Based on this, I would say the change of pattern would be to not terminate. That being said, you know you are on limited time as you cannot afford to pay out of pocket for him (an assumption), so you have roughly 4.5 months to go at weekly sessions that's roughly 16 sessions given holidays and such. Would increasing frequency be an option for you? Is there some kind of specific goal you could work with him over the 16 weeks, such as just staying connected when you know an ending is coming? Have you ever had a special student that you connected with and didn't want the school year to end because that would mean not seeing them any more? How did you handle the foreknowledge there that the relationship was finite? I know a student is not the same as a peer or a T. Just trying to see if you could tap into some other emotions.


I hear your confusion and pain, I don't know what I would do if I was in your shoes. When I was in a similar situation, I panicked.. literally started having panic attack like symptoms. The thought of her leaving while we were still in the middle of stuff, made me feel like how I felt when my parents separated/divorces through my high school years and I had no one to show me how to be a grown up. I made it to the 8 month before possible separation before I had to talk to her about it. So you are already much closer to being through that than I was ever. You've been hanging in there for many months knowing this was coming. Give yourself credit for doing that work. And if you've done all you can this time around, move on. It's your life... way the risk vs rewards... the gains vs costs. And if you do stay... say those words next time or work out something with him so that you can say some set of words that lets him know how suicidal you are. Maybe he really just missed the boat on that one. Some of us have really good masks and minimize our experiences very well.



An aside about costs does your insurance cover any out of network providers? For me, I have found using the medical savings plan to pay for the yearly out of pocket expense for out of network provider, useful now that my T is in private practice. Even with being out of network, my insurance pays for half the costs. It allows me to spread the cost of the out of network over the year because I hit that annual max at about 5 months. So after 5 months they are all covered... but I have paid only about 1/2 the amount.


I think you are doing a wonderful job here trying to determine what is your next course of action. I don't see an impulsive move here but one where you've considered your thoughts, feelings, other's opinions, and even your doubts. Based on everything you are going through, this is a very realistic set of behaviors.


Take care Daisy,

Elio