent folks in mind. and ADHD shows up differently for different people. So, I was pretty miserable throughout my schooling years, having undiagnosed ADHD.  and I got really good grades and did really well. there are people whose ADHD shows up in a way where they're not able to be successful and work their way through it. So, that burnout might look like a kid dropping out from school or failing a class or whatever. and the burnout for me was being emotionally disregulated a lot, being really like normal teenage angsty, but also then undiagnosed ADHD and not understanding why

Jeremy Schumacher: was so upset about being boxed in the various ways I was boxed at that point in my life. why life was pretty good and yet I had this strong middle finger to the law streak. so yeah, I don't know that I understand that question. What's difference between ADHD and burnout? There's a correlation, but they're different things. Lots of people who don't have ADHD also experience burnout.  Latestage capitalism promotes a perpetual state of burnout so that we don't have time to think about how the system could be better or organized to tear the system down. Can it be autistic and outgoing? Yeah, this is a thing that I about This is a thing I talk about a lot with ADHD. just for instance for people who are new to their diagnosis to understand the wide range of variance. Sorry, I just feel like I've got a frog in my throat. Some Red Bull will help.

00:30:00

Jeremy Schumacher: it gives you wings and clears your throat. can you be honest coin? Yeah. So, when people are new to a diagnosed with ADHD, one of the things that I talk about a lot is the difference between just somebody who has ADHD who's an introvert and somebody who's ADHD and is an extrovert looks very different.  And we sort of have this idea, I would say through the '9s and early 2000s, the idea of what ADHD was and how it's diagnosed was very much built on an extroverted model of it. It's a hyperactive boy is what we sort of diagnosed and what our model of hyperactive ADHD looked and that's not true. I'm very much an introvert. I am restored by alone time.

Jeremy Schumacher: I'm restored by ideas not People are tiring. And so looking at introversion and extroversion as how do you recharge your batteries? People fill up extroverts. And alone time, but often again it's not being alone fills you up. It's what you're doing when you're by yourself that fills you up. It's ideas. it's thoughts. It's books. It's music. Whatever. introverts aren't just in love with ourselves, and that's why we like to be alone. Our brain is doing something else other than engaging in a relationship with another human. and the flip of that, I think, is autistic is that a people with autism are socially awkward and therefore must be introverted. And that's not true at all.

Jeremy Schumacher: that is the case for some folks on the spectrum, but other spokes folks on the spectrum are deeply extroverted and require a lot. They might plow through social norms. They might be the life of the party because they're so captivating and engaging because they don't pick up on all the social cues or because they don't care about the social norms.  So, yeah, I don't know that it's been studied at length, but I would hazard that there is not a strong correlation between extroversion or introversion and neurode divergence.

Jeremy Schumacher: I would hazard an educated guess that any correlation that exists is sort of that environmentally people have learned the feedback loop that exists for not not following social norms, not hitting your social cues is to lean more introverted because it becomes so taxing to be social  and neurode divergent. But I think they're unrelated. I think lots of extroverted folks are lots of folks on the autism spectrum are just naturally extroverts and it looks different. That's why our diagnostic criteria have taken so long to catch up because just the variability of neurody divergence is really high. and that's just looking at one criteria, neurode divergen introvert looks a lot different.

Jeremy Schumacher: And so yeah, getting criteria that catch up to that variance was very complicated and we only studied white men for a while and white men were the only people who were diagnosing for a while. So we got some catchup to do. Do I need a diagnosis to claim the label? I'm a bit of a mixed bag when it comes to self diagnosis.  I think I'm deeply aware because I swim in this water every day that we do not have enough professionals to diagnose the people who are curious about a diagnosis. there are not enough professionals. that's America for sure because we just don't have enough mental health professionals anyway.

Jeremy Schumacher: but even like knowing and coordinating with people who are in other countries. I know some lovely folks in Ireland, some lovely folks in the UK who work in neurody divergence and pretty high up in their health care systems and the government health care systems because that's how countries that are functional do healthare that it is worthwhile for a government to have a healthy populace. So the government does healthcare not for profit. but this is a separate soap box. but even in some of those other countries that don't have the ups of American healthcare there aren't enough professionals who are well trained in diagnosing something like this. And I've seen a lot of people go spend thousands of dollars on their big fancy diagnosis and it's just like a wanking motion to it. it's rudimentary or it's real f****** basic stuff.

00:35:00

Jeremy Schumacher: often for me the difference is when it's done by somebody who wasn't neurode divergent who's just following their textbook and they don't really know what it's like. They don't have that lived experience. but I also see the people who come in and say, "Hey Jar, I'm new to therapy. Thanks for having me. I've been watching a lot of TikTok. I think I'm"  I'm skeptical of that self diagnosis because there's research that says as much as 80% of the autism information on TikTok is wrong. So, I look at a lot of factors when I'm doing Diagnosis is somewhat diagnostic criteria, but then it is also the clinical interview.

Jeremy Schumacher: So, I think there's a middle ground here where you don't need an official diagnosis to identify that way. yourself better than any professional can ever hope to just because you like chicken nuggets doesn't mean you're autistic. and for instance that's a big one on the internet of chicken nuggies and autism.  And again, a lot of these things, I've talked about this elsewhere, there's a kernel of truth in what the internet then takes and amplifies a lot of people who have sensory issues related to neurode divergence have a very specific pallet and will eat the same thing over and over again. If you're on the spectrum, that might be a number of foods that are okay, texture, taste, whatever, and you eat them over and over and over over again in perpetuity.

Jeremy Schumacher: And if you're more on the ADHD side of things, you might eat the same thing over and over and over again for three months to 18 months to whatever and then one day you just never want to touch it again and it actually grosses you out.  So, again, there's that piece of sure, people on the spectrum will often have some food quirks, and having food quirks doesn't necessarily mean you're autistic, and having autism, being on the spectrum does not mean that you have food quirks. there's variability here. So, I like for people to do real assessments, take screeners that have been scientifically validated.

Jeremy Schumacher: Embrace Autism is a great website that has free scientifically validated screeners and assessments on them. Do I think you should go through those things with a licensed professional who has some expertise in this area? I got openings right now, but also, lots of people who specialize in this stuff are full and have a wait list. So, I get that it's not accessible for everybody to get an official diagnosis. but there's a middle ground to watching a lot of TikTok and self-dagnosing or being like, I have some awkwardness. I must be autistic. I don't know that almost veers paradoxically into abbleism when we distill it down like that. it's It becomes unhelpful and it can retroactively get in the way of people who are bad faith actors like many of our politicians are.

Jeremy Schumacher: who want to take away accessibility for folks, who want to take away accountability, taking away DEI has been the big thing here in the current administration here in the US and that harms people who have accessibility issues because they're differently aabled. the Americans Disability Act is really important and was passed in 1994.  That's not that long ago that we were not making sure differently aabled people could get into buildings or had bathrooms that they could use. what the f*** are we doing? So, too many people self diagnosing inaccurately harms the people who do need those resources because there becomes a pendulum swing or a response from other people to say, " no, I'm not going to do that accessibility piece because it's b*******."

Jeremy Schumacher: So, long- winded answer. Do I need a diagnosis to claim the label was the question. No, and you should do more than just watch Tik Tok or listen to podcasts or whatever. I'm not picking on Tik Tok. There is research that suggests Tik Tok particularly is very bad with their autism information.  So, this is a great question that makes me feel miserable. why do therapists charge so much if they want to help people? I charge $160 an hour to my clients who are tuning in. Spoiler alert, that's going to have to go up soon.

00:40:00

Jeremy Schumacher: my therapist is 175 an hour. I think there's a range in there that is reasonable. as a provider myself, the amount of hours I spend with clients is around 15 a week, and that is a pretty strong boundary for me. I used to see 26 people a week.  I don't think I did as good a work then as I do now. 15 people is enough time to collaborate with other providers, to text clients in between sessions, to look up resources for them and get them sent out, to do super bills and other administrative things that I need to do on my client's behalf, to do credentiing, continuing ad, all the things that I need to do to keep my license. I have a podcast, I have a YouTube channel.

Jeremy Schumacher: I think those are more requirements of being a small business owner. I pay someone to do my social media. So I have costs that I acrew. I have a lot of time that I spend that isn't face to face with clients that I don't get paid for. And I'm not saying I should get paid for the podcast. I'm just saying a lot of my continuing ed stuff, those things have costs for me. Not only am I not being paid for that time, I am having to pay stuff to do those things. so yeah, that 16 175 sort of rate puts me in a space where I can see 15 people a week and pay my bills. I'm married to a teacher, another profession that is not paid very well for the amount of work they have to do.

Jeremy Schumacher: And so I think most Americans are one major health crisis away from not being financially okay. we're not traveling internationally. but we are capable of looking into doing that. We have small children, so traveling locally, visiting family, etc. tends to be more of what we're doing now.  But taking a week off or two weeks off vacation is not sustainable for me at this point and I'm 16 years into my career. I couldn't swing that because when I don't see clients, I don't get paid. there's nothing else coming in, So, if my wife were to take the summer off and not be working like an 11 or 12 month contract, there's nothing coming in. So, again, can I take time off? Yeah. And I do. I take long weekends.

Jeremy Schumacher: I'm recording on a Wednesday now. This is the second podcast I'm recording today. And I'll do a YouTube video, too, before I go pick up my kid from school. So, that's quote unquote. I don't see clients on Wednesdays, which means I'm working without having money come in. but it's expensive to pay for all the stuff that we need to.  So the cost of therapy is tied into how much bureaucratic b** and other stuff goes into running a therapy business. I think the people who are pushing $250 $300 a session, that's not a good deal. I don't think there's a therapist out there who is worth that. Sorry fellow therapists.

Jeremy Schumacher: and if I had an inn in Hollywood and could charge 500 bucks a session to see celebrity couples, like, hell yeah, sign me up. I don't know. it's late stage capitalism. I support people for getting paid. if you have an in to get money that isn't harming other people, great, do that. so therapy is expensive. One, because late stage capitalism is expensive. there's a lot of costs that go into it and two we have an hourly rate because when we're seeing clients it's the only time we get paid and there's a lot of time and energy that goes into being a good therapist outside of that just regulating se taking care of ourselves dealing with our own b******* so that we don't bring it into your sessions like we have to do continuing ed and most of the therapists that I know and are doing

Jeremy Schumacher: more training and continuing ed than they are required to by law because they like to learn and they want to provide good service to their clients. So yeah, I don't know. There's a lot of costs behind the scenes that go into being a therapist. If you're seeing somebody private pay, that's that all-encompassing hourly rate that they charge. If you're seeing somebody through insurance, like that is still there. It just gets filtered out.  So, the insurance company takes a cut and then the agency that somebody is working at takes their cut and to cover all those things that I just mentioned rent and marketing and billing and all that other stuff. So, there's just a bunch of costs. Everything is expensive. Our office space rentals are expensive. Our electronic healthcare records are more expensive.

00:45:00

Jeremy Schumacher: The reason I will raise my rate is because everything I use on a daily basis to run my business has increased in price in the three years that I've been having my own practice. from simple credit card reader to the systems I use to run my calendar and send out reminders and all that stuff. So, another question about We're not judging We love our clients. We care deeply about them.  Sometimes they do things that we wouldn't necessarily recommend. Why does self-care feel like b*******? That's such a good question. man, why does selfcare feel like b*******?

Jeremy Schumacher: It's not and there are scammy people out there who do take advant advantage of the wellness spaces and there's a range in which self-care is not b****** and everyone needs it and it's really great for you. And there's another range where it gets commodified or commercialized and then it can turn into b***.  And then when we have no self-care at all and we're in that hustle culture, we're in that grinder mindset of everything we need to do needs to be productionbased and we need to be successful as societ society deems it with 2.3 children and x number of dollars in the bank account and a side hustle and commercial real estate that we're subleasasing and whatever passive income b****. yeah, I don't know. The world's hard. It's stressful.

Jeremy Schumacher: a lot of that stress is contrived and policy choices that we could not do. The fact that there are starving children in the world is a moral failing of world leaders everywhere. that's a thing because there's enough food produced in the world to feed whoever's pro hungry kid,*** whoever is thinking that children who can't pay for school lunch should be hungry again, f*** I don't know. so self-care feels like b******* I think because our system's so broken and we're trained that taking time for ourselves investing in ourselves in which we don' are not able to commodify that investment or get a obvious return on investment somehow bad.

Jeremy Schumacher: the idea that we as humans are supposed to be in production mode all the time we're not even from a biological perspective we rest often we are required to or we die and what late stage capitalism has done capitalism has done and ended late stage capitalism is just bastardized that until squeezing out as much as I don't even want to say as possible because obviously people used to work 16 hour 18our days in

Jeremy Schumacher: a coal mine. f*** that noise. and the idea that that countries can't be doing 4 day work weeks, no, there's a ton of research that says we can do that. There's a ton of research that says kids should be in school way fewer hours and start later in the day so they can sleep in. so we're just in the system that is prepping us, that is training us, that is trying to desensitize us to not take care of ourselves.  so that someone else can make profit off of our work, So, no, self-care is deeply important and lovely and great.

Jeremy Schumacher: And then if you veer so far into, spending a thousand dollars to have some former military dude with a beard screaming your face about how you're a beta something, whatever slurs they use because you are vegetarian or whatever. I don't f* I don't get the masculinity grift. there are people who, commodify self-care to be spa days and thousand retreats where you do Iawaska and body painting. I don't know. if those things are your jam and can be healing for you, that's great. But the b*** becomes the commodification of it, not the activity itself. Self-care is really important.

00:50:00

Jeremy Schumacher: Most people I see in therapy are not doing enough of it. Not because they're flawed humans, but because The system teaches us to not do that. good question though. How do I keep giving a s*** when the world is on fire? The world's always been on the one hand because of the internet we're way more aware of the world being on fire in places that I don't know. That's what humans do. I don't love that answer when I say it out loud. I don't know.  We keep showing up because there are people in our lives that matter and those relationships matter and we're self-aware mammals on a rock flying through space at 600,000 miles an hour.

Jeremy Schumacher: a lot of what we're doing is stupid and a lot of what we do won't matter on a global scale, but that lens you have of there 20 to 100 people in your life that you matter too and they matter to you and that's sort of like human beings at scale and I think sort of the world on fire is like our nervous systems didn't evolve to know about all the stress and trauma everywhere in the world  all the time. we're wired for 20 to 100 people and being able to turn that off sometimes and reset and regulate. And that's the part of the world being on fire is like there people who are profiting off of us being dregulated all the time, humans being disregulated all the time.

Jeremy Schumacher: So, as an act of resistance, it keep going as an act of resistance to cultivate joy, to grow community, to make meaningful connections. that's what puts some of the fire out, at least in your local space. and then as you are well resourced and able, we try and put out larger fires.  I mean, again, I just sort of talked about how people used to work 18 hours a day and that's a thing we fought for and I can be frustrated that there's a mountain of research that says a 4-day work week is great for people's mental health and we should be doing it and then Arkansas's rolling back laws that protect children from having to work 14-year-olds from working, there's a stupidity to it.

Jeremy Schumacher: and we have progressed overall as a society in a way that 150 years ago people wouldn't have thought was possible. So I don't know I think progress on a global scale is really slow and we're not wired for that global scale even though it's available to us. That doesn't mean bury your head in the sand. don't be  just means be aware that regulating yourself and being in your local environment, touching grass literally in your local environment. Grounding as in put your feet on the ground matters and the relationships we build matter. Every story we tell about the human species, about existence is about human connection.

Jeremy Schumacher: I'm a comic book nerd, so I'll go back to some comic books. Batman is a story about family. It's not about fighting a crime. It's about family. He loses his family and then he builds a new one. It's Alfred and Robin and Nightwing and Oracle and, those are the relationships that matter even after losing the rest of his family.  Superman isn't truth, justice in the American way. it's Lois Lane. It's Jimmy Olsen. it's Krypto the dog. I've been rereading some of Tom King's stuff before his next trade paperback of Wonder Woman comes out.

Jeremy Schumacher: and his run on Supergirl, Woman of Tomorrow is fantastic because it's such a personal story about Supergirl connecting with this one person throughout this entire galaxy, throughout this universe, this all powerful being of Supergirl helps this one girl and I don't know it that's what matters.

Jeremy Schumacher: the people in your life matter and you matter to them. And if you're like, "Nah, that's not true." maybe that's cognitive distortion in your brain. You should talk to a therapist about it or you should get better chosen family, And I don't say that to wag my finger at you and say, "Shame on you. You should be doing better." Just to say "Yeah, those connections Let's invest in the ones that build us up." I could have put this with the religious trauma ones. is it okay to be angry at my family for the way I was raised? Yes, obviously. and again, anger is neutral. I maintain that emotions are neutral. They are signals. They're neither good nor bad. They're are signals of something. What is that anger signaling to us? And what do we want to do with it? is it okay to be a d** to my family all the time for how they acted 20 years ago?

00:55:00

Jeremy Schumacher: I'm less likely to say yes to that, although I won't rule it out entirely. yeah, I don't know. anger is often a signal of some sort of injustice that has not been addressed. And some injustices are old and can't be addressed. Some things we can't go back and change. We don't have a time machine. I still go back and forth.  I have some pretty strong boundaries with my family certain members of family of origin because of how I was raised and they're still deeply religious and I am so I don't know that some of that stuff's ever going to be addressed. So I have boundaries around it. but it's hard to hold that complexity.

Jeremy Schumacher: it's hard because it's not easy to just be mad at them because they are well-intentioned people who were victimized by the same religious upbringing that I feel like I was. So, they weren't doing it as it made me stronger, it'll make you stronger. They were doing it because they truly believe that it was the right thing to be doing. That doesn't mean I have to give them a pass. it's different than they're bad people who are doing evil things. it's more complex than that. So yes, you absolutely can be angry at them and that doesn't necessarily tell you what to do next. that's the process, the journey of what to do in response. And again, it's going to be such a case by case basis. it's going to vary a bit.

Jeremy Schumacher: So, that's 15 questions. Good job, everybody. I love stuff like this, honestly. I love having The reason I don't always have guests on it's never because there aren't guests to have on, and it's never because I love to hear myself talk. I would love to have guests on all the time and never be the center or the focal point or the main speaker. and that's how my ADHD shows up is scheduling things with people is a very taxing thing for me. So, it's usually a scheduling thing life happens. Kids get sick, someone needs to reschedule, whatever. So, sometimes the schedule has to change. but this is fun. maybe we'll do another one sometime. I liked this. Good Q& A everybody. Episode 99. How exciting.

Jeremy Schumacher: episode 100 is recorded already, so I know it is great and fantastic, but that'll be next week, which is exciting. a little bit of a milestone. And yeah, I'm always open to feedback. This was great way to interact some people who wanted to talk and ask me questions about mental health. And yeah, we'll do it again. We'll get back to having guests on.

Jeremy Schumacher: I like to have a lot of different things. I'm not somebody who's probably ever going to lock in one form of podcast only forever. so is what it is. Thanks for tuning in. you can find out more about my work. You can find my website down in the show notes. We got Pride Month is coming up. So we have some Pride themed merch that we designed last year but is still there. it's cool. Your therapist needs therapy in the rainbow logo. That's actually quite nifty. Shout out to Kenny, my media person, who makes all my stuff look and sound nice and also does all my graphic design. They're One of my favorite humans. yeah. And then I don't know, leave reviews and stuff.

Jeremy Schumacher: I don't go on to Spotify or iTunes or, a lot of that stuff, but apparently if you leave review and like us, it helps people find us. So, that's cool. If you're a multi-millionaire and you want to just give me money to keep doing the podcast, I will also accept that. capitalism, So, yeah, thanks for tuning in everybody. always open to suggestions for guests or other topics.  Thanks for tuning in. We'll be back next week with another new episode. That'll be really great. Peace out, everybody.

Meeting ended after 01:00:08 👋

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