[ScarletPimpernel]

...to pay for sessions to deal with a rupture a T created!

I had two sessions with L today. After the first one, we determined I could use more support. She offered a second sessions today or tomorrow. I agreed and asked for one today. Long story short, she triggered me badly and instead of dealing with the other issues I'm struggling with, we had to do a session to calm the rupture. "Calm" not resolve.

I told her it's not fair that I'm paying for this financially and emotionally and it doesn't affect her.

I don't know what to do. She wants me to write to her about my anger. It's hard enough feeling anger especially towards her, but to also express it to her.

I hate ruptures...

[ElectricManatee]

Ugh. Yeah. I've paid for so many unpleasant conversations over the years, some of which were caused -- in my (clearly objective) opinion -- solely by my therapist's pigheadedness. I guess the benefit is that you don't have to support her emotionally and the focus of the conversation still centers you and your feelings. That's different from working through a misunderstanding with a friend or family member. But still, it's really unpleasant to go through.

[unaluna]

Its all part of the same pie, imo.

[Lonelyinmyheart]

I get it. I had to pay for two extra sessions when an ex T called me 'controlling.' The fallout was so bad it took me that long to deal with my feelings about it and her. I was very angry and upset that I had to use my money when it was my T's insensitivity and bluntness that caused the issue in the first place.

[Favorite Jeans]

I couldn’t agree more.

I know this isn’t your first rodeo and you already know all the potential therapeutic benefit of working it through and blah blah blah. But ugh. Sometimes, for what they’re paid, they could just shut up and be more perfect!

[LonesomeTonight]

I get it, too. When Dr. T and I had the big rupture that led to me leaving briefly a few years ago, I had to pay not only for a couple sessions to deal with it, but also for some emails he sent that I found to be really hurtful. I understand his policy is to charge for emails of a certain length, but it felt like a slap in the face.

He recently said how if a client leaves on what seems to be bad terms, he will sometimes email them and offer them a session for free to come in and talk. And I didn't say it at the time, but all I could think was, "Oh, but you didn't reach out to me when I left, plus you charged me for everything." Now maybe this is a new policy, or he thought I was just completely done at that point, so he felt it would be pointless to ask me back--or he was sick of dealing with me and relieved that I had left (though he did take me right back when I asked).

Anyway, yes, I definitely get why it's difficult to have to pay for a rupture that was entirely or mostly their fault (or even half their fault--we could split the cost of the session). Plus to be the one to deal with all the emotions (though I imagine L was sad about it, too). So I'm sorry you're having to deal with that. I hope you've been able to at least mostly resolve the rupture.

[Etcetera1]

I don't believe that there is any "potential therapeutic benefit" to these things. Nope.

I guess it's still true anyway that love cannot be bought with money.

Best to get clear on our expectations as to what we are looking to get from the therapist. Because, love, nah. Guidance for exploring yourself, providing psychoeducation and strategies, methods for coping skills, sure.

[Rive.]

Agreed, it's not fair to pay for sessions where a T created a rupture

I will add:
- it's not fair for a T to cause a rupture and then brush it off
- it's not fair to have to carry this pain because 'we' cannot talk about it
- it's not fair for a T not to offer to 'repair' or reflect on their own sh--

[unaluna]

Is it a detour or a shortcut?

[Oliviab]

I see it a little bit differently (although I certainly getting feeling that it's unfair). To me, working through ruptures IS the work of therapy. I see all ruptures as co-created. There is their action (or inaction) and then there is our reaction to it. Or there is our action and their reaction. Regardless, it is something that exists between the two of us. And we are paying them to stay and work through it with us--we are paying for their time and presence in the relationship. And the way I experience rupture/repair is that there is the potential for growth, healing, insights, and empowerment in that process.

That said, sometimes our Ts do or say really dumb things, and it's frustrating. And I know not everyone sees therapy the way I do or even wants it to be that way. And the process I outlined above is kind of the "ideal," but it relies on a therapist who is self-reflective, self-aware, committed to the "do no harm" principle, and to willing to own their crap and their role in things. Which, quite honestly, is not every (or even a lot) of therapists. It feels particularly unfair to have to pay for a therapist to sit there and deflect blame.

[ArtleyWilkins]

Did she intentionally trigger you? Or were you triggered?

I see a difference there.

Intentionally pushing a button knowing it will trigger someone is just cruel.

I've rarely had a therapist "intentionally" trigger me. But boy, I sure could get triggered by things at times. Usually it was sort of out of nowhere, and part of therapy was figuring out why whatever was said or whatever happened set me off. Understanding my own triggers was just part of the work. All that work helped me reach a place where I am less likely to be that severely triggered anymore.

I am responsible for managing my own triggers.

That said, I had therapists who were able to help me go through that process AND who were also quite willing and able to acknowledge any part something they might have said had in that trigger. But they were ALSO learning in those instances because my therapists didn't deliberately set out to trigger as strong reaction; it just happened (which is sort of the nature of triggers), and they filed that information in their brains for future reference so as not to repeat that issue again. That's what I needed them to do.

[Echos Myron redux]

My therapist used to offer a session free for that, but he suddenly stopped offering that during our last rupture (which was more about his feelings than any other rupture we've had).

[ScarletPimpernel]

No, L would never ever intentionally trigger me. I know that. But I would say she wasn't careful. She played a huge role in this. She knew what I was dealing with and yet chose to bring up and focus on something that affects my situation.

I do want to add one more thing: I know L loves me. I do not question that. I do not pay for her love. That is not love if you do.

[susannahsays]

I agree it's not fair, although I tend to associate fault when I'm triggered less with the person who triggered me and more with whoever caused me to develop a trigger in the first place. So I guess in that way, I don't really resent the therapist if I have to pay to resolve something that is about me and my issues rather than some fundamental mistake on her part. Or at least, my resentment isn't directed at her so much as the entire circumstance of having to pay to fix something someone else (not the therapist) broke.

Of course, I get the impression therapists are prone to forgetting that sometimes they actually are in the wrong even if it involves a trigger (which by its nature involves overreacting and being irrational). I mostly mean when a therapist fails to think before spewing at the client something that half a second of reflection would have told them they should avoid.

I have doubts it occurs to the average therapist that a rupture can occur without it being about the client's issues at all. Sometimes my therapist says dumb things anyone would find offensive but she acts like my perception is the problem. Maybe when you deal with triggered people all day, you forget that you are capable of being ignorant, rude, or otherwise offensive. Idk. But it's frustrating.

Sounds like the second circumstance is what happened here and that sucks.

[ScarletPimpernel]

She triggered my fears of homelessness and abandonment by bringing up the topic of her fees in the middle of a very delicate situation I'm in. Homelessness is a huge possibility in my near future, and if finances run out, I fear her abandoning me. She did not need to bring up her fees when she did. And she definitely didn't need to try to force me to discuss it in that moment. Even she admitted that she should have talked to her assistant first before trying to work it out with me. And she shouldn't have forced the issue when I'm basically in a crisis.

She has no fears about me not paying her. She has my credit card on file, I've been with her for almost 3 years and have never missed a payment, she is up-to-date on my financial situation, she's seen my monthly bills in an excel chart. Hell, I just found out my copay is actually $35 and I've been paying $80 for the last 3 months. She's been well over paid.

[susannahsays]

Well wtf, has she refunded you? It sounds like she hasn't if you're saying she's been overpaid. I'd be really upset about that given you say she's aware of your financial situation and, I assume, the risk of homelessness.

I think you've said in the past that you voluntarily gave up disability when you got married. Maybe you should look into it again? Because it seems like if you can't work even to avoid homelessness (or what may be worse to you, abandonment by this therapist), that you are in need of a safety net. Think of it as making everything else you're working on more effective - it's hard to focus on improving your emotional wellbeing with the constant threat of homelessness hanging over your head.

Anyway, sorry to go off topic, just concerned about you. It's not acceptable to me that you could end up on the street. You have enough you have to deal with. Life is just so unfair.

[justbreathe1994]

Originally Posted by ScarletPimpernel

She triggered my fears of homelessness and abandonment by bringing up the topic of her fees in the middle of a very delicate situation I'm in. Homelessness is a huge possibility in my near future, and if finances run out, I fear her abandoning me. She did not need to bring up her fees when she did. And she definitely didn't need to try to force me to discuss it in that moment. Even she admitted that she should have talked to her assistant first before trying to work it out with me. And she shouldn't have forced the issue when I'm basically in a crisis.

She has no fears about me not paying her. She has my credit card on file, I've been with her for almost 3 years and have never missed a payment, she is up-to-date on my financial situation, she's seen my monthly bills in an excel chart. Hell, I just found out my copay is actually $35 and I've been paying $80 for the last 3 months. She's been well over paid.

Have you brought up overpayment of copays to her? That seems wildly unethical if you are overpaying copays and she hasn’t at least credited your account - it may even be considered insurance fraud.

[ScarletPimpernel]

She seems more concerned right now because the insurance hasn't paid her yet for January and February... because they've been sending their payments to the wrong address.

She's also concerned about charging me for double sessions because insurance will only agree to one session in a day. We haven't discussed my out-of-pocket fees for that.

Whatever I owe her, I'm sure my over payments for January and February (and probably March), will cover the 3? double sessions I've had (I paid $80 for those too).

But see all of this shouldn't have been brought up right now. I do not owe her anything (unless she raised her rates for me without telling me). Still! I am facing possible homelessness, and she's concerned about her fees? Right now? The exact time when I need her support?

Talking to my dad about this, I'm thinking her assistant is the main problem. I don't think she's been doing her due diligence. She's the one who was supposed to figure out the address to bill, she's supposed to get extended sessions, hell, she's supposed to bill my account on the day I ask her to.

Oh, btw, the overpayment is my fault. I assumed she was a specialist. I didn't realize mental health had their own copay. But it is her responsibility to readjust my account. She probably owes me like $600. I'm not worried about getting paid back. I am worried about my situation.

[ArtieTheSequal]

Hugs if wanted, scarlet. I always hated talking about money with L. I'm sorry her timing was so bad in bringing it up.

[susannahsays]

Ugh, I've been there. Well maybe not this severe as I wasn't worried about my housing but I've had the therapist rack up $650 in money I shouldn't have paid due to exceeding my out of pocket maximum. This was when I was in school and couldn't even afford heat. For some reason, this happened every single year until last year when I finally learned my lesson and started monitoring my progress toward reaching my out of pocket maximum.

I was also really irritated when nobody told me the therapist was using a different billing code that resulted in me having to spend an extra $72/month. I'm still kind of mad about that, tbh.

[susannahsays]

You know, I just had a thought. There's that new law about transparency in providing estimates of healthcare costs. I wonder if that's a factor in why she felt she had to talk about fees before having a session you'd have to pay out of pocket? Idk, just a thought. Therapists have been abuzz regarding the implications on reddit, so I just wonder if there was more to it than her just being oblivious.

Probably unrelated, just a thought.

[ScarletPimpernel]

!!! I actually brought that up to her just a month ago? When I had a session with T when L was having her wedding. T had me sign a paper, so I took it to L. L still has yet to have me sign one.

[divine1966]

So she brought up money, which upset you, but now you have to have extra session for which you have to pay for. It makes no sense. It should be free imho, otherwise it’s a catch 22.

They have to pay you back ASAP. My husband overpaid in co pays snd they sent us a check immediately ;our insurance covered therapy co pays due to pandemics but neither we nor the clinic knew). Are they planning on giving you money back?

I am sorry about potential homelessness. Is your husband not working? Why isn’t he working? Can your t help you with some ideas re avoiding homelessness? My ex T gave me some good ideas when I was in not so good financial place at some point, was single and no one to rely on.

[justbreathe1994]

Originally Posted by ScarletPimpernel

Oh, btw, the overpayment is my fault. I assumed she was a specialist. I didn't realize mental health had their own copay. But it is her responsibility to readjust my account. She probably owes me like $600. I'm not worried about getting paid back. I am worried about my situation.

I hear that, but I don’t think it was your responsibility to know what your copays are. When therapists decide to take insurance, they are responsible for verifying that information (that’s one of the reasons many therapists don’t want to take insurance in the first place - along with having to wait for insurances to reimburse them). It sounds like the financial aspect of her business has become a bit disorganized IMO, but that’s not on you. Also, I mean no offense to your T - I know the relationship means a lot to you.

[ScarletPimpernel]

H is working. He just doesn't make enough to support us. He's now looking for a new job. The job he's at promised him a huge raise this March that would have got us breaking even. Now the employer is changing the contract for no raise until mid-May, and we only get half the raise.