[stopdog]

I think that if someone claims to be so sensitive that they cannot discuss a topic without sobbing - then that is being used as a control to stop the other person from saying what they want to say - the super sensitive person is controlling there. So maybe being super sensitive is not always controlling, but I believe acting overly sensitive can be and is a lot of the time. It shuts the conversation down.

[Yellowbuggy]

Hi LT:

You remind me a lot of myself. I know I've mentioned that before, but I say that because I want you to know that the advice I'm giving you is advice I give myself.

I love your T. I think he's perfect for you, and I believe some of what people consider 'cold' about him may be intentional on his part based on his assessment of your needs. I know there is some disagreement about this on the forum, but I feel strongly that he is offering what you need. I am highly sensitive, as you are. My T doesn't give in to my requests for reassurance or endless discussions about attachment. He spends a lot of time trying to lift me OUT of that space so I don't get lost in it, which I am prone to doing. I feel that this is what your T is doing... for perhaps the same reason.

I want to comment on something you said regarding the conversation about the affair. You said you felt as though your T was "taking your husband's side" when he said he believes your husband should be able to bring up the affair, despite how it makes you feel. You acknowledge that you realized he was only trying to help you, but I want you to consider this - perhaps it's ok that he 'takes your husband's side.' It doesn't mean that he doesn't like you / thinks poorly of you / doesn't want to work with you anymore, etc... it just means he feels differently than you do, and that's ok. I get upset when my T doesn't "take my side," but I have learned over time that it is my ego getting in the way.

As a thought experiment, imagine if the roles were reversed - your H had the affair, and you wanted to bring it up but your H became too emotional and couldn't tolerate your emotions around it. Would you feel differently about it then?

No need to respond I just wanted you to reflect on it. The only person you need to be honest about it with is yourself.

[LonesomeTonight]

Thanks, YB, I appreciate your comments. I agree that T is offering me what I need. He's asked before about if I think I need a more warm, fuzzy T instead. I said how that might be what I *want* at times, but not what I think I ultimately *need.* I fear that I'd just get stuck with getting the warm, fuzziness from such a T, as I felt I did at one point with ex-MC. My T is trying to push and challenge me and help me to figure out how to give myself what I need. It's not always going to feel good or be easy. And yeah, sometimes he's definitely right on the line of pushing/challenging me and kind of being a ****. But...I also find I'm now at a place where I can call him out on that, if he says something that offends or upsets me, which I think is quite a bit of progress for me (and he'd agree with that). It feels like this relationship where we can both be really honest with each other, which is very different in some ways from how things were with ex-MC (where he just seemed to accept everything I did and said, right until the very end). It's also the sort of relationship I'm not used to.

And you make a really good point about role reversal with the affair...

[LonesomeTonight]

T Thursday. Went back and sat down. I pulled out a list. T looked pointedly at it, and I said just a few things to discuss. He asked where I wanted to start.

I said I wanted to share something that I thought was progress. That he'd said something the previous session that normally would have upset me, and it did for a second, but then I realized he was just trying to help me. T said that sounded encouraging. Me: "I guess you probably want to know what it is." T: "Yes." So I told him about how he'd said that it was like H wasn't allowed to talk about my cheating. That at first, there was this thought of "Hey, you're supposed to be on my side!" Then I realized it wasn't about sides, that he was trying to help me. Me: "And if you're just going to be a..." T: "Yes man?" Me: "Exactly. If you were going to be a 'yes man' to me, that wouldn't be helpful." T: "Well, it would likely feel good in the moment if I just agreed with everything you said. But it wouldn't lead to change." Me: "Yeah. So I think my realizing that is progress." T smiled and said he agreed.

We talked briefly about my cheating and how I react so strongly whenever it comes up (for example, I was crying right then). I said I suspected that I still felt guilt over it, and T agreed. He said it's something that I have to work through, that if I don't, the guilt would continue to be there. How I need to work on forgiving myself. Me: "I do think it's definitely something I need to work on, but I don't want to do that today." T: "Yes, I have the sense you wanted to talk about other things." Me: "yeah."

I said one thing was tied to my emailing him Sunday when I felt really awful. That I'd considered trying to reach out to him another way, like texting and requesting a call. Me: "But I was afraid because of the conversation we'd just had that you'd think I was testing you." T: "I probably would have thought you were testing me." Me: "Oh." I wasn't sure what else to say to that.

Me: "I think something else is...I worry that you might not take me seriously enough when I'm feeling bad, like if I'd contacted you then.

Possible trigger:

Me: "I get this sense that you think, even if I mentioned SUI, you'd be like 'Oh, LT would never really do anything. She'll be fine.'" T: "Well, I was worried about you Sunday night until I saw the other email saying you'd be safe." Me: "Oh...OK." (It kind of made me feel good to know he was worried, but I didn't want to tell him that."
Me: "I also think of how you might compare me to other clients, like how you say my SH isn't dangerous, while other clients' might be." T: "Well, yours isn't generally dangerous. You've told me that yourself." Me: "True...

Me: "I guess I just think of you maybe comparing me to higher-risk clients, where you'd take them more seriously." T: "At this point, if I get the sense in the intake that a client is particularly high-risk, I'm actually likely to refer them out." Me: "Oh. OK." T: "I don't know if you've ever had a job where you're on call, but that's basically what this job is like all the time. There were times when I'd be done with my workday and kind of expecting to get a call from a particular client. I found that I really disliked that feeling." Me: "I could understand that." T: "So I tend not to take on higher-risk clients." I said how I know that ex-MC does tend to take on high-risk teens. And how he'd always look at his phone in sessions when he got a text, saying, "I just have to check the number." How that bothered me because it made me feel like the other client was more important at that moment than the one who was sitting in front of him. And the one time he took a call from a client in our session. T: "I remember you telling me that." Me: "So I guess it felt like the clients who were higher risk were bigger priorities for him. So maybe I was afraid of that here, too, I don't know. But then in saying that, I worry you'll think that I'm exaggerating how I'm feeling just to get attention. But I wouldn't do that." T: "I know you wouldn't." Me: "OK, good."

I forget where this part came up, but it was before his "two questions" at the end, so I'll put it here. Me: "I know this is really stupid but...OK, I'm judging myself there." T: "Yes you are." Me: "I think it's progress that I'm catching myself when I do it though." T: "I agree, you're aware of it." Me: "I guess ideally I'd catch myself before even saying it." T: "Yes."

Me: "So this is...uh, maybe a month ago, I mentioned how I liked you saying 'take care' at the end of sessions. Even though I know it's stupid that...OK, not stupid, but it feels that way that it matters to me because, I mean, a random cashier will say it to me. And it doesn't really mean anything about what you're feeling toward me right then." T: "It must be difficult to live like that." Me: "What do you mean?" T: "To be reading so much meaning into what everyone says and does." Me: "Yeah...but what I was going to say is that for the first couple sessions after that talk, you'd say 'Take care' as I was leaving, but then you stopped." T: "I forgot, I'm sorry." Me: "It's OK, but it would be as I was leaving, I'd look back at you, hoping you'd say it, and it would be like you'd already turned back to your computer, like you'd already put me out of your mind and just...ugh, this seems so ridiculous...why it matters to me." I forget his response to that, but it seemed understanding (I was sobbing as I said all that, incidentally).

I said another thing I wanted to bring up was still being unclear about whether it's OK to request a phone call when in crisis. Because I wasn't sure after last session. T: "Well, much of it depends on what's going on for me at the time." Me: "Yeah, I guess I just wanted a clearer answer about what's OK." T: "Can I ask you two questions first?" Me: "Uh, OK."

T: "First, when you email me, you often will say something like, 'I just want you to tell me that things will be OK,' like if you've had a bad fight with H. But you know I'm going to say they'll be OK, that you can get through it. So if you know what I'm likely to say, then why do you still ask it?" I started crying again, "I don't know, I'm sorry..." T: "It's not a criticism. I just want to understand why you ask if you know what the answer will be." Me: "I think sometimes I just need to hear it. And part of why I tell you what I'm looking for is that sometimes in the past, you've said it's not clear what I'm looking for when I reach out. So I've tried to be more clear about it, and that seems to have helped."

T: "You still haven't really answered about why you ask when you know what I'll say. Couldn't you just say that in your head?" Me: "I'm just not sure I've internalized it enough yet to do that." T: "I would agree with that." (I didn't say this, but I wanted to be like, "Then why are you asking me???") Me: "It's like...how I used to listen to the voicemail from ex-MC to give me comfort." T: "And I don't understand how that helped, because it was about something from the past, not the current thing going on." Me: "I think it just helped remind me of his caring. And hearing his voice. But I don't have a voicemail from you that I could listen to. I could look back at old emails I guess." T: "But those aren't about what's currently bothering you either." I started crying again. "I don't know, now it feels like I'm bothering you when I email you, like you're thinking, 'Why is LT bothering me about this?'" T: "No, you're not bothering me. I'm just trying to understand what's going on in your head." Me: "Maybe some of it is about the connection, too, wanting to hear something from you in that moment." T: "You think it might be about connection then?" Me: "I don't know, I'm sorry, that's probably weird to you." T: "No, it's not."

Me (attempting to change topic): "What was your other question?" T: "What?" Me: "You said you had two questions." T: "Thanks for reminding me. In terms of whether you can reach out to me in crisis, what exactly do you want to hear from me regarding that? What sort of answer do you want?" Me: "I think just that you trust me to use my judgment regarding when I should reach out, like by text or phone. And...that you won't be angry at me if I reach out. Maybe 'angry' is the wrong word. Annoyed. Well, if you are a bit annoyed, as long as it wasn't just me reaching out to say 'hi,' that you wouldn't tell me that. Like, you wouldn't tell me you were annoyed at my interrupting you while you were watching 'Game of Thrones.' or something" T: "The thing is, any time you would reach out to me, you'd be interrupting something." Me: "Uh...OK. But if you said, 'I can't talk right now,' I'd understand." T: "But doing my job would just mean I'd have to hit 'pause' during 'Game of Thrones' for a bit so that I could talk."

Me: "OK...and I just want to clarify, this isn't like something I'd do all the time. Just if I'm feeling really awful and nothing else seems to be helping. I would try the other stuff first. I've been doing that lately before emailing you, too." T: "I know you have, and that's really good." Me: "It's just sometimes the other stuff doesn't work. And I guess I also worry...I mean, you turn off your phone by 10. I wouldn't contact you at 9:59 to test you." T: "Good!" Me: "But the thing is, maybe I'm feeling pretty bad at 8 p.m. And I'm worried about how I'll feel later that evening, but by then it would be too late to reach out to you. And also by 10, most people I'd contact, other than a crisis line, wouldn't be available either. So I'd maybe want to reach out earlier if I found myself going down a bad path..." T: "Hm, that makes sense." Me: "And the other thing is, if it was, say, a really bad fight with H, and I was at home, it could be awkward to call. Would you ever be willing to text back and forth a bit?" T: "It's not my preference, but I have done it before in certain situations." Me: "OK. I just want to make it clear, I hope to never have to do this. But I just want to know what my options are if I am in that place again. I mean, this would be like an...I don't know, once a year or once every 6 months sort of thing, not regular."

T: "I'm honestly surprised you haven't reached out to me before like that." Me: "You mean a phone call?" T: "Yes, or a text." Me: "I was afraid that if I was feeling really awful and reached out and you said I was bothering you, either then or later in session, then I'd feel rejected and likely feel much worse. So I didn't want to risk that." T: "OK. What made you think that would happen?" Me: "Well, the one time, a long time ago, I sent a text including more info about why I wanted an extra session (uncle had passed away plus big fight with H), and you told me it felt intrusive. So, I was trying to follow the rules in texting since then, and I think I've done a good job?" T: "Oh. Yes, you have." Me: "So that's why I want to be totally clear about what's OK for contacting you in a crisis." T: "OK, and you said this is like a once every 6 months sort of thing?" Me: "Ideally, I mean, I don't know how I'll feel of course." T: "Well, if it ended up happening frequently, I wouldn't terminate you or anything, we'd just talk about it." Me: "Well, I hope you realize that I'm worried about pushing too much, so I'd have to be in a really bad place to use this." T: "Yes."

T: "OK, then I feel comfortable saying this to you" (he looked into my eyes when saying this): "I trust you to use your judgment in contacting me in a crisis. I'm not going to get upset with you for reaching out. Does that feel OK?" Me: "Yes, thank you. That's what I needed to hear. I just need to know if it's there as an option." T: "OK." Me: "I know we have to stop." Confirmed schedule for next week.

I grabbed my pile of used tissues and threw it away. As I was walking over to pay, I said, "I think I feel OK about this conversation." T: "Ideally, we'd have spent more time on it." Me: "Yeah, but it feels OK to me." T: "See how you feel later this afternoon." Me: "OK." We shook hands as he said, "Have a good weekend." Me: "You, too." T: "Take care of yourself." Me: "Thanks, you too."

I did continue feeling OK about that, but unfortunately, I found out about an insurance issue later that night that I ended up contacting him about the next day. Will do separate post about that.

[LonesomeTonight]

OK, Insurance thing. My T is out of network, and I pay him his full fee up front, then submit to my insurance for partial reimbursement. Insurance can take a few months to actually send the reimbursement (partially due to assorted clerical errors on their end, but I won't rant about that right now...) Since we got this insurance, they've reimbursed 60% of current T's, as well as ex-MC's and ex-T's fees. Ex-MC charged the same as this T. Apparently, starting this year, they now have a certain limit as to what therapists can charge and will only reimburse 60% of *that*, not their actual fee (H called and confirmed this). I learned this on a statement we got from them Thursday. What that means for me is that I'm now paying an additional $28 out of pocket per session than I was before. Which is pretty significant in general (I think it's around a 40% increase?) and particularly affects me when I'm going twice a week.

T had told me in the past when I was worried about layoffs at H's job (he was spared, thankfully) that he works with clients on fees if their income changes, and once charged a client only $5 a session for a few months when he was in a really bad way financially (he also has a statement on his website that he can work with clients on his fees depending on their financial situation). I emailed T Friday morning (after H talked to insurance company--wanted to make sure it wasn't an error) and explained what was going on, asking if he'd possibly reduce my fee by $25 for a few months so that I could continue going twice a week, then I could transition to once a week at the full fee.

I felt quite nervous about this, particularly what my emotional reaction would be if he said "no," even though it would of course be fully within his rights to do so. In reality, I could have just started going twice a week every other week (like twice one week, once the next, twice the week after...) and made cutbacks in other spending, so it wouldn't have been too drastic of a change. But it was really more what it would feel like to me, I think.

He replied that evening, saying he was willing to reduce the fee as I'd requested, starting with our next meeting. He also said that I shouldn't feel like I have to switch to once a week before I feel mentally or emotionally ready, which implies that he's OK with me having the lower rate for longer than a few months. Which felt really good to me. I mean, it makes sense, I've been seeing him 1.5 years (and am likely not going to be done with therapy anytime soon), I'm a very reliable client (don't no-show), and keeping me at a lower rater is likely better for him than having to drum up new business, even just for the second slot of the week, particularly because many of his clients are shorter-term (due to one particular focus of his business).

However, along with being grateful, I do feel slightly awkward about this and don't know how much to talk about it today. I worry a bit that he'll resent me for paying a lower fee, particularly if I opt to come for twice a week more than a few months. I wonder, if I only see him once a particular week, like if one of us is out of town or sick, do I offer to pay his full fee that time? Should I feel bad if I mention going out to dinner or show up in a new shirt, wondering if he'll be thinking, "She could have used that money to pay me"? But the idea was really more, I don't want all income beyond the basic necessities to have to go to therapy, I still want to be able to go on a date night with H, attend yoga class (which T supports--and they're like a net of $13.50 a class with a particular pass I get), etc. And I think T would understand that. But I don't know if I should bring up those concerns? I mean, for all I know, I'm one of his few clients who was actually paying the full fee, especially as he sees some college students. So maybe this is no big deal at all to him. And I don't want to make it into some big thing. I guess I'll just see how I feel today, express appreciation that he's working with me on fees and maybe not making some big deal unless he does. Or if, say, a month from now I'm feeling awkward about it.

[InkyBooky]

Of course, I don't know you personally, but I enjoy reading your posts and even just from what you've written on this forum I can tell that you are definitely not the type of person to take advantage of someone's help or generosity. I seriously doubt your T would worry about that (from you) either.

Try not to be too hard on yourself for asking for what you need. If your T wasn't comfortable giving you a discount then he probably wouldn't offer it at all. Most Ts have good boundaries around this sort of thing...and they usually aren't afraid to say what they will and will not offer (for example, he will refer out a high-risk client if he doesn't think they are a good fit for his practice). He obviously has no problem with (ethically) declining services or setting his fees as he chooses. So, if he does offer a discount then I would guess he is totally comfortable with it and he trusts you and the financial situation he is agreeing to.

Just my two cents anyway!

[unaluna]

Yeah that "no new shirts" thing can really mess with your head. It did mine.

Me: "Maybe some of it is about the connection, too, wanting to hear something from you in that moment." T: "You think it might be about connection then?" Me: "I don't know, I'm sorry, that's probably weird to you." T: "No, it's not."
Me (attempting to change topic): "What was your other question?" T: "What?"

It looks to me like he was trying to lead the discussion to connection here, that you are looking for connection, and he is trying to bring that to light. Because the question after your previous question is, how would HE know its "going to be alright"?

When you were calling ex-MC, it seemed like it was a regular Friday night thing. Like you were trying to replace the connection that was missing with h, by connecting with ex-mc.

This T is not afraid to approach that question head-on. Ugh, I hate when that happens!! If i dodged things at that point, my t would i swear deliberately make it harder if not impossible for me to get back there. Or maybe i did, by dodging it. The path to hell.

[kaleidoscopeheart]

Originally Posted by LonesomeTonight

However, along with being grateful, I do feel slightly awkward about this and don't know how much to talk about it today. I worry a bit that he'll resent me for paying a lower fee, particularly if I opt to come for twice a week more than a few months. I wonder, if I only see him once a particular week, like if one of us is out of town or sick, do I offer to pay his full fee that time? Should I feel bad if I mention going out to dinner or show up in a new shirt, wondering if he'll be thinking, "She could have used that money to pay me"? But the idea was really more, I don't want all income beyond the basic necessities to have to go to therapy, I still want to be able to go on a date night with H, attend yoga class (which T supports--and they're like a net of $13.50 a class with a particular pass I get), etc. And I think T would understand that. But I don't know if I should bring up those concerns? I mean, for all I know, I'm one of his few clients who was actually paying the full fee, especially as he sees some college students. So maybe this is no big deal at all to him. And I don't want to make it into some big thing. I guess I'll just see how I feel today, express appreciation that he's working with me on fees and maybe not making some big deal unless he does. Or if, say, a month from now I'm feeling awkward about it.

For starters, I have really enjoyed reading your posts and I feel like you and I approach therapy in a very similar way. That being said, I totally think that you should bring it up with him. You seem to be more than willing to bring up the hard and uncomfortable topics with him and this shouldn't be any different. I understand how hard it is to talk about but, if you are like me, not talking about it will just allow that fear and insecurity to fester and that is never a good thing. I have complete faith that you can do it though and that your T will handle it really well.

[Xynesthesia2]

LT, it sounds like you have a tendency for wanting to know exact rules and worrying a lot about not doing everything properly - that can definitely be part of perfectionism, OCD, call it whatever. But also pushing those limits when they are at least somewhat defined Perhaps your T does not make them super straight and clear on purpose? Dunno, it just reminds me of something my last T said once when we were briefly discussing boundaries in therapy. He said that he did not like to set anything in stone, more go with the flow and adjust on the go. He thought that strict boundaries usually have an effect that people want to push and test them, often just for a sense of momentary accomplishment that they are able to affect someone else's boundaries. I personally agree with this, not for everyone as there are indeed people who want to do everything by the book, but many find it rewarding to challenge existing rules and boundaries. I definitely do and this is only one reason why I usually work better with people who are reasonably flexible and adaptable, not just Ts but in general. That also means sometimes we learned the limits by pushing them and I think that is okay if not too aggressive - I would just trust that the T will tell you when something is too much. Your T definitely seems direct enough for that, so I would really just leave it for him with the outside contact stuff, fee, etc. You know, just like when he said he trusts that your own judgments about your needs are reliable. I think when someone reasonable expresses that an act is too much and they want to participate differently, it most often does not mean they are mad or do not care at all - they merely share their side of the construct and negotiate.

[Lemoncake]

Originally Posted by LonesomeTonight

I wonder, if I only see him once a particular week, like if one of us is out of town or sick, do I offer to pay his full fee that time? Should I feel bad if I mention going out to dinner or show up in a new shirt, wondering if he'll be thinking, "She could have used that money to pay me"? But the idea was really more, I don't want all income beyond the basic necessities to have to go to therapy, I still want to be able to go on a date night with H, attend yoga class (which T supports--and they're like a net of $13.50 a class with a particular pass I get), etc. And I think T would understand that. But I don't know if I should bring up those concerns? I mean, for all I know, I'm one of his few clients who was actually paying the full fee, especially as he sees some college students. So maybe this is no big deal at all to him. And I don't want to make it into some big thing. I guess I'll just see how I feel today, express appreciation that he's working with me on fees and maybe not making some big deal unless he does. Or if, say, a month from now I'm feeling awkward about it.

I think you should bring up those concerns with Dr. T. I hope he can reassure you, that he is okay with it, I don't think he would have said it otherwise though.

[Anne2.0]

Originally Posted by LonesomeTonight

What that means for me is that I'm now paying an additional $28 out of pocket per session than I was before. Which is pretty significant in general (I think it's around a 40% increase?) and particularly affects me when I'm going twice a week.
. . .

I emailed T Friday morning (after H talked to insurance company--wanted to make sure it wasn't an error) and explained what was going on, asking if he'd possibly reduce my fee by $25 for a few months so that I could continue going twice a week, then I could transition to once a week at the full fee.

. . .

He replied that evening, saying he was willing to reduce the fee as I'd requested, starting with our next meeting. He also said that I shouldn't feel like I have to switch to once a week before I feel mentally or emotionally ready, which implies that he's OK with me having the lower rate for longer than a few months.

. . .

However, along with being grateful, I do feel slightly awkward about this and don't know how much to talk about it today. I worry a bit that he'll resent me for paying a lower fee, particularly if I opt to come for twice a week more than a few months. I wonder, if I only see him once a particular week, like if one of us is out of town or sick, do I offer to pay his full fee that time?

I'd summarize this interaction like this: 1) you asked a very specific question, a very straightforward one. Would he reduce his fee by $25/session until you stop doing twice/week and land at once/week?

2) He said yes. No qualifications, no exceptions, even going beyond and offering a reduction in your self-identified pressure to do this sooner rather than later. He said he would reduce his fee by $25/session for the foreseeable future until you are ready to go once/week.

I think you should feel good about asking a clear question-- straight up. And you got an even straighter answer that is VERY clear. Yes, he will reduce your fee by $25 per session until you decide to go once/week, then you will pay the increased fee per session.

So is it really helpful for you to spend your time and energy on pursuing endless variations and possibilities and trying to get him to stake out scenarios and expectations of his feelings about them (not exactly helpful in the abstract, as no one, even a therapist, really knows how they will react until the thing is in front of them)? You're not in control of how he reacts or how he will feel and how you do or don't want him to feel can't be determined or dictated by you, or even anticipated. Seems like a really fear-based approach to relationships, one that you spin out in every so often.

From my perspective, I think it might help you to just accept what he said at face value. It is very clear. Your thoughts and wonderings are just mucking up the waters. Move forward. You have your answer; it's very clear. Deal with your current life issues rather than self-created therapy dynamics, which I think will also help you get to a once/week place. Assuming that's what you want. Maybe some of this is your fear of having to cut back therapy at some unspecified point in time? If it is, it seems your T has reassured you that you won't have to do that, at least for financial reasons. I am really impressed with how he handled this.

[Xynesthesia2]

Anne has made an excellent summary above. I see it exactly the same way. This all may be similar to those previous experiences when the T told you that he does not ruminate over what happens in your therapy and about the details of your relationship nowhere near as much as you do, and many other people also do not. Perhaps these different scenarios are manifestations of the same tendency driven by anxiety and doubts that you have specifically, maybe not that unique as some people express here periodically that they have similar reactions. But many other do not and may get surprised when you bring them up. This is how accepting what others say at face value is a better approach, especially others who have already proven themselves to be reliable. I don't have the same tendencies as you regarding relationships and interpersonal interactions but something similar regarding the quality of my own performances and whatever I produce, especially professionally. I tend to second guess and and come up with potential trouble spots endlessly unless I really force myself to stop and truly consider external feedback. It usually helps me tremendously when I trust and accept externals not not just the content and processes of my restless mind. Having a penetrating perception and attention to details and how things (and people) harmonize can be a powerful ability but can also drive one crazy when anxiety distorts it.

[JaneTennison1]

Your T is always honest, even when it hurts you to hear. I see no reason not to believe him now or to worry about 100 different scenarios. It is obsessive perfectionism, I do it too because if i can just get it "right" and follow the rules I will be ok. It's worth it to look at why this happens.

[LonesomeTonight]

Thanks for all the comments. Will post the session a little later this evening. I did end up talking a bit about my concerns (but not with all the detail I mentioned here), and he was...I was going to say "quite reassuring" but realized that's not the right word. Basically, he made it clear that he was fine with it, that he didn't want my mental health care to be dictated by finances. And then we went on to discuss some other non-therapeutic-relationship-related topics.

[LonesomeTonight]

T Monday. I was a nervous because he'd just let me know over email Friday that he was OK with reducing my rate due to my insurance decreasing their coverage. I wasn't sure if we'd have to spend a long time talking about that. Or that he'd act differently toward me.

He retrieved me with a smile. Went back and sat down, he was being his usual self. Brief conversation about my D's struggles during spring break. Then I was like, "So, uh, I really appreciate your being willing to reduce your fee. I...do you need me to explain more what happened with the insurance?" T: "I think you explained it in the email." Me: "Yeah, I just didn't know if you needed any further explanation." T: "Nope." Me: "OK...I guess I just want to make sure you're OK with that amount of the reduction in fee." T (smiling): "Well, I was planning on just reducing the quality of my therapy by the same percentage." Me: "Ah, OK! I'll be prepared for that then."

Me: "Also, I appreciate you saying I could go twice weekly for as long as I needed to" (before switching to once a week at full rate). T: "Well, I wouldn't want you to feel that you'd have to switch after 6 months if it was before you were ready." Me: "Oh, by 'few' I actually meant more like 3 months, but OK." T: "I don't want finances to have to determine your mental health care. I think if you were forced to switch before you were ready, that could be very detrimental to you." Me: "Yeah, I wanted to be the one to make that decision." T: "I want you to be able to as well, for it to not be about money." Me: "OK, thank you." He did mention he had some other clients on a reduced rate, mainly ones he saw as teens who are now young adults, so their parents aren't paying anymore.

Me: "OK, this probably sounds stupid--OK judging myself again--but I'm sort of worried that if I mention going out to dinner or you see I'm wearing a new shirt, that you'll think, 'Oh, LT could afford to pay my full fee.' But it's like I still want to be able to go to yoga, which is only like $13.50 a class, and which I think you feel is good for me." T: "Yes." Me: "But again, I don't know, if I bought a new shirt, I wouldn't want to be worried if you'd be thinking I should pay you more..." T: "No. Maybe if you bought a boat." Me: "You don't have to worry about that!"

I said how a lot had come up in the previous session, but I thought I felt mostly OK with it. He said he wished we'd had a bit more time on that topic, but if I felt OK, good. But I could bring up more about it if I wanted. I said my main concern was if I'd sort of twisted his arm to get to agree that it was OK to call or text him in a crisis, if I got him to agree to something he wasn't fully comfortable with. He said I didn't twist his arm, that he was OK with it. Me: "I guess I was just thinking how you said you don't like to take on high-risk clients, so now you might be thinking, 'oh great, now LT is talking about reaching out in a crisis, this is the sort of thing I tried to avoid.'" T: "Well, anyone can have a crisis, it's hard to predict." Me: "True."

Possible trigger:

I think I mentioned something about ideation? T: "And everyone has suicidal thoughts at some time or another." Me: "You mean likea fleeting thought as you're driving your car, 'what if I drove this off the road right now'?" T: "Yes, or just thinking about how you'd do it."

T: "And I should clarify, I didn't mean that I don't take high-risk clients. It's that if in the initial session someone seems like they'd want or need something that isn't part of how I want to do therapy." Me: "Like if they'd want frequent phone calls or texts?" T: "Yes, exactly." Me: "Oh, OK. That makes me feel better. Also, I was thinking about it, with ex-MC, yes, there were calls maybe every other month or so, but those were more to address issues that I couldn't really talk about in session, like transference or if I was upset with him about something. Whereas with you, I could just talk about whatever during session. And with ex-T, I mean, the only times I really talked on the phone with her was that weekend I was in crisis. I texted with her a bit once when I was coming back from a trip and kept panicking in the car and just needed help getting through it." T: "So that was only a few times in 5 years really. OK." Me: "Yeah." T: "That definitely fits in with the about every 6 months that I'm comfortable with." Me: "OK, good."

Me: "So I had this dream last night but am unsure if I should share it. Well, we just won't spend much time on it." T: "OK." Me: "I'll just share the relevant parts. I was in Los Angeles for some reason. At first, I was staying with my parents, and we all had to sleep in one bed, and I had very little space." T asked how it made me feel, and I said kind of trapped.

Possible trigger:

Me: "At some point, I SHed on my arm. I think this is the first dream where I'd done that. But then I went to stay with these other people, we were also all sharing one bed. There was this random woman, and she said she could do the SH for me. Which...I guess wouldn't make it SH, would it? So she did that on my other arm." T: "How did you feel about that?" Me: "It felt kind of good to me, that she'd help me out. I felt accepted, unlike with my parents." T: "OK. What do you make of the whole dream?" Me: "Well, then in the dream I was back home and in my elderly neighbor's house, and we were talking. He pointed out the marks on my arm and said 'You shouldn't do that.' It surprised me that he knew what it was. I told him I was in therapy and he described you, and I said, 'yes, that's my therapist.'" T seemed amused by that. He found it interesting that the woman in the dream helped me with SH but the neighbor said I shouldn't. I agreed and said I imagined each represented something or someone, but I wasn't sure what.

We still had half the session left. Me: "I guess we should maybe talk more about my cheating so that I can get to place where I can forgive myself more about it." T: "How do you think we should work on that?" Me (joking): "Is this part of the reduction in therapy quality, where I have to figure out how to address it?" T: "Yes." Me: "OK."

T said he'd told me before some of the steps to forgiving oneself and how one involves understanding why you did something and also knowing what you learned from it. So we talked about that a little, but won't go into that here because the next part is what I keep thinking about.

Talked more about how I hadn't forgiven myself. T: "I feel like you keep torturing yourself over this and other things. It almost feels like another form of self-harm." Me: "Yeah...maybe it kind of is." T: "It seems like you don't feel that you deserve good things to happen to you." He looked kind of sad as he said that. Me: "Yeah, I do feel that way at times. Like I don't deserve things. That other people have it so much harder. I don't mean like the starving kids in Africa sort of thing, but just the struggles that other people I know have had. Like a few friends who struggled to get pregnant, then I got pregnant the first month of trying. And some people had really awful childhoods. While I grew up with parents who took care of me and I essentially had everything I needed. I mean, they didn't meet all my emotional needs but..." I paused for a second. "But I guess I deal with anxiety and depression and those are struggles..." T: "Yes. Plus you have a special needs child who can be more challenging than a typical child to raise." Me: "Yeah..."

Talked about working to forgive myself and thinking I deserve good things. Me: "Do I maybe need to start small, like, forgive myself for something little?" T: "Actually, I think you need to go bigger." Me: "Bigger?" T: "I think this all goes back to your inability to be the daughter your mother wanted." Me: "Oh. Yeah, it probably does. So, you think I should start there?" T: "I think that's the key to work through this, to forgive yourself for not being exactly who she wanted you to be." Me: "And I guess I couldn't have been, no matter how much I tried." T: "No, you couldn't. Because of her own issues and anxieties." Me: "So how do I forgive myself for that?" I looked at the clock. "I guess we have to stop." T: "You just need to figure that out before next session." Me: "Oh, that's my homework?" T: "Yes."

Confirmed Thursday, scheduled for the next week. I went over to pay. He accidentally charged the usual rate, apologized, and put a $25 credit on my account. We shook hands as T said, "Have a good week." Me: "Thanks, you too." T: "You can make it through the rest of spring break." Me: "Yeah, I just have a couple hours then I pick D up at camp." T: "You can do it!" Me: "Yeah." I think he said "take care" really quietly. I sort of mumbled, "You too" since i wasn't sure

[DP_2017]

Wow, lots of intense anxiety coming from that recap.I know how exhausting anxiety can be. Have you been working with the mindfulness stuff still or CBT? It might be helpful to focus more on how to manage the level of anxiety for things. I mean, as my T always said about himself "Anxiety is my forever friend" so I get it, it never goes away (sadly) but it is manageable. I also feel like you don't really trust your T yet. It's sad but I do hope you can get here and I get it, trust is hard. I have trust issues. I am just pointing out things I see. I still think it might be worth it to find a temp T or a second T to work through attachment issues and that could maybe even help the anxiety level.

That being said, I like that he gave you homework. It is good homework, since you are going tomorrow, did you find an answer? Hope so I also have to say that was an interesting dream. I usually don't read much into dreams but they can still be interesting. I hope your session is good tomorrow. Maybe take a few minutes to ask about more mindfulness ideas and other ways to help reduce anxiety levels. Good luck

[Anne2.0]

Originally Posted by LonesomeTonight

. . .
Me: "So I had this dream last night but am unsure if I should share it. Well, we just won't spend much time on it." T: "OK." Me: "I'll just share the relevant parts. I was in Los Angeles for some reason. At first, I was staying with my parents, and we all had to sleep in one bed, and I had very little space." T asked how it made me feel, and I said kind of trapped.
. . .
Talked about working to forgive myself and thinking I deserve good things. Me: "Do I maybe need to start small, like, forgive myself for something little?" T: "Actually, I think you need to go bigger." Me: "Bigger?" T: "I think this all goes back to your inability to be the daughter your mother wanted."

I think the juxtaposition of these two things is very interesting, and very important. In the dream, being with your parents, even being brought into their "intimacy" (I realize you're not saying anything inappropriate happened here, dream or otherwise), was constricting. Maybe paying attention to that feeling is really important. Is it possible that not being the "right daughter" is the root of this feeling? I think this happens pretty often in families, where parents want to "box in" children, tell them who they are, how they have to be. Sometimes marriage does this, too (I, at least, identify with the constricting nature of marriage and trying to live up to who my spouse wanted me to be). Sometimes, just like animals caught in a trap where they chew their own leg off to escape, people do pretty extreme things to get away from the perception of being trapped in something they don't want to be in, or perhaps more deeply, trapped inside someone else's idea of who they are supposed to be.

We all need our freedom from something, even if it's something we box ourselves into. A mortgage that's too big, a relationship that doesn't quite work for us, our own ideas of who we're supposed to be and what we're supposed to do. The exodus or escape from whatever's holding you back in your life seems to be central to this dream and maybe the therapeutic theme connected to it.

[DP_2017]

anne

I love your posts, you always have a way of wording things just right. Often things I agree on but I can't word very well. Once again, great post.

[Anne2.0]

LT, sorry for being off topic, but thank you DP for the kind words. Means a lot.

[LonesomeTonight]

Originally Posted by DP_2017

Wow, lots of intense anxiety coming from that recap.I know how exhausting anxiety can be. Have you been working with the mindfulness stuff still or CBT? It might be helpful to focus more on how to manage the level of anxiety for things. I mean, as my T always said about himself "Anxiety is my forever friend" so I get it, it never goes away (sadly) but it is manageable. I also feel like you don't really trust your T yet. It's sad but I do hope you can get here and I get it, trust is hard. I have trust issues. I am just pointing out things I see. I still think it might be worth it to find a temp T or a second T to work through attachment issues and that could maybe even help the anxiety level.

That being said, I like that he gave you homework. It is good homework, since you are going tomorrow, did you find an answer? Hope so I also have to say that was an interesting dream. I usually don't read much into dreams but they can still be interesting. I hope your session is good tomorrow. Maybe take a few minutes to ask about more mindfulness ideas and other ways to help reduce anxiety levels. Good luck

First, the homework thing was actually sort of a joke--I should have made that more clear! It's difficult to relay a dry sense of humor (my T's and at time's mine) in written words. Basically, "Yep, you just have to figure this major thing out in 3 days on your own! i'm sure that won't be an issue at all!"

For the anxiety, yes, I was definitely expressing quite a bit of it. I did some mindfulness work with him a couple weeks ago and have been going to yoga regularly, which helps (it's more of a gentle, meditative form of yoga, not, say, hot yoga). But I've been thinking about the anxiety thing and how he handles it. I feel he handles it in the best possible way for me. He lets me express it and doesn't get annoyed with me for it (H) or totally dismiss it (my parents). He doesn't over-the-top reassure me like ex-MC would--like he didn't say, "I would never resent you for paying less" or "Of course you could always come to me in a crisis, no matter how often it was," for example, which I think this how ex-MC would have handled it. Instead, he's more matter-of-fact with me about it, letting me get the fears out while being quite rational about it. Joking a bit (like about reducing the quality of his therapy), which he knows helps diffuse things for me when I'm really anxious (I know that could potentially bother some clients, but he knows me well, plus I use humor when I'm anxious, too).

I think his method is working, because, yes, I seemed really anxious in session. But I haven't felt any sort of need/want to email him about it to be sure. I don't feel like I need to bring it up again in session in 2 hours. I mean, sure, it could come up for me again, as things in life tend to do. But I also feel like it's OK if I share my anxieties with him, he's not going to be like, "FFS, LT, I told you it was fine, let it go!" OK, maybe if I mention it every single session, but I have no intention of doing that. And I know much of this anxiety is coming from my own stuff, like from my mom, for example--I'm sure she wouldn't think it acceptable to pay someone less for the same service.

I also think there is an element of the anxiety related to him--I'm not referring specifically to you here, but I know my T isn't overly popular on this forum (yes, he has his fans!), so I think at times I sort of think, "Maybe he is the jerk that people think he is" so it's hard for me to reconcile that with, "My mental health is more important to him than the exact number on his paycheck." (And yeah, that comes down to my working on trusting my own opinions/feelings first and putting those of others through the "LT filter.")