Here’s a tip. It’s free, and well worth taking if you’re going into psychotherapy (or any type of counselling-type relationship):
Make sure you know what you’re paying for.
It sounds sensible, doesn’t it? Actually it’s kind of obvious. The thing is that I thought I knew what I was paying for (for eight years)… but I was wrong… apparently.
I should add that even if you’re in the very fortunate position of not having to pay for your therapy, it’s also worth knowing what is on offer before you start.
Jump back a month for a moment, and I was in England visiting my boyfriend. One morning I was sitting in bed, drinking very nice, and very strong coffee, while I checked my emails that had come in overnight. I was surprised to see one from my psychotherapist.
It’s just as well by coffee was good because his email attached his account for the six weekly therapy sessions I was missing while I was away.
My therapy is not cheap. On the basis of the health system in New Zealand I really don’t think I should have to pay anything, but I realised (eight years ago) that if I wanted something that was actually going to make a difference, then I would have to pay cold, hard cash (not helped by the publically funded mental health system telling me a few years back that I was basically beyond their help).
And so I have paid myself, for around eight years now. I’m not even going to dare to add up all that has cost. That would be too mind-boggling, except to say that I know it has helped save my life, and therefore it must have been worth it. It has meant living on an extreme tight budget for that time, but I dont’ regret that.
As I said, what my therapist offers is not cheap, and so the account was sizeable. He wanted me to pay for each session I missed, regardless of the fact that I was out of the country, and regardless of the fact that I had given him three months notice that I wouldn’t be at those sessions. Ouch! That was a bit of a shock to my morning. More coffee needed.
Right from the start of seeing my therapist I understood that if I missed, or cancelled the odd session, because I was sick or for any other reason, that I would have to pay for that session. My understanding of that, for eight years, has been that this is a regular practise for many health professionals, used when a client doesn’t turn up or cancels the appointment at the last-minute.
I accepted that. It’s hard to pay so much money for something you’re not getting, when you’re lying in bed sick and have to miss an appointment, but I could understand it from his perspective. I just never expected that after giving three months notice of my intended absence from the country, that he would still charge me for those appointments I would miss. And that’s where we have come undone.
Since receiving that email, and then in my weekly appointments when I got back to New Zealand, we have discussed this. His expectations and mine are vastly different. Apparently even though I wasn’t there for those appointments, and was not even in the country, he sees that he was providing me with a service. He was ‘being there’ for me… even though I wasn’t there.
It made me ask the question of what it is I’m actually paying for. From my perspective I always thought I was paying for a 50 minute appointment for therapy. Outside of that weekly 50 minute appointment, I didn’t think I was paying for anything other than it being helpful if he would remember (in the way that works for him) the details we discussed from week to week.
He has always said I could telephone him in between appointments if I was really struggling and needed his help. I guess (although am still not entirely sure) that was what he meant by ‘being there’. It took a long time before I got a specific answer to my question… and then it wasn’t at all specific.
In eight years I might have rung for help outside appointments twice. I find it very difficult to ask for help and have never felt comfortable with doing this, even though he made it clear that I could. Actually that’s an whole other post just to cover why I haven’t used this. But it’something he and I have been very clear about in terms of my need.
As for the six weeks I was away, he had said (before I left) that I could speak to him by telephone, Skype or email if I needed to, although I made it clear that I wouldn’t telephone or Skype (I’m not good on those mediums), and doubted I would have the need to email him. I guess he was saying if I needed help, then he would ‘be there’. And from what I can ascertain, that is the basis on which he charged me for appointments I wasn’t there for.
Is this getting confusing? Apologies. It’s taken a bit of brain power for me to get my head around this but at the end of the day, it appears that he is charging for one thing, but I have been paying for another. Yes, for eight years. I actually don’t see any reason why I would pay anyone to ‘be there’ in this way for me.
My therapist knows that I am not willing to pay that money (nor do I have such funds). I am also not prepared to be charged on that basis, anytime in the future. I have never heard of anyone having to pay for therapy on that basis, and would be interested to hear, if you have. Is this as odd as I think it is? I’d also like to know what any therapists who might follow my blog, make of this arrangement of paying to ‘be there’, even if not there physically.
I’ve decided that I need to end this therapy relationship, because I’m not prepared to pay on this basis. I’ve told my therapist this today. Why is it that when you have to talk money that people start playing mind-games? I have nothing I against my therapist but don’t appreciate the way he has handled this particular issue. It was a relief to finish and leave today.
While this is a really big step for me, because I know this therapy has helped me considerably over the years, I know too that I can make it without his help from here on. It’s not going to be easy to not have that sounding board or the unique understanding of me that he has had.
My therapist has been really good. I have no doubts about that. But I feel that while everything is not perfect in my life, and never will be, I am at a good point to do this. Hindsight is always a great thing, but I don’t think I would have gone into therapy with him, if I had understood what it was I was paying for… some obscure idea of ‘being there’. I’d go so far as to say that it’s a little spooky for me. But that’s just me. I like to know that someone is there in front of me, and that is what I pay for. I actually don’t want anything else.
I think I will do more writing, and drink more tea (or coffee). Maybe I will finally take up meditation. Oh, and talk to my teddy bear more. He doesn’t charge for ‘being there’… regardless of whether he is (or I am) there.
“A combination of fine tea, enchanting objects and soothing surroundings exerts a therapeutic effect by washing away the corrosive strains and stress of modern life. [… It] induces a mood that is spiritually refreshing [and produces] a genial state of mind.”
― John Blofeld, Chinese Art of Tea