The xtra week. Does your T do this ?

I get all triggered when my T suggests I take more time in between sessions. I seem to take it as a big rejection. I see her every week and every now and again she asks if I want an extra week in between. I’ve asked why and she says people need more time in between sometimes. Then I feel like a stage 5 clinger if I dont go with it.

It’s great that she’s not just all about money and making people come every week to keep seeing her etc. but I just feel rejected and bad when she says it, like she’s phasing me out and I am powerless because I cant say anything when feelings of not being important, being bad etc just get triggered and I feel like I should disappear.

Does anyone else’s T do this ? I hate that it’s even a thing. I just want a standard weekly thing that I don’t have to feel stupid or pathetic for wanting.

My therapist has learned to never mention reducing sessions to me. I currently go 3 times a week (started for coping in early part of pandemic), sometimes 2, and intend to reduce to 2 soon. At times when I've considered reducing, even him saying something like, "did you want 2 or 3 next week?" could make me feel rejected, and I'll start crying. He'll sometimes say things like, "How do you want to handle next week?" which is fine. So I get it.

I know it's difficult to do. But I think you need to tell your T how it makes you feel. That you do want to attend weekly. And maybe to let her know that if you want more time in between, you'll be the one to ask for it. That until then, to just assume you want to come once a week. If you don't feel you can say it out loud, maybe you could write it down and hand it to her or let her know via email or text if she allows those.

This would leave me feeling upset. Shoot, I was left feeling like she was wanted to get rid of me when she suggested I look into seeing an OT for sensory integration.

I don't know why I do that - feel that way and get all upset when people say or do stuff like this. For me it is a feeling I have with pretty much everyone, part of my issues. I honestly don't know if it's an attachment thing or a routine thing. It's probably both and neither. All I know is it hurts and leaves me questioning the very nature of the relationship.

I think telling her these things would really good way to approach it. It seems like a safe way of saying it, not having to get into the weeds of how it leaves you feeling. Instead it can be seen and felt as you taking charge of getting your needs met.

And if you ever what to explore the whys of you feeling the way you do, you can always bring it up when you feel comfortable talking about it.

Thanks for this! Exactly! The wording matters.. Like if he asks do you want 2 or 3, and you feel stupid for wanting 3 because he just made it a thing. That’s how I feel, once she says it I feel like I shouldn’t want to come every week and I’m pathetic if I do.
I told her I wanted to come next week and I gave a specific reason and she said ‘ok we’ll work on that and then think about giving it an extra week in between’

Like why is this even a thing!? They must have an idea that it’s going to be triggering to clients. I just don’t get it

I will try and tell her 🙈 But I’m afraid of being entitled and pushy and feel like I should be able to handle the perceived rejection and will be showing her how weak I am if I tell her. Then I’ve given her all the power and that’s not good either

Thanks Elio! I wish I had the guts to say it matter if factly like that! I just don’t feel I can take control when it’s in my head that she wants the opposite
I’ll think about it over the next few days

I think it may be helpful to discuss why they are asking. I don't see it as rejection at all, to me it sounds like they see something you don't. They feel you ae making a lot of progress and it may be helpful to you at this point to see how you handle taking an occasional week off. Based on their response to you saying why you wanted to meet next week, I get a hunch that maybe you are starting to spend more time chatting rather than working on any distress. (I have no idea on that, just a possibility.) Anyway, it may be helpful to ask the why.

I don't think L would ever suggest taking off a session unless prompted by me in some way. Like if I were to say I needed a break, she "might" suggest that. Probably though, she'd suggest a more relaxing and connecting session. She does respect my space and I know would support me if I needed it, AND she knows that if I am seeking space from her, something is up because that's not like me.

Definitely talk to your therapist especially because it's bothering you. There might be a miscommunication or misunderstanding somewhere there.

Well the last session was all about me bringing her up to speed on a change I had made in my thinking about something. It was one of those aha moments and I wanted to share it with her. Had I known she would act like we were done I would have kept it to myself. I am not done, I am just getting started and was just starting to think it might actually be possible to work on some of the harder stuff (that she knows is there) So yes I’m kind of hurt and afraid of being more hurt if I continue
I did ask her why and she just said sometimes people need more time and something about being in the advanced stages. And that just triggers my sense of being bad and that even she is skipping over the remaining issues because she doesn’t want to do that work with me because I just infect everything. God I hate her right now

when My therapist first started doing this to me, suggested / asked whether I wanted to space out my sessions it did make me a bit nervous .....until.... I asked him/her about it.

I found out it was a required thing with that mental health agency requires of their therapists. they had previously run into a problem with insurance plans.

you may remember back a few years when the USA enacted a federal law that all Americans must have basic health insurance, that includes mental health plans.

The health plans can come in the form of being enrolled through the state (welfare, SSI and so forth Medicaid, Medicare), the workplace (employee benefit packages) or private insurance plans (blue cross, blue shield and so forth). There was even a big website you rarely hear about today where Americans could sign up for various types of health insurance plans.

well long story short with all americans required to have health insurance, insurance companies had to do some changes.

some now go by a "point value system" or "so many appointments per year". Think of it like a bank. you have so much in your bank account and must space out your spending in a way that lasts you the whole year.

imagine having 25,000 and that has to last you 12 months. you get to month 6 and realize you dont have any money left to cover everything for the rest of the year, you end up having to go with out for 6 months,

finally one day someone explains to you that your insurance only pays for so many sessions and you get to decide how you spend those sessions and whether you do nothing or get things done.

do I use them all up by going to therapy ....more.... than once a week?

Do I want to use them by going once a week?

do I look at that number of sessions in my "account" and space it out in a way that gives me a chance to see my therapist all year.

Do I do a bit of extra spacing the appointments out so that it not only gives me enough appointments to see my therapist all year and have a few left over for those emergency appointments that sometimes come up.

Now that I know how it works when the question comes up about whether I want more time between appointments I choose the last option....

I add more space between appointments so that not only will my insurance cover all my appointments for the year, I will also have enough coverage left over for emergencies.

most if not all mental health agencies in the USA let the client decide how they want to schedule their appointments and how to spend their allotted time in therapy.

tips to manage this new point system -

I always enter therapy with a plan of what my problem is and at least 3 goals I want to accomplish by being in therapy.

I always enter therapy with an idea that because my insurance plan pays out for 52 sessions. that amounts to going weekly (4 therapy sessions a month) if I dont want any extra sessions.

I also know myself, my family issues, my life style and work issues. they all at times affect my life in one way or another, so do I think I may need an extra session placed somewhere to deal with those things yes.

so that narrows my regularly scheduled sessions down some more, to where I attend therapy every other week instead of weekly. that allows for me to see my therapist all year (26 sessions) and allows for the 4 psychiatry appointments for meds renewals per year for a total of 30 sessions.

this leaves 12 sessions through out the year to be put in for those times I may need an emergency appointment or an extra sesssion slipped in due to stress and hard times.

by setting up my schedule this way I can rest assured that Im not going to over draw or zero balance my "health care bank account"

You can always request more sessions from insurance. L requested extra sessions, double sessions, and even 60min sessions and got approved for all. She has to do this every 3months, I think?

I really depends on your insurance. Mine has unlimited MH - except only 1 therapist per day can bill.

What my t does is surprise cancel on me last minute and doesn't make up for it the following week (our appointments are on Fridays).

My last T would just ask me at the end of sessions if I was doing somewhat well, "do you want your next appointment to be in 2 or 4 weeks?"

Thanks guys. It’s nothing to do with insurance since I don’t use it.. Although it was interesting to read about how it’s done in the USA.
To be honest I’ve been very triggered several times now and have never spoken to her about it. Thought I was beyond it as I’ve had a few good weeks. But now I know once again how hard it is to recover from and that I can’t keep doing this unless I know she is going to stop it

It sounds like you really do need to let her know about it. It's one lesson some of us have to learn - telling people what we want and don't want.

It sure isn't an easy task for some people; especially me.

She hasn't asked about cutting down on the number of sessions. However, on occasion when I am struggle I have thoughts of wanting to quite therapy. Recently, I have been struggling with this. Last week when i told her this she told me taking abreak is always an options.

I fear she wants me to stop seeing her. I plan to talk about it at our next session.

I asked my therapist not to bring it up because it upset me when I didn't feel ready. Then about 2 years ago I knew I was doing better and for several months in a row I had to miss one session per week and I did ok. So I hesitantly tried on my own and now we routinely do 3x/month and I handle that well. But it had to wait for me to be ready, not for when my therapist thought I might be ready.

No my T didn't. In fact she was of the mind that being in the therapy space was the safest place for me during tough times.