Monday, February 19, 2024

I BELIEVE in Ted Lasso

Like many people, I had a hard time believing how mean-spirited and destructive toxic narcissism could be until I was proverbially smacked upside the head by it in ways I couldn’t ignore or benignly explain away. I look at the world a little differently now. Whenever possible, I like to share my hard-won insights to help others navigate the world with a little less pain and a lot more joy.

 

We recently started watching the Apple TV show Ted Lasso. As a clinical psychologist, considering the emotional intelligence of characters in the TV series and movies I watch adds a lot to my viewing pleasure and Ted Lasso has a lot to recommend it. I also happen to be reading Dr. Ramini Durvasula’s book Don’t You Know Who I Am?, so I have been thinking a lot more than usual about narcissism and how it manifests in daily life. If you haven’t read anything by Dr. Ramini or checked out her YouTube channel, you should. She’s a very wise and rare gem and a breath of fresh air in a difficult world. 

 

I see Ted as an “anti-narcissist.” It’s fascinating to watch him interact with difficult people with a gentle non-judgmental cheerfulness that can be brittle at times but is always striving for connection and understanding. He has a lot of love in his heart, and it shows. Ted’s superpower is making people feel emotionally safe, which generally builds trust, respect, and affection. Over the course of the series, you see him bring out the best in others by simply being his authentic caring self, which isn’t actually so simple at all. 

 

We just watched episode 10 of season 3 called “International Break.” It really got me thinking about how skillfully the characters in Ted’s circle have learned to deal with the narcissistic people in their lives. They are learning to skillfully avoid getting sucked into the manipulation and boundary violations of the exploitative people they find themselves subjected to. In this episode, (SPOILER ALERT!) we see Rupert try to ruin Nathan’s budding romance with Jade by setting him up to spend what was supposed to be a “boy’s night” in the company of two exceptionally lovely and seductive young women at a private club. We see Jack ghost Keeley and then pull the funding from her company. We see Akufo host an exclusive meeting with club owners to convince them to further commercialize football to increase their profits, ignoring the love of the game and the devotion of its fans. We also saw Akufo go to great lengths to undermine Sam’s restaurant. Last of all, we see a warm moment between Rebecca and Rupert, which leads to Rupert (as usual) attempting to violate Rebecca’s boundaries and assert his dominance.

 

All of this would be very disturbing, except Rebecca, Nathan, Sam, and Keeley have benefited from Ted and Dr. Sharon’s gentle wisdom and guidance. Ultimately, they handle these challenges masterfully and it’s such a pleasure to watch. Nathan finally see’s Rupert for who he really is, and decides he has to quit as his house of cards comes crashing down around him. Keeley realizes she ignored all the red flags around Jack. During a bout of serious misery and soul-searching, she builds an actual house of cards on the bar at Mae’s pub. As she watches it fall, she sees who she can turn to and what really matters in her life. She gets a little closer to understanding what real love is as we cheer her on. Sam doesn’t bend to Akufo’s pressure. He’s sucked into playing the “hand-shake game” with Akufo’s lackey, who once again “pulls the football” on him as Peanuts’ Lucy perpetually did with Charley Brown. But Sam remains impassive, unperturbed by Akufo’s puerile machinations. 

 

The piece-de-resistance is when Rebecca calls out Akufo during their meeting. She gives what I call the “how-dare-you response” in the form of an eloquent soliloquy about the worthlessness of making money simply to accumulate wealth you don’t need and the true meaning of the game of football for the team owners and the devoted fans. It’s a beautiful moment. We should all cultivate our ability to formulate adroit “how-dare-you responses” when we’re being gaslit by toxic narcissists. The world will be a much better place for it. The brilliance of this move is that it shrewdly rips the mask of civility off Akufo, showing all present that he is not someone they would ever want to associate with. The ensuing food fight must have been hilarious to film, but we only see the aftermath as a bunch of stodgy old men remember how to laugh at themselves.

 

The scene concludes with a moment of connection between Rebecca and Rupert, which gives you a rare glimpse into the man she thought he was when she fell in love with him. As is his wont, he misinterprets the situation as sexual instead of sweet, which is his singular response to any woman who shows him any warmth or interest. Rebecca skillfully asserts her boundaries and realizes she no longer feels the need to allow him to influence her life and her decisions. She has come a long way from the first episode. She is finally free.  

 

I think Ted Lasso’s wild popularity stems from moments like these. The series is almost over, and I will miss these characters a lot. Watching them grow, connect, and learn to trust one another has been pure pleasure. The show has given those of us who’ve been paying attention a playbook for adeptly facing challenges and building the strong supportive relationships that help us successfully navigate our lives with our integrity intact. I think it’s cleverly demonstrated strategic moves we can make in the chess game we are forced to play when we are manipulated, exploited, and gaslit by toxic narcissists. It’s been a wonderful classroom. I look forward to confidently applying what I’ve learned going forward and I hope you do to. 


Thursday, May 26, 2022

How to talk to your kids about school shootings


"How can I talk to my kids about something this frightening and horrible?"

My heart is breaking for the children, families, community members and professionals affected by the tragic shooting at Robb Elementary School in Uvalde, TX.  Why horrific events like this occur is a complicated issue for another day.  Right now, many parents, teachers and loved ones are faced with explaining what happened today to the youngsters who trust them.  Here are some suggestions.

First of all, turn off the news when your kids are around.  Young children are not equipped to make sense of the ongoing news coverage of tragedies like this one.  In fact, if YOU are having trouble coping with something you see on the news, you can be sure your children will have trouble with it too.  Little kids often can’t tell the difference between what is real and what isn’t on television.  Also, because a child’s sense of time and reality is different from adults, a child watching ongoing news coverage may fail to understand that the terrifying event has ended.  The child may think the shootings are continuing and may be confused and upset about why adults and police are doing nothing to stop it. 

Toddlers and preschoolers will rarely comprehend what has happened so it’s usually best to only discuss traumatic events if your child spontaneously brings them up.  Very young children’s ability to tell fact from fiction on television is very limited and even very tragic events that don’t directly touch their lives are unlikely to effect them very much.  However, their emotional radar is very sensitive so they may pick up on your sadness, grief and horror.  If you are feeling emotional don’t just brush it off.  You might explain to your child that something sad has happened and you are feeling sad about it but you will be OK.  Accept a comforting hug, the loan of a favorite stuffed toy or cup of water offered by your child and let them know they are helping you to feel better. 

When discussing traumatic events with school aged children it’s important to consider your child’s developmental level.  Your child will usually give you clues about how much they can handle.  Children do need to understand that there are bad people in the world and sometimes those bad people do bad things that hurt people.  If your child doesn’t bring the topic up on his own, you might start out with a general statement, such as, “A bad thing happened at a school in Texas today. Have you heard about it?” It’s important to listen carefully to your child’s answer.  Don’t hurry the conversation.  Maintain good eye contact and use hugs and other kinds of touch for comfort.  Answer any questions they have as gently as you can. Don’t lecture or provide excessive detail but strive to be as honest and direct as you can. 

Allow your child to talk out their worries and concerns and provide responses that will help your child feel safe, secure and taken care of. Avoid making promises that you can’t keep but be as reassuring as you can.  The conversation might go something like this: Child: “Why would someone go into a school and shoot up a bunch of little kids? Schools are supposed to be safe!  Why didn’t the police and teachers keep him from hurting those kids?” Your responses might be “Most people are good and most people would never harm a child or shoot anybody.  There are bad people who sometimes do bad things.  Often there is something wrong with these bad people but sometimes nobody knows what’s wrong with them until it’s too late. Most of the time, adults keep children safe and nothing bad happens to them.  Schools are usually very safe and it’s very rare for any child to be harmed in a school.  Teachers and principals do everything they can to take care of school children and keep them safe.  Policemen usually keep bad people from hurting other people. The bad things that happened today are very unlikely to happen here.  I will do everything I can to keep you safe and prevent bad things from happening to you. It’s also important to think about all the good people today who did great things to help.  Most of the children and teachers were not hurt.  The police came and did a good job today. Do you have any worries about your own school or your teachers or friends?” Listen to the child’s answer.  Then ask if there is anything they would like to do to help the children families and people in the community where the shootings occurred.  You and your child can draw and mail condolence cards, send money or toys, or light a candle and say a prayer. Children have very generous hearts and helping them help others can be a particularly beautiful way for them to cope with tragedy and help themselves as well.

Your child may regress. Children may start wetting the bed or having nightmares.  Handle these occurrences calmly and provide support and comfort.  Encourage the use of “transitional” objects such as blankets or stuffed toys if they help the child feel safe and secure.  If your child starts having angry outbursts or tantrums, be as patient as you can and help the child understand their feelings and talk them out. Violence or aggression is not acceptable and should be discouraged and appropriately consequenced in a way that is consistent with your values and family rules. 

Older kids and teens may raise some very difficult questions.  If you don’t know how to answer a question it’s OK to admit it.  Moral, spiritual and faith-based discussions and prayers can be very helpful and comforting. If you are unsure how to handle a situation have the child talk to a counselor or religious leader about their concerns. You can still be a loving caring parent without having all the answers! You aren’t required to know how to handle all situations but you are responsible for finding the resources your child needs when you aren’t sure what to do.

It’s always a good idea to discuss safety issues with your children.  To effectively address your child’s fears and worries, have a discussion about how they can respond if something bad happens or if they find themselves in a dangerous situation.  Be practical and realistic. While you don’t want your child’s response to trauma to be a life ruled by fear and worry, you do want a child who knows how to keep him or herself as safe as possible in a world where bad things sometimes do happen. We all want to raise children who make good decisions and know how to stay calm and handle adversity well.    

Be sure to bring the focus back to the positive aspects of family, community, comfort, caring and faith. Draw the child’s attention to all the heroes of the day. Help your child do something positive and constructive to help the victims.  Teens in particular may also be interested in participating in political or community action to help prevent future re-occurrences of similar events. Artistic or written self-expression and music can help your child process the experience and the deep feelings it may have evoked. Religious services, vigils, memorials and community ceremonies can be very comforting so participation should be encouraged if the child wishes.        

Sadly, coping with your child’s reaction to traumatic events can be a long-term process.  If your child has been directly affected by tragedy, expect ongoing conversations.  Your child will be unable to process everything you tell them the first time they hear it.  Be open to your child’s feelings and reactions.  Validate their feelings. Listen, give lots of hugs, provide comfort and have confidence that things will get better.  Most children are resilient so with love and the right kind of support, they will be ok.

Check out my new Couples Counseling workbook on Amazon: 

My website: wwwdrjillpsychologist.com
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Sunday, January 24, 2021

Sharon Begley, Your Memory is a Blessing

 I was pursuing Twitter this afternoon, where I read about Sharon Begley's passing with great sadness. Sharon was a prolific journalist who wrote about science for Newsweek, the Wall Street Journal and STAT. She was particularly interested in psychology. She wrote several books about the mind and the brain and published articles in Psychology Today. For many years, until the magazine folded, I was a subscriber to Newsweek. Her column was one of the first things I would turn to when I sat down to read that week's edition. She was a lovely writer whose crisp prose made complex ideas about a broad variety of science topics easily understandable. Aside from learning new and interesting things about cutting edge research each week, she taught me a very important and meaningful lesson about kindness and diplomacy which has really stayed with me. 

I used to pride myself on writing highly critical letters and reviews when I heard about or read something I didn't like or strongly disagreed with. In 2009, she wrote an article in Newsweek about the dangers of psychotherapy, which claimed psychotherapists don't inform their work with scientific research. Her piece was based on a highly controversial and biased article, which she was summarizing. As a clinical psychologist with a doctorate in which I was trained in the scientist practitioner model, I strongly disagreed with what she wrote. My graduate training required me to understand research and do both a master thesis and dissertation, so I was horrified that what she wrote would erroneously discourage people from seeking therapy. 

I immediately dashed off a scathing email about her irresponsibility in writing this article and her callousness about the harm it would do. I was surprised to receive a reply within 45 minutes. She had carefully read my message and took responsibility for what she had written. In fact she agreed that she shouldn't have been so heavy handed and was also worried about the negative impact the piece might have on people deciding whether to reach out for counseling. I was dismayed to realize that I had apparently hurt her feelings. This is not to imply that she was a fragile hot-house flower. As a professional journalist, she could stand the heat and didn't need to stay out of the kitchen. However, while I felt like my points were valid, and so did she, I realized I hadn't even considered how she would feel reading what I'd written. I hadn't intended it to be mean-spirited, but it definitely came across that way. We had a brief but pleasant correspondence about this which completely changed the way I write to people who I disagree with and the reviews I leave for books I've read that I don't like. She and I became LinkedIn and Twitter followers. Although we didn't correspond again, I always felt a connection with her that was special to me.

Her role as a journalist was to influence people. I'm quite certain she had no idea bout how she'd influenced me to be more tactful and diplomatic in my correspondence and reviews. I'm also a writer and a public speaker. I gave a TEDx talk Why Can't We Be Friends on friendship, which is posted on youtube and has many hostile and scathing comments underneath the video, many of which are hard to read. Articles I've written have resulted in letters to the editor or emails to me where I feel misunderstood or attacked. Of course most of the commentary on my work is positive, which is a good counterbalance to the negativity. As I frequently say to my psychotherapy and coaching clients, light and shadow exist everywhere. If you are going to put yourself out in the world, you will see both. 

I appreciate her taking the time to grant me the opportunity to hear her perspective as a writer faced with the challenging task of sharing complex information to a diverse audience. This perspective has served me well now that I'm frequently on the other side. She probably never realized it, but she taught me that I could also stand the heat and stay in the kitchen with confidence and grace. I wanted to take a moment today to thank her and to share my gratitude with others who cared about her and her work.


Tuesday, December 18, 2018

Keeping the Happy in Happy Holidays

Whatever holidays you celebrate this season, I hope they are happy. For many people, this is the best time of the year. Parties, gifts, decorating, baking, festivities and seeing friends and family bring considerable joy and delight. However, for those struggling with mental illness, loss or family dysfunction, December can be stressful and depressing. If you’re grieving and this is your first holiday without your loved one, things that have brought joy in the past may trigger sadness and tears. If you’ve had a big life change such as a divorce or all the children have left home and they won’t be with you for the holidays, the empty nest can hit very hard especially when it seems like everyone else is focusing on their kids or grandkids.

If you just haven’t been feeling in the holiday spirit this year, be easy on yourself. In my psychotherapy practice lately, I’ve been seeing significantly higher levels of stress, anxiety and depression than in previous years. So unfortunately, you may in much better company than you probably expect. You don’t have to go all out celebrating; in fact, you don’t really have to do anything about the holidays at all. The week between Christmas and New Years can be a time of self-care and peace if that’s what works for you. Keep it simple, positive and calm. You don’t have to attend a single party, buy elaborate gifts, bake or send Christmas cards. Think about what is meaningful to you and do as much of that as possible. For many of us here in the Vail valley, the start of ski season is a highly anticipated time of adventure and fun. Don’t let holiday obligations keep you off the hill or out of the snow. 

Be careful about spending, overeating and too much alcohol. Hopefully you didn’t go beyond your budget when buying gifts. Research shows that in the long run, we remember and value positive activities and quality time with loved ones more than material objects. Stick to your fitness schedule and a healthy diet. Be sure to get enough sleep. People really underestimate how important quality sleep is in managing stress and keeping your mood bright. 

Social media can be a source of pleasure and amusement or it can be a real downer. Remember most people only post the good stuff that’s happening in their lives. Don’t overgeneralize and conclude that everyone but you has a great life and is having perfect holidays. It’s fun to share your best, most joyful or entertaining moments on your social media feed so don’t hesitate to do so. Using social media to feel closer and more connected to the people you care about can be a cherished source of happiness, validation and emotional support.

If you are introverted and find socializing exhausting, be attentive to your self-care needs. Consider attending only those events that are most meaningful or comfortable for you. It’s fine to leave a holiday celebration after only an hour instead of staying for an entire evening. If you have guests staying with you or you are staying in someone else’s home, make sure you carve out some quiet time for yourself without apology. Excuse yourself to lie down or take a walk. Offer to help in the kitchen so you have something to do if you find small talk difficult. It’s perfectly fine to decline events that are too loud or overwhelming for you. Instead, schedule small get-togethers that help you feel comfortable and relaxed instead of stressed and pressured. 

Many people feel alone and isolated this time of year. For members of our community who’ve moved here from other places, this can be an especially lonely time. If you have to work long hours during the holiday season, you may feel stressed, grouchy and disgruntled. If you work or live near someone who has no local family, the greatest gift you can give them may be to invite them to share in your own festivities. If they decline to attend, drop off some treats from your holiday table. Be flexible about when guests can arrive or leave to accommodate the schedules of those who have to work on Christmas or New Years. 

Practicing tolerance, acceptance, kindness and generosity of spirit are some of the greatest gifts we have to give, and they don’t cost a thing. Remember the reason for the season. Hint, it’s not about glamour, extravagance and exhaustion. Do what makes you feel relaxed, connected, and joyful and brings meaning to your life. That will be your best recipe for happy holidays. 

Friday, September 28, 2018

Dealing with Brett Kavanaugh's Supreme Court confirmation hearing if you've been a victim of sexual trauma

This past week’s Supreme Court Confirmation hearings and Dr. Christine Blasey Ford’s testimony are affecting just about everyone who’s paying attention. However, survivors of sexual abuse, assault or harassment are likely to be affected in a way that those who’ve never been through it may have a hard time comprehending. While the actual statistics about sexual victimization vary, there seems to be a consensus that at least 1 in 4 women have been affected. This means that all of us are regularly interacting with women who may be profoundly distressed by what’s happening. While some survivors may feel validated and empowered because people are finally talking about this, others are feeling triggered and overwhelmed. As they see news coverage and social media posts confirming their worst fears about shaming and disbelief, their trauma symptoms escalate.

If you or someone you care about is struggling, encourage them to seek help. Feeling isolated and alienated only makes things worse. Psychotherapy, support groups or online forums can provide a sense of community and teach valuable coping skills. Recovery from trauma is possible and no one should feel like they need to suffer alone in silence. Setting boundaries on news exposure is critically important. Avoid the news if it’s highly disturbing to you. Reading articles or short summaries may be easier to handle than watching live coverage or video updates. Take care with your social media exposure. You may want to pare down your friends list. If someone on your feed is sharing posts that are upsetting, consider clicking the unfriend button. Alternatively, you can block their posts without actually blocking them. Establish a rule on your own feed that negative or incendiary comments will be deleted as soon as you see them. It’s your page and realizing you have control over what populates it can be powerful. 

If you are struggling, be compassionate towards yourself. Feeling badly about bad things that have happened to you is actually reasonable and healthy. It’s not a sign of weakness. Feeling triggered means that you are hijacked by a flood of fear and panic, intense negative emotions and a loss of the sense of your current time and place. While you may not experience a full-on flashback, the sense of feeling overwhelmed and out-of-control can be hard to manage. If this happens to you, bring yourself back to the present moment. Take deep breaths, focus on something in the physical world, feel your feet against the floor or the wind in your hair, observe the leaves on the trees or play with your pet. Hop on your bike or go for a hike. Listen to uplifting or inspiring music. Use as many of your senses as you can to ground yourself. Deep breaths and a mindful focus on the world outside your head can stop the cascade of fear and panic and help you reset. Your goal is to remind yourself that you are not stuck in the past and that you are safe. Reach out to compassionate friends and family. Don’t turn to alcohol and drugs to manage your reactions. While they may seem like a good short-term fix, they make things worse in the long run.

Reading #metoo posts can create internal pressure to disclose your abuse or harassment history. While there is comfort and strength in community, don’t feel compelled to share your story if doing so makes you uncomfortable. It’s OK to let other’s take the lead if you’re not ready to participate. On the other hand, hearing other’s #metoo stories or experiencing outrage about what you’re seeing onscreen can be a galvanizing force that motivates you to disclose your story. Do whatever feels right to you and be OK with it. Whatever you choose, don’t let guilt and shame define you. You are so much more than your worst experiences.

Whether you have been a victim of sexual harassment or assault, or love someone who has been victimized, take this opportunity to think long and hard about what we want from our relationships, our country and our leaders. Any positive or constructive effort you make is a step in the right direction.  Don’t sit back waiting for someone else to be the change you want to see in the world. And if you only do one thing, remember that your vote counts, so get out and cast your ballot on election day. 

Tuesday, November 8, 2016

Recovering From Post-Election Traumatic Stress Disorder

As the divisive 2016 presidential election finally draws to a close, let’s all agree to breathe a collective sigh of relief as we bid farewell to the most hostile and vicious campaigning many of us have ever had the displeasure to experience. The constant negativity associated with this election cycle has permeated our homes, workplaces, neighborhoods and communities. It’s damaged marriages, families and friendships. I’ve witnessed its toxic effects on the clients I see in my practice. I’ve been deeply dismayed by the frustration, worry, outrage and hopelessness expressed by so many of the people I’ve come in contact with recently, both personally and professionally.

There are many reasons why the 2016 presidential contest will go down in history as the most stressful election of our lives to date. Aside from the pre-existing deep divide in the views of liberal and conservative Americans, the 24-hour news cycle, endless exposure to intrusive and disturbing commercials and constant derisive commentary on Facebook and other social media have kept most people stirred up to a fever pitch with little respite.

As both a psychologist and member of my community, I am gravely concerned about the adverse impact this election has had on people’s emotional well-being and relationships. The negative fall-out from conflicting political beliefs has caused serious distress within couples and families and threatened friendships, collegiality in the workplace and community cohesiveness. Campaign messages have highlighted threats and security issues, mistrust, economic decline, gender, racial and class divides, and narcissism and nastiness in people we are supposed to look up to as our leaders. Many voters have experienced intense feelings of anger, fear and discouragement compounded by the bitter arguments that have ensued among people who usually care about and respect one another.

So, how do we recover from Post-Election Traumatic Stress Disorder? First and foremost, avoid thinking the worst and expecting imminent catastrophe. The peaceful transition of power, which happens after every election, assures a comforting degree of stability. The constitution and three branches of government limit political power, so regardless of campaign promises, the wheels of government move ponderously, as every newly minted president with lofty predictions for the first 100 days has discovered the hard way. And if you don’t like who won, you can take some comfort in term limits. Whether your candidate was the winner or loser, it is a privilege to participate in a process that people have fought, sacrificed and died for. I hope you exercised your right to vote and that you wore your “I Voted” sticker with pride after you did so. If you are unhappy with the outcome of the presidential election, focus instead on state and local results and initiatives that went your way. Your vote DID matter. Limit your media consumption if watching or reading about politics and the election is disturbing to you. Exercise your power to change channels or push the “off button.” Refuse to participate in contentious political exchanges with friends, family, coworkers and neighbors, especially as the holidays approach. You can always step away, change the subject or simply state that it’s not something you want to talk about right now. Remember that nobody ever changed anyone else’s mind with a Facebook post so declare your wall a politics-free zone. Share good news, happy photos and cat videos to bring smiles to the faces of everyone who reads your posts. If someone puts something rancorous on your Facebook page, simply delete it. It’s your wall after all!


Political beliefs and voting choices are only a part of who we are. Now that the election is over, reconnect with those you care about who have disparate beliefs and voting habits by focusing on your similarities and shared joys instead of your differences. And remember, variety is the spice of life! Being married to or best friends with your clone would be awfully dull. Relax, be playful and enjoy activities that have absolutely nothing to do with politics. Watch a good movie or non-political comedy show so you can laugh together. Life goes on, and there is so much to celebrate, appreciate and look forward to, regardless of the outcome of this election.

Sunday, October 4, 2015

Psychotherapy Practice Finance: Credit Card Worries?

October 1 2015 was an auspicious day for mental health professionals in private practice for two important reasons. As health care providers, we had to switch to ICD-10 for our diagnostic coding. And as small business owners, we got worried about whether we needed to change the way we processed our credit card payments. 

So what was so special about October 1, 2015 in the world of credit card processing?  That’s the day liability for transactions resulting from fraudulent EMV chip credit cards shifted from the bank issuing the credit card to the business owner running the transaction. In terms relevant to our profession, if a client payment using a fraudulent EMV chip card goes through AND we don’t have an EMV Chip Reader terminal to run the sale, the bank will charge back the cost of the service and we will be stuck unpaid. The good news is, no additional penalties or fees are incurred beyond the charge back. It’s also good to know that nothing has changed for transactions using cards without the EMV chip. So, if your usual method of processing credit cards is using a magnetic swiper (either a free standing terminal or one attached to your computer or smartphone), hand entry from a client’s form authorizing repeated automatic card payments, or client entry using a payment portal web site AND the client uses a fraudulent magnetic strip card, the bank will still be the liable party. The bank also still incurs the liability if we run the card in a way that wouldn’t customarily use an EMV Chip Reader, such a remote entry when the customer and card are not physically present while the transaction is being run.

So what’s the big deal and why all the fuss? Well, apparently just under half of all the world’s credit card fraud occurs here in the USA, even though only one quarter of all credit card transactions occur within our borders. A key reason for these disheartening statistics is that America’s love affair with cheap and easy to use magnetic strip credit cards has lingered way past its prime. Magnetic strip cards are simply too easy to counterfeit. EMV (which stands for Eurocard/Mastercard/Visa) technology has been in use in other parts of the world for years. The inclusion of an electronic chip embedded within the credit card makes it significantly more difficult to create usable counterfeit cards. It is currently estimated that here in the US, only one third of all transactions are processed using chip enabled cards, but that number is expected to rise rapidly. All chip-enabled cards will still have a magnetic strip and will work in magnetic strip readers, but the liability for fraudulent transactions processed in this way has shifted from the bank to the merchant. For the time being, there are no plans to charge merchants differential rates for running EMV chip-enabled cards vs. magnetic strip only cards.

Switching to a new card reader that will do magnetic strip cards, EMV cards and NFC (Near Field Communication) devices such as Apple Pay will eventually be a worthy endeavor and is likely to incur only minimal costs and inconvenience. Given (1) the volume of business we private practitioners generally do, (2) the fact that we hand-enter many transactions based on credit card information we keep on file, and (3) the ongoing professional relationship we have with most of our clients, our actual risk of getting stuck because someone paid us with a fraudulent chip card AND we didn’t have a chip reader is, in fact, pretty low.

I use Transfirst for running my credit card sales and when I called to ask, they freely advised me that they consider my current risk extremely low. Their advice was to plan to get a chip reader at some point but not to worry about it for now. They don’t currently have a chip or NFC based system to use with the iPhone/iPad but they anticipate having something on offer in the near future. I haven’t yet done any diligent research on the new “Chip and Dip and NFC” card reader systems but it seems like options are still pretty limited. I did review Squares’ site and if you use a Square reader plugged into your phone or an iPad to process your credit cards, you can purchase one from them $49. Free-standing machines seem to be running in the $200-$300 range. Remember, if you purchase a free-standing machine, you need to check with your credit card processor first to make sure it will work with their system. I couldn’t find any good peripherals currently available that connect directly to a computer via USB cable. It seems like you will need to hold tight for the time being if you routinely run your transactions through a swiper peripheral connected via USB cable to the computer running your practice management system, as I currently do. Again, check with your credit card processor before buying anything to make sure it will work with their system.

I am all in favor of easy to use, inexpensive systems that reduce fraud. Whether we eat the cost or the bank eats the cost, it is still theft and it is wrong. Updating our equipment as more affordable user-friendly options come available is something we can do to help curb the use of fraudulent cards here in the US. When I have some good affordable options to choose from, I will definitely get an EMV/NFC card reading system. For now, I will stick with what I’ve got, and cross this off my “Things to Worry about List.”