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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Catmom on January 13, 2004, at 11:11:16
This is a general question and perhaps, an observation: How many people are going to therapy more than once a week nowadays? I am an older woman (53 actually) and when I grew up in a university town in the 1950s and 1960s, I recall lots of people going to their "analysts" 4 or 5 times a week. (I have no idea how they could afford it). When I read books about therapy, a lot of them, even recent ones, speak of patients who are in therapy 3 or 4 times a week.
Are these very wealthy people? When I read the models of analysis and transference in the literature, it makes me wonder how a lower frequency (once a week, or twice a month) can affect therapy, transference, the "need to see" the therapist.
My therapist has been flexible about seeing me for periods of once a week, once every two weeks, or once every three weeks, depending on my ability to pay. I first saw her in October of 2001.
She does "psychoanalytical therapy" and "psychodynamic therapy."
I wonder what the opinions are about frequency of sessions and how that impacts growth, transference, and the psychiatric dialogue.I often think that my therapist gets a really distorted view of my life since I don't have the time to spend telling her about the little things or the things that please me. I don't end up telling her about the social interactions that seem "functional" or healthy.
In any normal week, I will bring to her at least one bad dream, or at least one moment of discomfort, etc. I don't feel I have the luxury of time to tell her what feels right and decent about my life.
Posted by Joslynn on January 13, 2004, at 12:35:11
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
Well, I see my pdoc only once every 3-4 wks for an hour, for therapy and med check, and my transference to him is actually stronger than my transference to my female therapist. However, I used to see him every day for about ten days when I first went to him for a severe depression. He saw me a lot until I pulled out of that, so that intense time of lots of sessions could be how the transference got cemented.
Or maybe it is because he is a man and a lot of my "issues" concern growing up with my Dad, who was alcoholic and verbally abusive.
I see my female therapist every other week now, and while I like her a lot and get a lot out of the session, I don't have that tender/vulnerable/sometimes painful feeling of transference that I have with the male pdoc. For example, I worry less that she will abandon me and don't dream about her as much as the pdoc. My pdoc actually has more of a psychoanalytic background that the therapist, who is more family systems and behaviorally oriented. That could also cause the transference discrepancy.
So, I don't think it's just frequency. There are other elusive factors. That's just my experience...
Posted by Elle2021 on January 13, 2004, at 12:44:43
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
>Well I used to go once every two weeks, but now I go once a month. I'm trying to get that changed to once a week. I know I complain a lot about my doctor on here, but he did actually offer me 4-5 times a week when I first started seeing him. I declined because, as it is, I already have to drive an hour up and an hour back. As for paying, my insurance picks up the tab, but he has to fill out papers saying that I need more sessions every once in a while. I also have a small co-pay that I have to pay in the office each time.
Elle
Posted by naiad on January 13, 2004, at 15:16:03
In reply to Re: Frequency of therapy sessions?, posted by Elle2021 on January 13, 2004, at 12:44:43
I started with once a week but then he suggested twice per week which has been the schedule for about six months. He is an MSW so is not as expensive as a PhD. or MD. I have an appointment with a psyciatrist next week to find out about anti-depressants and her hourly fee would make regular visits impossible.
Posted by sadmom on January 13, 2004, at 15:26:01
In reply to Re: Frequency of therapy sessions?, posted by naiad on January 13, 2004, at 15:16:03
My insurance only pays for 30 visits per year. Last year I went 33 times, so I had to pay the full $95 for the 3 sessions I went over. Then in the beginning of the year I have to pay full price until I've reached my $500 deductable. After my $500 deductable is met, my insurance pays 70%. I would really like to be able to go every week though, but I can't afford it.
Posted by lookdownfish on January 13, 2004, at 16:04:27
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
I go once a week for psychoanalytic therapy. My therapist is constantly saying I should be going 2 or 3 times / week. I could possibly afford more, but it would be difficult to find the time.
> I often think that my therapist gets a really distorted view of my life since I don't have the time to spend telling her about the little things or the things that please me. I don't end up telling her about the social interactions that seem "functional" or healthy.
I know what you mean - but we would be wasting our time and money if we talked about all the good stuff. I'm sure that's why my therapist thinks my marriage is such a disaster, because I only tell her about the arguments, or about when I'm not getting enough sex.
Posted by crushedout on January 13, 2004, at 16:42:17
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
I know exactly what you mean, Catmom, about not feeling like you have the time to give your T a complete picture of you. I started seeing mine three times a week a while ago, and that really helped me with that part (although we've since cut back) (I have really good insurance and also spend a lot on therapy). I also started talking faster, I think.My T tells me they have these institutes where you can get analysis 4-5 times a week and it's actually a lot cheaper than regular old therapy. I never looked into it, but I can't imagine why she'd make that up.
Posted by Dinah on January 13, 2004, at 17:08:02
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
I go twice a week and that's all i can afford, even with a good medical reimbursement plan. My new EMDR therapist and my real therapist seem to think I'll continue to see him twice a week and her once, but that just is not realistic, I don't think.
Posted by Miss Honeychurch on January 13, 2004, at 17:27:50
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
I go once a week but that is about to change since I will soon run out of my insurance "sponsored" sessions. My T will then charge me the rate he charges the insurance $75/session as opposed to his regular fee which I think is around $100. With this new arrangement, I can afford twice a month. I think I'm ready to do cut down though, I've been seeing him once a week since July.
And I am actually afraid to tell my T about all of the positive things in my life for fear he'll say I don't need therapy anymore..
Posted by Dinah on January 13, 2004, at 19:54:47
In reply to Re: Frequency of therapy sessions?, posted by Miss Honeychurch on January 13, 2004, at 17:27:50
>
> And I am actually afraid to tell my T about all of the positive things in my life for fear he'll say I don't need therapy anymore..That's a fabulous thing to be able to say! I'm so happy for all the positive things in your life.
Whenever I try something new, I ask my therapist if I can still come in from time to time if I get all better. He always says yes, I suppose to keep me from trying to stay sick. :)
Posted by gardenergirl on January 13, 2004, at 19:54:57
In reply to Re: Frequency of therapy sessions?, posted by Miss Honeychurch on January 13, 2004, at 17:27:50
I go once a week, but I don't have to pay because I go to the campus counseling center and I am a full time student.
There are psychoanalytic institutes around. There's one in my town, that take on cases for a reduced rate in order to provide training for the analysts being trained there. The director at my work site is in training there and has some reduced fee clients. One of my classmates has been going three times per week at the reduced rate and has found it invaluable.
But there are a great deal of others out there who are not able to do this for a variety of reasons. That's why psychoanalysis has developed into other models which allow for less frequency and sometimes shorter duration. Of course you will not have the same experience as true psychoanalysis, but that doesn't mean that shorter duration and frequency is not helpful.
What's most important is the match between what you can do, what you want and need, and what's available out there.
I know if I were paying out of pocket in addition to my weak insurance, I would feel much more pressure to "perform" in therapy versus just relaxing and trusting the process. And I don't know if that would actually speed things up or interfere.
g
Posted by Dinah on January 13, 2004, at 19:55:17
In reply to Re: Frequency of therapy sessions?, posted by Miss Honeychurch on January 13, 2004, at 17:27:50
Posted by DaisyM on January 13, 2004, at 20:49:41
In reply to Frequency of therapy sessions?, posted by Catmom on January 13, 2004, at 11:11:16
I go twice a week "for now" but have access to more sessions if I need them.
I think you should occasionally say, "today was a good day" because then you can look at why this was so...and hopefully replicate it.
I do think frequency effects the theraputic relationship in as much as the more you go the less "start over" time there is. Attachment is tricky but important as a change agent. I suspect that is why my Therapist wants me to come in more..I'm so use to dealing with stuff on my own, I keep pushing him away and stuffing or minimizing the bad stuff.
Posted by Speaker on January 13, 2004, at 21:39:13
In reply to Re: Frequency of therapy sessions?, posted by DaisyM on January 13, 2004, at 20:49:41
With my old T I went once a week but did a double session...that really helped me feel like I could actually discuss something and finish it without...Ok time is up. With my new T I go twice a week for an hour but it isn't as good for me. I'm afraid to open up and then have to quit. My insurance only pays 1/2 and for 30 sessions so the double session only counted as one session. I'm trying this new way but it doesn't seem to work well for me.
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