Wednesday, August 7, 2013

Are You Code 300.02 or Are You Code 296.3? And Are You Angry At God?

August 7, 2013
10:30 am
Cloudy Day

During Joe’s illness and after his death I was given a set of materials to read regarding the grieving “process”.

According to Webster, the definition of process is: “a series of actions or steps taken to achieve an end”.
Just as I cannot relate to the so called “stages of grief”  I don’t understand the relationship of grief to process.
I’m not quite sure if I have begun any sort of “process”.  At least I don’t feel as though I have consciously done so.    Particularly since I am not sure what goal I am working towards achieving.
However, one of the “steps” I did take was to see a counselor.
So, once a week, for a little over a year, I had a place to go for that much needed bit of extra support.
I didn’t have to “stay strong” or “hold on”.  I could just be.
In this country, certain birthdays are meaningful.  For instance, when you are 18 you can vote and drive and serve in the military.  When you are 21 you can legally consume alcohol.  I’m sure there are rules about what age one has to be to be able to marry.
A year ago I celebrated what in this country is a significant birthday. I turned sixty-five.  This milestone birthday affected my health insurance, which in turn affected my relationship with my counselor.   Because my counselor did not participate in my new insurance plan, the fee for each session would increase from a $20 co-pay to the full price of $140.  Since I could not afford to do that, we had to part ways.
And by the way, this was not the first time I have had a medical professional drop me, after being under their care for several years, because my insurance changed.
This last incident happened about 6 months after Joe passed away.  If I was making my way down the path of the five stages or if I was in the middle of the “process”  at that point,  I certainly had not progressed very far.
Finding another counselor at that time was, for me, overwhelming.  I could not see how I could possibly start all over again with another person.  Basically, it would mean that I would have to relive Joe’s illness and his death.
A major obstacle was getting a suggestion for a “good” counselor.  Neither my former counselor or my family doctor were willing to make a recommendation.  In all fairness to each one, though, the reason they couldn’t was partly because they did not know who would accept my new insurance plan.
So here I was somewhere in between “stages” and stuck in the middle of a “process”.
Recently I realized that I am still having such a difficult time coping with my grief.  So, during the past couple of months I have started the “process” of finding a new counselor.  That means getting a list of participating counselors from the insurance provider,  closing my eyes, pointing to one and making an appointment.
The first person I chose decided that she no longer wanted to continue to practice, so my appointment was cancelled.
My second experience was quite frustrating.  I arrived about 10 minutes before my appointed time of 10:30.  The receptionist informed me that the person who had to check me in was not available.  She instructed me to take a seat.  I figured, okay, I am a little early after all.
At 11:00, the check in person arrived.  At 11:05 she called me up to the desk to check me in.
“Checking me in" meant copying my insurance cards and filling out insurance type information.
At 11:15 the counselor called me into her office.  I was taken aback by the counselor’s appearance.  She was at least seven months pregnant.
The “office” was a cubby.  There was no sofa or even a comfortable easy chair.  She sat on a metal chair at a metal office desk which was up against the wall.  There was not even enough room for “my” metal chair to be in front of or even next to the desk.  So I sat kind of off to the side.
She started off the session by merely asking why I was there.  As I knew it would be, it was emotional for me and I had difficulty getting through the explanation without breaking down.
After we talked for a while, she told me that she would be going on maternity leave in approximately four weeks and would be unavailable for eight to ten weeks after that.  I walked out of there shaking my head, wondering why, why, why, she would have been taking on any new clients.
Two days later, I was “checking in” with counselor number three.  She took me into her office at the exact appointed time.
Her office was quite large and very comfortable.  I had the choice of the sofa or easy chair.
So far so good.
She spent the next 45 minutes asking me questions from what looked like a stack of standardized forms.
One of the more interesting questions was whether I was affiliated with a religious group and if I believed in God.  When I told her how I felt, she seemed to find my answer puzzling.
At the end of the question and answer period, she picked up a large book and began leafing through it.
She wanted to know if my former counselor had “diagnosed” me with a specific condition.
“You know,” she said, “such as 'Major Depressive Disorder' or General Anxiety Disorder”.
I told her that I didn’t think so, but that I really didn’t know.
She explained that for insurance purposes, she needed to put in a diagnosis code and that it had to be specific.

She said, “We’ll just say depression for now.”
I guess the “grieving process” or the “five stages” don’t have a code.
Well, by now time was up.  She told me to make an appointment for the following week.
“But before you go,” she said, "I want to let you know that we will have to address the God issue.”
Now it was my turn to look puzzled.
“You know,” she said, “I’m sure you are angry at God.”
Since my answer to her previous question about God or religion couldn’t possibly coincide with her edict, I was actually more than merely puzzled.  Outraged would more likely be the “diagnosis”.
I admit I did make another appointment.  In fact I will be seeing her later today.
The first thing I will make clear is that while it’s true I am angry, at this moment my anger is directed at her.
At the end of today's session, depending on how receptive she is to my concerns about her approach, I may once again find myself in the midst of the "process".
While I am grateful that Ross and I do have health insurance coverage, my experience has been that the time, energy and cost of the “process” of bureaucratic insurance and who pays takes precedence over the care and concern of the insured.

Oh, tomorrow I'll be writing about how the session went with my potential new counselor.

That'll be $20 please.



  1. I hate dealing with counselors and psychiatrists, especially ones that seem to conform to the "God" edict. I'm sorry, I'm not a religious person and if you're going to drag God into my ______ process (grieving, depression, eating disorder, whatever), we're going to tangle and you will be down a client again.

    Of course, I didn't last in counseling very long because, let's be honest, talking doesn't do much for me.

    1. Well for me it is a place to vent. Sometimes the counselor even gets it right and points out a different way to look at things. We’ll see how this goes.

  2. Great article. I live in a country where it is extremely rare for people to go to counselors. I used to wonder what it would be like and I think I had rose-tinted spectacles about the whole process. Now I know I'm not missing anything!!

    1. Sometimes life gets to be too much and having someone to talk to can be just the right kind of support. Of course finding that right person is a challenge.

  3. I can very much identify with the search for a counselor you feel comfortable with whom you can also afford (whether through insurance or other means). It can be very difficult, but as you said, it can also be valuable--even essential--to have that outlet when you are dealing with such overwhelming events and their emotional aftermath.