[mindmechanic]

My therapist was a staff working for an adult clinic, but her primary, full-time job is at a hospital/university. The hospital/university established a new policy stating that full-time employees are not allowed to have another contract a different employer. Because her primary, full-time job is at the hospital/university, she had to leave the adult clinic where we did therapy. Without going into the complicated details of how the clinic operates, leaving the adult clinic entailed that we had to switch to a different room, but still within the same building. I've seen her for over two years now, and we had always used the same room. The room that we're moving to is bigger and is a kids room. We all have our triggers. I don't have of any memories from the childhood, but do get intrusive thoughts and images and nightmares. The director of the clinic did give me an additional three months in our regular room, but that time is now running out and we have to transition to that dreaded children's room.

She said that most patients are attached to the person who they are working with, not the space or room. But I am who I am, you know. I'm schizoid. So is it so surprising that I'm more attached to the safe space than I am attached to her? No. And because the triggers are too much for me, I told the therapist that I like walking away - quitting. She said that she hopes I would continue our work.

So I gave it some thought and decided to try and continue our therapy work together. But to do so, I need flexibility and accommodation during this transition. I said that I cannot guarantee that I would stay for the entire session; it might be too much for me and I would have to leave. I'm already getting flashes of nightmares and intrusive images and thoughts. Because I'm also tight on cash (struggling fresh college graduate and all that), I asked if she could meet me halfway and not charge the full fee while I'm making this transition. She isn't open to that idea.

Is this a reasonable request? I feel that it is. After all, this cause of this change did not originate from me.

[healinginprogress]

Sine you're attached to safe space and not the T I would say sorry, nope, please give me some referrals. I can't imagine that continually being triggered is going to do anything but harm you in the long run.

If you do really want to try and work with her more, would she be willing to do 15 or 20 minute sessions (scheduled up front) and prorate the cost?

[AllHeart]

I just finished a book about psychotherapy and it said many clients get attached to the therapy room. It can be like a sanctuary, so comfortable and safe. My t is moving in 2 weeks. I am also more attached to her awesome, cozy, safe space than I am to her. Makes perfect sense, schizoid or not, to feel attached to the room, I think.

As for the fee thing-- I think every therapist ought to have a sliding fee scale, but that's just me. Sorry your t isn't willing to work with you on that. I guess what concerns me more than that is what your t is or isn't doing to help you deal with the stirred up trauma stuff you are experiencing now. She should be discussing with you what can be done to help you-- at least in ideas to transform the room (can partitions or curtains be used to create a small room within the room??).

Moving an office into a kid's room to treat adults isn't exactly providing a professional setting. Nor is it a safe setting for those with childhood trauma. I would not be comfortable doing therapy in a "daycare" type environment. It wouldn't provide the right kind of energy for me. If my t expected me to pretty much just deal with it without making adjustments or helping me cope, I'd find someone else.

[mindmechanic]

It is a therapy room within a bigger room. The main room says it is a grief center for children. The therapist said that the room is actually not part of the children clinic. But because I could clearly see toys in the room - something that wasn't present in our usual room, I call it the kids room. The therapist said that our usual room has toys as well, but they are kept in the cabinet and not out in the open.

I asked her to lower the fee, but didn't actually use the word prorate. Maybe I should.

You know what? I asked if other of her patients had trouble switching to the other room. She said that I'm the only one, but she understands. Really? Do you? I haven't even made the move yet and I'm already having nightmares and intrusive thoughts. I told her at least meet me halfway. She did try looking for an alternate room, but could not find one.

[ScarletPimpernel]

As much as it sucks, you have your options. Try to deal with the new room the best you can, or find another T. Same goes with the money situation. If you can't afford your T and she's not willing to do a sliding scale, then find another T. It doesn't sound like it was her choice for the room change. And Ts have a right to charge whatever they want.

[LonesomeTonight]

Originally Posted by AllHeart

I just finished a book about psychotherapy and it said many clients get attached to the therapy room. It can be like a sanctuary, so comfortable and safe. My t is moving in 2 weeks. I am also more attached to her awesome, cozy, safe space than I am to her. Makes perfect sense, schizoid or not, to feel attached to the room, I think.

I know what you mean by getting attached to the therapy room--my ex-T and MC had to move to a different office a year ago, and it was a difficult transition for me. Didn't help that ex-T complained about the new office (much smaller than her old one--as is MC's, though he didn't complain) pretty much every session. And I hate the waiting room in the new building (smaller and more cramped) and the different receptionist. It doesn't feel as safe to me.

[ruh roh]

So is her rate changing now that she can't practice out of the clinic or is it that she won't accept your insurance any more? Because most private practice therapists still accept insurance, although they may not accept all kinds of insurance.

Either way, I would think she'd understand that the money situation is going to be a hardship. I have never known a therapist to not have a sliding scale, but if she says she doesn't, I don't see much wiggle room there unless you ask for half sessions or something.

As for the room issue, is this where the phone call session came up in your other thread? Because that might be an option for you. As a meet halfway solution, I would ask about a half hour phone call. That way, you get a reduced rate and don't have to be in that room.

[guilloche]

Oh wow. When you talked to her about this, did she understand that you're having nightmares and intrusive thoughts? Because, that seems like a pretty big deal to me, and makes it a different situation than just "being uncomfortable".

I also don't think it's uncommon at all. I saw my last T in four different offices (!). A couple of those moves were really rough... his final office was one that he purchased (his "forever office"!) and I really didn't like it. At all. It was huge, and I could hear people in other offices through the walls.

He worked with me to try to to figure out what I needed to be more comfortable. And, in the end, put up soundproofing (in the ceiling, I think?) so that I wouldn't hear the neighbors - which was pretty incredible of him, I thought. He also let me choose where to sit. Most clients sat in the therapy section, but to sit there, I couldn't see the door and I felt nervous that someone would come in, sneak up behind me, and listen (there was a bit of a wall there, so someone could theoretically get in the room but not be visible).

I ended up sitting on the couch (that apparently nobody else ever sat on, ever!) that had a clear view of the door. Even though the T had to take his regular desk chair (not his usual therapy chair) and wheel it over to sit in the couch area.

So. I don't think you're being unreasonable at all, though I can understand why she doesn't want to discount her rate. I like the idea that was posted about doing shorter (pro-rated) sessions to help get you used to the room, if that's what you want. It would be like "desensitization" for a phobia - and you could even ask her to work with you in that way - you'd do a short session there, but focus on how you're feeling, and on feeling calmer while you're there.

But do you think that's going to be enough? Intrusive thoughts from a childhood you don't remember tends to be bigger, more complex stuff to deal with. Which makes me wonder if a couple of 20 minute sessions to feel better about the room might not help much.

Is there anything else you can think of that would help you feel more comfortable with the room? Is there any way that she can actually put away the toys, so they're not visible? Or anything else that would help the space feel safer to you?

Since you said that you're not attached to her, do you feel like there's any value in continuing with her, specifically, versus someone new? Has she been helpful to you so far? If you weren't already seeing her, and your first session were in this room - do you think you'd continue, or find someone new?

I'm sorry you're going through this. It really sucks when therapy becomes about how to deal with changes/things in therapy, rather than in your life.

[mindmechanic]

@guilloche: Thank you for a very thoughtful reply. Yes; she says that she thinks she understands the distress that the nightmares and intrusive thoughts are giving me. I, on the other hand, feel that she doesn't really understand or isn't really empathizing with it.

About the pro-rate. She said that we still have until the end of the month in our usual room. She wants to see how that goes first before deciding on what to do. She said that she is not giving me an absolute resounding no. I said that I need to know what my options are. I don't see why it's so difficult for her to just give me a yes or no about whether pro-rating is an option. Why wait until the end of the month? I need to know what my options are now in order to feel safer.

She did say that she could find a way to keep the toys away from sight. Where and how - I don't know. I don't like that the room is bigger either. And it is noisier in there. But I'm not sure if there is much anything she can do about it. She is also sharing the office space with other therapists. We have always done Tuesdays 6pm since we started working together over two years ago. And we cannot even keep our 6pm time because she would not have access to the room.

If things do not work out with this therapist, I would be done with therapy and not seek out another person. These relationships don't seem to work out, which makes anything positive that we have worked on seem like a lie or an illusion.

What would it mean or be involved for you to work with her on making it a safer space for you? Is that a possibility.

I understand her wanting to see how it goes before giving you an answer about prorating sessions because she may want you to face your fear. Could your bolting become a problem when you have to deal with other difficult issues in session? I know I wanted to bolt several times to the restroom or my car several times. I’m not saying you would do this I am just raising it as a possibility. When the weather permits can you walk or sit outside?

It does sound like she is willing to work with you which is rare compared to many others that post here.

[fille_folle]

Do you think you might be subconsciously using this issue as a way to flee the relationship? I have done some reading on schizoid disorder, as I have at times wondered if I have it, and I recall that some people theorize that emotional intimacy feels unbearable to schizoid individuals. Is it possible that, while your concerns are reasonable, you are also motivated by the impulse to disengage from the relationship? Just a thought.

[mindmechanic]

Hmm; I appreciate the thought-provoking questions. But I don't think I'm using this situation to bolt because I have schizoid tendencies. I actually wanted to quit because the change was too much for me, but decided to give it a try. I don't think it is too much for me to explore my options. The therapist is supposed to provide a safe space. She was open to the idea of us checking out the new room while we still have our usual room. But why can't she tell me if shorter, pro-rated sessions are a possibility? Why does she have to wait and see? I need to know what my options are in order to feel safe, less anxious, and more secure moving forward. Is it about money and profit for her? She did mention something about maintaining the frame of the nature of this work. She was talking about how this is a professional relationship where I'm paying her. I agree. But I don't think that asking for shorter, pro-rated sessions during such a difficult time violates the frame of therapy.

I have actually done therapy in a gyneacologist's exam room - on the table - once, although I didn't use the stirrups. (was shortly after my leg amputation. Sitting hurt a lot and I couldn't for more than an hour or so at a time, so I asked her to arrange a room where I could lie down during the session (as I'd also have to sit in the car during the trip). This was the nearest empty room.) x)

Would it be possible to start the sessions in the room, then when it gets too much you'll take a walk outside or sit on a bench or something? With your T, I mean, to continue the session from there. Or just to calm down and then go back to the room.
Maybe it would also be helpful to go slow, I mean, don't feel you have to continue the regular heavy therapy-y stuff immediately in the new room. Take some sessions to acclamitize the new room. Look in all the cabinets if it'd be helpful. Chat about the weather. And then if after a week or a month or two months you'll feel more comfortable, start talking about things that matter. Then about upsetting things that matter.

For you (and the rest of us), therapy safety is a triad: yourself, feeling safe with the T, feeling safe in the room. If you go to see a new T, no one will expect you to bare your soul immediately. The room is also a part of the triad: so no one should expect you to bare your soul immediately in a new room.

[mindmechanic]

Well; I'm back in town and going to see the therapist later today.

I'm feeling quite mad at her. We planned for her to ask the director of the clinic if we could move a picture in our usual room to the other dreaded new room because of how I'm attached to it and it gives me comfort. The director of the clinic said that we can do that if other therapists who use that room are fine with it. Without my knowledge, the therapist sent an email blast to the other therapists saying that she has a patient in transition to another room and is attached to the picture, and whether they had any patients who would be disturbed by the picture being replaced.

I'm angry because she sent an email blast without first telling me. And I find it entirely unnecessary to go into details of why the picture is being moved. She could have simply said it was in the interest of a patient, and whether they were okay with it. I feel violated.