T Wednesday (a day earlier by request): Went back and sat down. He mentioned I had something on my face, so I rubbed frantically at it, and he said it was gone.

He picked up a magazine and said there was an article about autism in it, so he'd saved it for me. He flipped through it and found the page, then showed me (was about losing an autism diagnosis). I asked if I could take it with me to read, he said sure, that I could just return it to the waiting room when I was done or even keep it--it wouldn't be missed. He hadn't done anything like that before, and it sort of conflicted with my "he doesn't care enough" feelings from Monday's session. So it was a bit confusing. Because obviously he was thinking of me outside of session and went the extra step to bring something in for me.

I said how I'd been a bit upset when I left Monday, then was emotional that night about parts of what happened in session. But I was determined not to email him. Then Tuesday morning, I was crying as I was getting in the shower and knew I had to talk about it. So I requested an earlier session.

I said before I shared the actual things that I realized how some of it was likely transference, in this case paternal. And I know he feels uncomfortable when he feels like some feelings I have are about *him*, so part of why I want to emphasize that it's transference is to make it clear that I know intellectually it's about other stuff, maybe stuff from my past, rather than about him. But I also know he's not all that comfortable talking about transference, as he's often said he isn't trained in it. So...

T said another way to look at it is through what cognitive therapists see as core values. I said I recalled him talking about that with me before. And how with those, it wouldn't be so much "I'm experiencing transference with Dr. T" as "Dr. T is saying something that's tapping into this core value." (Obviously, he was using his name there, not "Dr. T.") So it's more about what's happening right now. And how it could happen with anyone, not just therapy. T: "There's something I've written a few times in your chart." Me: "Uh, OK." T: "That you've got lipstick on your teeth." Me (frantically rubbing my tongue on my teeth): "What? I do?" T: "Sorry, I was joking, just trying to lighten a difficult topic." Me: "Oh, OK, that's OK." T: "But what I wrote is that I think two of your core values, and I don't know that this is all of them, but they're being understood and accepted for who you are." Me: "Those seem accurate."

T said it seemed like times I reacted very negatively to him were when it seemed like I wasn't getting that, where I wasn't being either understood or accepted. I agreed with that. And when I did feel understood and accepted, it felt really good to me. He talked some more about that stuff, then saw we had 20-25 minutes left. T: "I'm sorry if I've kept you from talking about what you wanted to talk about." Me: "It's OK, it was helpful and was part of it. There are just some other things I need to mention." T: "OK, go ahead."

I said I'd hoped he would have said something like, "You should have just emailed, we could have figured out the money later, if it came to that." (Note: He once said after charging me for an email that if I couldn't pay it right then, he could take it later, so I'm not just coming up with that out of nowhere.) Me: "But instead, it seemed like you were suggesting I should have just had another drink. Rather than encouraging me to reach out."

I think T said he was trying to consider my finances. T: "And if you emailed me, you likely wouldn't have heard back until the morning anyway." Me: "Yeah, I know" (thinking how the previous Monday, he had emailed me back that night, as he had some other times...but didn't want to say that, because I imagine he's only able to do that sometimes and didn't want to guarantee anything). T said because of that, I could just type something up to him, then wait to send it until the morning, as he'd likely see it around 8 am. To then see if I still want to send it. I said I've done that before and guess I could again, but sometimes it helps to just send it off, even knowing he might not see it until morning.

I said part of my struggle is not knowing when he's going to charge me because his policy isn't totally clear about that (we've discussed that multiple times). T started to say, "We never really determined..." and I thought he was going to say something about a more set email policy. Instead he said, "...some other coping mechanisms for you that don't involve other people." Me: "And I guess other than drinking (or the trigger thing)." T: "Right, positive coping mechanisms." Me: "Yeah, I guess I need to figure more of those out...but certain ones I couldn't have done Thursday night, like I couldn't have gone for a walk to a yoga class." I mentioned listening to music, and he said that's a form of distraction, which can be a coping mechanism. I said how I guessed watching TV or YouTube could be, too, and he agreed. Me: "But the problem is, that might just push them away for a bit, then I could wake up in the middle of the night and they're there again."

I brought up the uncertainty of whether he'd charge me for emails again. And he just talked about all the different variables there. He said he'd considered coming up with a policy just for me, that would be he'd charge me for every third email. Which didn't seem fair at all. Particularly if the policy would apply to me only and not other clients (even though he's said I tend to use email differently than he does). He went on some more about why he charges for it sometimes. He said maybe I could have a jar that I put money in to save for emails (which...kinda bothered me).

I brought up ex-MC and ex-T having lots of outside contact with me--multiple long phone calls, some texts--when I'd been in crisis for like 5 days a few years ago. Which they didn't charge for (they never charged for outside contact). How at the time, they'd realized I was in crisis, that I needed that, and that I wouldn't have continued at that rate, so they were OK with it. T: "I'm sure that made you feel very cared about." Me: "Yeah, it did." T: "Well, I would have charged you for all of that time. So I doubt it would have felt the same to you." Me: "Yeah...probably not." (I was crying during all of this.)


ETA: Oh right, he also said that at times they were probably annoyed with me for the emailing/texting but just didn't say anything. Which, great, thanks, that helps. But he said his policy of charging when it hits a certain time threshold or frequency would keep him from getting annoyed.

I saw we only had a couple minutes left. Me: "I guess the other thing I wanted to discuss--I know we have to stop soon. But I felt like I was being really vulnerable when I shared that stuff at the end of session, where I said I needed you to be there with me, to support me. And you just said, 'That's my intention.' It's like it didn't feel strong enough or something." T: "Well, it is my intention." Me (crying really hard): "Yeah. I guess it's just...I want you to really care...but then I know you can only really do that within the boundaries of the therapeutic relationship...I mean, like as part of a professional relationship. Not like I'm looking for....like a friendship or something. But it's just really hard to deal with sometimes that I'm in here and sharing so many things with you and so vulnerable and then...I know it's just, OK, now you have to move on to your next client. It's just really hard to sort of...reconcile all of that. I know we have to stop..." T said something about it being a different type of relationship and how that can be difficult, I think? It's all kind of fuzzy. It just felt I was in all this emotional distress and he was just sort of...there. I don't know. Like I wasn't feeling the connection or support, which may have been more about me than him. And he did say his back was really bothering him that day (he apologized for fidgeting), so maybe that made him off his game.

He said we were scheduled for next week. T: "And I'm here Friday, too, if you want to talk before that." Me: "OK." T: "Just let me know." Went over and paid. I must have really seemed a mess because T said again how he'd be there Friday, but if he didn't hear from me, he'd see me Monday. As he shook my hand, he said, "I hope you'll be OK--I really do." And that had a lot of meaning to me--I really felt his caring in that moment. It seemed genuine and not just a job.

I still texted him a few hours later and asked what he had Friday or possibly Thursday. He replied a few hours later with a slot each day, saying Thursday would be a little easier for him, but he could also do Friday. I opted for Thursday (partly to get in there sooner). Will write that up in a bit, but (spoiler alert), it really helped.