Bringing this thread back for posting email exchange with Dr. T:
Hi Dr. [T],

I had hoped to come into session today and reconnect with you. But I feel like it was the polar opposite. I now know what kept me from mentioning the standing thing for the past year and a half. Maybe deep down I knew what your reaction would be? Like I had hoped you'd say, "Wow, I had no idea that bothered you, of course I can stand for a minute when you leave." When instead, it's apparently too much of an imposition for you to stand up for 60 seconds. I know we're going to try the paying at the beginning thing, so that you'll be willing to stand, because you'd be standing anyway. But it still really bothers me that you are unwilling in the pay-at-the-end arrangement.

And also that you seem rather reluctant to consider what you're saying at the end as I'm leaving, even though we've had multiple conversations about it. I guess they just seem like small things to me that could make a huge difference to how I feel when leaving.

I know you might not understand why these things are important to me. I tried to explain and you said you understood--but I don't know that you really did? Honestly, it's almost easier for me to deal with it if you just don't get it (though I'd want to try to explain it to you more). But if you *do* get it and just aren't willing to make the effort (whether physical with standing or mental with remembering what I prefer you to say when I leave)...it just feels like you don't really care enough. And I'm not just expecting you to care out of the goodness of your heart--I'm also paying you for that consideration (yes, I know I'm paying a reduced rate, which I appreciate).

The thing is--I think much of this is coming from a young place in me. Like this isn't only just about your standing up (though it would be nice if you could do that!). It's partly about something else, but I'm not sure what, and your reaction to my bringing it up makes me feel reluctant to try to address that with you. But I feel I need to. Because I had a really strong reaction to something that likely seemed not to warrant it. So that suggests other s*** is going on. Can we explore that?

I just feel really disconnected and doubting our therapeutic relationship today, and I don't want to feel that way. Help? I accept the charge if you opt for a longer response.

Thanks,
[LT]

T's reply at around 7:15 this morning:
Hi [LT],

I appreciate your sharing with me how you felt about the session today, and I'm sorry to know that you felt so hurt and disconnected by my reaction to your request that I stand and say something specific at the end of our sessions. I'm glad that you shared your feelings with me, and I do appreciate what you had to say, and while I do not fully understand why this is so important to you I think I 'get' your request.

I've been trying to think of the best way to write this, but can't come up with anything other than taking a direct approach. Hopefully you will be willing to come in on Thursday to talk about it in greater detail. You know how I feel about emails, they lack emotional inflection and can come off as more cold or hostile, which I'm quite sure you will read from what I write. I had debated just having this wait until Thursday, but I felt there was an insistence in the tone of your email that suggested to me your wanting a response more quickly than that.

While I can understand your position, I am not willing to make all the changes you suggested, although I believe I have already made an effort to say something in parting that is more in-line with what you had requested previously. I can also understand your observation about parting comments being more in-sync with the tone of what came previously, although my opinion is that a parting comment can often have a hopeful or optimistic encouragement even it if that's not parallel to what came prior.

Regarding standing up or sitting down, I will continue to do what I feel comfortable with. I would prefer it if you didn't read into it, although it's clear that you already do. I believe you are taking personally something that has nothing to do with you, and while I do not want you to perceive me as rude, that would be your right to judge if you so choose. I have no desire to allow my actions/behavior to be micromanaged by you or anyone else, and I feel quite strongly that as long as I listen and consider my behavior thoughtfully I have the right to make my own decisions about something like standing or sitting. I also do not feel that I owe an explanation about the decision if I don't want to give it, and that is the case in this situation. The most I am willing to say is, it has nothing to do with you.

I'll add that turnabout is fair play. Many people have behaviors that I find irritating or annoying, or even rude. I feel as though I can ask them to change or stop those behaviors but in the end it is up to them whether or not they choose to do so. And the purpose of those behaviors may be unknown to me. I also feel that people don't owe me the privilege of changing for my benefit, whether or not I am paying them for their time.

I understand that you are likely to be frustrated or angry about my response, and I am prepared to talk to you about it. I do not want you to feel disconnected, and I'd like to work on a path through this. We have worked through many issues in the past, and I am optimistic that this can be one of them.