September 26, 2025 • 34 mins
What happens when a health crisis leads to profound personal and professional transformation? Marina Livis' path from speech therapy student to holistic psychotherapist illuminates how conventional medicine can miss crucial connections between body imbalances and mental health symptoms.
Marina's story begins with a suspicion about her own neurodivergence while studying at Northwestern. During a period of debilitating symptoms that felt like "dementia, ADD, and depression in one," conventional psychiatry offered only medication after medication without improvement. Her breakthrough came through functional medicine, which identified mercury toxicity combined with a genetic mutation affecting detoxification pathways—root causes entirely missed by traditional approaches.
This experience fundamentally reshaped her understanding of mental health conditions. "Depression is not a chemical imbalance in the brain," Marina explains, "it's a body imbalance that affects the brain." Now specializing in working with late-diagnosed autistic adults, she combines evidence-based psychotherapeutic approaches like EMDR and hypnotherapy with functional medicine principles addressing nutrition and lifestyle factors.
Her work reveals critical gaps in conventional care for autistic individuals, who often have underlying medical imbalances creating symptoms labeled as anxiety or depression. Without addressing these root causes through appropriate testing and treatment, patients remain caught in what Marina calls "a hamster wheel" of medication trials. The American insurance system creates additional barriers, making truly integrative care inaccessible to many who need it most.
Marina's practice represents a powerful alternative model where mental health treatment doesn't separate mind from body. By combining psychological approaches with functional medicine insights, she offers clients a path toward healing that addresses the whole person rather than just managing symptoms.
Have you considered how unexplored body imbalances might be affecting your mental health? The connection might be stronger than conventional medicine has led us to believe.
Guest Biography
Marina Livis, LCSW is a holistic psychotherapist, certified hypnotherapist, and passionate advocate for functional medicine. Drawing from her own lived experiences with mercury toxicity and a late autism diagnosis, Marina helps neurodivergent adults navigate mental health with compassion and depth—without overreliance on psychiatric medication. Her integrative approach blends EMDR, hypnotherapy, trauma-informed care, and functional wellness strategies. Marina is based in the U.S. and works with clients virtually through her private practice.
Contact Details
- 🔗 Website: www.marinawellness.com
- 📧 Email: mlivis@marinawellness.com
- Linked In: https://www.linkedin.com/in/marinalivis/
- 📱 Phone: +1 (561) 877-0517
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:00):
Welcome to Voices in Health and Wellness,
the podcast where we explorewhole person healing, emerging
care models, and the inspiringvoices changing how we think
about health.
Today's guest is Marina Levist,a licensed clinical social
worker, holisticpsychotherapist, and certified
hypnotherapist whose work sitsbeautifully at the intersection
of mental health and functionalmedicine.
Marina brings her personalhealth journey, marked by
(00:23):
mercury toxicity and late autismdiagnosis, into her mission of
helping others reclaim healthwithout over reliance on
psychiatric medications.
She's a powerful advocate forintegrative care, ethical
collaboration with healthcareproviders, and expanding support
for autistic adults navigatinga system not built for their
needs.
So, Marina, thank you so muchfor your time and coming on the
(00:43):
show this afternoon.
Marina Livis (00:45):
I'm really impressed by your summary.
I couldn't have said it bettermyself.
Dr Andrew Greenland (00:50):
As long as it's accurate, that's the most
important thing.
I hope you have accurate byhim.
Marina Livis (00:55):
Very well worded.
Dr Andrew Greenland (00:56):
Wonderful.
So maybe we could start at thetop and perhaps talk about a
little bit about your journey,is what's led you into doing the
work that you do.
Marina Livis (01:05):
Well, it's interesting.
Um I was first in graduateschool at Northwestern
University and was in a master'sprogram there for speech
language pathology.
And it was around that timethat I started uh suspecting
that I might be on the autismspectrum.
I became obsessed with TempleGrandin and her books.
(01:27):
And I also around that timestarted really getting curious
about holistic health andholistic nutrition, and found
myself instead of reading thebooks that are communication
disorders based, which of courseI was required to read, I was
finding myself more drawn tobooks on nutrition and
(01:51):
alternative medicine and TempleGrandin, of course.
So those became my specialinterests, which, as anyone who
knows even a little bit aboutautism, special interest is one
of the traits.
And it was then that I wentthrough an interesting
(02:12):
experience where I realized thatthis was not the path for me,
even though I got into one ofthe best programs in the
country.
And ironically, I was in voicedisorders class on the same week
that I got a case of laryngitiswhere I literally could not
(02:34):
speak, had no voice.
And at the time I was alreadyinto the practice of meditation
and I was practicing Buddhism aswell, and I found myself really
going inward and reflecting onwhat I should do with my career,
what is this illness that I hadreally telling me?
(02:57):
And the inner voice that I themessage I received from my inner
voice was clearly that I meantto be a therapist, just not a
speech therapist.
And I meant to be more of amental health-focused therapist
because at the time I wasstruggling with my own mental
health.
(03:17):
I was dealing with depression,which now looking back might
have been heavy metal toxicity,but none of the doctors I was
going to that were veryreputable doctors really tested
or checked anything beyond thesurface.
So all I knew was that I hadthis so-called chemical
(03:39):
imbalance.
But I I knew at that time Istarted to suspect there's more
beneath the surface that I'mjust not aware of.
So that's kind of how itstarted for me.
Dr Andrew Greenlan (03:51):
Interesting, fascinating.
And you mentioned mercurytoxicity and your autism
diagnosis were big turningpoints.
I mean, how did those shape notjust your health but your
identity and the work that youdo?
Marina Livis (04:03):
Well, for me, when I found out after that was
years later when I found myselfworking for the early
intervention program in New Yorkand really having suddenly a
tough time remembering things,uh, having a tough time even
showing up for work, feelingvery scattered.
Uh, it almost felt like a caseof dementia, ADD, and depression
(04:28):
in one.
The psychiatrist I was workingwith at the time just wasn't
helpful, just kept putting me ondifferent antidepressants,
SSRIs.
And I knew I had to findanother way.
And because I was working withfamilies through the early
intervention program as aservice coordinator, helping
(04:49):
them get connected to services,and at the same time, I
completed school for integrativenutrition as a health coach.
I was already interested inlearning about how you know the
interface between integrativemedicine and autism.
I was interested in it morefrom the point of view of how
(05:11):
can I help these families, howcan I give them additional tools
beyond what they were gettingthat was covered by insurance.
And then there was this doctor,Dr.
Levinson, who happened to cometo New York City and was doing a
lecture and how he's actuallyable to reverse autism through
(05:31):
functional medicine ororthomolecular medicine.
And I remember thinking tomyself, well, if he can reverse
autism, he could certainlyreverse my depression.
And uh I found myself on thenext flight to Miami to see him,
and all I had was maybe twoweeks before I had to be back at
work, and uh he just it feltlike a miracle.
(05:54):
He right away identified theroot cause, which in my case was
mercury toxicity, and acombination of that and a common
SNP, a genetic mutation calledMTHFR, that makes it difficult
for the liver to detoxify.
And so that perfect stormcreated what he called organic
(06:16):
depression.
And um, within a week of seeinghim, I was back at my job
functioning better than I had inyears.
It was just incredible, it wasreally like a miracle at the
time.
And so a year later, I decidedto go back to school for social
work.
Um, and while I was in school,I ended up writing an academic
(06:39):
paper about how depression isnot a chemical imbalance in the
brain, it's a body imbalancethat affects the brain, and
that's essentially thefunctional psychiatry framework
that I now understand that wasnot popular at the time.
So my professor was not happywith the topic of my paper, but
(07:02):
he had no choice but to give mean A.
Because I did my research, andof course, none of it was coming
from my field.
Um, but I was very proud ofmyself for doing that because
the paper really reflected notjust the research that was out
there, but my lived experience.
You can't argue with that.
Dr Andrew Greenland (07:25):
Totally.
So tell us a bit um on thatsubject, tell us a little bit
more about your practice and thetypical patients that that come
to you.
What are they coming to youwith and what's what's your kind
of approach with them?
Marina Livis (07:37):
So I just started my virtual private practice this
year, and I decided to focus iton working with other late
diagnosed or late identifyingautistic adults, mainly because
at the time that I was latediagnosed, which was back in
2019, I faced a lot ofdiscrimination.
Um I really didn't have a lotof supports.
(08:01):
I didn't even realize thatthere were other autistic
therapists.
Um, so it was quite a journeyfor me finding out more about
how prevalent it actually is andthe supports that are out
there.
So I really wanted to give whatwe call in the field a
(08:22):
corrective emotional experienceto my clients who in this day
and age I think uh it's become akind of trendy to look for a
neurodivergent uh therapist,neurodivergent meaning someone
who whose brain doesn't functionin the same way as a
(08:43):
neurotypical brain.
Um and so I decided that'sgonna be my focus.
However, my focus is alsomaking sure to tell every single
client I work with that I donot support the practice of
conventional psychiatry.
Not to say that I'm againstthem taking Adderall or whatever
(09:08):
it is that they choose to take,but it's just not the framework
in which I view theircondition.
And so uh I encourage all myclients, if possible, to see a
functional medicine doctor andfor me to collaborate with that
professional.
And I'm finding that those thatactually follow that advice do
(09:33):
much better than those that donot.
And I understand, especiallyhere in the US, um, it's a an
issue of what will insurancecover and what will insurance
not cover.
And unfortunately, functionalmedicine is not covered by
insurance because, as we allknow, insurance is not in the
business of health, it's in thebusiness of maintaining illness.
(09:57):
It's a sick care system, not ahealth care system.
And so being in the system, buttrying to work outside of it
has been quite a challenge.
Dr Andrew Greenland (10:09):
And I was gonna ask you on that note,
what's your process for helpingpeople to improve the quality of
life without jumping straightto psychiatric medication?
Marina Livis (10:17):
So I uh I do EMDR therapy, which is trauma
focused.
Uh, they don't have to havePTSD to benefit from EMDR, but
if they do, that's certainly agreat modality.
I also use hypnotherapy toaddress any kind of mental and
physical ailments if they'reopen to it.
(10:37):
I introduce them to differentmindfulness practices, including
EFT tapping.
EFT is emotional freedomtechnique, and also different
forms of meditation.
I encourage them to I educatethem about healthy nutrition and
I encourage them to move awayfrom ultra-processed foods if
(11:01):
they haven't already, toconsider going on a sugar
elimination diet, to consideryou know, various diet and
lifestyle changes.
And I'm not saying this fromthe perspective of a health
coach, which I was before.
I'm not like giving them,telling them this is what you
should eat, this is what youshould not eat.
(11:22):
It's more in the form ofpsychoeducation, like FYI, your
symptoms might improve if youtry XYZ.
So I I kind of uh help them betheir own advocate.
Dr Andrew Greenland (11:38):
And in working with um autistic
patients, what do you see arethe biggest gaps in care for
them right now if they're goingelsewhere?
And is you're saying that fromsomebody who understands this
condition better than anybody,if you suffer it with yourself,
you have a better understanding.
But what gaps do you see in thecare for for these patients?
Marina Livis (11:57):
The gaps I see is that a lot of individuals that
are autistic or that haveautism, however you want to put
it, um have a multitude ofunderlying medical imbalance
like conditions and bodyimbalances.
And those body imbalancesactually create the symptoms
(12:22):
that we call anxiety,depression, inattention, etc.
Um so I think the biggest gapis that if they're not seeing a
functional psychiatrist, umthey're constantly kind of in
this hamster wheel of, oh, let'stry this medication, let's try
(12:43):
that medication.
And most of them don't even getgenetic testing to see which
medications are appropriate forthem, much less genetic testing
to see if they have the MTHFRmutation, which is very common
among autistic individuals.
Um and so they express to mehow frustrated they are with
(13:04):
being part of the system.
A lot of them don't want totake all these medications, but
they're also suffering and theydon't know what else to do.
And so it's a very toughsituation where you know there's
layers of issues, but they'renot being properly addressed by
the medical system.
Dr Andrew Greenland (13:26):
I understand.
And in terms of the challengesin doing the work that you do,
because I guess you're fairlyunique combining you know
psychotherapeutic tools with afunctional medicine approach,
what's the challenge for you asdoing this kind of work?
Marina Livis (13:40):
Well, the challenge for me is just
knowing, almost like just frommy own lived experience, knowing
and suspecting that there mightbe some uh micronutrient
deficiency, or there might besome parasite uh that you know
maybe they would benefit from aparasite detox, or uh suspecting
(14:01):
that well they might haveceliac or gluten sensitivity,
but uh they haven't been testedfor it.
Um, you know, all of thesedifferent things, but then not
being able to, like not being amedical provider, not being able
to write the script for them toget those things done.
And sometimes even when Iencourage them to speak with
(14:24):
their conventional doctor aboutit, getting resistance, you
know, being told, well, that'snot necessary, or there's no
proof that this is an issue.
Dr Andrew Greenland (14:38):
So is it something you would like more
therapists or family doctors tounderstand about what your
approach can really offer if youhad to kind of put down a few
things that you would like themto really know that would help
them to help their patients?
What kind of things would youwant them to know?
Marina Livis (14:53):
First of all, I would like them to know that
genetic testing should be anabsolute mandatory part of their
practice.
And I don't mean just testingto see which medications are
appropriate for the patient, buttesting to see if there's any
SNPs, you know, singlenucleotide polymorphism similar
(15:14):
to MTHFR that are very commonthat might be a driving force to
you know a lot of the symptoms.
And also for them to do moredetailed testing, not just the
surface level blood work, andand in the case of heavy metals,
(15:36):
for example, it's it's notenough just to do a blood test
to check for heavy metals, asyou probably know yourself.
And so uh I would honestly makeit mandatory for all doctors to
go to IFM and to studyfunctional medicine as part of
their training, not as a youknow, post-medical school thing,
(16:00):
but it should be an absolutelyintegral part of uh medical
education.
Dr Andrew Greenland (16:07):
So I don't disagree with you there.
So I'm just for background forlisteners, I'm a functional
medicine doctor, and functionalmedicine is really taking a
holistic approach to people andtheir complex chronic illnesses,
looking at the whole dietaryand lifestyle piece, but looking
at them functionally, theirbiochemistry, their genetics,
their gut microbiome, all thestuff that never really gets
looked at in conventionalmedical world.
(16:28):
And we put all these piecestogether in our jigsaw puzzle
and really can come up with aholistic approach that actually
helps the patient treat theirproblems at the root cause and
gets them well.
That's essentially whatfunctional medicine is.
And it sounds like you're a bigadvocate for that with your
work, but you also have theadditional ability to layer in
helping thempsychotherapeutically as well.
So I think that's an amazingcombination.
(16:49):
I don't think I've met anybodythat does what you do.
Marina Livis (16:51):
Yeah, thank you.
Dr Andrew Greenland (16:54):
So, what are the challenges that you face
right now?
So you're doing this work,you've kind of found your niche,
you've found the thing that youlike to do, you're using the
tools that you like to use, butwhat are the challenges in doing
what you do right now?
Marina Livis (17:08):
Well, there's uh you know, the challenge I
already talked about, and thenthere's also the challenge of
insurance.
I don't know if you know aboutthe US insurance system, but we
don't have national health care,unfortunately.
Dr Andrew Greenland (17:22):
And I know it very well, only from the
point of view that I've had lotsof conversations with people in
North America, and the onething that they all talk about
is insurance.
But very interesting to hearwhat your take on it is because
everybody's got a slightlydifferent nuanced approach on
how they view the insurancething.
Marina Livis (17:37):
So some of the practical challenges that have
come up is there were some newautistic clients I started
working with, um, and we weredoing, you know, they they
became more aware of uh, youknow, what the symptoms, what
diagnoses uh their symptoms uhwere reflecting, and how their
(17:59):
childhood experiences createdthe PTSD, for example, that they
now you know had symptoms fortoday, but then I had to almost
abruptly stop treatment becausesuddenly insurance uh decided to
uh for whatever reason make menot part of the network, and I
(18:24):
don't understand that.
Um and you know, in thosespecific cases, the the clients
who are unable to pay cash tocontinue therapy, so it's really
unfortunate.
Um, you know, there's all kindsof insurance problems that
happen.
Maybe there's issues withaccurate insurance eligibility
(18:46):
verification in the first place,because how do you explain that
they have the same insuranceand uh they've been paying for
the treatment for months andmonths, and then all of a sudden
they say, Oh, you're not anetwork, we can't pay for this
anymore.
Um, so the cost of gettingtherapy outside of insurance is
(19:08):
prohibitive to most people, andthat's a big barrier.
And then the fact thatinsurance puts up so many
barriers, like, oh, you have tomeet your deductible first
before we pay anything, or youhave this co-pay, which may be
too high for someone to pay.
Um it's just they create moreobstacles for uh proper care.
Dr Andrew Greenland (19:34):
So insurance is a big thing.
Is there anything else that isa challenge or a bottleneck in
the work that you do or thebusiness that you run?
Marina Livis (19:42):
Yeah, um I think a lot of people question
hypnotherapy.
So hypnotherapy is just aspowerful as AMDR for the
treatment of anything likeanxiety, depression, PTSD, all
kinds of things.
Um, but I'm finding that a lotof my clients who are all
(20:05):
insurance-based, most of them,with the exception of maybe two,
are afraid of tryinghypnotherapy.
And there's something, maybeit's because they've seen stage
hypnosis and it was kind offreaked them out.
Or maybe it's just that our inour society and our culture,
hypnosis is frowned upon uh forvarious reasons.
(20:28):
There's all kinds of um, youknow, really inaccurate notions
about what hypnotherapy is.
So that's another challenge, isyou know, I do a lot of
psychoeducation about the powerof the subconscious mind and
hypnotherapy, and how much moreum effective and powerful it is
(20:53):
to work on the level of thesubconscious as opposed to
talking like you and I are doingat the level of the analytical
conscious mind.
And you know, it makes sense tomy clients, but to most of
them, it's also just scary to gointo that experience.
Dr Andrew Greenland (21:11):
I completely resonate that.
So I have trained inhypnotherapy in the past, I
don't practice anymore, butyou're right, it's one of the
biggest things.
You spend half the consultationexplaining what hypnotherapy
isn't because of themisconceptions that people have
or pre preconceived ideas thatpeople have from what they've
seen on the media.
And you have to kind of get ridof all of that before you can
do the work.
So I totally understand thatone.
(21:32):
Um, are people are the patientsthat come to see you um
requesting hypnotherapy, or areyou suggesting it as something
that will be helpful to them andthen you have to do this
overcoming of their ideas?
Marina Livis (21:44):
Most of them are they're more likely to request
EMDR because they've heard aboutit than to request
hypnotherapy.
So so far, my private practiceclients, none of them have
requested hypnotherapy up front.
They've requested EMDR if ifany kind of modality that was at
(22:05):
the forefront.
But I, like you said, have to,you know, even after starting
EMDR, for example, the way Iexplain why hypnotherapy might
be a good addition along withEMDR is if they have trouble
recalling certain memory targetsfrom those early childhood
(22:27):
years.
I find that hypnotherapy canhelp them with that.
And so I actually just guidedone autistic client who was just
uh recently late diagnosed, anduh he was amazed, and I was I'm
always um just in awe when Isee you know the transformation
(22:50):
after a hypnotherapy session.
So it just so happened I ledhim in two hours of hypnotherapy
yesterday over a virtual uhHIPAA compliant platform, and um
you know it it was just amazingto see how much came out.
A lot of emotions came out thatthat were suppressed, um, and a
(23:14):
lot of uh awareness of certainchildhood memories that we can
now target through EMDR, not tosay that we didn't work on them
and process them through thehypnotherapy session, but we can
do even more with thosememories through EMDR, and we
kind of stirred it up for him.
So I am quite confident thatyou know his subconscious mind
(23:38):
will give him some more clues asto what are some other memory
targets we can address, even ifwe don't do any more
hypnotherapy sessions.
So I find that for especiallyfor people that maybe had trauma
in childhood and have uhamnesia, like for example, I
(23:59):
can't remember most of uh whathappened before immigration to
the US from Eastern Europe.
So a lot of my childhoodmemories are also kind of
blurry, and I found thathypnotherapy has really helped
me access even early memories ofmy birth, which was I had a
traumatic birth experience.
(24:20):
So I know this from again myown lived experience, which is
one of the reasons I becametrained in hypnosis.
Um and you know, I find that atleast for the clients that are
able to go into trans states,which not everyone can, um, the
combination of EMDR andhypnotherapy can be a great way
(24:44):
to access those memories.
Dr Andrew Greenlan (24:48):
Fascinating.
So um you mentioned that yousort of treat autistic patients
and autistic patients come tosee you because you have an
understanding, because you'vehad the condition yourself.
How does that work from amarketing perspective?
How do you sort of market whatyou do?
Um, or does it just peoplegravitate to you through other
means?
I'm just very curious to knowhow this works.
Marina Livis (25:09):
So I created a psychology today profile where I
don't openly state that I'mautistic, but I ask questions at
the beginning of the profilelike can you relate to this, can
you relate to that?
Um, you know, do you feel likeuh you aren't understood or are
misunderstood?
(25:30):
And and to kind of help them uhas they read the profile, help
them connect with me andrealize, oh, this is someone who
gets it.
And then hopefully they thenvisit my website where in the
about me section I talk about mystory and I share openly about
how it came about that I waslate diagnosed, and then I have
(25:53):
a whole page on autism and uh apage on the different, you know,
for each modality.
I have a page where I kind ofexplain not just why the
modality is powerful, but whyit's powerful for someone who's
autistic.
So visiting my website isdefinitely helpful.
Dr Andrew Greenland (26:18):
I guess you must be flooded because I mean
you must be one of the very fewpeople.
Uh not only do you have a sortof understanding of
psychotherapy and psychotherapytools, functional medicine, but
an understanding of thecondition itself from lived
experience.
So I'm I'm guessing you must beflooded with demand.
Marina Livis (26:36):
Well, I can't say I'm at the point of being
flooded yet.
Uh they're slowly trickling inwhere you know maybe I'll get uh
two or three new referrals uhthrough my website and possibly
through psychology today.
I think the algorithm withpsychology today is working
against me.
(26:56):
They've I think from what I'vegathered, uh they don't
prioritize virtual therapists.
Um so I've had to play aroundwith it, like changing the
wording, changing putting that Ihave an office location, which
then confuses people when theycall.
So that's the other issue isum, you know, if they want an
(27:17):
in-person therapist, that's notsomething that I offer.
Um, I do virtual only.
One thing I started thinkingabout is uh potentially doing a
home visit, like one or twotimes, not each session, but you
know, that can really make adifference for some clients.
And so I I'm consideringoffering that as well.
Dr Andrew Greenland (27:42):
If you um could wave a magic wand and fix
one thing about your practice,what would it be?
If you went it was a bottleneckor a challenge, what would it
be?
Marina Livis (27:53):
It would be insurance.
Dr Andrew Greenland (27:55):
So I knew you were gonna say that.
Marina Livis (27:59):
So the reason the reason I say that, and it's been
at the forefront of my mind, isyou know, I hired a medical
billing company when I startedmy practice, and I thought
hiring a bidding a billingcompany is gonna make my life
easier as a private practicetherapist for the first time.
But they are still dealing withinsurance.
(28:20):
In this case, it's Florida BlueInsurance.
So the first mistake that wasmade was the insurance somehow,
even though the companycredentialed me, I was supposed
to be an in-network provider.
The insurance was showing me asstill being out of network two
months after credentialing.
So there was a delay.
(28:40):
I started seeing clients, Iwasn't getting paid for all
those sessions.
There was a delay with evenfixing that glitch of me showing
as in-network.
So my biller had to hold off onactually submitting claims
until just last month when theglitch was finally fixed.
Then a part two of theinsurance problem came, of
(29:04):
course, which I was kind ofanticipating.
And that's that the insurerssuddenly uh told my biller,
well, we're gonna pay like it'sa rate of maybe $40 less than
they originally had agreed to.
And also they didn't even saythat the rate is gonna be
different based on the billingcode, which it should be.
(29:27):
For example, a 90791, which isthe intake assessment code, is
usually billed at a higher ratethan a follow-up.
So I don't know how this ishappening or why, but the
billers trying to reach theinsurance to resolve the
problem, still hasn't.
It's been over a month now.
(29:48):
I still haven't been paid.
So the insurance takes theirsweet time with actually sending
me a check for I don't knowwhat amount.
So it's just the Crazysituation.
In the meantime, I'm stillseeing the clients because, for
you know, clinical purposes, Ican't just tell a client, oh,
(30:08):
well, I can't see you for thenext month and a half or two
months or however it's long it'sgoing to take for these issues
to get resolved.
Dr Andrew Greenland (30:18):
I understand.
Um if you had to go back to dayone of building your practice,
what would you do differently,if anything?
Marina Livis (30:27):
I might just be a cash pay therapist, but then I
wouldn't be able to work withsome of the clients who you know
really would love to work withme, but can't if it requires not
using their insurance.
So that was one of the reasons.
You know, I had some clientsfollow me from my agency job,
(30:48):
and I wanted to have a practicewhere it combines um, you know,
insurance uh offering um tobuild certain commercial
insurance plans and cash pay forthose that are able.
And that was my intention.
But had I known that it wouldbe this complicated, I probably
(31:10):
just wouldn't deal withinsurance.
And and I have my own therapistwho is just cash pay, so I I
totally understand now why shechose to go that route.
Dr Andrew Greenland (31:22):
I hear you.
And I said this is a verycommon theme with um all of the
North American clinics that I'vespoken to.
Insurance is the big stumblingblock for most of them.
Think about um the next six totwelve months.
Where would you like yourpractice to be?
And is there anything that'sstanding in the way?
Marina Livis (31:38):
So one of the big things I would like to see is
um, you know, I I want tocollaborate with a functional
medicine doctor uh so that youknow, when clients are open, I
can say, well, I have thisdoctor that I already know that
I collaborate with.
So, you know, letting them knowthat if they choose to take
(32:03):
that referral, that they couldwork with that doctor, and we
can collaborate on their carefrom this more functional
medicine perspective.
Um, I've been trying to get allmy um psychiatric nurse friends
to do training through IFM orsome other functional medicine
training.
Um, they're very slow to takeme up on that.
(32:27):
But yeah, I was just trying tofigure out a way to make it so
that someone um I already knowor maybe someone I connect with
in the near future would bewilling to have this kind of
referral partnership with me andcollaboration because I think
it would make uh continuation ofcare and you know uh the
(32:51):
holistic model much easier towork with.
Dr Andrew Greenland (32:57):
Cool.
And um, I I guess you want togrow and expand your practice.
I suppose most people do.
I mean, what what what wouldhappen though if you had a
sudden influx of new patientsnext week?
What would be the first thingto break?
Marina Livis (33:09):
That would be kind of a challenge.
Uh the thing is that I I knowthat a lot of private practice
therapists often think aboutcreating a group practice and
hiring other clinicians, but umI don't think that's really my
goal.
And for me, it's more importantthat I work with clients who
(33:30):
are aligned with me, and thatevery single client I work with
is aligned with me because it'sa win-win in this case.
I understand very well how hardit is to find a therapist
that's really aligned with youin terms of your values, your
perspective, um, what you'veyour lived experience.
(33:51):
Um, and so I would rather havea small caseload of aligned
clients, a combination of cashpay and insurance rather than a
large caseload of clients thatmay be better off with another
therapist.
And I'm very upfront about thatduring home consultations.
Dr Andrew Greenland (34:13):
Marina, thank you so much for your time
and appearing on the show thisafternoon.
I think your story, yourcourage, and commitment to this
kind of deeply integrated careis all very meaningful.
And I think people listeningwill walk away not only feeling
informed but also inspired.
So thank you so much for yourtime this afternoon.
Marina Livis (34:30):
And thank you for taking the time to explain
functional medicine to thoselistening, and that's helped
hopefully for those of you whoare listening who don't have uh
an understanding of howfunctional medicine differs from
conventional medicine.
Um, hopefully, it's helped youto understand where I'm coming
(34:52):
from.
Welcome to Voices in Health and Wellness,
the podcast where we explorewhole person healing, emerging
care models, and the inspiringvoices changing how we think
about health.
Today's guest is Marina Levist,a licensed clinical social
worker, holisticpsychotherapist, and certified
hypnotherapist whose work sitsbeautifully at the intersection
of mental health and functionalmedicine.
Marina brings her personalhealth journey, marked by
(00:23):
mercury toxicity and late autismdiagnosis, into her mission of
helping others reclaim healthwithout over reliance on
psychiatric medications.
She's a powerful advocate forintegrative care, ethical
collaboration with healthcareproviders, and expanding support
for autistic adults navigatinga system not built for their
needs.
So, Marina, thank you so muchfor your time and coming on the
(00:43):
show this afternoon.
Marina Livis (00:45):
I'm really impressed by your summary.
I couldn't have said it bettermyself.
Dr Andrew Greenland (00:50):
As long as it's accurate, that's the most
important thing.
I hope you have accurate byhim.
Marina Livis (00:55):
Very well worded.
Dr Andrew Greenland (00:56):
Wonderful.
So maybe we could start at thetop and perhaps talk about a
little bit about your journey,is what's led you into doing the
work that you do.
Marina Livis (01:05):
Well, it's interesting.
Um I was first in graduateschool at Northwestern
University and was in a master'sprogram there for speech
language pathology.
And it was around that timethat I started uh suspecting
that I might be on the autismspectrum.
I became obsessed with TempleGrandin and her books.
(01:27):
And I also around that timestarted really getting curious
about holistic health andholistic nutrition, and found
myself instead of reading thebooks that are communication
disorders based, which of courseI was required to read, I was
finding myself more drawn tobooks on nutrition and
(01:51):
alternative medicine and TempleGrandin, of course.
So those became my specialinterests, which, as anyone who
knows even a little bit aboutautism, special interest is one
of the traits.
And it was then that I wentthrough an interesting
(02:12):
experience where I realized thatthis was not the path for me,
even though I got into one ofthe best programs in the
country.
And ironically, I was in voicedisorders class on the same week
that I got a case of laryngitiswhere I literally could not
(02:34):
speak, had no voice.
And at the time I was alreadyinto the practice of meditation
and I was practicing Buddhism aswell, and I found myself really
going inward and reflecting onwhat I should do with my career,
what is this illness that I hadreally telling me?
(02:57):
And the inner voice that I themessage I received from my inner
voice was clearly that I meantto be a therapist, just not a
speech therapist.
And I meant to be more of amental health-focused therapist
because at the time I wasstruggling with my own mental
health.
(03:17):
I was dealing with depression,which now looking back might
have been heavy metal toxicity,but none of the doctors I was
going to that were veryreputable doctors really tested
or checked anything beyond thesurface.
So all I knew was that I hadthis so-called chemical
(03:39):
imbalance.
But I I knew at that time Istarted to suspect there's more
beneath the surface that I'mjust not aware of.
So that's kind of how itstarted for me.
Dr Andrew Greenlan (03:51):
Interesting, fascinating.
And you mentioned mercurytoxicity and your autism
diagnosis were big turningpoints.
I mean, how did those shape notjust your health but your
identity and the work that youdo?
Marina Livis (04:03):
Well, for me, when I found out after that was
years later when I found myselfworking for the early
intervention program in New Yorkand really having suddenly a
tough time remembering things,uh, having a tough time even
showing up for work, feelingvery scattered.
Uh, it almost felt like a caseof dementia, ADD, and depression
(04:28):
in one.
The psychiatrist I was workingwith at the time just wasn't
helpful, just kept putting me ondifferent antidepressants,
SSRIs.
And I knew I had to findanother way.
And because I was working withfamilies through the early
intervention program as aservice coordinator, helping
(04:49):
them get connected to services,and at the same time, I
completed school for integrativenutrition as a health coach.
I was already interested inlearning about how you know the
interface between integrativemedicine and autism.
I was interested in it morefrom the point of view of how
(05:11):
can I help these families, howcan I give them additional tools
beyond what they were gettingthat was covered by insurance.
And then there was this doctor,Dr.
Levinson, who happened to cometo New York City and was doing a
lecture and how he's actuallyable to reverse autism through
(05:31):
functional medicine ororthomolecular medicine.
And I remember thinking tomyself, well, if he can reverse
autism, he could certainlyreverse my depression.
And uh I found myself on thenext flight to Miami to see him,
and all I had was maybe twoweeks before I had to be back at
work, and uh he just it feltlike a miracle.
(05:54):
He right away identified theroot cause, which in my case was
mercury toxicity, and acombination of that and a common
SNP, a genetic mutation calledMTHFR, that makes it difficult
for the liver to detoxify.
And so that perfect stormcreated what he called organic
(06:16):
depression.
And um, within a week of seeinghim, I was back at my job
functioning better than I had inyears.
It was just incredible, it wasreally like a miracle at the
time.
And so a year later, I decidedto go back to school for social
work.
Um, and while I was in school,I ended up writing an academic
(06:39):
paper about how depression isnot a chemical imbalance in the
brain, it's a body imbalancethat affects the brain, and
that's essentially thefunctional psychiatry framework
that I now understand that wasnot popular at the time.
So my professor was not happywith the topic of my paper, but
(07:02):
he had no choice but to give mean A.
Because I did my research, andof course, none of it was coming
from my field.
Um, but I was very proud ofmyself for doing that because
the paper really reflected notjust the research that was out
there, but my lived experience.
You can't argue with that.
Dr Andrew Greenland (07:25):
Totally.
So tell us a bit um on thatsubject, tell us a little bit
more about your practice and thetypical patients that that come
to you.
What are they coming to youwith and what's what's your kind
of approach with them?
Marina Livis (07:37):
So I just started my virtual private practice this
year, and I decided to focus iton working with other late
diagnosed or late identifyingautistic adults, mainly because
at the time that I was latediagnosed, which was back in
2019, I faced a lot ofdiscrimination.
Um I really didn't have a lotof supports.
(08:01):
I didn't even realize thatthere were other autistic
therapists.
Um, so it was quite a journeyfor me finding out more about
how prevalent it actually is andthe supports that are out
there.
So I really wanted to give whatwe call in the field a
(08:22):
corrective emotional experienceto my clients who in this day
and age I think uh it's become akind of trendy to look for a
neurodivergent uh therapist,neurodivergent meaning someone
who whose brain doesn't functionin the same way as a
(08:43):
neurotypical brain.
Um and so I decided that'sgonna be my focus.
However, my focus is alsomaking sure to tell every single
client I work with that I donot support the practice of
conventional psychiatry.
Not to say that I'm againstthem taking Adderall or whatever
(09:08):
it is that they choose to take,but it's just not the framework
in which I view theircondition.
And so uh I encourage all myclients, if possible, to see a
functional medicine doctor andfor me to collaborate with that
professional.
And I'm finding that those thatactually follow that advice do
(09:33):
much better than those that donot.
And I understand, especiallyhere in the US, um, it's a an
issue of what will insurancecover and what will insurance
not cover.
And unfortunately, functionalmedicine is not covered by
insurance because, as we allknow, insurance is not in the
business of health, it's in thebusiness of maintaining illness.
(09:57):
It's a sick care system, not ahealth care system.
And so being in the system, buttrying to work outside of it
has been quite a challenge.
Dr Andrew Greenland (10:09):
And I was gonna ask you on that note,
what's your process for helpingpeople to improve the quality of
life without jumping straightto psychiatric medication?
Marina Livis (10:17):
So I uh I do EMDR therapy, which is trauma
focused.
Uh, they don't have to havePTSD to benefit from EMDR, but
if they do, that's certainly agreat modality.
I also use hypnotherapy toaddress any kind of mental and
physical ailments if they'reopen to it.
(10:37):
I introduce them to differentmindfulness practices, including
EFT tapping.
EFT is emotional freedomtechnique, and also different
forms of meditation.
I encourage them to I educatethem about healthy nutrition and
I encourage them to move awayfrom ultra-processed foods if
(11:01):
they haven't already, toconsider going on a sugar
elimination diet, to consideryou know, various diet and
lifestyle changes.
And I'm not saying this fromthe perspective of a health
coach, which I was before.
I'm not like giving them,telling them this is what you
should eat, this is what youshould not eat.
(11:22):
It's more in the form ofpsychoeducation, like FYI, your
symptoms might improve if youtry XYZ.
So I I kind of uh help them betheir own advocate.
Dr Andrew Greenland (11:38):
And in working with um autistic
patients, what do you see arethe biggest gaps in care for
them right now if they're goingelsewhere?
And is you're saying that fromsomebody who understands this
condition better than anybody,if you suffer it with yourself,
you have a better understanding.
But what gaps do you see in thecare for for these patients?
Marina Livis (11:57):
The gaps I see is that a lot of individuals that
are autistic or that haveautism, however you want to put
it, um have a multitude ofunderlying medical imbalance
like conditions and bodyimbalances.
And those body imbalancesactually create the symptoms
(12:22):
that we call anxiety,depression, inattention, etc.
Um so I think the biggest gapis that if they're not seeing a
functional psychiatrist, umthey're constantly kind of in
this hamster wheel of, oh, let'stry this medication, let's try
(12:43):
that medication.
And most of them don't even getgenetic testing to see which
medications are appropriate forthem, much less genetic testing
to see if they have the MTHFRmutation, which is very common
among autistic individuals.
Um and so they express to mehow frustrated they are with
(13:04):
being part of the system.
A lot of them don't want totake all these medications, but
they're also suffering and theydon't know what else to do.
And so it's a very toughsituation where you know there's
layers of issues, but they'renot being properly addressed by
the medical system.
Dr Andrew Greenland (13:26):
I understand.
And in terms of the challengesin doing the work that you do,
because I guess you're fairlyunique combining you know
psychotherapeutic tools with afunctional medicine approach,
what's the challenge for you asdoing this kind of work?
Marina Livis (13:40):
Well, the challenge for me is just
knowing, almost like just frommy own lived experience, knowing
and suspecting that there mightbe some uh micronutrient
deficiency, or there might besome parasite uh that you know
maybe they would benefit from aparasite detox, or uh suspecting
(14:01):
that well they might haveceliac or gluten sensitivity,
but uh they haven't been testedfor it.
Um, you know, all of thesedifferent things, but then not
being able to, like not being amedical provider, not being able
to write the script for them toget those things done.
And sometimes even when Iencourage them to speak with
(14:24):
their conventional doctor aboutit, getting resistance, you
know, being told, well, that'snot necessary, or there's no
proof that this is an issue.
Dr Andrew Greenland (14:38):
So is it something you would like more
therapists or family doctors tounderstand about what your
approach can really offer if youhad to kind of put down a few
things that you would like themto really know that would help
them to help their patients?
What kind of things would youwant them to know?
Marina Livis (14:53):
First of all, I would like them to know that
genetic testing should be anabsolute mandatory part of their
practice.
And I don't mean just testingto see which medications are
appropriate for the patient, buttesting to see if there's any
SNPs, you know, singlenucleotide polymorphism similar
(15:14):
to MTHFR that are very commonthat might be a driving force to
you know a lot of the symptoms.
And also for them to do moredetailed testing, not just the
surface level blood work, andand in the case of heavy metals,
(15:36):
for example, it's it's notenough just to do a blood test
to check for heavy metals, asyou probably know yourself.
And so uh I would honestly makeit mandatory for all doctors to
go to IFM and to studyfunctional medicine as part of
their training, not as a youknow, post-medical school thing,
(16:00):
but it should be an absolutelyintegral part of uh medical
education.
Dr Andrew Greenland (16:07):
So I don't disagree with you there.
So I'm just for background forlisteners, I'm a functional
medicine doctor, and functionalmedicine is really taking a
holistic approach to people andtheir complex chronic illnesses,
looking at the whole dietaryand lifestyle piece, but looking
at them functionally, theirbiochemistry, their genetics,
their gut microbiome, all thestuff that never really gets
looked at in conventionalmedical world.
(16:28):
And we put all these piecestogether in our jigsaw puzzle
and really can come up with aholistic approach that actually
helps the patient treat theirproblems at the root cause and
gets them well.
That's essentially whatfunctional medicine is.
And it sounds like you're a bigadvocate for that with your
work, but you also have theadditional ability to layer in
helping thempsychotherapeutically as well.
So I think that's an amazingcombination.
(16:49):
I don't think I've met anybodythat does what you do.
Marina Livis (16:51):
Yeah, thank you.
Dr Andrew Greenland (16:54):
So, what are the challenges that you face
right now?
So you're doing this work,you've kind of found your niche,
you've found the thing that youlike to do, you're using the
tools that you like to use, butwhat are the challenges in doing
what you do right now?
Marina Livis (17:08):
Well, there's uh you know, the challenge I
already talked about, and thenthere's also the challenge of
insurance.
I don't know if you know aboutthe US insurance system, but we
don't have national health care,unfortunately.
Dr Andrew Greenland (17:22):
And I know it very well, only from the
point of view that I've had lotsof conversations with people in
North America, and the onething that they all talk about
is insurance.
But very interesting to hearwhat your take on it is because
everybody's got a slightlydifferent nuanced approach on
how they view the insurancething.
Marina Livis (17:37):
So some of the practical challenges that have
come up is there were some newautistic clients I started
working with, um, and we weredoing, you know, they they
became more aware of uh, youknow, what the symptoms, what
diagnoses uh their symptoms uhwere reflecting, and how their
(17:59):
childhood experiences createdthe PTSD, for example, that they
now you know had symptoms fortoday, but then I had to almost
abruptly stop treatment becausesuddenly insurance uh decided to
uh for whatever reason make menot part of the network, and I
(18:24):
don't understand that.
Um and you know, in thosespecific cases, the the clients
who are unable to pay cash tocontinue therapy, so it's really
unfortunate.
Um, you know, there's all kindsof insurance problems that
happen.
Maybe there's issues withaccurate insurance eligibility
(18:46):
verification in the first place,because how do you explain that
they have the same insuranceand uh they've been paying for
the treatment for months andmonths, and then all of a sudden
they say, Oh, you're not anetwork, we can't pay for this
anymore.
Um, so the cost of gettingtherapy outside of insurance is
(19:08):
prohibitive to most people, andthat's a big barrier.
And then the fact thatinsurance puts up so many
barriers, like, oh, you have tomeet your deductible first
before we pay anything, or youhave this co-pay, which may be
too high for someone to pay.
Um it's just they create moreobstacles for uh proper care.
Dr Andrew Greenland (19:34):
So insurance is a big thing.
Is there anything else that isa challenge or a bottleneck in
the work that you do or thebusiness that you run?
Marina Livis (19:42):
Yeah, um I think a lot of people question
hypnotherapy.
So hypnotherapy is just aspowerful as AMDR for the
treatment of anything likeanxiety, depression, PTSD, all
kinds of things.
Um, but I'm finding that a lotof my clients who are all
(20:05):
insurance-based, most of them,with the exception of maybe two,
are afraid of tryinghypnotherapy.
And there's something, maybeit's because they've seen stage
hypnosis and it was kind offreaked them out.
Or maybe it's just that our inour society and our culture,
hypnosis is frowned upon uh forvarious reasons.
(20:28):
There's all kinds of um, youknow, really inaccurate notions
about what hypnotherapy is.
So that's another challenge, isyou know, I do a lot of
psychoeducation about the powerof the subconscious mind and
hypnotherapy, and how much moreum effective and powerful it is
(20:53):
to work on the level of thesubconscious as opposed to
talking like you and I are doingat the level of the analytical
conscious mind.
And you know, it makes sense tomy clients, but to most of
them, it's also just scary to gointo that experience.
Dr Andrew Greenland (21:11):
I completely resonate that.
So I have trained inhypnotherapy in the past, I
don't practice anymore, butyou're right, it's one of the
biggest things.
You spend half the consultationexplaining what hypnotherapy
isn't because of themisconceptions that people have
or pre preconceived ideas thatpeople have from what they've
seen on the media.
And you have to kind of get ridof all of that before you can
do the work.
So I totally understand thatone.
(21:32):
Um, are people are the patientsthat come to see you um
requesting hypnotherapy, or areyou suggesting it as something
that will be helpful to them andthen you have to do this
overcoming of their ideas?
Marina Livis (21:44):
Most of them are they're more likely to request
EMDR because they've heard aboutit than to request
hypnotherapy.
So so far, my private practiceclients, none of them have
requested hypnotherapy up front.
They've requested EMDR if ifany kind of modality that was at
(22:05):
the forefront.
But I, like you said, have to,you know, even after starting
EMDR, for example, the way Iexplain why hypnotherapy might
be a good addition along withEMDR is if they have trouble
recalling certain memory targetsfrom those early childhood
(22:27):
years.
I find that hypnotherapy canhelp them with that.
And so I actually just guidedone autistic client who was just
uh recently late diagnosed, anduh he was amazed, and I was I'm
always um just in awe when Isee you know the transformation
(22:50):
after a hypnotherapy session.
So it just so happened I ledhim in two hours of hypnotherapy
yesterday over a virtual uhHIPAA compliant platform, and um
you know it it was just amazingto see how much came out.
A lot of emotions came out thatthat were suppressed, um, and a
(23:14):
lot of uh awareness of certainchildhood memories that we can
now target through EMDR, not tosay that we didn't work on them
and process them through thehypnotherapy session, but we can
do even more with thosememories through EMDR, and we
kind of stirred it up for him.
So I am quite confident thatyou know his subconscious mind
(23:38):
will give him some more clues asto what are some other memory
targets we can address, even ifwe don't do any more
hypnotherapy sessions.
So I find that for especiallyfor people that maybe had trauma
in childhood and have uhamnesia, like for example, I
(23:59):
can't remember most of uh whathappened before immigration to
the US from Eastern Europe.
So a lot of my childhoodmemories are also kind of
blurry, and I found thathypnotherapy has really helped
me access even early memories ofmy birth, which was I had a
traumatic birth experience.
(24:20):
So I know this from again myown lived experience, which is
one of the reasons I becametrained in hypnosis.
Um and you know, I find that atleast for the clients that are
able to go into trans states,which not everyone can, um, the
combination of EMDR andhypnotherapy can be a great way
(24:44):
to access those memories.
Dr Andrew Greenlan (24:48):
Fascinating.
So um you mentioned that yousort of treat autistic patients
and autistic patients come tosee you because you have an
understanding, because you'vehad the condition yourself.
How does that work from amarketing perspective?
How do you sort of market whatyou do?
Um, or does it just peoplegravitate to you through other
means?
I'm just very curious to knowhow this works.
Marina Livis (25:09):
So I created a psychology today profile where I
don't openly state that I'mautistic, but I ask questions at
the beginning of the profilelike can you relate to this, can
you relate to that?
Um, you know, do you feel likeuh you aren't understood or are
misunderstood?
(25:30):
And and to kind of help them uhas they read the profile, help
them connect with me andrealize, oh, this is someone who
gets it.
And then hopefully they thenvisit my website where in the
about me section I talk about mystory and I share openly about
how it came about that I waslate diagnosed, and then I have
(25:53):
a whole page on autism and uh apage on the different, you know,
for each modality.
I have a page where I kind ofexplain not just why the
modality is powerful, but whyit's powerful for someone who's
autistic.
So visiting my website isdefinitely helpful.
Dr Andrew Greenland (26:18):
I guess you must be flooded because I mean
you must be one of the very fewpeople.
Uh not only do you have a sortof understanding of
psychotherapy and psychotherapytools, functional medicine, but
an understanding of thecondition itself from lived
experience.
So I'm I'm guessing you must beflooded with demand.
Marina Livis (26:36):
Well, I can't say I'm at the point of being
flooded yet.
Uh they're slowly trickling inwhere you know maybe I'll get uh
two or three new referrals uhthrough my website and possibly
through psychology today.
I think the algorithm withpsychology today is working
against me.
(26:56):
They've I think from what I'vegathered, uh they don't
prioritize virtual therapists.
Um so I've had to play aroundwith it, like changing the
wording, changing putting that Ihave an office location, which
then confuses people when theycall.
So that's the other issue isum, you know, if they want an
(27:17):
in-person therapist, that's notsomething that I offer.
Um, I do virtual only.
One thing I started thinkingabout is uh potentially doing a
home visit, like one or twotimes, not each session, but you
know, that can really make adifference for some clients.
And so I I'm consideringoffering that as well.
Dr Andrew Greenland (27:42):
If you um could wave a magic wand and fix
one thing about your practice,what would it be?
If you went it was a bottleneckor a challenge, what would it
be?
Marina Livis (27:53):
It would be insurance.
Dr Andrew Greenland (27:55):
So I knew you were gonna say that.
Marina Livis (27:59):
So the reason the reason I say that, and it's been
at the forefront of my mind, isyou know, I hired a medical
billing company when I startedmy practice, and I thought
hiring a bidding a billingcompany is gonna make my life
easier as a private practicetherapist for the first time.
But they are still dealing withinsurance.
(28:20):
In this case, it's Florida BlueInsurance.
So the first mistake that wasmade was the insurance somehow,
even though the companycredentialed me, I was supposed
to be an in-network provider.
The insurance was showing me asstill being out of network two
months after credentialing.
So there was a delay.
(28:40):
I started seeing clients, Iwasn't getting paid for all
those sessions.
There was a delay with evenfixing that glitch of me showing
as in-network.
So my biller had to hold off onactually submitting claims
until just last month when theglitch was finally fixed.
Then a part two of theinsurance problem came, of
(29:04):
course, which I was kind ofanticipating.
And that's that the insurerssuddenly uh told my biller,
well, we're gonna pay like it'sa rate of maybe $40 less than
they originally had agreed to.
And also they didn't even saythat the rate is gonna be
different based on the billingcode, which it should be.
(29:27):
For example, a 90791, which isthe intake assessment code, is
usually billed at a higher ratethan a follow-up.
So I don't know how this ishappening or why, but the
billers trying to reach theinsurance to resolve the
problem, still hasn't.
It's been over a month now.
(29:48):
I still haven't been paid.
So the insurance takes theirsweet time with actually sending
me a check for I don't knowwhat amount.
So it's just the Crazysituation.
In the meantime, I'm stillseeing the clients because, for
you know, clinical purposes, Ican't just tell a client, oh,
(30:08):
well, I can't see you for thenext month and a half or two
months or however it's long it'sgoing to take for these issues
to get resolved.
Dr Andrew Greenland (30:18):
I understand.
Um if you had to go back to dayone of building your practice,
what would you do differently,if anything?
Marina Livis (30:27):
I might just be a cash pay therapist, but then I
wouldn't be able to work withsome of the clients who you know
really would love to work withme, but can't if it requires not
using their insurance.
So that was one of the reasons.
You know, I had some clientsfollow me from my agency job,
(30:48):
and I wanted to have a practicewhere it combines um, you know,
insurance uh offering um tobuild certain commercial
insurance plans and cash pay forthose that are able.
And that was my intention.
But had I known that it wouldbe this complicated, I probably
(31:10):
just wouldn't deal withinsurance.
And and I have my own therapistwho is just cash pay, so I I
totally understand now why shechose to go that route.
Dr Andrew Greenland (31:22):
I hear you.
And I said this is a verycommon theme with um all of the
North American clinics that I'vespoken to.
Insurance is the big stumblingblock for most of them.
Think about um the next six totwelve months.
Where would you like yourpractice to be?
And is there anything that'sstanding in the way?
Marina Livis (31:38):
So one of the big things I would like to see is
um, you know, I I want tocollaborate with a functional
medicine doctor uh so that youknow, when clients are open, I
can say, well, I have thisdoctor that I already know that
I collaborate with.
So, you know, letting them knowthat if they choose to take
(32:03):
that referral, that they couldwork with that doctor, and we
can collaborate on their carefrom this more functional
medicine perspective.
Um, I've been trying to get allmy um psychiatric nurse friends
to do training through IFM orsome other functional medicine
training.
Um, they're very slow to takeme up on that.
(32:27):
But yeah, I was just trying tofigure out a way to make it so
that someone um I already knowor maybe someone I connect with
in the near future would bewilling to have this kind of
referral partnership with me andcollaboration because I think
it would make uh continuation ofcare and you know uh the
(32:51):
holistic model much easier towork with.
Dr Andrew Greenland (32:57):
Cool.
And um, I I guess you want togrow and expand your practice.
I suppose most people do.
I mean, what what what wouldhappen though if you had a
sudden influx of new patientsnext week?
What would be the first thingto break?
Marina Livis (33:09):
That would be kind of a challenge.
Uh the thing is that I I knowthat a lot of private practice
therapists often think aboutcreating a group practice and
hiring other clinicians, but umI don't think that's really my
goal.
And for me, it's more importantthat I work with clients who
(33:30):
are aligned with me, and thatevery single client I work with
is aligned with me because it'sa win-win in this case.
I understand very well how hardit is to find a therapist
that's really aligned with youin terms of your values, your
perspective, um, what you'veyour lived experience.
(33:51):
Um, and so I would rather havea small caseload of aligned
clients, a combination of cashpay and insurance rather than a
large caseload of clients thatmay be better off with another
therapist.
And I'm very upfront about thatduring home consultations.
Dr Andrew Greenland (34:13):
Marina, thank you so much for your time
and appearing on the show thisafternoon.
I think your story, yourcourage, and commitment to this
kind of deeply integrated careis all very meaningful.
And I think people listeningwill walk away not only feeling
informed but also inspired.
So thank you so much for yourtime this afternoon.
Marina Livis (34:30):
And thank you for taking the time to explain
functional medicine to thoselistening, and that's helped
hopefully for those of you whoare listening who don't have uh
an understanding of howfunctional medicine differs from
conventional medicine.
Um, hopefully, it's helped youto understand where I'm coming
(34:52):
from.
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