What would you really like to do in this situation, Bud? I can certainly understand it from your side. What I don't know are the background things going on in the therapist's life.

As far as her opinion of you - that isn't something you can change, control or cure. You were open and honest with her and you paid the entire bill although you didn't expect it. You've done more than your part in this arrangement as far as I'm concerned based on what I understand you have written here. This became a game changer you didn't anticipate and rather than storm off in a huff you tried to work it through with her and you paid off her bill, too.

Based on your past experience of her word to you and that your trust is broken now, could you continue with her as your therapist with full confidence in your partnership? To me, a therapist is like a mid-wife helping us give birth to ourselves. They are our equals and we are theirs. I'd feel uncomfortable sitting in a down one position in relationship to any therapist. But, that's me. How do you feel about her now and about her effectiveness and helpfulness as your therapist?

-- Edited by grateful2be on Friday 17th of January 2014 09:20:53 PM

 

Been there and done that some what like yourself also bud and then was told by my sponsor to inventory my thoughts, feelings and behaviors regarding this "life" event.  He worked great with me on responding to situations rather than reacting to them where I would come up with thoughts, feelings and behaviors which were based upon pre-program stuff.  He was right and when I would take the time to inventory events such like this I found alternative thoughts, feelings and behaviors I could use instead which were more realistic.  Including my therapist into the picture and giving him grace and margin to be involved as best he could allowed me to maintain his trust and also see him as a peer rather than someone with more power.  He deserved to be paid just as also he was being affected by outside forces; we both were.  I told him that I would up my Al-Anon attendance which ticked him off a bit and then he had no control over that, the decision was mine and I was getting much better using the program.   There is a difference between theapies he agreed and also agreed it was up to me how I initiated my treatment.  There were times when he needed to be able to trust me which he openly stated and which concerned and saddened me and then when I inventoried it he was correct.  He was not only helping me arrive at a "new" me, he was also dealing with the old one which I came to agree would have and did also concern me when I was a therapist.  I learned that I don't only come away with new alternatives, I also bring some causes for concern and my therapist needed assurances that he could trust me when crises arrived.  I trusted his reputation at first because he had a grand one and was hignly spoken of in the recovering community and after a while I trusted his willingness to be a peer.  Both of our respects grew for each other.   Outside forces for me get run  thru the 3c filter and I am able and willing to include the therapist in that margin.  I don't like fuzzy understandings when I work with others who seem to have more authority than I regarding situations which primarily affect me.  I press for as much mutual clarity as I can ...or else.    (((((hugs))))) 

 

Thank you for great responses and tools that will help me sort my thoughts out. I suspect that some of my reasons supporting my reaction and bad feelings is because of old stuff manifesting that needs to be recycled through Alanon. I'm grateful because I want to know if this is just in my head or if it also exists in reality outside my head.

Grateful- Yes, I'm feeling my foundation of trust has been broken. Even in trying to work through it, it has become too much of an effort. My therapist is viewing this as a business transaction. I know that just because I would have handled things with greater refinement, not every one thinks like me. Come to think about it, my therapist never gave it a second thought and would probably find it curious that I'm obsessing. I'm appreciative of your feedback that I've done at least my part- that is important to me.

Breakingfree- After considering your response carefully, I realize that the shame is in my head, and doesn't exist outside of it. Thank you for helping me with this. Maybe I have been sensitive to the abruptness and timing (very difficult week in court). If I had started this way, I would have been ok with a sliding fee. Or, if she had that conversation with me when I told her I was experiencing difficulty back in September. The abruptness was startling, but my confusion continues when after needed the money immediately that she offered the sliding scale. If the money was that important, why would a sliding scale now be ok? In my state, doctors are required to give 30 days written notice to find another doctor so the patient isn't abandoned- I would have appreciated having this option in an honest manner- it would have given me all the info I needed and the ability to choose what is best for me. Thank you- will continue to process this.

Jerry- Yes- this would let me know what to take and what to trash. It never crossed my mind that she wasn't deserving of her full fee- because of the typical cycles of paperwork, I had no idea of the changes in my health care policy and no on told me when the doctor changed to a fee based service; the first I heard about it was after 5 weeks had passed. So, I felt like I was processing a triple whammy... and slid back into taking it personally.

Thanks- I'll sleep better tonight without bringing shame with me, without taking it personally. I don't know how I'm feeling about her support going forward. I think I may cancel my appointment for next week and see how the week goes. I can always call back and bring a check for the full amount at the time of service, or confirm if a discounted sliding scale is still available.

The good news is that I clearly will be stepping up my Alanon program. Thanks for being here.

Serenity said what I was going to say, get everything in writing. Whenever an agreement is made get some paper for so you know you have a meeting of the minds.

This exact thing happened to my friend. Her husband traded services with a guy to do their septic. Husband asked s person when he wanted him to do the  work ? S kept putting it off, told him not to worry about it. They see each other a lot, husband always brought it up. Next thing they know they got a rude, mean letter, even threatening them with court! So they just paid it too.

They ended up not wanting to do their service of pest control over this. As for all they know he would say something was done wrong and sue them!

So in saying that, I would drop whoever the loser is, as I could not trust them as a professional anymore. Take it as a lesson learned.

Great vent/share! hugz, debilyn

 

 

 

Bud: If it is any help to you, I have learned that when people say "Don't worry about it. Take as long as you'd like," they are predicting a future that may not come about. In business, there is always a bottom line that is concrete whether it is spoken or unspoken. I never trust that phrase because life is constantly changing and it isn't always predictable. What I've also learned is that when life changes, there is generally a new solution to a new challenge. You didn't trust that phrase either when she spoke it. When the game changed, what I see here is that a new solution for paying the bill outright appeared for you. I think you handled this with proper decorum and shame just came along and tried to tell you that you'd done something wrong. I don't see it that way. I see that you met the new challenge with a new solution.

I can't think for somebody else and yet if I look at this from a therapist's view who is in business to help others but still needs to pay her own bills: If I, as a therapist in private practice who has to pay for insurance and overhead and still pay my own way in life decide that it is better for me to operate on a cash basis only rather than bill insurance companies, I also realize the risk in losing patients due to this new policy. I'd still have to pay my bills, so I'd offer sliding fee scale as I worked on rebuilding my client base with the new cash only policy.

If it was me running a business like this, I wouldn't be working to get rid of clients. I'd be working to keep them while still trying to meet my own expenses and financial obligations. To me, the most important person here is you and what you need to feel safe and secure in relationship to a therapist.

Gosh, Bud. I don't know. I do know that you are feeling uncertain about how to proceed in this case because of the shift you didn't anticipate. Maybe this is one of those ask for knowledge of your HP's will for you and the power to carry it out? I know when I'm uncertain and feeling distrustful, just turning things over to my HP and waiting for clarity helps me.

Thanks SerenityRUS. Yes, I agree and I think that she may have forgotten or simply made a business decision that was right for her- tend to think it's more of the latter, as when I inquired, I was stonewalled. Anyway, I guess whichever is not important, the outcome is what I need to deal with.

Yes, I had received EMDR as one of many of the treatments. Thank you for sharing- it's good information to have.

And thank you- I am aware this is a growing pain, but the growth is good. I think that I am wondering if I've outgrown what she has to offer is there. Perhaps, in a backdoor way, this has created a readiness for me to spread my wings. Of course, this only deepens my commitment to working my program even harder.

Thanks Grateful- I will meditate on it over the weekend and see where it takes me. I may decide to cancel Tuesday's appointment on Sunday if I am still undecided. I think it is good to wait and listen for a clear message from my HP.

Big Hug and thank you to my MIP family- I am so grateful!

Bud - Great feedback from everyone else so far. I can only share a few things based on my experiences:

The therapist is ethically obligated to not end treatment for nonpayment. On the other hand, if the therapist doesn't get some payment from clients, she might have to close her practice. Therein lies the dilemma. So often a therapist will use bill collectors to help them with that end because hounding their clients for payment will destroy rapport....especially when dealing with clients who have really sensitive issues and trust was difficult to attain in the first place. So...the person doing billing for the person is hired to "keep the practice thriving" more or less and that is their job. If the therapist undercut the person she hired to do her billing, that would be sabotaging her for the reason she hired her....which is to keep the business afloat despite her now having issues with insurance collection and payment in general. As the consumer/client, this puts you in a very very awkward place because there are lots of reasons to QTIP this situation, but it's a relationship that is complicated due to having both money and highly sensitive personal issues involved. When I go in the direction of "I know this professional is a caring person (if I believe that truly), but they also have to get paid" it helps me. Even though I do see your reasons for being upset and they are valid.

I also see that this therapist doesn't want to lose you as a client for both clinical and financial reasons and that is probably why you were not told ahead of time "Hey, I'm having financial issues and need as much payment from all my clients or I gotta shut the doors." If she told you that, it would detract from your therapy also, raise the chance of you just leaving her as a therapist, and then she definitely would have to shut the practice down if all clients did that. So yeah....it's a tricky business to be providing human services and trying to get paid for it.

I teach future counselors. 

This is not okay in my book. If he/she has hired bill collectors, she can hire a company that allows for people to make reasonable payments, and a company that doesn't pull the rug out from under people. Sometimes counselors have a hard time saying "no" in the moment, and then get someone else to do their "dirty work." I wonder if this is what happened in this case? He/she wanted to be nice in the moment...

I would explain to her that this namby pamby waffling...has broken your trust, which is significant when someone has trauma issues. She has some issues, it seems to me, to clear up before she ropes people into her practice. I'm sorry, but you don't treat vulnerable people this way...with moving and unclear boundaries. 

I understand the need to make money and keep a practice going...but if money is that tight in this practice, he/she needs to make payment boundaries CLEAR up front...no waffling. 

Sometimes I wonder if we ALanons are so self-reflective that we blame real bad things that other people do on ourselves...our own stuff, if you will. I think it is good to reflect, but it's also okay to not be happy when we are treated unfairly....just saying, maybe it's NOT you. 

My 2 cents -- you can 86 them if you wish...

all best, 

RP