Couch 252: Kitties and Hawks

Well, it seems I made the right choice in seeing Dr. T virtually yesterday (after he'd been traveling--I asked if he'd been around crowds in confined spaces and he confirmed). He texted me an hour ago to say his wife had tested positive for Covid, so he'll be doing the rest of his sessions this week virtually. That he tested negative and feels fine, but wants to be careful. Which I appreciate.

Today's soul medicine was a preview of Liz Gilbert's forthcoming book.

Hearing her read the first chapter to us on Substack settled me in ways I didn't know I needed.

Glad that was helpful for you, Lost!

Well, Dr. T does have Covid, his first time actually testing positive for it (though he thinks he had it a couple years ago). He was well enough to have a virtual session today and actually seemed in better shape than he was Wednesday.

Generally a good session, all things considered. He was having some connection issues though (eventually figured it out) that would lead to freezing and some seeming stuttering. I made a Max Headroom reference, and, being a little older than me, he got it.

So, guess it will be virtual for all or most of next week. I'd be more willing to risk in person if he was testing negative by Wednesday if we weren't all going on vacation the following week, along with my parents (staying in separate locations, but spending lots of time with them).

Connection issues add a whole new level of complexity to the virtual experience.
I'm sorry you had to go through that, LT.

Hard that you have to make that call for the sake of your vacation.

Sending hugs,

Lost

Thanks, Lost. I've rarely had connectivity issues with Dr. T, even through such a long stretch of virtual during the pandemic, so it felt a bit jarring. I did think of you and knew you'd get it. He realized near the end that his computer was connected to the lower-speed WiFi in their house, and it got better once he changed it. He said he should have thought of it early on. But hopefully, it means it will be better Monday.

I had intended to take a session or two to process the office move, which was a year ago, during this time, but obviously, this isn't a good time for that, with his being virtual and ill. So maybe in mid-September (as there will be my vacation, then another short trip of his)? Maybe I don't really need to process it--or maybe I can do it through writing instead of with him--I'll see how I'm feeling.

I'm glad he recognised the issue and did what he could to fix it.

I hope it will be better on Monday.

It's odd that virtual has so much impact on the conversations we're able to have.

Hope you can take some time to process if you need to.

Today in awkward places for Zoom to freeze, then crash:

Dr. T: I wonder if... [closes eyes to think}
[30 seconds later]
Me: Yes??? Wait---are you still there?
A few seconds later, I was shifted to the meeting host. I was able to rejoin a minute or two later.

We were talking about my doing EMDR with R and any concerns he had. I was especially emotional during the whole conversation. I think it dredges up paternal/maternal stuff for me. My parents allowing vs. not allowing certain things. And having issues with me confiding in/connecting with people other than them (well, my mom was concerned about it, my dad not so much). Which, I suppose, is something I can process in EMDR...

Oh, man...

I'm sorry you had to endure that at such a pivotal point, LT.
Did he at least re-state his point?

I hope you can take some time to be extra gentle with yourself today.

Hugs,

Lost

Thanks, Lost. He said he wasn't sure how long he was talking before realizing I was frozen, but my saying it cut off with "I wonder if" made him realize where he needed to start.

It's weird that I've rarely had issues with connectivity when working with him on Zoom, through many months during the pandemic, yet I've had issues the last two sessions. And this time he was in his office, not his home (he tested negative but is still just doing virtual), so it wasn't that. My home WiFi is generally completely fine for everything, so I don't think it's me.

When you submit a superbill to your insurance, do they pay based on the whole amount you paid or on a discounted rate?

I paid the therapist $180.
Insurance had a discounted rate of $106 and bases all their calculations off that amount.

If the calculations were based on $180, I'd be paying $72 and they'd pay $108.
I'm actually paying the 40% coinsurance of $42 plus the difference between $180 and $106. So instead of paying 40%, I'm paying 65%. (All amounts rounded to the nearest dollar.)

Is this the normal way insurance companies do this? I'm kind of perturbed. I think I'm paying double what I paid P and getting half the number of sessions.

I *think* that's how it works, sadly, but I'm not sure. That seems like a very low allowable amount. How long are your sessions, and how does your therapist code the time on the superbill? Dr. T now codes for 60-minute sessions (I'm usually there for ~55 minutes), which makes the allowed amount higher--it's like $190 or $200, I think. I also pay $180 (slightly discounted from his increased rate), and they reimburse half of that with out-of-network benefits (50% coinsurance).

I'm trying to recall what they covered when he was coding for 45-minute sessions (he changed it for all clients a few years ago). At the time, I was paying $150, and they allowed a bit less than that, like $142 or some random amount. So I'd pay just over half.

I hope that made some sort of sense--I'm only partway through my coffee!

How did it work with P? Did he just have a considerably lower rate?

Thanks for sharing how yours works. He accepted my insurance and was in network so the coinsurance I paid was 20%. I'm not sure how much they reimbursed him. Probably not enough which makes me feel bad. I'll have to check what type of session she codes for.

I'm struggling this week and feeling overwhelmed. I talked about some really personal stuff in therapy this week and then I read some things I wrote while I was still with my ex that were related to what we talked about. It was basically a first-person, frontline account of how my life was going as I was telling it to a Better Help therapist I used briefly when I felt like I was too much for P. It was a lot to take in and old hurts have resurfaced.

I'm feeling like I want to quit therapy now. I'm also feeling like I should send this document to my current therapist. Contradictory, I know. I'm also really, really struggling with wanting to email P. It's only been two months since we last had contact so it feels like it's too soon but I want some contact with him very badly. I wonder if he ever even thinks of me anymore. I hate everything and I want to give up right now.

Hugs, NP. That all sounds really difficult. I understand the mixed feelings about it. Maybe it could be worth sharing the document with your current therapist, so you could discuss it? And did you and P set up any sort of guidelines about how frequently contact is OK? I Imagine it would be OK to reach out. I can't believe he'd have forgotten about you this soon, given the length and closeness of your relationship. I imagine he's wondering how you're doing. I asked Dr. T once about whether he still thinks of former clients, and he said that he does. Not as often as when he was seeing them, but he still thinks about them.

Feel free to PM if you want to share/talk about more.

Very insightful session today with Dr. T regarding ex-MC (I head to the beach tomorrow, so we met today--he works Sundays). He said it seemed inevitable that something would go wrong, with the combination of how I am seeking acceptance and unconditional love and how ex-MC was as a therapist (plus the fact that he was my marriage counselor). That it was like a hot, humid summer night when a thunderstorm seems inevitable--just needs some trigger to spark it. I agreed with that.

I also mentioned how for a stretch before sending the "I love you so much" email to ex-MC after the concert, the transference had been fading. Dr. T said he hadn't recalled my saying that before (I thought I had, but it was likely years ago). He said how it made sense that it would eventually fade, that the magic would go away because ex-MC was the transferential object, not the original subject (my parents). But how maybe it fading felt threatening to "Little LT," and that mixed with the emotions of the concert led me to send the email. Which makes lots of sense to me. I'm at the point where I can look at it with more logic and less emotion (a few years ago, I'd have likely been sobbing during this conversation--today I wiped my eyes once, but that was it).

It's understanding, as we talked about today, how it was the situation and the combination of people that led to how things turned out, that there were many elements at play, not so simple as I messed up (which I thought for a long time) or he messed up. It was complicated. As many relationships are.

I'm proud of you, LT.

It's inspiring to me that you are able to look back on the experience and appreciate what you've learned from it.

Hugs, if wanted.

Lost

Those are interesting insights, LT! The perfect storm does makes sense for those of us seeking unconditional love and acceptance. Therapy tends to create that connection and safety that we long for. But it’s kind of a facade. I’m not saying they don’t care or don’t love. But I don’t think that’s what we actually need anymore: that parenting love. It feels SO good! But we are not a child and no amount of love will replace what we lost. So it’s almost like it’s doomed to fail.

You know, I know that Dr. T’s boundaries have been very challenging for you at times. Sometimes I understand his boundaries, sometimes not. And I really wish you didn’t have to struggle during those times. But I wonder… do you feel you’re healing with Dr. T? Have you made progress on your core issues? I wonder because I get almost everything I want from L. And though I’m addicted and don’t know how to let go, I really am starting to believe that I’m not really making any progress.

I totally agree that all relationships are complicated. There are just so many factors. There’s each person’s strengths, weaknesses, baggage, and then there’s life affecting each person, and then life affecting the relationship and somehow we have to sort and balance and then connect. It’s never really one person’s fault. Every aspect plays a role. And sometimes we don’t even know what those aspects are! I have never thought you or ex-MC were “bad”. I do hold him more responsible because of the role he took in your relationship. But you didn’t mess up. It’s not all on you.

So growing up when I was like 6, I remember we had some German steins on display. I was always told they were my paternal grandfather’s. I don’t remember seeing them after 8 years old. My mom, a few years back, told me she had “her grandmother’s” steins and she wanted to sell them. That pissed me off because the only person in my family who owned steins was my paternal grandfather. So she must have taken them in the divorce. I was stupid and told my sister who in return called out my mom and was threatening her for the steins. I asked my mom just for one. Any. Just the other week, my mom went to Vegas to pawn the steins at that tv pawn shop. Around 10 steins. They offered her $44 for ALL. She took it!!! $44 for family heirlooms! Today, I went over and she brought out the “stein” she saved me, the one even the pawn shop didn’t want. It’s not a stein. It’s an extremely ugly little tea pot… Of course they didn’t want it. No one would! So my family heirlooms are gone and I have a stupid tea pot. All for $44.

Thanks, Lost. I'll take the hugs!

Scarlet, I agree with what you said on how we're looking for parental love, but we aren't kids anymore, so it's doomed to fail, in a way. I feel like ex-MC made me aware of this wound, of this missing care, of what I could have had. But then he wasn't able to fill it because he wasn't my father and I wasn't a child anymore. Plus, as Dr. T pointed out, his being my marriage counselor made it extra complicated.

As to your question about healing with Dr. T, yes and no. He's really helped me with certain things, like trusting my own opinions/feelings without relying on others to confirm or validate them. And he's helped me some in my relationships, like with H (he's actually helped me more than the person who was supposed to help with that, ex-MC!) And to have better boundaries.

However, I still can get very triggered by certain things. And he's not good at communicating with "Little LT." Which is why I'm going to try more EMDR with R (Dr. T's backup). He's agreed to my seeing her some to do that while still seeing him (I think I'm going to go every other week to her). The one EMDR session I had with her last month seemed to really affect me, so it suggests it could be effective for me. She also does Internal Family Systems (and has done a bit of that with me, when Dr. T has been away), but I'm unclear on whether I'm allowed to do much of that with her or not.

Have you tried EMDR? I can't recall. Just wondering if it could be something helpful for you.

And what you said about relationships being complicated is similar to what Dr. T was saying about it. How there are so many factors at play. Thanks for saying you don't think I messed up. I realize now that it was more on him in terms of his role to me. That he held more responsibility for the relationship. Much like a parents does for a child, really.

I really hopes the EMDR helps! I have not tried it yet, but it has been suggested by a few people here and I know L would support that. The few people here seemed to really benefit from it. And like you said, you had a reaction to the first time. So that will hopefully be useful in your next sessions. Do you know when you will start?

I really like the IFS that L does with me. It does help meet the needs of all my different parts. It’s like when a problem arises, L, I, and my parts get around a round table and discuss. Then at the end, hopefully, there are answers or suggestions to help the problem. It really has actually taught me self compassion and to stand up for myself and to trust my inner self. And, acknowledging and loving “little SP” is so helpful. That the part of me that all my parts are trying to protect. If you do get a chance to try IFS with R or someone else, I would actually suggest bringing in childhood pictures if you have any. At least for me, they really allowed me to connect and see “little SP”. It helps remember why that part of me hurts, why it’s important and valuable to meet her needs, and reminds me who I’m fighting for.

Hi LT. Hope it's okay for me to weigh in here. I'm struck by your language around what's okay or not okay for you to see another therapist about. Dr. T is not the boss of your therapy--you are. True, you're in a therapeutic relationship with him, and probably there are some ethics around seeing two therapists at the same time--like, do you have to let them know? Or is it your own business? If I wanted to see a second therapist for something specific my main therapist couldn't provide, I'd tell my therapist as a courtesy, but it wouldn't occur to me to get permission or approval. This isn't a judgement of you necessarily. I guess I find myself having a strong reaction to this "allowed" wording--but maybe that's more about me than you! Anyway, just wanted to put that out there.

Update on the ugly tea pot: you can buy them off of eBay starting at $9. They were made in England in the 1960’s. Vintage, but not antique.

Thanks for your comments. The complicating factor here is that she's his backup T, who I see when he's on vacation. And she rents space from him, though it's not like he's her boss or anything.

I'm also bothered by the "allowed" aspect. Dr. T has expressed concern that I could become attached to her and want to see her instead of him. He has said before that doing so would "cause problems." But in discussing my seeing her for EMDR, he also said that he wants what's best for me. And he's come around to say that he would "back off" and that if I ultimately wanted to switch to R, whether termporarily or permanently, he wouldn't object to it.

I think if it wasn't someone he knew, it wouldn't have been as much of an issue, thought I don't understand why? He's said he trusts R, in part that she wouldn't be trying to "steal me" (I said if so, it was a very long game, as I've seen her when he's been away, and occasionally at other times, for like 6 years now). And also that she wouldn't be saying negative things about him.

So some of that concern is from stuff I've told him about ex-MC and ex-T. Where, on occasion, ex-T told me that ex-MC shouldn't have had a 40-minute phone call with me. Or that she had issues with other things he was doing. Which was very confusing to me. (I was just discussing that again with Dr. T in a recent session, and he was saying how he'd have handled it in ex-T's position).

So, we'll see how it goes. I did say to him recently that I'm worried it will be "messy." And he said, "We've dealt with messy before." Which is true! I think it's just a case of needing to see what happens, rather than trying to predict every possible outcome (I suppose it's ironic I'm saying that, as someone with anxiety, who will often try to think of all the ways something could go wrong).