Posted by emmanuel98 on January 23, 2012, at 21:02:14
In reply to I'm upset about an exchange with my therapist, posted by Dinah on January 23, 2012, at 10:51:54
Well the whole relationship is hard. I once said to my DBT therapist, concerning my p-doc, that I feel like the whole set-up is arranged to cause pain. You love this person, depend on them, but somehow they never forget to ask for their fee, to remind you that you are not their friend or loved-one. But the fee is important. It's how they make a living. I think I mentioned before that I agreed to pay my DBT therapist 3x the required co-pay because the insurance payment was so little and she felt that, if she was going to take responsibility for my suicidality, which she and my p-doc agreed would be best, she needed compensation sufficient for the risk and distress I caused.
I have learned to live with this. But it's hard. My p-doc once said he would see me even if I lost my insurance and couldn't pay, that he would charge whatever I could afford, even $10 or $20 dollars. But he wouldn't, I don't think, accept nothing. The payment is the representation, whether they need it or not, of the limits and nature of the relationship. And that's hard to handle sometimes.
Sometimes I just wish he would see me because he loved and cared about me. He does love and care about me, but the boundaries are there, for your protection as well as his. I have realized that his boundaries, including his asking me for the co-pay even if I am in tears, have kept me from destroying my marriage and life for him, which I would have done gladly, had he allowed it.
Glen Gabbard, who writes these textbooks for psychiatrists on dynamic therapy, says that a good therapist creates and "as if" space or a "play" space. It is as if they are your parent, but they are not. Asking for their fee is part of reminding us that it is "as if" and not entirely real.
poster:emmanuel98
thread:1008146
URL: http://www.dr-bob.org/babble/psycho/20111220/msgs/1008237.html