Frequently Asked Questions
General FAQs, Logistical and Financial FAQs
What do you do?
The short answer is that I work with shock and dissociative states ... including for people that don't know they have them or why they might be relevant! This work happens via scheduled one-on-one consultation sessions (Zoom), and courses with live group sessions. For more information, please read the FAQs, course descriptions, or reach out with questions or an initial consult request on the Contact page.
What is your background/training?
Following completion of medical school at the University of Kentucky (2005-2009), I trained in Physical Medicine and Rehabilitation (PM&R) at Walter Reed National Military Medical Center (2009-2013) and later served as staff physician and then Chief of PM&R at Eisenhower Army Medical Center until 2017. During those seasons, I became interested in the question of why some people heal from intense or traumatic events, and others become disabled or stuck - physically, emotionally, mentally, or relationally.
What is your approach to client care?
I work to equip and assist clients in resolving shock and dissociation, no matter what the original cause, nor what the resultant issues and symptoms might be. From my own perspective, I view this as working to identify and mature or resolve immature or unresolved physical and relational feedback loops (often, but not always, fast-acting survival loops). In some cases, I am teaching clients how to do this themselves (independently), and in other cases I am facilitating the process directly.
What happens during a typical session?
Depending on the context, that may be as simple as answering a question and determining whether I can help someone (prior to formally working); it could involve teaching on general tools; or it might involve assisting a client in the use of those tools in the context of a particular goal or issue.
Generally, it takes most cognitively organized and emotionally stable adults around 2-4 hours to learn about how survival state, bonding, precognitive, and sensory perception can be accurately identified and integrated or resolved. Independent, healthy adults in a stable environment can often take and implement this knowledge immediately after small amounts of practice and feedback.
Those in a dependent or unstable state or environment may require additional assistance to restore confidence and independence, and to facilitate that process directly. During this time, most people (80-90%) find there are additional issues they had not previously identified or acknowledged (due to the dissociative state). Once these additional issues are identified, some people are already equipped to address them, and others require or prefer some additional, particularized assistance (whether from me or someone else).
In an instructional class setting, I usually take about 4-5 months for a group to digest 10-15 hours of lecture material on these topics. In that context, the material must still be understood and acted on in a way specific to the individual for things to change.
Do you work with children?
Adult children, yes ... but young children and teenagers only if the parents are willing to have their own issues, understanding or connections to the situation brought up or confronted. Children are generally very easy to work with directly, but parents often need context and understanding for this work, so I work with parents to help them understand why certain things might be helpful, and then work with the child in a more streamlined format. Of the individuals that I work with, 80-90% of them have deeper issues than they initially presented to me as the problem, and for children those issues often include the parents' approach or understanding of the real issue.
Additionally, many children struggle if their home or relationships are unstable, unpredictable or unloving (not at peace with God and each other) or unprotected, and so that may reflect a need for more mature leadership, presence, repentance, or wisdom by the father or mother. Often, behavioral problems in children are evidence of unresolved or unrecognized problems in the home and family. Because of this, I often focus on the changes needed in the parents or entire home, not just the child's behavior.
For those who have adopted children from unstable homes or locations or who have a child with a unique experience (or physical or relational injury), there may be issues particular only to that child. These issues may or may not respond to "typical parenting". I do work with parents to understand and address these situations when needed.
What things do you provide care for?
I assist people with a wide-array of physical, emotional, and relational symptoms and situations. But my focus is generally on understanding the situation accurately and centers around restoring accurate perception and healthy feedback loops (resolving shock and dissociation, sensory perception and bonding issues). Sometimes this relates to physical issues and sometimes to emotional or cognitive issues.
That being said, I am approached by people with a wide variety of symptoms (generally autonomically mediated when physical) and complaints and a wide variety of life experiences (mostly associated with either traumatic or life-altering events, or with formative periods of life). Generally, with appropriate care and resolution of the acute exposure or injury, people recover quickly and well from things like brain injuries, infections, mold exposure, environmental toxins, emotional injury, etc ... - so the people that I work with (who have not recovered) often have deeper issues (that they are unaware of or have normalized), which are being revealed through their lack of recovery from these events.
For those who are not sure, I discuss it with them prior to deciding.
Do you provide clinical medical, counseling, or therapy services?
As part of moving away from clinical medicine, I no longer provide diagnostic, prescriptive, or prognostic services (i.e. practice clinical medicine) ... nor do I provide clinical counseling services. My focus is on educating and equipping people to identify and resolve shock and dissociation, physical and behavioral feedback loops, and other related issues ... no matter what the cause.
You might say that I provide counsel and teaching ... but not "counseling" (clinical or otherwise). True counsel is distinct from clinical or therapeutic counseling. True counsel transcends any one discipline and is not about education only, but is actually about those with character (their own character), wisdom (about timing, prioritizing, etc ...), capacity (not overwhelmed by your issue), and practical knowledge or skill gained through formal or informal education in areas relevant to your issue ... linking these qualities with you and your issue and providing all of this in a way that seeks what is good for you and others, and that can be tested and proven true or false.
Just as a good mechanic provides counsel on what to do for you and your car, and looks out for your interests, I do the same within my own areas of experience and expertise. Continuing the same analogy of a car mechanic ... you should not want counsel or professional help from anyone (mechanic, lawyer, me, a doctor, a clinical counselor or therapist, a spiritual authority) who is:
- Lacking in character (dishonest, etc ...)
- Lacking in wisdom or timing (didn't bother to tell you not to replace the alternator on a car that needed the whole engine overhauled)
- Lacking in capacity (overwhelmed with work or by the fact that your transmission was failing)
- Lacking in practical knowledge in the area relevant to you (didn't know how to fix a transmission or what your car symptoms meant)
- Not looking out for your interests (predatory)
- Fixing things that didn't help your actual problem
Discerning accurately whether your needs overlap with my areas of expertise is why I take time to answer questions and hear context prior to someone making a decision on whether to work with me (and me with them!).
Those who need clinical medical or counseling services are welcome to pursue them in parallel with what I can provide. Most people that I work with are needing to see some aspect of the bigger picture and tools related to survival states and behaviors, relational patterns, feedback loops, and dissociated or shock states. And then they pursue any specific traditional medical or counseling as needed and helpful in parallel with that.
For specific questions about whether your particular issues might benefit from services that I do provide, please contact me directly.
Are sessions and communications completely confidential?
No universal confidentiality should be presumed. If you have a question, you should ask. If you do not know or trust my character, judgment, or track record, then you should take that into consideration in your communications.
If you are actively harming someone, I have a responsibility to rebuke you - in order to love and protect them, and to warn you from continuing in evil. If you do not take responsibility for your behavior, then in certain situations, I have a moral obligation to make issues known to the appropriate leaders so that others can be protected.
I do not treat these situations or decisions lightly, and I seek to act with composure and not in a hasty manner. And I remain open to all reasonable questions.
If evil is involved (either against you or by you), then the best thing you can do is acknowledge it, and seek God's help and the help of the appropriate secular or spiritual authorities (as long as they aren't the ones harming you and are actually seeking your good).
How do shock and survival responses relate to "root-cause" issues?
It is important to understand that shock and survival responses can occur:
a) adjacent to other root-cause issues
b) be themselves caused by other root-cause problems
c) be themselves causing the perceived problem
d) or not be relevant to the particular case
Option A - a leg injury that includes both structural (injury to bone or ligament that may or may not need surgery) and survival responses (that may or may not need attention to resolve)
Option B - someone with a nutritional deficiency or infection might be in a state of heightened physiologic stress (i.e. resolving the nutritional issue or infection might resolve the physiologic stress). Depending on several factors (duration, previous physical or emotional health, etc ...), the survival reflexes might or might not "auto-reintegrate" or normalize once the root item is resolved.
Option C - someone might be in a heightened state of physiologic stress (for whatever reason), which impairs their digestion and absorption (thus resulting in a nutritional deficiency). You can imagine how Options B and C could compound and amplify each other for some people.
Option D - you can have any issue without it having a shock/dissociative connection
Additionally, whether the survival responses cause the secondary issue (nutritional deficiency, inflammation, behavior, etc ...) or the primary pathology/event (infection, injury, etc ...) causes an unintegrated survival response
... both the primary and secondary issues will have associated symptoms and behaviors (i.e. causes and effects both have symptoms). Symptoms mean something is real, not that it is the cause. Unfortunately, many people feel pressured to debate the "reality" of their symptoms, when it would be more helpful to acknowledge they are real, and move the mental focus to look at what are causes and what are secondary effects.
Because of this range of options, it is best to pursue whatever care or work-up is appropriate to your unique situation, carefully consider timelines of symptoms and all options, and have a "both/and" mindset instead of "either/or" (willing to address both the injury/environmental issues and the internal/survival state issues, not creating a false dichotomy or unnecessary choice).
What are the easiest and hardest things you work with?
The easiest situations are where there is some element of physical shock or dissociation from a non-malicious event (i.e. head injury, surgery, or accident) without a previous history of trauma. These are even easier to address when the current home or environment is stable and loving versus chaotic or unstable.
The next easiest group to work with is those who (regardless of the extent of their historic issues) have well-developed knowledge of themselves and who have tried various things in the past, have good resolve, and simply do not know how to resolve physiologic shock or dissociation. This becomes even easier if they have developed, internal physiologic awareness (interoception) through high quality training (athletics, martial arts, ballet, yoga/Pilates, breathwork, weight lifting, etc ...). Not all training or physical exercise is high quality!
The hardest situations (which comprise the majority of my work) involve clients with symptoms of uncertain cause, complex histories, and current mental or emotional fatigue and depression (making learning and implementing difficult). This is often compounded when accompanied by current situations of instability or dependency in their life, home, or relationships - which makes prioritizing resolution of current versus historical issues an important question.
Improving perception and healthy bonding is usually helpful even in unstable situations because it is difficult to make accurate and productive decisions without accurate perception. Resolving shock and dissociation also often allows people to modulate between various responses which might be appropriate and needed depending on the situation - fight, flight, freeze, etc ... - highlighting an important point that survival response themselves are not innately bad, they are simply calibrated or not calibrated to a particular situation. So we work to calibrate those responses and perception, not eliminate them.
Who should not work with you?
- Anyone not resolved to address whatever physical or emotional issues relates to their goals and symptoms.
- Anyone not intending to follow through on an initial plan
- Any parent seeking help for their child who isn't open to addressing their own emotional or physical or mental needs, and their interpretations and responses to their child. Any parents not open to non-cognitive strategies to their child's issues.
- Anyone rushing and not considering the timing of this work, not just whether it is possible to heal
- Anyone doing multiple things simultaneously should be cautious of dividing their focus and distraction from the real issues
- Anyone looking to "re-wire" their nervous system versus identify what is or isn't emotionally or physically healed
- Those who want to focus on symptoms
Who takes longer to work with?
Generally people who are dissociated and/or minimizing and not acknowledging major issues to themselves or others. Also, people with significant generational issues. In these cases, we generally start working on some initial issue or symptom only to find much bigger issues present. This is not necessarily willful or malicious. Sometimes it is simply a feature of dissociation, or not realizing that something is important and dysfunctional because it feels normal.
What should I do if I am a third party (spouse, parent, child, friend, pastor, professional) who is concerned about the truth or accuracy or what is being related to you, or concerned about something I have heard reported that you have recommended or said?
Please reach out directly. I welcome context and concerns.
Because of the nature of my work (working with complex or nuanced situations that have many facets, situations where evil or danger are present currently or historically, situations where perception is not 100% accurate - like a minefield with gunpowder and tripwires everywhere and no map!), I am fully aware that I don't immediately see or hear the whole picture (including the full picture of what is occurring across time or between individuals when I am interacting with only some of them in one moment in time). It would be impossible to see everything all at once, and there are naturally differences of perspective between people in the world.
I am also aware how quickly perception or hearing or memory can change, how much perception is affected when someone is in a survival state, and how that can propagate errors as people communicate things to others unless there are ways to verify what is correct. Additionally, even separate from malicious intent, memory itself is not infallible, but based on perception (not strictly on reality) and perception is affected by precognitive filters and is sometimes biased or altered (read more about precognitive and subconscious at the bottom).
Because of all of these things, I am acutely aware that I work with people that I care about, but who may not perceive or communicate things 100% accurately, and I am also subject to the same possibilities, so if you ever have a concern, question, correction, or clarification, simply let me know - whether that concern is about what you believe I am being told, or about something you have been told that I have said or done that doesn't make sense.
The protection in these situations is to be slow to judge, to ask for evidence and specific examples (not just undefined judgment statements since people mean different things with the same words), to always be willing to be corrected by the truth, to not be scared of people, to notice when the details or evidence don't add up, and to operate based on principles while seeking to discern over time how they apply to individual situations. All of this should be done in an atmosphere of humility, willingness to be corrected, and welcoming things into the light because life situations are complicated.
Defining Notes - I am roughly defining precognitive as "operating faster than (i.e. before) cognition/thought". The simple fact that survival patterns are reflex based (fast neuronal connections) and not thought based (slower neuronal connections) means that reflex patterns operate physically faster than cognition (i.e. you don't think about moving your hand from the stove, you just move it) - that means they are "precognitive" or have already occurred prior to conscious thought. This is extremely important to understand and consider the implications of. This is one reason why it is difficult to use mental tools to resolve precognitive issues, or "talk someone out of things". It is also why defense patterns are often normalized as "personality traits" since they are present prior to thought, or presumed to be fixed and unchangeable. It can also be a clue about why people have behaviors or responses that they find difficult to mentally control.
This means that any perceptual issues rooted in survival/reflex systems will have already occurred prior to conscious thought, perception, communication, or memory ... and that is the world that I routinely inhabit. This makes communication difficult unless certain safeguards are in place - things are peaceful and slow enough to notice accurately and concerns or disparities of perception are honored and examined when present with ways to verify reality outside of one person's perception.
An example of this is the strong precognitive (fast/reflexive/instinctive) tendency to avoid pain, which means that certain things are avoided (topics, ideas, thoughts, people, etc ...) without knowing cognitively that avoiding is happening, or while cognitively rationalizing the avoidance. It is quite probable that the somewhat vague psychological terms of subconscious or unconscious basically boil down to two things -
1) things avoided at a precognitive level due to physical or emotional pain
2) experiences that are normalized/unexamined
- normalized within the experience of the individual because they have no other reference point for comparison - in this case the word "normal" means common or expected self-referentially to the individual, not "normal for a healthy person" or for the rest of the world or other communities
- the person or community is often insulated from other experiences that would cause them to question the "normalcy" or what feels normal
- "normal" can also be a way to avoid acknowledging problems or avoid thinking about things that we don't know how to solve and therefore feeling frustrated or despair. Placing something as normal or beyond change is a way to protect from disappointed hope.
What are your costs and charges, and what are the phases of the work?
Phase 0 is the Pre-Decision Phase. I provide up to 45 minutes of my time without charge to answer any questions that will determine whether both a potential client and myself see likelihood of achieving goals through my services, and whether the timing is right to begin work.
Following an affirmative decision, Phase 1 is the Discovery Phase (until both parties are completely confident in our results and progress). During this Phase, the rate/charge is based on my confidence in success and the expected range of hours we will be working. It generally is a period of both work and learning and usually is actually good (in terms of progress), but feels mixed (based on things getting better as we work, but additional layers and insights coming up along the way, which can be difficult).
For example, if I am 80% confident that areas we work on can heal or improve with 4-6 hours of work over 4 months, then the charge would be $1375 upon completion of the Discovery Phase.
- If results are achieved significantly faster than I expect, then I adjust the invoice as a courtesy to them.
- If results are going to take significantly longer than I expected, then I would check if they still desire to work toward that goal.
- If results are not achieved, then the client pays nothing.
Phase 2 is more flexible and is a period of mutual confidence in results and progress. During this Continuation Phase, any fees are paid at the time of service ($200/hr).
During the Decision Phase, there is no cost; and during the Discovery and Continuation Phase, if someone has financial limitations, but desires to work and the timing is right, then I cover any portion of the cost necessary (or all of it when necessary). They can say "thank you".
Generally, it takes 2-4 hours to have cognitive understanding of foundational skills with some practice together. Working on a particular area or issue may take shorter or longer depending on what is involved. Working on multiple issues may take longer. Most people have more or deeper issues than they are aware of when they first reach out.
How do sessions and invoices work?
All sessions occur remotely (over Zoom) unless someone does not have internet access. Links will be sent via e-mail prior session.
Generally most sessions last 60-75 minutes ($200-250). A quick working session might be 45 minutes ($150) or a longer session (in amount covered or working and learning at the same time) could be 90 minutes ($300). Generally, unless mutually agreed on, session charges cap at $300.
Generally, we are able to identify what to work on during these times, and then 3-5 weeks is given to continue that work, followed by the next session to gain feedback on changes and continue with other layers or issues coming up.
As an example, averaging 60-75 minutes every 4 weeks, one might expect 5 hours of work total to occur over 3-4 months and cost $200/hr paid via individual invoices sent after each session (if working hourly) or at the end as a lump sum of around $1375 (if working in a Discovery Phase).
Invoices will be sent electronically via e-mail and should be paid at the time services are provided.
Summaries and any communication will occur via e-mail, so you will need a reliable e-mail address that you check at least twice per week.
Can I record our sessions?
Yes. This can be helpful for a variety of reasons.
1) I often (not always) send a copy of my own notes and reminders to clients, but a video recording allows you to review any material independently.
2) There may be a family member (parent, spouse) or another individual (professional, pastor, counselor, etc ...) who has an appropriate care in the situation - either to better help and assist, or in cases where someone has appropriate protective concern that what I share or the client shares will be accurate and reasonable. That person may not be available at the time of the session and so having a recording can be helpful for the client to share with them when appropriate.
- Related to this general reasoning, I am fully aware that there are situations where a spouse or child has concerns about control or surveillance or needs for protection and that should be taken into consideration and brought into the light; and also situations where a parent or spouse has concerns about someone under their care being given false and inaccurate suggestions and advice. Both are legitimate concerns.
3) During a session, a client is often focused on doing something they were asked and may not remember the steps or process of how we got there - having something to review is helpful.
4) I work in situations that can be intense or nuanced or impulsive and involve survival responses and reflexes that affect perception ... or have multiple parties that do not share the same perspective! Slowing down and records are helpful.
- Some situations also have a historic (or present) concern of violence or evil. With a goal or neither denying this reality, nor acting impulsively, it is important to understand when these require action and having a record can be important and allow things to be clarified if anything is ever understood or related in error (by the client or by me).
- Often in first attempts to communicate, things may be vague or not fully accurate and later clarifications may be needed.
- Clarity or a recording also allows people to ask for another perspective or second opinion from someone else when they are dealing with complex situations.
5) People who are overwhelmed or living in unstable stress states don't always either remember things well or perceive them fully or accurately in the moment. Having reminders and references is humble and good. It is meant to be a help and gift to them, so they don't have to "try to remember everything" or feel bad about it.
- This is especially important because if something was not perceived accurately in the moment, then the memory will be inaccurate unless there is a way to correct or fine-tune that perception.
6) It is generally better to 'do less' and do it well. Committing to review, understand, and take action based on an accurate plan will accomplish more than adding lots of talking and noise with little accuracy or action.
For all these reasons, those clients who record sessions usually report significant value from that.
What do you consider successful, and can you guarantee results?
If we see clear progression in areas worked on, and a growing foundation of knowledge and confidence in how to identify and resolve "loose ends" (unresolved feedback loops) in a healthy fashion, then I consider that successful. I expect that to be accompanied by a reduction in symptoms as the areas are worked on related to those symptoms.
While I cannot guarantee results based on symptoms only (since symptoms can arise from multiple causes and require time to change), I do cover all costs during the Discovery Phase for those who do not achieve results as defined above, and I let people know how confident I feel in achieving those results and how long I expect it to take during the Decision Phase before they make a decision.
I reserve the right to charge for time spent if someone chooses to begin this Discovery Phase and then chooses not to follow through.
Together, this protects clients from paying if results are not achieved or I am incorrect, and protects me from clients not following through on their commitments or our plan.
Do you accept payment plans?
No. I prefer people to not be indebted to me. If any financial assistance is needed, I cover that as mentioned above.
Do you accept insurance or work with healthshare groups?
Since I function in a non-clinical capacity, I do not accept insurance, and do not provide anything other than a standard consulting invoice. Similarly, I do not work with healthshare groups, since I do not find that they cover my services. For those who require assistance, I provide that to them directly by allowing them to pay what they are able and covering the remainder of the cost myself.
What are your hours?
Monday - Friday, 9am to 6pm EST.
Scheduling slots for consults or sessions are generally at 9 or 10:30am, or 1pm, 3pm, or 4:30pm EST.
Do you work on Saturdays?
Not typically, but I will consider it on a case-by-case basis. The cost is higher ($400/hr) than my typical hourly rate ($200/hr). Contact me directly if requesting this option.
Do you have a wait list?
I do have a wait list in place at times.
If I am scheduling 4-6 weeks out or more, then I generally have a wait list in place for new clients (to preserve my availability to those I am currently helping). When less than this, then I may be able to schedule immediately.
Generally, if you are referred from someone I have fruitfully worked with and who knows the depth of what to expect, then I am more likely to see you sooner. If you are someone "looking to try something new" or referred from a person that I haven't worked with personally, then I am less likely to see you unless there is clearly availability in my schedule. People that I have worked with personally tend to have greater respect for the depth of issues that surface to resolve, and therefore more patience on timing when referring someone.
At a minimum, you should expect between 3-6 weeks before work can begin even without the wait list, although we might have an initial phone call sooner. If something sooner than this is needed or your needs are urgent, then I would suggest you look for other resources, since I am not set up for most emergency situations.
If you are considering your options or learning more, some people benefit from reviewing and practicing principles from recorded class materials in parallel with their personal work, or prior to focusing on their particular issues.
What is your cancellation or rescheduling policy?
Non-emergency cancellations, no-shows (failure to be present within 15 minutes of session starting time), or reschedules without 24 hours' notice (1 full business day) may incur a $100 cancellation or rescheduling charge.
Do you work with emergency cases or situations?
I work with many people in unstable situations or with significant symptoms, but if someone requires care or responses in less than 72 business hours, then I do not work with them unless those needs are met separately. I do not personally have emergency response capabilities.
I will respond to most communications within 2-5 business days.
Do you accept referrals from other professionals?
I prefer to receive referrals from people I have worked with. I don't tend to accept or pursue referrals from professionals or non-professionals whom I have not worked with or known personally.
Professionals or clients I have personally worked with tend to understand better what is going to be asked of a client; the possibility of healing or improvement; the work, general support, humility, and honesty that will be required; and are more sensitive to overall timing (where something like this fits into someone's current life).
So they are more honest, hopeful, and realistic ... that is, they are more objective in their referrals and communication, which is why I prefer referrals to come from people I have worked with.
Professionals who have questions about this are welcome to reach out and have those answered.
Are there good books to read?
There is currently no singular book I would suggest. Different books and resources touch on different topics, either descriptively or practically, but none completely... and none without certain gaps or pitfalls. For this reason, I recommend people exercise the same discernment with my own material as I would suggest is appropriate with other material; and I do not provide book recommendations at this time.
For those who would like it, I generally provide introductory group classes several times a year. To request information on the next class, use the contact form.
Do you ever work with groups?
I do work with groups desiring to heal (support groups) and desiring to learn (professional groups, pastors, educators, clinicians, therapists, etc ...). I also work with group practices to provide either client care or equip their providers with additional toolsets.
How does class registration work?
Class registration gains you access to that level of material (Basic, Intermediate, etc ...) and the ability to audit any future classes if desired at that level at no additional cost.
The basic format is a pre-recorded lecture and live review and discussion. Lecture and previous live review and discussion times are both recorded (and therefore accessible at any time). Because of this, it is possible to go through material independently, and then also join/audit with a future group for the discussion and practice time - understanding there may be some amount of variation in the material presented or format for a particular group.
Either way, you should watch the informational video that has some helpful suggestions and warnings and go through the Checklist for Deciding. And then decide after that.
The advantage of the live class setting is a healthier accountability and time to practice and discuss (and ask your own questions). The advantage of the recordings is the ability to digest at your own pace, or review.
What should I do?
Ask questions. Contact via email if you would like to set up an appointment or discuss particular questions. Sign up for email announcements if desired.
