Should you break up with your therapist?

Plus: Your optimism tips [View this email online]( [NPR Health]( May 7, 2023 by Andrea Muraskin We love our NPR readers. Though every day we report depressing news, you’re resourceful when it comes to staying optimistic in spite of it all. So this week we’re sharing some of your [best tips for keeping hope alive](. Also, [when to call it quits]( on that most intimate of health care relationships – therapy. And, though [medical credit cards may seem like an accessible way to handle outsized bills]( the federal government says think again. --------------------------------------------------------------- [We asked, you answered: What's your secret to staying optimistic in gloomy times?]( Leif Parsons for NPR In Voltaire’s Candide (full title Candide, or Optimism) the protagonist, also called Candide, starts out as a sheltered young noble. Pangloss, Candide’s tutor, teaches that “we are living in the best of all possible worlds.” But when he leaves the nest, Candide encounters wars, diseases, and natural disasters – the world proves Pangloss wrong. And yet all is not lost. At the story’s end, Candide and his friends meet an old man living peacefully on a small plot of land, unconcerned with wealth or politics. After the encounter, Candide reflects “[we must cultivate our garden]( The idea of focusing on the good in your own little corner of the world showed up in the responses of many NPR readers [when we asked how you find hope when things seem hopeless](. Robbie Cranch in Fresno, Calif., volunteers teaching gardening to families. Naomi Krokowski of Berthoud, Colo., stays optimistic by carefully choosing what she reads and listens to, and always keeping an eye out for good things. Mary Theresa McCarty of Halfmoon, N.Y., writes “I do what I can and understand that change is slow.” Others source their optimism through humor, music, and even embracing sadness. [Find what works and keep your chin up with these tips.]( [Also: Social change innovators from around the world share what gives them hope]( --------------------------------------------------------------- Newsletter continues after sponsor message --------------------------------------------------------------- [Deciding when it's time to end therapy]( Stefania Pelfini, La Waziya Photography/ Getty Images Between limited insurance coverage for mental health and the surge in demand for counseling since 2020, just finding a therapist who’s available and affordable can be haaaard. Then you finally find one, and you spend a session or two telling the story of your life before you can really get to work. I went through the process last year. And after all that, I noticed that after every session with my new therapist, I actually felt worse. But, I wondered, even if she’s not the best fit, is it really worth trying all over again? Moraya Seeger DeGeare, a licensed marriage and family therapist, says therapy should feel like a coffee date with a friend where you get into deep conversation. "You should feel so in alignment with your therapist in some of those great sessions," she says. Seeger Degeare [shared advice with NPR’s Life Kit]( about how to know when it’s time to move on – even when you and your therapist are simpatico. Positive reasons to leave therapy might be if you've made progress to the point where you don’t have much to talk about in sessions, or you’ve developed the tools you need to cope on your own. Then there are red-flag reasons, like if your therapist comes onto you, harrasses you, or violates confidentiality. Seeger Degeare says many people find themselves in between, where you’re getting some support from therapy, but wondering if you might be able to find a better fit. If that’s you, Seeger Degeare recommends asking yourself questions like ‘What does this feel like in my body at the end of the session? What really stands out for me?’ Write down your answers and follow up with yourself to see if your feelings change over time. [Find out what to look out for and check out Life Kit’s video to learn how to break up with your therapist, and find a new one.]( [Also: How some therapists are helping patients heal by tackling structural racism]( [Medical credit cards? Biden admin says stay away]( [Doctors' offices often offer special medical credit cards as a solution to paying off large medical bills. But patients may end up paying far more for their bills when they have to pay interest down the road.]( Fly View Productions/Getty Image Find yourself unable to pay a medical bill and your dentist's office or hospital’s billing department might offer you an alternative: a medical credit card like CareCredit from Synchrony Bank or the Health Advantage Card from Wells Fargo. The cards typically offer a promotional period during which patients pay no interest, but if you miss a payment or can't pay off the loan during the promotional period, then you can face interest rates that reach as high as 27%. In a new report, the Consumer Financial Protection Bureau estimates that Americans paid $1 billion in interest on medical credit cards and other medical financing in just three years, from 2018 to 2020. That includes loans offered by health care financing companies like AccessOne. An analysis of records from North Carolina's public university medical system found that after the system outsourced payment plans to AccessOne, the share of patients paying interest on their bills jumped from 9% to 46%. "Many people would be better off without these products,” the CFPB concludes. [Learn more about the multibillion-dollar patient financing business and its cost to patients.]( [Try this instead: How to eliminate, reduce or negotiate your medical bill]( [Also: Sick and struggling to pay, 100 million people in the U.S. live with medical debt]( Before you go: [Michelle Obama promoted healthy eating habits when she was first lady. Now, as co-founder of PLEZi Nutrition she aims to give parents healthier food options for their kids.]( Chip Somodevilla/Getty Images - Listen: Will AI help – [or hurt – health care?]( - Michelle Obama launches a food company aimed at [healthier choices for kids]( - Small amounts of coronavirus still hiding out in parts of the body [could be a major cause of long COVID]( - How to address America’s [loneliness epidemic]( We hope you enjoyed these stories. Find more of [NPR's health journalism]( on Shots. All best, Andrea Muraskin and your Shots editors --------------------------------------------------------------- Listen to your local NPR station. Visit NPR.org to find your local station stream. [Listen Live]( [Facebook]( [Instagram]( [Twitter]( What do you think of today's email? We'd love to hear your thoughts, questions and feedback: [shots@npr.org](mailto:shots@npr.org?subject=Newsletter%20Feedback) Enjoying this newsletter? Forward to a friend! 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