New boundaries implemented

I do worry that I am upsetting you by slamming your therapist so hard, Myrto, and I'm sorry if it's too much. She just really infuriates me. You are a great person and deserve so much better, which is why I get so worked up. I know you are attached, and it must be an endlessly frustrating thought to have to leave all those unresolved issues behind, but I fear it is the only solution at this point. She is not going to change, and she might get worse, still. I don't know that she qualifies for an NPD diagnosis, but she certainly has narcissistic traits, and narcissists have a way of charming people into seeing them the way they see themselves - smart, wonderful, better than you. The last one is very important. You must not question her authority or competency. You must accept her word as truth.

Except you absolutely mustn't, of course. Whenever she tells you that something is "for your own good", you should take a moment to ask yourself: "Is it, though?" Because it very likely isn't.

I'm sorry this is so hard right now.

(PS: I am sat here looking at my bracelet, trying not to weep, so you know... the struggle is real. )

!!!!!!!!!!!

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Thank you!

this thread caught my eye because setting new limits on this very thing (emailing, texting canceling sessions if receiving emails and texts and regular mailings) is exactly what a few treatment providers in my location are going through...my own therapist had limits right from the beginning so for me it isnt a major issue. but with others I know itis an issue.

short version here in my location treatment providers have to bill for taking time through emailing, texting, and what is now called snail mail. insurance plans require this billing to be under two categories... advocacy or therapeutic session. then you add in that insurance companies budget so much per person covered. (either number of sessions usually 52 therapy sessions per year, or number of credits per service per fiscal year by treatment providers)

heres how it works in my location...

say I get 52 therapy sessions on the insurance plans. thats enough sessions for a session once a week. my treatment provider has to bill insurance for any emails that I send her as equal to a therapy session. if I want to have 52 face to face therapy sessions then I cant send an email. if I send an email that subtracts one face to face therapy session because the email is billed to insurance as a therapy session.

therapists most times have to bill insurance for the time that they are face to face in a therapy session plus any time that they spend on things like reading emails, reading mail sent the regular way.

how I keep track of things is that I have a small note book when I have sent an email or letter through the mail or attended the session face to face. this way as the end of the fiscal year I know how many more sessions or emails I have available. for every email it knocks out a face to face session billing wise.

Im wondering if maybe this is why the therapist is saying if you send her an email she has to cancel your next session.

suggestion maybe you can ask her if she has to bill for her time reading and dealing with the issues in the email as if it was a face to face therapy session. then maybe you and she can come up with some sort of arrangement where you can send so many emails and have so many face to face sessions, maybe alternate one session then an email then a session then an email. this way billing wise it will even out.

I'm sure you're attempting to be helpful by describing your experience of how things are billed in your location, but it really seems to me that if this is indeed how things work in your location it seems more than a little absurd. I timed myself reading your email. It took me 1 min. 3 seconds. Personally, I think that any T that charges or counts an email, similar to the length of yours, as equivalent to one of the 52 sessions a client is permitted on his/her insurance plans the T is committing something equivalent to fraud. Even if the T took the time to compose a lengthy and well crafted response, that would mean that the therapist would have to spend another 58 min. 57 seconds on the email! I don't know about you, but even when I'm taking my time to write an email, it never takes that amount of time. If this kind of billing practice is going on in the T's office across the U.S., I think the insurance companies need to be looking into things. Jeesh, no wonder our insurance plans here in the U.S. are hitting the stratosphere. Sounds like bill padding to me.

OP, I'm sorry you're getting dinged by your T for emailing. I have no problem with a T putting a limit on my emailing. But he/she needs to be upfront about it from the very beginning of the therapy experience. For example: A T saying, "I can't read and respond to lengthy emails, but I'm fine with you sending one email a week. I'll let you know that I've read and received it and we'll discuss it in session." Or "I'm sorry but I'm unable to read and respond to emails, but if there is an emergency, please call and leave me a message, I will get back to you." If a T needs to change the rules midstream, I need him/her to DISCUSS it with me like an adult. I'd like to hear some suggestions from the T on how things might change and I'd like her to listen to my thoughts on the subject and my suggestion on how things can be handled. In my world, it needs to be a negotiation with both parties being able to express how they feel about the changes.

From my perspective, any T threatening to cancel my next session because I've called or emailed too much is treating me like an infant. Example: "Because you were late getting home last night, you're grounded for a week." This kind of thing would NOT be helpful in my book and it would tell me that the T was inexperienced or lacking in therapeutic skills. I do understand that it's hard to leave a T once you feel attached, but the thing you have to realize is that if she keeps doing things like this, you'll be in for even more heartache and hurt in the future. I'm sorry you have to go through this.

My therapist never stated rules about emailing because I think she had never had the experience of a client emailing. It is obvious to me now. She created a spécial email address for me and I have only realized now that it's because I am the only client emailing her. My T has less than 10 years of experience. She reacted badly to sth she saw as harassement.

posting on psych central for me is not called an email. an email in my location is when some goes to their email account (ie yahoo.com or gmail.con or google.com) signs into their email account and then sends a letter.

with mental health agencies receiving an email theres more involved then just taking one or two minutes to read it.

first the treatment provider has to make a copy of the email (making copies cost the agency time and money)

there there is the agency paperwork and stamping of that copy because the treatment provider must document that they received that email. (this also takes time and money especially if an agency has receptionists and assistance to this receptionists and assistance do not do their jobs for free)

then theres the actual reading and formulating a treatment plan around the content of that email. Obviously the client wants the therapists help or therapist do something like email them back or discuss \work on the issues in the email in some way. otherwise they wouldnt have needed to send that email.

there is also the replying to the email process when agencies do allow their employed therapists to use emailing....

the treatment provider has to write the email
make a copy of the email
document they sent an emaail

there is much more than this going on, on the filing side of this also that takes time and money.

my therapist told me the whole process with her office usually takes anywhere between an hour to 4 hours depending upon whether the receptionist\secretarial people do all the documentation and filing and copying and sometimes dictation or calling the client who wants to reschedule or if she does the whole process her self.

since the whole process usually takes the same or more than the amount of time of a therapy session and whats contained in the email is therapy issues, things the client can discuss in sessions its billed as a therapy session here in my location.

my suggestion is when sending an email ask ahead of time what the process is and if the therapist has to bill for it and how. that way at some point when thinking about sending an email anyone wishing to email their therapist will know whether its a billed service and how it will affect their sessions and insurance plans.

This is where I see indications that your T went off the rails, Myrto. A well trained T should really be questioning herself if she finds herself considering or doing something "special" for a client. As much as we'd all like to be treated "special", in a therapeutic setting, such behavior on the part of the T usually leads to BIG problems. A T who performs "special" things for a particular client is usually not looking at her own personal reasons for doing so. If she did examine those reasons, with a well-trained supervisor and/or peer, she would usually discover that her reason for doing so is wrapped up in her own NEED to be the rescuer or savior of the client. What she hasn't realized is that her OWN needs will eventually trip her up. By trip her up, I mean that the T will eventually reach a point where she gets overwhelmed or doesn't receive the admiration/appreciate SHE requires in order to maintain the behavior she has encouraged or said she has "no problem with".

I'm not opposed to a T individualizing her treatment approach to clients, but when she encourages a particular approach in therapy (ie. emailing, texting, calling) and then gets angry or punitive when the client actually uses those methods of communication because they overwhelm the T, I want to say to the T, "Uh, did you not think about or consider that this might happen? If you had taken a moment to consider the possibility that the client's idea of emailing is two emails a day or ten a week and yours was one email once a month, how can you think that you're a role model on how to communicate your needs appropriately!?" It is craziness that T's who don't think things through dump on the client by threatening or terminating a client for something like this. Changes in treatment boundaries is a negotiation; a negotiation that BOTH members (T AND the client) get to discuss and decide upon. it's ridiculous that the T, who failed to communicate her perception of what her own boundaries are in clear and concise terms, gets to lash out and punish the client when she doesn't like how the client views her vaguely defined boundaries. I really am so sorry that you're having to put up with this craziness.

Lolololololol. Too funny!!!😂😂😂

That sounds like a very tough position to be in. This is why I have trouble trusting therapists.