Jdcoopers journal

[jdcooper]

So I texted her.  I said, "Do you understand how your comment, about how you would rather work with someone whose insurance is better, hurt me?  Do you get that that is a hurtful thing to say?  She said, "Yes, I am very sorry!  Can you accept my apology-I very much hope so! I messed up!

She acknowledged that our discussion about insurance/money/ brings up feelings in both of us and that we can hopefully "make peace" with it.  The whole transference thing.  It is so very complex.  She most definitely has issues around money (and she says she has had years of therapy) But she admitted she made a mistake.  That took courage.

I think I am going to have a consult with a therapist who is on my insurance panel, whose website looked great and see how that goes.

In the meantime, maybe we can repair this rift.  We have both invested a lot in this relationship.  I have discovered things about myself with her that I never knew.  I have showed parts of my soul that have never been revealed.  It has been very healing. 

Do you give up on a troubled marriage when both partners openly acknowledge the problems and agree to work through them?  Maybe I am learning something very valuable here.  People screw up, they hurt us, in the case of my family they never apologize, but she did.  And she did so when I spoke up for myself.  When I brought it out into the open.

My problem is that I do not speak up when something makes me feel uneasy.  This has been a huge thing in my life. I wonder if this whole insurance thing would have been solved months ago if I had just had the courage to say, the very first time it came up, hey, whats going on here, this whole telling me I have crappy insurance-its making me feel bad.  Instead, I let it go on for months.

The people on this forum, San, Radical, you have made me realize my blind spots.  This therapist most definitely has issues around money.  I am going to have to speak up anytime something makes me feel uneasy.  I am going to have to let her know that continuing to bring up my going back to practicing law is causing me internal conflict.  I think this is part of her MONEY issue.  She wants me to go back to a better paying job.  I just want to think it terms of "a good enough job"  a "good enough life."

I think that most of my healing has been through discovering this forum and researching, journaling, discussing, reading books, etc.  The therapist part - well - that has been a part of it too-but not the most.  I am so grateful for the intelligent, insightful, generous and compassionate people of this forum for help in my healing.  I would not be where I am today without it.  I would be stuck in that frozen like depression, detached from the whole world.

[radical]

I feel really happy for you.  It's a great thing in itself, and a really good sign for your therapy relationship.  Of course everyone screws up.  The awful thing is that something is important to us and we don't speak up the  distance grows - between ourselves and others, and somehow inside too in the form of a kind of learned helplessness and depression.

When I think of the mess I've made in relationships because of this it makes me so sad.  All I wanted was to be close, yet I was creating distance.

I'm also going to work really hard on recognising what is important to me and finding healthy ways of speaking up when I need to. I'm so glad we can support each other in this!

  Yay JD

[sanmagic7]

well, jd, good for you!  well done!  not only about speaking up with this issue, but realizing that speaking up in general when something doesn't jive with you is important.  that's so great!  it sounds like you have learned a lot thru therapy with this t, but this may be one of the biggest, most important life lessons you've learned.  sometimes we get what we weren't even looking for or didn't exactly know we needed it.  i love it when it's nearly magical that it happens.

i don't think it's a bad thing to explore options, such as a consult with another therapist.  i think you made a good point, tho, about people making mistakes in relationships, even therapeutic ones, and if there is acknowledgment of the mistake, a sincere apology, and it doesn't happen again, the rift may be moved on from. 

it does sound like you have a valid point about her opinions leaning toward money with her continually bringing up your job wishes and goals.  you may have to speak up to her again about her not getting personally involved in anything you're discussing that has to do with money, then wait to see what happens.  can she put her opinions, her preferences re: money on the shelf and not let them creep into your therapy?  that sounds like it would be a challenge for her. 

you may want to give that a chance, see what happens.  if she messes up, or refuses to make that commitment, then, unfortunately, you may have gone as far as is good for you with her.  it's not unusual in a therapeutic relationship to have an 'end date', so to speak.  one therapist may only be able to take you so far, and that's it,  it's time to move on.  you can be grateful for what you got out of the therapy with her, but, like a coach, sometimes they reach their own level of being able to help.  that could be up to either of you to determine.

i think you're doing really well with this.  and, i have to say i agree with you about how much 'therapy' i've gotten out of this forum.  i had to end it with my therapist more than 6 mos. ago, and this place and the people here have slid into the groove quite smoothly for me. 

keep up the good work, jd.  best to you!  big hug, my dear.

[jdcooper]

So I had a bad dream about the therapist in my twenties who abused me sexually.  There were all these themes of money and me trying to stay away from him.  I know its about my current situation with T.  She apologized for hurting me- but can I let it go?  I feel like she renewed her contract with Aetna, didn't read the small print and took my insurance.  After I was already established she realized my insurance didn't reimburse her like it used to.  It started slipping out in sessions-her anger about that.  She resented it.  Then she became fond of me; proud of me and she was ok with the insurance thing then.  But I hadn't resolved it.  When I tried to resolve it she just got defensive.  She half-way acknowledged what she did was wrong but just tried to justify it.  She felt she was being truthful with me when she says she'd rather be reimbursed at a higher rate. (She would rather see someone who has better insurance)  Well who wouldn't? She must have thought.  Duh! Obviously.  She didn't see how very painful it was for me to even bring it up. She couldn't see my pain.  Sleepless hours agonizing over just bringing it up but being brave and doing it anyway.  Just walking away from that session feeling low.  Hoping it was resolved but it wasn't. And then I text her. She says she gets it.  That she is sorry.  I melt a little.  Its ok, I can trust her. I can continue seeing her.  I don't have to feel abandoned.  I feel better.  But it doesn't last.

She was in a great mood when I walked into that session.  I was feeling like crap from not sleeping.  The first thing she says to me, before I can get a word out, is that the book I gave her to read was great.  That it even had helpful information for another client, she says.  How well written it is etc.  And she says, "did you say I could keep it?" with a delighted smile on her face.   I meekly say yes, even though I didn't feel good about it.  Then I started talking about the insurance issue-she is slowly realizing the dynamic I brought up-that I didn't feel I should be asking her to do homework (reading the book) when my insurance doesn't pay well. She says I shouldn't have done that-(brought up the insurance)-I am just mad at insurance companies. She says "I shouldn't have asked you to keep the book".  I am still silent.

Later I think, I underlined all of these key parts of that book, so she would know what I thought was important.  And it was also for my benefit in rereading it.  And I just gave it to her, because she asked.  And I don't feel like I can take that back.  Does she like me giving her gifts for some reason-like when I gave her extra money when she was also reimbursed by insurance. She was delighted.  Other people tell me this isn't ethical.  She shouldn't be taking money from me for sessions that the insurance has already reimbursed.  Its not ethical.  Does it make her feel some sense of gratitude that fills some need in her.  She once told me her mother learned to use men to get money.  Is she still wounded about money because of how her mother handled money?

I don't know if I can get over this money issue with her.  She said in her text.  "I took your insurance and I am glad now"  That tells me she wasn't glad at all at first.  The fact that she was working with me in the beginning, but really resented it.  I don't think I can just get over that just because "she no longer resents it."  Because now she has bonded with me.  She apologized to me by text but is she willing to do it in person?

So I am having to go through more sleepless nights figuring out how our next session is going to go.  I have to tell her, I want the book back.  (How could she think its o.k. to keep this book with my underlining things all over it?)  I have to tell her to stop mentioning going back to practicing law.  I have to tell her about the dream about my old therapist.  I have to tell her I feel a sense of betrayal.  We have to talk about transference and countertransference. Uhh! This is agony.  Should it be this hard?  My old therapist tried to trick me out of thinking and knowing, I was betrayed, by saying therapy is hard and I was doing good.  Is she going to try and do the same?  Am I just too needy for her?  Too wounded?  Do I need a therapist who specializes in trauma?

So I started obsessing over finding a new therapist.  The kind of obsessing that is not healthy.  The list of therapists that take my insurance is huge.  I kept googling therapists over and over.  So many were clearly all wrong.  Some couldn't spell the word "holistic" correctly.  Some did EMDR and tapping-I don't think those things would be helpful for me at all.  Some specialized in kids, but said they do adults-that didn't work with my previous horrible therapist that specialized in kids, that didn't even know what a narcissist was.  Some said they take my insurance but I have to submit the forms! What!  Some said if my insurance doesn't reimburse me I have to make up the difference.  Again what? I thought that wasn't ethical.  So I do email one or two people.  One immediately emails me back.  She even gives me a time and date.  She specializes in family systems therapy and had the word, Narcissitic Personality in her list of items treated.  She works in an upscale area of town.  Her linkedin profile has lots of skills and endorsements. Her credentials and experience look solid.  And I think good, she knows what a narcissist is.  She knows how important the FOO is.  She casually mentions in her email, that if I am using insurance just call Tessa at this number.  So I think that my low reimbursing insurance shouldn't be an issue.  So I should have stopped there right?  I keep going.  I find a therapist that practiced as an attorney for awhile and had credentials that were very impressive and I leave a message on her voicemail.  But I didn't really like the sound of her voice.  It didn't sound warm.

I try to talk to my husband about it but he doesn't know what to say.  He didn't like a couple of things she has said, one about our marriage.  But he knows I am attached to her.  I tell him I am going to stop obsessing over a new therapist.  I am just going to go to my next session; see how that goes.  Then go for a consult with the new therapist and see how that goes.

So last night we were watching a movie.  Short term 12.  Its about a female director (who was abused herself) of a group home for neglected youth.  These youth have been so abused and they do alarming things - all the time- like running as fast as they can toward the gate that they can jump over and once they are over the staff aren't allowed to touch them.  They also have screaming fits and need to be calmed down.  I say to my husband - my god these staff (two are former foster kids) they have been through so much and here they are in the midst of other kids pain.  He says to me, "they are just trying to help people like you".  I start crying.  I realize he gets it now.  That I was abused.  In our 22 years of marriage he hasn't known the real me until the last few months, after my discoveries.  He tells me the things my father did, how horrible that must have been for me.  I hugged him.  I felt so validated. I have been hiding for so long.

[radical]

This is gut-wrenching for me right now - betrayal of trust, trying to find someone you can trust, trusting yourself in doing this , in going through this.

It is really courageous of you to be so honest.  I know how mind-bending it is to go through this.

I'm so glad your husband got it, and that he gave you what you needed in that moment.  I'm glad you finally feel you can start to come out of hiding.

Keep being true to, and trusting in yourself.

Thank you for sharing your struggle with this, it is helpful for me to know I'm not alone.

[jdcooper]

Radical,

Your story is gut wrenching to me too!  Thank you for seeing this today and writing your response.  I know that what you are going through is just as complex and agonizing as what I am going through.

Thank you for validating my honesty.  I know its the only way through.  We can't live in denial of our emotions anymore.  Like San said, we got to get this stuff out of us.  Its just poison.

This forum is keeping me accountable to my true self.  I don't know where I would be without it.

[jdcooper]

I am feeling stronger.  I have researched issues of insurance and money in therapist practices.  I have learned about ethical practices.  I have learned about strong feelings that arise when therapists feel de-valued by insurance companies.  I know that it must be a painful feeling.  I see both sides.  I see my therapist as someone who is feeling the decline in the value that insurance companies place on the work they do.

I also know there is a therapeutic frame.  Boundaries are set.  The frame is key.  When that frame is broken; like the ways in which my therapist broke them-repair must be done.  She let her own personal feelings about insurance companies devaluing her work slip into our personal relationship.

What I am expecting this therapist to do is to acknowledge her deficiencies in keeping the therapeutic frame in place.  If she acknowledges that-well she is admitting she is human.

If she doesn't acknowledge or understand how her personal feeling about money are impacting our relationship-well then - she isn't very self aware.  At that point, I would have to think that I am more self-aware then she is.  That is where my power comes in.  I am intelligent, resourceful, self-aware of my own deficiencies (my vulnerability when I feel like someone might abandon me) that I can go in there and let the truth come out and see where the chips fall.  So power can come from vulnerability.  From just seeing the truth of things.  That is powerful.  Seeing the truth of things and not ignoring it.  I don't want to interject politics here, but certain leaders are people who are blind to the truth and we are seeing that play out on the world stage in ways that are frightening and enlightening.

[jdcooper]

My researching skills and persistence are paying off.  I learned that Aetna Insurance actually pays some clinicians a higher rate than what my therapist gets.  I had a therapist tell me directly she gets paid more than my therapist under the exact same insurance.  So my therapist screwed up her negotiation with this insurance company and she was taking it out on me?  She told me I would never find a good family therapist for me and my husband (not that we even need one-but she thinks we do) because of my crappy insurance. 

She made me think my insurance is so crap that I could never find a therapist as good as her and that  I am dependent on her and her good will in taking my crappy insurance.  There are hundreds of practitioners with better credentials than her that take my insurance.  It was only when I started digging into the list of therapists on my insurance panel that I discovered this.  I had a really crappy therapist before her and I was thinking she was right-my insurance is going to limit my options.  But that's not true!  I found a therapist in network who has extensive experience in treating CPTSD and Narcissistic abuse  with really impressive credentials-she says experts have trained her in dealing with people with complex trauma.  And we are going to set up an appointment. 

Therapists stay on insurance panels for a reason (and Aetna is a huge network. ) They get referrals from them.  Most therapists can't rely on self-paying clients and survive; only the wealthiest people can afford to pay $100-$150 per session without a burden on their finances. Also my therapist was denying the fact that a lot of therapists genuinely want to help and will even offer sliding scale to people who can't afford their rates.

So I have a lot of power here.  I am going into this termination session with information that is going to blow away anything she says.  The fact that she acted unethically in taking money from me for sessions that were already reimbursed could get her into trouble with a licensing board or with the insurance company. (this was confirmed by another therapist)

Ok, so how to use this power I now have?  How do I want this session to go down?  Do I want to vent and tell her exactly how bad she made me feel about this issue and infer she is a terrible therapist who even breached professional and ethical boundaries?  Do I want to bring up the multitude of other problems in our therapeutic relationship? Or do I want to take a softer and gentler approach and let her know this isn't working for me because her continually bringing up the insurance made me feel disempowered and less than?  Do I tell her I found another therapist who has the exact experience and credentials to deal with my specific circumstance?  She should be happy for me.  She didn't even know what CPTSD was.  When I gave her a book to read about it and asked her if she thought I had this diagnosis she said she wasn't good at diagnosing, she didn't know, then she said "were you physically abused?" (SHE COULDN'T REMEMBER THIS KEY FACT ABOUT MY CASE!!!)  She doesn't realize that severe emotional abuse and neglect will cause CPTSD!  I starting talking a few minutes about my amnesia in remembering much of my childhood and she said yeah I think you do have it.

She has never given me a treatment plan with goals.  (Neither did my other crappy therapist) She has never discussed when I will be through with therapy except to tell her it could take years.  She has never discussed her approach or what we are doing in therapy.  She has given me unsolicited advice more times than I can count.  She has discounted my good marriage by saying we have problems and need therapy for them.  She told me she thinks my son's ulcerative colitis is caused by emotional issues-making me doubt my parenting skills. She constantly says my husband doesn't "get it" but that my son does.  This is so not true, my husband is extremely empathetic and gets it and my teenage son is so in his own world he has no idea whats going on with me-he's away at college.

I had had such a horrible therapist before.  One that didn't know what a narcissist was, one who would ask simply how I was doing and then have nothing else to say.  When I went into therapy with her I was just so glad she knew about this dysfunctional family system and I was validated for the very first time in my life that my father abused me.  I was so grateful for this validation that I continually ignored her other faulty observations.

I got twisted in knots about her continually bringing up me going back to practicing law and when I brought up my internal conflict she discussed it briefly and a few sessions later she was back with the "I need to keep my bar license active."  That I will be well enough (with her expert help of course) to get back to practicing law.  Even when I told her there are no jobs that fit with what I want to do and it may not be a viable option for me, she kept persisting.

I feel like I am coming out of the fog with her.  The same way I came out of the fog with my family.  By researching.  If there is a lesson to be learned here for anyone out there-if something doesn't feel right with a therapist-explore it; don't just be grateful for what you have.   Really delve into why you aren't feeling right about something.  I thought running away and not resolving conflicts with a therapist was not healthy.  I gave her second chances.  I was wrong.







Her making a blanket statement that any good therapist is going to turn me away because of my crappy insurance was such a breach of professional and ethical boundaries.  I am doing her a huge favor in going in there today to terminate my relationship with and letting her know what she did wrong.  It can help her with other clients.

[Three Roses]

Ok, so how to use this power I now have?  How do I want this session to go down?

What feels best for you? What, in your own healing, are you trying to achieve? Your concern for her is compassionate, but maybe not in your best interest.

Think of how you want to feel on the other side of this, and plan your moves accordingly. Best wishes to you!

[radical]

JD, be very careful here.  What do you want to achieve for yourself?

It's unlikely you will be doing her any sort of favour.  It's possible she will simply kindle your anger and make you feel crazy.  You don't want to leave this situation feeling worse, imo.

I didn't go in "all guns blazing" out to prove anything.  I wanted to resolve things and restore my trust, to leave, if necessary after an open and frank discussion which I thought would reduce tension, lead to a common understanding.  It will take me some time to deal with the aftermath.

It is entirely up to you, but remember, you are vulnerable, and you don't need her validation.  In this situation you are relatively powerless in comparison to her.  Having it out with her is unlikely to make any impression on her, other than, in a worst case scenario, proof for herself of how nuts you are.  (I'm very well aware that you are not nuts)

Consider taking a support person.

Also, my advice, don't tell her about your new therapist.

[jdcooper]

Radical,
Thank god you replied.  Its not like I can call you.  You have been where I am.  You're right.  I am vulnerable.  I am running on about 4 hours of sleep and my adrenaline is going crazy.  I am just going to put in on me.  Just like people here say confronting a narcissist does no good - its no good for me to confront her.  Its just going to keep it all stirred up for me.  I am just going to say I feel bad about how low my insurance reimburses her and that its affecting how I am doing in therapy.  That I need a break.  That I am not sleeping well.  Its too late to have someone go with me.  I may just leave early.

[jdcooper]

O.k.  so it went rather bizarrely.

So, I was pumped up with rage and adrenaline this morning; which thankfully, Radical, brought me into awareness about.  So I decided I wasn't going to go in there all angry and blow up at her.  So I went in there and I told her I still feel bad about the insurance thing.  And she kinda says, yeah.  And I say gently, "you have brought it up four or five times.  You asked me if I could get better insurance."  She says, "I did?"  She says, "I'm slipping.  I'm 73 years old.  I may have to close up shop."  She said I know you felt bad about the book.   I don't know why I asked you to keep it.  I said, yeah its got my writing all though it.  She said I brought it for you. But she doesn't tell me how far she got into it and whether we would discuss it.   She says she's having some kind of light therapy??? That she may have had a concussion.  She admitted to not having the best memory.  She said, " I think I'll be o.k. though.  Just let me know if I slip up.  She said I was doing good in standing up for myself.

At this point I didn't know what in the * to do.  She obviously is clueless that she has caused me so much distress.  I am feeling bad for her at this point.  She is admitting she may not be fit to be a therapist anymore.  What was I supposed to do-Be the one to tell her, yeah you might want to consider calling it quits.  At least for more challenging clients like myself. 

As a solution to the insurance thing she suggests what I think is rather bizarre.  She says once I get back to work, with a well paying job.  Just take the difference between what Aetna pays and other insurance pays which is now back down to only a $15 difference and not a $25 difference.  Just take that money and donate it to a charity; because I don't need the money.  What?  Not, sorry I brought it up, sorry I made you feel bad-no, some how I need to make it up to the universe?

I told her I wasn't feeling very hopeful right now about things.  She once again brought up me going back to practicing law.  Again I explained all the obstacles and problems with it.  She didn't back down.  She even suggested I open up a practice again.  After I told her how horrible my experience with that was.  We explored my phobia about court and she insisted that I could get over that.  I said the only way to deal with a phobia like fear of public speaking is to actually do it.  I said I certainly didn't feel ready to do that.

Maybe she is so desperate to keep her own career going she is projecting that on to me.  I don't know. 

She said some helpful things, about how I still need to grieve. To get in touch with my inner children.  They are the ones that are scared and hurting.  We also talked about my very scant memory of having been sexually abused by a teenager that was babysitting me.  I think its just way too vague a memory and that maybe just by reading so much about sexual abuse my memory is playing tricks on me.  But the memory I told her, she felt, was in sufficient detail to be taken seriously.  So again, she is very good at validating my pain but oh not so good in so so many other areas.  I have appointments set up with three different therapists and they are going to get peppered with lots of questions.  When I started therapy with both of these two recent therapists in the past two years, I was in a state of frozen-like severe depression and really didn't have the ability to be a wise consumer of therapy services.

Now I am aware.  I am going to consult with the therapists about how to end therapy with my current therapist in a productive way.  I am not mean spirited and don't want to tell an aging therapist that she badly screwed up-I think a part of her knows it, but hasn't come to terms with it yet.  Kinda sad.

[Three Roses]

Jdcooper, I'm very impressed with your strength here, and your insights. I'm glad you know it is her human flaws and not anything on your part that has necessitated the change of therapists. Good job, you!   

[jdcooper]

Thank you Three Roses.  Yes, she let herself be very vulnerable with me yesterday and even emailed me a link to this light therapy she is doing to help her cognitive functioning.  I think she really likes me; may be lonely and unfortunately didn't have a very good filter when it came to her own feelings and thoughts about things. 

I am looking forward to starting fresh with someone who has her good qualities of validating me and bonding with me but can keep a good therapeutic frame and not let personal feelings, opinions and lack of filter impact our work together.

[radical]

You did great.

It's sad that she is unaware, but you need and deserve effective treatment.  So glad you are being proactive in getting what you need.