Paying for therapy, and feeling guilt

[Scarlet13]

Hi every one, I need some advice.

I have an obsessive, repetitive concern circulating my mind and I am trying to ease it's constant nagging in my mind.

I see an out of network therapist who charges 100 dollars an hour, so my therapy bill is 400 to 500 dollars about each month.
I am trying to get the out of network benefits, but so far it is hard.

I have tried in network and went to nearly 30 intakes over the course of year, even leaving my current T to try to go in network.

I just felt in network T's were never as good.
I love my current T. She is a trauma specialist and is the right fit. It feels like we are doing deep work and I am making progress. It feels like I have something special and important with her.

She has me at a lower rate. Her normal rate is 140 an hour. I have seen her for 2 yrs at this rate and she knows I am or will be a long term patient. It has been hard to make this bill each mos, but manageable. I have 2 kids and I pay for childcare and I am a teacher so I am not making a lot of money.

It will be easier though to pay this now and not such a struggle as my husband recently got a better job and we are talking about buying a house.

However, I brought his success and our decision to potentially move up with my T and I feel tremendous guilt and insecurity talking about it to her. I still need this rate, especially if we are going to pay a higher house payment. I worry that she is thinking, "Well if your husband is doing better, than you should pay more."

But he is doing better enough that the current rate is not a struggle. And we need to get out of our current house.
So, I can bring these feelings up to her, but am worried that I will sound selfish and socially awkward.

How do I explain that I need the rate to stay there for a while (for a long while) so we can get on our feet and move into a better home? Does this sound selfish and like I don't want to pay her?

I could be using insurance with a 30 dollar co pay so paying 100 dollars is already a lot.

I struggle a lot with security and getting my needs met with resources.

 

[UnicornSightings]

I’ve felt the way you feel. Explain it all. Show her the post even. It’ll make you feel better. You’re mind reading here. She wouldn’t charge you $100 if it didn’t work for her. I’ve thought these same things. I really get it. But you’re causing yourself unnecessary angst. I found it’s way better to be super open and honest and have it feel awkward than to suffer on my own.

 

[Recovery4Me]

Many therapist work on a sliding scale of the patient’s income, not assuming that the significant other’s increase is handed directly to their patient. However, if that is how your scale was originally established based on both incomes, then it is a matter of ethics to mention the increase to allow yourself your own respect and authenticity.

As well when I am not in crisis mode my sessions are once every two but mostly three weeks. So in a worse case scenario, say your T did want a slight increase, then perhaps you might possibly offer that you might need to forego one session every _x amount of weeks to handle the increase. *Establish being able to contact the T through e-mail if need be as the anxiety may increase due to the change of length for that period.

Best of wishes for a clean resolution for optimal healing!

 

[Scarlet13]

Yes, I know I'm mind reading. This comes directly from my mother who would say to me when I was in high school, "You have enough money to spend on boots, but you can't help with groceries?"

I am really f*cked up when it comes to money.

I know this is projections/cognitive distortions, but doesn't it sound bad if I am talking about how we are doing better and I want to buy a house and don't want to pay her more?

Ughh so awkward.

 

[Recovery4Me]

Actually, your T may find this concern of yours an excellent topic to work through some areas. :hug: However, the choice to tell your T shows character. :hug:< hugs if you accept

 

[Scarlet13]

Many therapist work on a sliding scale of the patient’s income, not assuming that the significant...

Thanks for your reply. I cannot skip a week.
I could if she was more skills teaching/DBT based but she does deep trauma work with some skills intertwined.
I would increase it, but now the rate feels reasonable. Where as before, it was tricky and meant we could not buy anything else or get out of debt. My car died and for the past 5 mos we could not afford a new car and so we were sharing a car. Now we can afford these things.
I could handle a small increase like 10 dollars each session, but this does not feel right to me, as 100 still feels like a lot.
I am not trying to take advantage of her. I am just trying to figure out how to have this conversation. If she increases the rate then I would make it work because she is a good T.
I just don't know if it is ok to get a discount, and then buy other things that I need. It is not like I am buying a porsche.
I am so worried about talking about this and sounding like I am taking advantage of her that I want to quit therapy.
What should I do? Just offer to pay her more or explain that I still can't right now?
My husband thinks I should not bring it up at all. But she is my T. I usually talk about what's on my mind.
If this were my hair stylist this wouldn't be so hard.

 

[UnicornSightings]

I remember I would avoid telling my t if I bought something or follow up something with “I got a good deal” or something because I thought she might think I should be paying her the regular rate. I don’t think they think that way. Other people don’t think the same way, you know? I have money issues from my mother as well. Man. They really stay with you, don’t they?! I have a new t. I told him when first contacting him that I fit into a certain bracket of his sliding scale but I could only afford x amount and he was totally ok with it. Geez, your t is still getting $100 for not even an hour of work. She isn’t suffering. I get the guilt but this would fall into the unjustified guilt category.

 

[Recovery4Me]

You asked, “What should I do?”

In some circles the word should is considered an cognitive distortion. So it may just boil down to how you wish to respect yourself, represent yourself and the value held on being truthful or authentic with your therapist.

 

[Scarlet13]

Yes, I just need to talk to her about our other needs/issues. I hope she will understand that I still need that rate.
I just worry how it sounds.
I am a very reg and consistent patient, she has mentioned how she likes that.

 

[Recovery4Me]

:tup: I seriously believe this discussion with your T will open new doors in your hard work! I am excited for your journey.

 

[Scarlet13]

You asked, “What should I do?”

In some circles the word should is consider an cogniti...

Thanks, I like that perspective. That helps a lot. I actually feel like 100 dollars a session still feels reasonable for me right now. I am open to if she needs to change it.
I feel this way because it was really hard to handle before and I just sacrificed other needs now it is reasonable. It feels like I can respect myself with that.
But I still feel scared and awkward.

 

[Recovery4Me]

Understood... you are being very courageous. Good to meet you!