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."
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