(((TAS)))

That was quite interesting because I hadn't realised
that I do much the same thing! I'll always try
to find the highest denomination notes to pay
her with and even buy something just to get the
right notes to avoid her having to give me change.
I dont know why, but asking her for change seems
mean somehow. I always place the money carefully
on the corner of her desk rather than hand it to
her.
Oh and T will most times ask if I'd like a glass
of water or even a cup of tea when i arrive and
she'll often get herself one while I take my
coat off and settle down.

You're right, it is interesting...
I found myself getting so worked up about paying that I eventually plucked up the courage to ask if I could pay by bank transfer and avoid the whole cash thing. We had to talk about it (naturally...!) but that's what I do now and I find it one less thing to worry about as I'm struggling with goodbye.

I am always offered a drink - I refuse mostly, but recently I've allowed myself to accept a cup of tea.. But it's hard letting her do that for me.

((Iris))

I mostly refuse the offer of the tea as well!!
Like I don't want to put her to any trouble
although she sometimes has one herself. We're
a funny lot aren't we?

You guys get the offer of a drink!!!

I always have my money ready, notes folded the same way and it's handed over before I sit down, I have to get the money out of the way before anything starts. No eye contact either.

He always waits for me to sit down before his sits and when I am ready to go he stands and waits and holds the doors open etc

I see my T at her house, so I go upstairs to the therapy room, I always put her money in an envelope and leave it on her deck. When she comes in and sits down I tell her the money's on the desk. No eye contact at all lol

Scars I don't get the offer of tea

Luc

Interesting question, especially about the ritual of paying - something I always feel uncomfortable about.

Haven't been with my new P long enough for many rituals to have established themselves, but paying her is standard, I pay by cheque so have it already written and folded neatly in my bag and then fish it out at the end of the session and set it on the table between us.

With all my previous therapies I used the paying as a way of closing the session, it always signified to me that the session was finished and I'd mentally accept that. With this P, it doesn't seem to play that role because she will often keep talking after I've given her the cheque. She also doesn't immediately take it, it sits on the table for a bit so it doesn't work as the closing ritual.

I only just realized that. It's significant in some way, need to think about it.

LL

Not sure that this counts as a ritual either, but every therapy I've done before this latest one, the opening 'ritual' was always that the T would make me sit in silence until I finally managed to spit something out, or they couldn't stand it and made some opening comment.

New P always starts by talking to me as we go up the stairs to the room and once we're sitting she is the one who asks me a question or makes a comment. Something I appreciate SO MUCH! Never realized just how anxious making it was when Ts left it to me to start the session and how much more relaxed and comfortable having her start the talking is.

For me the ritual is money always at the start of the session (usually as T opens her door) and always in the same sort of little brown money envelope before we even get into the room

No tea around here either. I agree that would be a nice touch. I like tea. Sometimes I bring my own in a thermos because my throat can get dry and tired with so much talking. T occasionally has a cold drink or a coffee with her.

Paying rituals. . . hmm. I usually pay with a credit card. There is a window from the waiting room into a little receptionist's office where T has her filing cabinets, credit card machine, and office equipment. She has a secretary too, but she seems to work very part time hours as I hardly ever see her when I'm there.

After my session, I walk back into the waiting room and hand my card through the window to the secretary if she's there or to T if she's not. Sometimes while T is waiting for the transaction to go through, filling out my receipt and appointment card, etc., I will make some very light and non distracting chit chat (ie. "Oh, it stopped raining!") because it can feel a little awkward to just stand there in silence after all the talking in session.

On occasions when I have Baby with me, which is about half the time these days, T will leave us in her office and take my card out herself and just bring me back a receipt to sign, like at a sit down restaurant, lol. She volunteers to do this because juggling Baby, my purse, wallet, card, and thermos really can get a bit tricky.

Am I the only one who pays with a credit card? All of these cash transactions sound so quaint, lol. I hardly use cash for anything these days cuz I'm lazy about always having to stop at the bank to get more when I run out.

I used to pay with a check at the start of the session, but now as money is tighter I wait for my statement to come in the mail and I mail it at the end of the month. Actually I feel bad about waiting but I did mention something to her last time and she does know my financial situation, as it is one of the reasons I returned to therapy. I told her I would always pay her but it might not be as prompt as it once was.

Sometimes I am offered water but if not, I may ask for it during the session at a difficult or intense moment, as a way to back off the intensity. It usually works, as she has to leave the room to get the water. I'm sure she has noticed this tactic.

interesting and fun thread...

i don't have a ritual as such, but i always pay in cash - i prefer it this way, like buying drugs and no-one can trace it back to me. i dont mind how many notes i use, sometimes i kinda like giving her a stash of cash (i pay monthly).
i pay at the end of session, supposed to be the session after she has given me her bill (i assume, she's never said you have to pay within this time..). the problem is sometimes if i had a bad session and i'm pissed off, i simply can't make myself take the money out and give it to her, even though i have it in a separate pocket in my purse, and it will stay there until i pay her the next week (or in some unfortunate occasions, even another week later!)

puppet

Well just reading through here I see talk off paying in cash [which I do] and brown envelopes.
Just to say but cash and envelopes are famous here in far far away when it comes to politicians.
every little helps as the saying goes here in Ireland.
ND

Wow. I rarely hand it to him, but put it on his table before session. How do you deal with financial issues? Like if there is a time you have to pay less?

Ang, I had to tell my T today that I can't pay him for January and asked him to hold my sessions for me. It was REALLY hard. I was going to write it down and hand it to him at the end of the session but blurted it out at the beginning of the session. He is working it out so that I can still see him and, for that, I am eternally grateful. I have to remember to help someone like this when I am able. Pay it forward.

(((Liese)))) so sorry you are dealing with this. I'm glad your T is willing to work something out with you. My T tells me the same thing. He said he has never terminated or stopped seeing someone if they have a temporary financial problem.

I pay my current T monthly. I am paying his co-pays at that time (the part insurance does not cover). I am lucky that he takes my insurance and handles the paperwork. I hand him the check at the beginning of the session and he thanks me and then we move on. I do it at the beginning only because by the end I may forget to pay him.

With oldT I paid him at the end of each session. It fact, it became sort of a signal for the end of the session. He would pick up his book of receipts and I would know we were ending and the conversation would sort of wind down. I would wait for him to write the receipt and I would already have my check ready and I would pull it out and hand it to him. We would sort of do this nice exhange of him handing me the receipt at the same time I handed him the check. It worked well for us. I had to then submit all paperwork for reimbursement from insurance because he was out of network.

I have a lot of nice rituals with current T aside from payment. When I arrive he is usually out of his office for his 5 minute walk/break and his office door is open. He wants me to go in and get comfortable while he is out. I am free to look at any book in his bookcase or to pull down shades/turn off lights etc. The only place "off limits" is his desk. He usually has already closed the blinds and has my blanket draped over my chair waiting for me. He then comes in and shakes my hand and then goes to sit down in his chair across from me.

At the end of session he turns his chair back towards his desk and checks that my name is in his book for the next appointment... which is funny now because I have standing appointments. We then get up and I put my blanket away and put my coat on (in winter) and then we shake hands and he walks me towards the door. Then sometimes he pats my arm or shoulder. I let myself out and I close the door. He never closes the door on me.

I like our rituals. They are comforting. I am happy my T understands this.

TN

Very interesting thread.
For me rituals when I was in therapy helped to ease my discomfort. Paying is a great example. I always paid by check right at the beginning.
Paying to be in relationship with my therapist, especially when I became attached, felt shaming to me. From others descriptions of slipping cash, comparisons to buying drugs or not leaving a trace - maybe I'm not alone? Then again, I only felt that way with one of the many therapists Ive dealt with, so it was more feeling ashamed to be paying for being treated badly.
Back to ritual...
Rituals create structure and safety. You know what to expect. Kids need rituals and structure in their lives to feel secure. I think we as therapy clients do too. Therapy can be so open and scarey. How often do we sit there not knowing what to do or say, feeling lost.
The last time I used ritual in therapy was as a way to deal with termination. I had been abruptly terminated by phone (I still don't know why) and insisted on at least having a couple of sessions to deal with it - I told T it was more ethical. At the last session I made a ritual of giving her symbolic gifts and focusing onthe positive - I tried to create the relationship I wanted so that I could cope.

So I guess ritual helps us feel safe and deal with difficult emotions. On the other hand it can be used as a sort of mask so that we avoid the real pain. After reading everyones comments here, I certainly will be using more ritual in my life, AND try to deal more directly with what I might be avoiding. Sounds like a good New Years aspiration.
Thanks TAS and everyone for sharing! KD

Ritual for old T...She'd collect me from reception I'd sit down and she'd say so "how are you doing?" and it would go from there and then at the end she would give me a hug before she opened the door for me to leave....I loved that hug - it meant the world to me. Payment was with the reception so it seemed OK.

New T...haven't been going there that long but she would just sit and look at me and I hated that so I now write a letter, hand it to her to read, and then we talk about what is in the letter. As for making payment I hate it! It feels like I can't get my needs met naturally - it's like visiting a prostitute (not that I have visited a prostitute before but that is what I imagine) so I was just thinking about it this week - I'm gonna ask for her bank details and pay her like that. I already told her about my "prostitute scenario" so I will just explain it to her again if she doesn't understand my payment issues.

B2W

quote:

. As for making payment I hate it! It feels like I can't get my needs met naturally - it's like visiting a prostitute (not that I have visited a prostitute before but that is what I imagine)

B2W - Ive felt exactly the same. But I think it was also because I felt unloved, even rejected by T. It was just a business for her but I needed to feel lovable. Did you feel this way with oldT before she terminated you? About paying and about her feelings for you? Both of us are lovable of course just sometimes people are unkind and thoughtless or scared. Still, I agree, its like paying for love. Maybe we can think of it more like a dowery

Thats what my Ex I was paying for someone to care about me. Not sure about new T, since he sees me at a lower rate. But I think his mood improves when I pay him.

quote:

Maybe we can think of it more like a dowery

That made me chuckle.

KD's Quote:

quote:

But I think it was also because I felt unloved, even rejected by T. It was just a business for her but I needed to feel lovable. Did you feel this way with oldT before she terminated you? About paying and about her feelings for you?

I think you are right KD. I didn't mind paying oldT - somehow I thought she genuinly cared and understood me, but now with newT I just think I'm this pathetic person who needs to pay someone to care for me and understand me. Like I am not worthy of love. In fact at this stage I'm almost waiting for her to tell me "I can't help you". I imagine her thinking "what the hell kind of person has their therapy terminated - she must be crazy! She must have done something seriously wrong" Right or wrong that is what I think. NewT doesn't allow any contact with her. I don't have her e-mail address, landline or mobile number, only her office number and a shared e-mail address which is hardly something I can use. I sort of look at that in the sense that all I am good enough for is one hours paid transaction. Nothing else. The way my life has been I just feel that I'm not entitled to unconditional love.

[probably off topic so I'm going to stop now, but yes KD, I think you do understand]

B2W

((((B2W))))

You are not a prostitute. Are you stuck with NewT or can you look around?

Sorry to pop in from the middle of nowhere (I know I have been long absent) but thought that those of you who struggle with paying for therapy and what it says about your relationship with your therapist would find the article below on What a Shrink Thinks blog really helpful. I have struggled with many of the same feelings and I know it helped me.

What you pay for

AG

AG,
That was a really interesting article. I have had free therapy for several years. When my T goes on maternity leave in May I will continue to see her privatly, rather then change to a new T in the hospital.

I told her today that I am worried that it will feel different.
I have been concerned reading how so many people seem to feel uncomfortable about paying. I am also unsure how the outside contact will be, will I be expected to pay extra to cover any e-mails or phone calls?
It will be a new situation for me.
T has been great she told me early so we have plenty of time to discuss everything and make sure we are both happy with the changed situation.

Starlight

AG,

That is a really useful article to read, thank you.

(((B2W))) On the subject of therapy being akin to prostitution I came across the following article which I found interesting. Apologies if this has been posted before on here.

Love for Sale: Psychotherapy as Prostitution

(((AV)))

I found the article you gave us the link to a little depressing, a little too clinical about the "love" that happens in therapy. The author states that all of the outside strains on relationships are removed from the therapeutic one and this is what makes it so unreal. That is true for the parent-child relationship and I wouldn't call that relationship unreal either. Just different. Has a different purpose, plays a different role in our lives, just like the parent-child relationship. Relationships serve different functions. His candid admission that he wouldn't want to spend time outside of the therapy room with many of his clients was chilling. I'm glad he's not my T.

Thanks for the articles and input re payment/prostitution.

You know what I find really strange is that I had never read any of these articles or any other articles relating to the dynamics of therapy being equated to prostitution in some peoples minds. I thought I was alone in that thought. When I explained it to newT I saw she was a little uncomfortable with my analogy and I thought the analogy I had come up with was probably just a reflection on my perverse way of thinking. I explained that analogy to her on the 2nd visit - I told her how I didn't trust her and that it felt like I was no different to the man visiting a prostitute - I had a need and I had to pay for it to be met. Other normal people got their needs met through people who cared, but she could just be pretending because afterall I was paying her. I said maybe OldT kept me hanging on a string for just long enough to pay for her overseas holiday. Like it was just necessary to put up with me so she could get what she wanted with the funds that I paid her. Anyway enough about her and I.

My solution to my problem: I'm gonna ask for her bank account details. I still pay but it doesn't seem to carry the same burden in terms of the way I think.

B2W

Hi Starlight,
Glad you liked the article. I wouldn't worry too much, especially if you've not worried about it before. You may not have been paying your T, but I assume she was getting paid through the hospital? I know for myself (I don't want to presume to know anyone else's feelings) the anxiety about money really stems from the fact that there is transference in the relationship and I struggle to trust and move closer to anyone. Paying my therapist is just one of the hooks I hang my fears on. Because I pay my therapist and he keeps his feelings out of the room (as he should) there is an inherent ambiguity in the relationship. Does he really care, or is he just getting paid? Does he really like me or does he just have to act like that? But my problem is really in my inability to trust anyone's care for me. FWIW, I've worked through this one and no longer worry about it. I pay my therapist because he needs to support himself, which in turn allows him the time to attend to me. Seems like a good deal. I have also come to trust that his feelings and esteem for me are genuine and not something I have purchased. I pay for his expertise but the relationship is a real one.

As for your concerns about paying for outside contact, those are legitimate, reasonable questions that I am sure your therapist will be comfortable talking about, really you should just ask. It varies widely depending on the therapist. They need to set boundaries around outside contact that they know they can live with. For instance if a T knew they would start to resent "giving away" time outside sessions, then its better for them to charge for it, so they don't end up unconsciously angry at their client. On the other hand, some Ts see outside contact as something included in their fee. My T allows emails and phone calls outside of session and does not charge for either. Admittedly most of my calls are under five minutes but I have had a few run as long as 20-25 minutes in a crisis. Like most things in the therapeutic relationship, it needs to be worked through by the client and the therapist and it won't always be the same thing for everyone.

AV,
Thanks so much, I had never seen that article and found it fascinating. It felt a bit brutal at times, and I think at the end of the day, I disagreed with his conclusion that there is not love (but that may be my own desire speaking) but I found it a fascinating viewpoint and I agreed with the author that the premise bears exploring.

B2W, your welcome, hope you found it helpful.

AG

Hi AG,
Thanks for your comments. I think I am just worrying about all the changes ahead of me. Each week I seem to go back to T with another worry and each week we talk about it and sort it out.
Actually my worry about outside contact is not so concerned about payment, but about her availability with 2 small children. She knows the level of access I am used to and I think she will try to maintain that as much as she can.
It will be an adjustment for her as well as she only started her private practice in the summer alonside her half hours at the hospital.
We have a good relationship and she is keen for me to continue with her during her maternity leave, so I hope we can work it out!

Starlight

AV - Thanks for that link. I really enjoyed Smail's article and drilled down to read more Of his opinions about therapy. Its like the Emporers New Clothes. Like you, B2W, I think its strange or suspicious that these type articles and opinions aren't very visible. Then we think we are alone and crazy or wrong to think that way! B2W - thanks for bringing this topic up!
AG - Thanks for your link as well. It is reassuring and helpful. I think both articles were saying the same thing. But "what you pay for" helped me to better understand the one sidedness of the therapy relationship and how that is supposed to be healing.
So much is confusing and unspoken about therapy when you are in it. It is great to have MyShrink and you guys as resources!
Starlight - Hugs to you during this transition. Keep in your heart the knowledge that T cares for you and is on your side. If there are times when she is not available, maybe that knowing will lend strength and comfort to help ease your worries.
KD