[Leah123]

Well, my new year's resolution was to spend a reasonable amount on therapy, which for me is the equivalent of 1.5 hours, but I knew that was expecting too much of myself after doing an average of 7 hours a week last year, so I compromised with myself, on a plan for 2.5 hours a week, plus her rates went up a bit which didn't help.

Six weeks in, it's not going well.

I have cut back some, last week was 5.5 hours, but I need to definitely cut back more.

I have a difficulty being disciplined about spending in my life in general. I AM starting to see gains, where I can tolerate more anxiety about money, and I have touched on the subject more than once in therapy, but I need to spend less *soon*.... I am in over my head in debt.

I have a decent plan:

1. 90 minute session Monday to do in depth work/talk issues
2. 30 minute session Thursday to do DBT/skills/concrete work
3. One paid email session.

I am also thinking about switching my 30 minute to Friday, so I can plan on one paid email session during the Tues-Thurs. gap, maybe that will help a bit, then I'll just cope with the weekend, or maybe a super-brief check in email, and then the nice long session on Monday.

The reality is different though. For example:

1. I spent 90minutes resolving a miscommunication that bothered me last Sunday
2. I had two extra email sessions.
3. My 30 minute Friday session turned into almost 70 minutes.

I feel like I can't get enough of my therapist. She's really special to me and I'm in a very stressful period: last week I was dealing with four extra stressors (dentist which triggers me, kid home from school, major blowup with my husband, and doubling my workload on the job) along with the normal issues/stressors.

The thing is- the way my life is now IS going to be really stressful, long term, at least the next probably.... one year period, and so... I just have to cope with that, I can't pretend the stress level will drop next week and I can't pretend I'm going to win the lottery, sigh.

My judgement is: Therapy is worth spending significant money on. My issue is not that the time is excessive: the time in therapy has meant huge gains in my life, but... although I think it's a good investment, I just don't have the means to realistically afford it. So, I have to cut back without thinking it's a good idea, that makes it harder.

I think I need an accountability partner or something, like anti-spending pocket riders, haha. Someone to remind me the money I'm spending does NOT grow on trees in the backyard, and even though I have good credit, I do NOT want to be paying this back the rest of my life.

When I feel stressed and anxious, I've been willing to spend almost anything to feel better, I'm not used to have anyone to help me feel better, and now that I have her... it's extremely difficult not to turn to her. (I did also reach out to find a couple friends to socialize with and rely on, and that helped some, but between the holidays and a chaotic January, I've lost touch with them, am hoping to fix that.)

I did ask her to start working with me on DBT skills, and I have made some small gains with that in the last couple months, working to manage my anxiety and my triggers. I think changing to the Friday session will help too, so... maybe I'm making a bit of progress... I just really need to find the discipline/motivation/support to get the spending in control.

I know I will feel better once I do.

Please don't blast me for being too dependent on my therapist.

[MoxieDoxie]

I would be broke if my therapist made me pay for every email they replied to but then again If I spent 2 hrs week in therapy I would not need to email anyone. My insurance will only pay for one a week 45 min session.

[Leah123]

I don't have insurance that covers my therapist, so I have to pay out of pocket, and yeah, it is a huge strain on my finances, trouble is I don't "feel" the strain so much because I've been using credit, which I need to rein in.

My therapist doesn't charge for brief emails, but we do an email session, in depth writing/concerns, and a fairly detailed reply from her.

I am, for better and worse, haha, a prolific writer.

[MoxieDoxie]

I am sure there is something called therapy addiction. Make it a topic of your next session. Of course therapist can be selfish and see you as there source of income and if you cut back they lose money. Remember they are NOT your friend. You pay them for a service.

[Leah123]

Oh yes, we are working through my anxiety around therapy in therapy, sigh, it's something we've discussed. My therapist is certainly open to cutbacks and accommodating schedule changes and emails and such for me. She is willing to see me at a reduced rate or for free if I needed to, but I will not do that because I do not have a need for the therapy. I make progress, I find the work very compelling, but no, I don't need it and will not ask for a reduced rate, though she offered.

Nice that your therapist offers free emails!

P.S. I was just reminded of one thing I have done...maybe it will help to make it a practice: I've been inspired by my therapist to make a quilt representing the caring women in my life, and I also have a meditation/guided visualization audiofile I purchased- maybe if I focus on those when I most want to talk to her, it will help me ease the desire enough to just wait it out. It's so hard to have a confidant though, after not having one for 20 years, honestly. Sheesh.

[scorpiosis37]

Originally Posted by Leah123

I need to spend less *soon*.... I am in over my head in debt.

I feel like I can't get enough of my therapist.

I just don't have the means to realistically afford it. So, I have to cut back.

I think I need an accountability partner or something, like anti-spending pocket riders, haha. Someone to remind me the money I'm spending does NOT grow on trees in the backyard, and even though I have good credit, I do NOT want to be paying this back the rest of my life.

Why don't you make T your accountability partner? Tell her that you can only afford to have 1 90-minute session, 1 30-minute session, and 1 paid e-mail per week. When those times are up, have T end the session. Therapy really should have time boundaries anyway, in order to maintain the therapeutic frame and to keep the relationship healthy rather than excessive/obsessive (assuming you are stable enough, which it sounds like you are). It seems that it should be fairly easy for T to uphold those time boundaries if you simply ask her. This is your decision, but it seems like it is in your best interests to ask for this. Not only do you need to stop going into debt in order to pay for therapy, but it's good to have time between sessions to apply the DBT skills you are learning (like distress tolerance, self-soothing, self-coping, etc) and to turn to people in your life (husband, friends, etc) for support rather than to rely so heavily on your T. It sounds like this could be a really positive step for you, in order to continue doing intense therapy without allowing it to become obsessive.

[owlpride]

The reality is different though. For example:

1. I spent 90minutes resolving a miscommunication that bothered me last Sunday
2. I had two extra email sessions.
3. My 30 minute Friday session turned into almost 70 minutes.

It sounds like your therapist may be having some boundary issues of her own. She should not let a 30 minute appointment turn into a 70 minute session, period.

It may help you to ask your T to enforce the pre-arranged boundaries. For example, you could ask her not to let you go over appointment time limits and to ignore emails beyond a certain number. (For example, respond to the first email each week, ignore all further emails.)

If your T cannot maintain a "safe" treatment frame, she may not be the right T for you. To me, it sounds like your T is indulging your 'therapy addiction'. If she's always available to you when you feel anxious, it will be much harder for you to learn to do without her. It's like stocking the freezer of a bulemic with ice cream, and expecting her not to overeat when she gets stressed... It takes a tremendous amount of self-control, and the task would be much easier if the food wasn't so easily available.

[Leah123]

Originally Posted by scorpiosis37

Why don't you make T your accountability partner? Tell her that you can only afford to have 1 90-minute session, 1 30-minute session, and 1 paid e-mail per week. When those times are up, have T end the session. Therapy really should have time boundaries anyway, in order to maintain the therapeutic frame and to keep the relationship healthy rather than excessive/obsessive (assuming you are stable enough, which it sounds like you are). It seems that it should be fairly easy for T to uphold those time boundaries if you simply ask her. This is your decision, but it seems like it is in your best interests to ask for this. Not only do you need to stop going into debt in order to pay for therapy, but it's good to have time between sessions to apply the DBT skills you are learning (like distress tolerance, self-soothing, self-coping, etc) and to turn to people in your life (husband, friends, etc) for support rather than to rely so heavily on your T. It sounds like this could be a really positive step for you, in order to continue doing intense therapy without allowing it to become obsessive.

I am really glad you brought this up, because what you say sounds very reasonable and smart.

Still, it is a big sticking point for me, maybe I could use some help sorting out why I'm stuck. My fear is that if I ask her that, she will cut me off, and I will feel so... angry and abandoned. I have some history with really difficult therapeutic relationships and with other women in the distant past, and it has made me very very.... anxious to like get everything I can out of my relationship with her, for fear of it ending suddenly, or for fear that a misunderstanding would end the relationship, so... old news, you know, sigh.

She has reassured me she plans on being around as long as I want/need to see her. She has reassured me that no misunderstanding, nothing I can do, will cause her to stop seeing me, that she knows me well enough at this point to commit to that.

It's like- I don't want to give her the control, even if I am *giving* her the control.

I know that's not sensible, but it's emotionally sensible, because I have learned to be greedy about women like her in my life, that being understood and cared about is a finite experience, not to mention one that often ends badly.

I do know some of what's going on, but it's still hard to be disciplined.

I am thinking about doing two things in the interim... maybe they would help?

1. Set a timer 15 minutes before session end, so I wrap up in a timely fashion, and let her help me calm down if I need it so I don't feel like I have to keep going until I'm all the way through a long topic.

2. I can set up my account to cut me off after X period of time (it's online therapy, so there are some constraints like that I can employ sometimes.)

I have to think about what you said- it DOES sound like a good idea, but makes me very uncomfortable too.

[sweepy62]

Im so sorry for your cutbacks, and your anxieties, I never understood online chat therapy, is it less expensive or about the same price as seeing a therapist in person? That is if you dont mind me asking.

[Leah123]

Originally Posted by owlpride

It sounds like your therapist may be having some boundary issues of her own. She should not let a 30 minute appointment turn into a 70 minute session, period.

It may help you to ask your T to enforce the pre-arranged boundaries. For example, you could ask her not to let you go over appointment time limits and to ignore emails beyond a certain number. (For example, respond to the first email each week, ignore all further emails.)

If your T cannot maintain a "safe" treatment frame, she may not be the right T for you. To me, it sounds like your T is indulging your 'therapy addiction'. If she's always available to you when you feel anxious, it will be much harder for you to learn to do without her. It's like stocking the freezer of a bulemic with ice cream, and expecting her not to overeat when she gets stressed... It takes a tremendous amount of self-control, and the task would be much easier if the food wasn't so easily available.

My therapist would likely enforce time limits if I asked her to, and I replied to the issue of that in my prior post, which we were typing at the same time I bet.

Her style is to be open and available to me, to let me set the limits, and it's been very helpful in many other ways, but yes, I do need to manage limits better now, and I have made enough progress that I hope I can do that without losing much of the progress I've made... I think I can transition to less time, but it's a big adjustment.

We have started working on DBT which can help things like this, and I am trying to implement a few specific ideas....

1. timer
2. account limit
3. DBT tactics

Just trying to get a better lock on this.... it is a very tough one for me to address.

I should let her partner with me on this... I am sure she would absolutely do it if I asked, it is what she's been used to with other clients, I should....

making myself do it, making myself want to... that's the hurdle I need to overcome. The leap of faith that I can still make such good progress with limits, that she can still be there 'enough' for me.

I knew when I made the resolution, I would do well with limits, if I could keep them. I am really challenged because of my husband having some major issues right now, so usually I'd lean on him a lot more, and I can't. That kind of complicates things...

[owlpride]

Two more thoughts I wanted to throw out there.

If you are struggling with intermittent acute anxiety/stress, medication might be a good adjunct to therapy for the time being. Imagine destressing with a Klonopin or Xanax (for 10 cents a pill), instead of spending $120 (or however much you are paying) for an "emergency" session with your therapist. Not the best life-long solution, but it may protect your finances while you are learning that you can indeed survive without your therapist.

If you are having a hard time using the designated DBT skills sessions for skills training instead of talking, it might help to see two different therapists: one for talk therapy and one for skills training. That way, there's a clear division of tasks and much less temptation to "hijack" a session.

[Leah123]

Originally Posted by sweepy62

Im so sorry for your cutbacks, and your anxieties, I never understood online chat therapy, is it less expensive or about the same price as seeing a therapist in person? That is if you dont mind me asking.

Hi Sweepy, I'm glad you asked a neutral question, ha. Even though I opened this can of worms, it's not fun!

I pay $100 per hour of therapy. It was $80 but she had to raise her rates in the new year, so that's a bit of the issue too, a little part anyway- that it costs more now for less time. Half of the fee goes to her, half of the fee goes to the agency.

So, she charges less than some therapists, but it is still certainly expensive to me. She charges somewhat less for emails, usually $50 for a fairly long, involved email session, where I write maybe.... several pages and she replies a few times.

I did just hear back from her, she said we could change sessions from Thursday to Friday, so instead of me wanting to do a couple emails maybe I can just do one for the Tues-Thurs period and nothing major on the weekend, sigh. I don't know, I find life so stressful, ha.

[Leah123]

Originally Posted by owlpride

Two more thoughts I wanted to throw out there.

If you are struggling with intermittent acute anxiety/stress, medication might be a good adjunct to therapy for the time being. Imagine destressing with a Klonopin or Xanax (for 10 cents a pill), instead of spending $120 (or however much you are paying) for an "emergency" session with your therapist. Not the best life-long solution, but it may protect your finances while you are learning that you can indeed survive without your therapist.

If you are having a hard time using the designated DBT skills sessions for skills training instead of talking, it might help to see two different therapists: one for talk therapy and one for skills training. That way, there's a clear division of tasks and much less temptation to "hijack" a session.

Thank you. I have never considered medication before, but you make it sound awfully appealing. It would be so nice to have a 'no stress' switch. I have PTSD, so... stress is the word.

Do you or does anyone know of anything.... gentle I could take for anxiety? I'm scared of medications and messing with my biochemistry. I did just start taking mega vitamin B again a couple days ago- that used to help me with stress some, I will try and take that daily for a bit, it could help a little I hope.

Yes, it's about protecting my finances, yes, yes, yes, because the anxiety gets the better of me and I fear things more than I need to, where looking back a day later, I don't think the spending was the best solution.

I did think briefly about seeing a second therapist for skills.... that might be something to look into, but also, one thing I can do right now is keep on DBT topic more on Fridays now- I know I can manage that- and maybe if I do that, then the other issue of wanting more time will get easier.... That could be good! More skills focus. This is a new plan for us, the 90/30, we've only done it about... 2 weeks so still adjusting, maybe this week we can really see it work. No more stupid dentist anyway- that was like 30 minutes of debriefing.

[HazelGirl]

I take propranolol. It's a beta blocker that is very mild and non-addictive. It works wonders for me.

[owlpride]

Do you or does anyone know of anything.... gentle I could take for anxiety? I'm scared of medications and messing with my biochemistry. I did just start taking mega vitamin B again a couple days ago- that used to help me with stress some, I will try and take that daily for a bit, it could help a little I hope.

I don't know too much about psychiatric medication, but I can tell you what I do know.

Benzos (e.g. Klonopin, Xanax, Valium) are amazing for acute stress and anxiety. Klonopin seems to be the "mildest" of those. It erases my anxiety and gets me back to normal functioning without making me feel impaired. Benzos in general act on some of the same neurotransmitters as alcohol. Stronger benzos can make you socially disinhibited, physically impaired and/or put you to sleep, just like alcohol, but I've never had that problem with Klonopin. The big disadvantage of benzos is their addictive potential. If you take them every day, you'll get addicted to them in a matter of weeks. Benzo withdrawal is supposed to be worse than alcohol withdrawal. However, if you take them intermittently (e.g. once or twice a week), they shouldn't have any adverse effects.

Another popular treatment for anxiety and PTSD are anti-depressants (SSRIs), but they don't work well for everybody. They can have unpleasant side effects (dry mouth, too much or too little sleep, loss of libido) and their positive effects don't kick in until several weeks into treatment.

Some psychiatrists like to prescribe atypical antipsychotics (e.g. Seroquel) as an alternative treatment for anxiety and PTSD, when there's concern about the addictive potential of benzos. I wouldn't recommend that though. Yes, they will immediately take away all of your anxiety, but it feels as if they'll suck the life out of you... I have met several people who were prescribed antipsychotics (for a purpose other than acute psychosis) and not a single one of them would voluntarily take it again...

There are supposed to be other non-addictive drugs for anxiety, but those above are the only ones that I have personal experience with.

[Leah123]

Originally Posted by owlpride

I don't know too much about psychiatric medication, but I can tell you what I do know.

Benzos (e.g. Klonopin, Xanax, Valium) are amazing for acute stress and anxiety. Klonopin seems to be the "mildest" of those. It erases my anxiety and gets me back to normal functioning without making me feel impaired. Benzos in general act on some of the same neurotransmitters as alcohol. Stronger benzos can make you socially disinhibited, physically impaired and/or put you to sleep, just like alcohol, but I've never had that problem with Klonopin. The big disadvantage of benzos is their addictive potential. If you take them every day, you'll get addicted to them in a matter of weeks. Benzo withdrawal is supposed to be worse than alcohol withdrawal. However, if you take them intermittently (e.g. once or twice a week), they shouldn't have any adverse effects.

Another popular treatment for anxiety and PTSD are anti-depressants (SSRIs), but they don't work well for everybody. They can have unpleasant side effects (dry mouth, too much or too little sleep, loss of libido) and their positive effects don't kick in until several weeks into treatment.

Some psychiatrists like to prescribe atypical antipsychotics (e.g. Seroquel) as an alternative treatment for anxiety and PTSD, when there's concern about the addictive potential of benzos. I wouldn't recommend that though. Yes, they will immediately take away all of your anxiety, but it feels as if they'll suck the life out of you... I have met several people who were prescribed antipsychotics (for a purpose other than acute psychosis) and not a single one of them would voluntarily take it again...

There are supposed to be other non-addictive drugs for anxiety, but those above are the only ones that I have personal experience with.

Thank you. I started reading the Kloponin side effects and had to stop, there were so many and serious, but... of course, they're probably overstated for liability. I have always been scared of substance addiction though, Alcoholism in the family, so I do not drink, smoke, or do any other substances, so... not sure, but I might have to learn some more about it.

Am hoping to control the spending without that type of help, but, I can see the appeal..... one way or the other, I do need to implement my resolution better.

[Favorite Jeans]

Trazodone can be used a bit like a benzo but without the addictive potential. You could take very small doses when needed for acute anxiety/stress. Also a walk can be very helpful. Some people seem to do well with omega 3 supplements taken regularly (not as needed). Good luck.

[Asiablue]

Would it help to take say a weeks break or two weeks if you can manage it and come back to a fresh start and a fresh set of rules?

Sometimes a break can give us the perspective we need and a rest from of the introspection.

[Person66]

Why don't you take the reduced rate?
You get a discount for buying things wholesale, and I think that's the way you should look at the reduced rate. You "purchase" so much of her services that you deserve a discount.

Paying for Emails sounds ubsurd, no matter ho long they might be!

I've been using benzodiazepines since I was 14yo, they saved my life.
Don't listen to all those side-effects they mention, as you alluded to they're for liability purposes, benzodhiazepines are for the most part very well tolerated.
A very small dose like half or a whole .25 mg tablet of Xanax or a half or whole 0.5 mg. Klonopin will be very gentle.
If you take these judiciously only when severely anxious you won't get dependent on them and even if you take them daily you'll become dependent on them not addicted, there's a world of differenc. Your vigilant attitude towards addiction will help safeguard you.

I think you should tell her you need her help in setting boundaries.

[Perna]

Originally Posted by Leah123

I have a decent plan:

1. 90 minute session Monday to do in depth work/talk issues
2. 30 minute session Thursday to do DBT/skills/concrete work
3. One paid email session.

When I get confused I do plans like this, like one would do if one's life were a business and I would look at these three different types of sessions and see which one is giving you the most bang for the buck and then just do that one kind. Personally, I'd do the 90 minute session (what I had for 9 years only it was 100 minutes). #2 I would do with self-help books of some sort and I'd start writing letters for number 3 but not "discuss" back and forth (did that too, wrote to my T's business address and just assumed she read what I mailed her and that was enough for me). Eventually I only did the in-person work as that is really all we have in life, people face-to-face, the rest is pretty much our imagination and illusion/not possible to do reality checking on in space and time.

[Leah123]

Originally Posted by Asiablue

Would it help to take say a weeks break or two weeks if you can manage it and come back to a fresh start and a fresh set of rules?

Sometimes a break can give us the perspective we need and a rest from of the introspection.

I'm not sure if a break is best: I am living a pretty stressful life right now, and having her to "spot me" when I'm struggling to keep it together for my daughter and to let out some of the emotions from my insane schedule right now seems wise.

Day in the life: work 11 hours, school, 2 hours, family, 3 hours, manage the household an hour, sleep, maybe 6 hours (usually interrupted), and every day, some type of calamity- last night, for example, my poor daughter got food poisoning and we were up until 3am. We just lost 40% of our staff at work a couple weeks ago so now my workload has doubled, and my husband told my daughter we would get divorced if she didn't behave last weekend, which led to hours of work to start resolving, so... I feel like I need some support to keep my emotions in check and thrive in the midst of this hectic period, somewhere to deal with all the stress, and cutting her off completely for a couple weeks seems really hard.

[Leah123]

Originally Posted by Perna

When I get confused I do plans like this, like one would do if one's life were a business and I would look at these three different types of sessions and see which one is giving you the most bang for the buck and then just do that one kind. Personally, I'd do the 90 minute session (what I had for 9 years only it was 100 minutes). #2 I would do with self-help books of some sort and I'd start writing letters for number 3 but not "discuss" back and forth (did that too, wrote to my T's business address and just assumed she read what I mailed her and that was enough for me). Eventually I only did the in-person work as that is really all we have in life, people face-to-face, the rest is pretty much our imagination and illusion/not possible to do reality checking on in space and time.

I have struggled in the past with writing to her and not sending it. Sometimes, that's productive, I often post things I've written for her live in session and like working through them that way.

Other times, I've spiraled- I've tried not to write her, and get so lost in my head or overwhelmed by emotion that I dissociate, which I hate, and then I've regretted not keeping the line of communication open. I used to have significant issues with dissociation, though they are much better now. I have been trying to journal more than write to her lately, it's about 50/50 useful.

I will try and do more of the DBT workbook on my own, maybe that will help me keep on topic Fridays, yes.

[Leah123]

Originally Posted by puzzle_bug1987

I think you should tell her you need her help in setting boundaries.

I think you are right, but I am so scared to do that. I don't want to give up the control, even though I am not meeting my financial goals well this way. Maybe I can say something jokingly tomorrow, like "ok, don't let me talk too long this time, I really have to get back to work on time" and just broach it that way, I really don't want her cutting me off, more of a gentle wrapping up process. So hard for me to believe sometimes that an hour with her won't be the last hour ever, you know... I have this huge compulsion I've been trying to get a grip on, to do everything now, fix everything now.... no time like the present, don't count on the future!

She's been trying to talk me out of that a while, lol. And I do need to have more faith in that, but I'm making slow if any progress on that aspect.

[Leah123]

Originally Posted by Person66

Why don't you take the reduced rate?
You get a discount for buying things wholesale, and I think that's the way you should look at the reduced rate. You "purchase" so much of her services that you deserve a discount.

Paying for Emails sounds ubsurd, no matter ho long they might be!

I've been using benzodiazepines since I was 14yo, they saved my life.
Don't listen to all those side-effects they mention, as you alluded to they're for liability purposes, benzodhiazepines are for the most part very well tolerated.
A very small dose like half or a whole .25 mg tablet of Xanax or a half or whole 0.5 mg. Klonopin will be very gentle.
If you take these judiciously only when severely anxious you won't get dependent on them and even if you take them daily you'll become dependent on them not addicted, there's a world of difference. Your vigilant attitude towards addiction will help safeguard you.

Thank you for clarifying about the benzos, they sound very appealing but still scary to me. I know what you mean about wholesale, haha, I do keep her busy, she was thinking of raising her rates to $115 an hour, so... the $100 seemed a fair meeting in the middle, but it is hard to afford. I just figure... it's probably good for me to cut back some, it's hard to even make so much time for therapy, and doing so much therapy itself causes some anxiety because it's such raw work, so... right now, I would just be happy with myself if I could go from the 5.5 hours last week total to the 2.5 I am budgeting now (90/30/email billed at 1/2 hour).

I think it's a very good point you and others raised about something, whether a pill or otherwise, like even a walk, to cap my anxiety and worry less about feeling alone with all the things on my mind... that's the real issue. I'm not in crises typically... I am really stable except for an occasional temper, it's often just stress that gives me the drowning feeling, so if I can just calm myself down for an hour... that would probably help a great deal. I think I will look into this more.