Expert Integrated Mental Health Care in Portland, OR

Insurance updates, "War Torn" Portland, and more book recommendations-

Living in Portland has sure been exciting this month! This update is going to cover a couple of themes I've been seeing, what's going on with insurance, exciting new changes, and a "vibe check" style recommendations list.

Doomscrolling & Living in "War Torn" Portland

When everything is happening all of the time, it’s easy to either stay scrolling to stay informed or to stay distracted. It’s ok and normal for that to be your response, but that response to continuing to live in “unprecedented times” isn’t very sustainable. For those scrolling to stay informed, remember that algorithms prioritize engagement- and engagement is measured by the amount of time people spend with content, whether there was interaction in the content beyond a basic click, and whether people talked about the content. These systems are also designed to maximize your exposure to advertising- which means they want to keep you on your device. Studies have shown that algorithms tend to reinforce existing patterns - which makes it easier to get stuck in a negative news spiral, hear untrue or actively divisive information, and drives people to seek connection in ways that feel validating in the moment- whether or not that content is helpful for folks long term. If you are terminally online, it is worth taking the time to do an “internet content check in” and answer these questions for yourself:

Do you feel better or worse after you’ve been online?
Are you completing activities offline that you want to get done?
Does the content you engage with help you be a better version of yourself?
Are you moderating the content you engage with to avoid things that are always distressing to you?
Are you making sure that you’re seeing content that has viewpoints that you don’t routinely come into contact with/ avoiding an echo chamber?
How do you make sure information you share is true?

These are all open ended questions with no right or wrong answers. Y’all know I love the internet, and I’ll freely admit that I have been online since AIM messaging was a thing. I have friends all over the world because of social media, but I also am careful about how my algorithmic feed works because curating my internet space is really important for my mental health. You could use these same question ideas to look at anything you are spending time on- reading, games, social spaces- to make sure you are showing up in the world the way that you want to.

Living in a war torn hell: practical tips for sound dampening and living in unprecedented times:

For those of us who live in neighborhoods that are now circled by helicopters on a regular basis, noise pollution is a huge problem for a lot of different aspects of health. There’s plenty of evidence that noise pollution can disrupt your sleep, increase your blood pressure, give you more psychological stress, and decrease your quality of life. If you, like me, are sleep deprived and cranky about it, there are some things you can do to try to sleep through all the extra noise.

Take a minute to see if some of the noise is changeable. If the choppers are shaking your dishes, you can put paper towels or wash cloths between them to make them rattle less. You might need to move your cups further apart from one another, too. If a picture is rattling on the wall, it might be worth taking it down for some extra sleep.
If you’re able to, add a noise barrier. Put bubble wrap or cardboard in your windows, or if you are able to, fully soundproof your sleeping space. (Make sure there’s still a fire alarm in your sleeping area)
If you know sleep is going to be a challenge, it might be worth an office visit to discuss medications or supplements that may help you sleep through the noise.

Folks that are going protesting, I’m going to reiterate protest safety planning I emailed about in April, with the added caveat that the illegal detainment is happening actively, and that ICE not only prevented emergency healthcare from happening in a timely manner, they threatened to shoot EMTs this week. They also detained a preschool mom with no charges, shipped her across state lines, and delayed her arraignment for no given reason. The unprecedentedness of the times is accompanied by openly illegal actions that are hurting our community, and you need to be prepared for this to continue to happen until we make laws matter again.
Here are things I want you to think about granted upcoming and ongoing protests:

Is this a safe activity for you on the day that it occurs? For those who (like me) are on the line of more disabled, will the walk be a distance that your heart/lungs/etc be able to do? If you were detained- and recall that there was definitely illegal detainment of peaceful protesters and lawsuits afterwards- would a disruption to your normal medications be life threatening?
Do you have a plan of who knows where you are, who you would contact if you needed to call someone for any urgent situation, who would be a support while you're there?
If this is a new activity for you, are you familiar with basic tactics for crowd monitoring via cell phone data, how to recognize a kettle, what to do if you get tear gassed?

By the people, for the people mean that we need to be involved. There are lots of ways to be involved, and lots of ways to stay safe. Here are some resources you may need:

Riot Medicine : downloadable guide to tactics and emergency first aid.

Human Rights Campaign: tips on preparing for and going to a protest

Even more resources: collated by this blog with good info and citations for everything. (While I have been on tumblr since the deep magic was written, I don't know this person. Their advice in this post is solid, I did not vet the rest of their content.)

Insurance Updates & Exciting News

Transparency for the state of insurance:

I have trialed billing careoregon as an out of network provider for the first 2 weeks of October, and so far they haven’t paid me at all despite my effort to ensure I was discussing things beyond mental health and only coding for physical health. The state could be behind, granted all of the other chaos going on, but it’s not promising.
I have also tried billing providence since they moved their naturopathic processing through ASH, and while they haven’t said anything to me, they have sent patients estimation of benefits that state that they aren’t paying me and I’m taking the visit as a “provider write off”.
For the year to date, insurance has paid 31% of the bills I’ve sent to them, despite you paying 100% of your premiums.

I think it’s important that the healthcare industry is very transparent about what is happening with insurance, because there’s unending misinformation about how doctors are ripping you off and are all rich- when we can see it’s the insurance industry that’s reporting billions in profits, even as they raise your costs and narrow what you can use your benefits for. To that end, the numbers make it easy to choose to go out of network with all insurance, as my landlord continues to not accept letters from insurance that state they are notifying me that they "need additional time to process the claim."

Next Steps & Exciting News:

I will be out of network with American Specialty Health (Aetna, Cigna, Providence) as of December 14th, and out of network with Blue Cross Blue Shield on February 9th, 2026. The ASH contract specifies that I cannot onboard any new ASH patients during this termination period, so for the next 59 days, I am closed to new Aetna, Cigna, and Providence patients.

After I am out of network, visits will be out of pocket and I will give you a superbill to submit to your insurance company for reimbursement. Click here for more information on what superbills are and how to submit them, and a link to a company that I haven’t used or connected with, but have heard good things about that submits superbills for you. The good news about this is that I already create a superbill for every visit we have, and because you are the person who pays the insurance premiums, insurance is generally better at paying you back.

I know this change is not what many of you hoped for, and I wish there was an easy solution like there is in every other country to improve access to care.

One thing that will improve access to care- I am joining Dr. Wood over at NW Regen in Tualatin, about 2 blocks from the first clinic I worked at. Dr. Wood is an orthopedic genius who does prolotherapy and a bunch of other cool procedures. The clinic focuses on connective tissue disorders, which you know I love working with, and we have a plan to get me trained to do tilt table testing for POTS! I am working on transitioning over there a few days a week starting this month, with the intent to fully be at NW Regen in 2026. I will maintain my Clockwork Botanicals for lecturing and consulting, and will have limited hours by appointment only in the new year. I am working on figuring out additional accessibility plans- right now I’m looking at volunteering for low income clinics, dedicating a percent of clinic time to financial hardship rates, or finding some new way to make this work for all of us. If you hear of a grant or program that you think would be a good fit, let me know!

Vibe Check

Vibe Check is a news podcast that I learned about at a recording for NPR's "Wait, Wait, Don't Tell Me" last year- and I really enjoy how they close the show out with recommendations about books, shows, music, and more that are helping them thrive through the week- so I'm joining the trend!
Books I really enjoyed recently:

"Sword Catcher” and "The Ragpicker King” by Cassandra Clare- though, fair warning that the next book is not out yet and I went through these so fast that the lack of availability of a third book felt like running into a sliding glass door at full speed. This dark fantasy world mixes rich world building, political intrigue, conspiracies, and yearning into delicious escapism.
“I’m Afraid You’ve Got Dragons” by Peter S. Beagle (yes, that Peter S. Beagle, the one who wrote The Last Unicorn). Absolutely delightful YA fantasy, full of whimsy and humor.
“The Alice Network” by Alice Quinn. I know it’s probably shocking for y’all that I can’t get enough of well cited and accurate things, and Kate Quinn is so good at writing down stories of real people in historical fiction. This is about spies in France, during world war 1 and also after world war 2- and just be warned in general that content warnings of many types apply. The resistance network and sabotage orchestrated by these spies was absolutely badass, and Quinn has the court transcripts at the back to prove it.

I have also spent a lot of time over the last month playing chess with my oldest kid, and am really enjoying the game. I am still losing around 50% of the time to a 13 year old (who is pretty good at chess), and am practicing and getting better!

What is bringing you joy? What should I read next? Let me know!