Spending money on therapy?

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Is your T in practice by herself? If she has some control over the situation, she might be able to get...
She would not do that. She tried insurance in the beg of her career and felt frustrated.
She said that insurance reps would tell her directly to encourage her patients to go on meds (with a psychiatrist or md) as ultimately that was cheaper than patients just staying in talk therapy.
So as a PsyD, she felt insurance did not support her and what she felt she needed to do for each patient.
I have already been with her for 2.5 yrs and will likely continue for a long time. If I was in network maybe that would be more difficult to stay long term.

She is a great T, but not perfect. Sometimes there is that "ho hum session" where she is not as engaged. That feels frustrating because Im paying for each session.

Sometimes I thwart the session because of ADHD and I get distracted easily or because I will be disassociated the whole session.

Sometimes, the psychodynamic thing gets to me. I get that its a great process for healing and I feel lucky that I have T who can do it, but THAT is the most exhausting part because I project so much into her all of my child hood rejection I put on her. So, I go before her aching with pain and the need to be seen and then she just is a therapist that I pay.
I pay her to love me.
I constantly think she hates me (she doesn't) but its a projection.
We took a year just talking about our relationship and how it connects to my mother.
I think I would enjoy spending the money if it weren't for all of the projections/psychodynamic bull shit that clouds my mind.
I have an anxious/avoidance attachment issue that I am trying to work out. So, I constantly want to leave her.


My therapist is disenchanted with insurance too, but she has applied to be an “authorized non-network” provider for me. We are waiting to see if this goes through so that I will be able to get reimbursed for about half of her session fee. The application was ridiculous, but this will hopefully maintain her professional autonomy while easing some of the financial burden for me.

I agree that you’re probably trying to use the money as an excuse to leave her, because of your attachment issues. I think I share some similar struggles. I’ve found myself acting like I’ve seen foster kids behave...testing her limits and all that. She is aware and does her best to reassure me that, if it’s at all within her power, she’s not going anywhere and we’re going to figure out this insurance stuff together. When I felt guilty about all the paperwork she had to fill out, she reminded me it’s her job to help me even if that means hours of paperwork and time on the phone with insurance. It’s part of her job.

I forgot to add that I grew up poor and with a lot of chaos and insecurity. I can waste money mindlessly when I’m stressed (gas, too many trips to the grocery store, ordering pizza and treats for the kids, etc)...but making intentional purchases that seem large and possibly selfish (like getting a decent haircut, having shoes that don’t hurt my back, bodywork, therapy, etc) can set off panic attacks. I have an embarrassing problem with buying canned goods when I feel unsafe and with telling my kids “no” when it comes to grocery items because I don’t want them to feel unsafe. Of course my 5 year old can have 5 pomegranates if she wants them! (Insert eye rolls here) Distortions from poverty. Working really hard on it and thank God for my husband’s patience.
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My therapist is disenchanted with insurance too, but she has applied to be an “authorized non-net...
I can totally relate to this. I like the point you make about big, sound and important purchases like a good hair cut and lasting shoes can cause guilt. I was denied many "needs" as a kid over and over again so now I can be polar opposites with money.
I will purchases things to make myself feel better, yet feel guilty when it is a valid purchase like therapy or clothing.
My husband's actions have triggered and uncovered a lot of my issues with money.
In general, I am really cheap and very careful with money. I am obsessed with maintaining a good credit score.
So, that is my comfort-my gut tells me to spend the money on my T and that says a lot being that I am so careful on the whole with money.
It just became hard to justify the cost because our in network benefits became really good.


But if it is working for you, why change now? Especially as your husband has a better paid job now.
If you change, you risk a T that doesn't meet your needs as well as this one.
It seems like that might sabotage your progress.
Maybe make some goals to hit with this one and when you've reached them you could reassess?


I mentioned above this feeling of paying my T to love me. I don't know how to get around this.
I know the "love" I am referring to is therapeutic.
I define it as validation, being seen and heard. And she does it deeply with me, it is specific. She really listens and remembers and uses this like a tool or a strategy. She says I have been through relational trauma and I need a caring relationship to heal me. When she says things like this I can feel the PTSD wounds sort of melt a little.
Yet, I pay for this.
When all of our financial troubles were swirling around me I became suicidal.
I felt like I had lost my husband. I did not know who I had in my life.
I managed to scrape up 100 dollars to see her and I was struck by the impermanence of my T.
If I did not have the money she would not be in my life.
I reached out to a hot line. This random guy was all I felt I had, a stranger.
I reached out to my abusive mother and got 50 percent help and 100 percent triggered.
I reached out to my sister who was mostly there, but with issues.
I joined a church, but that is triggering.
I have no close friends.
PTSD really is a bitch.
I realize this could be a new thread.
But honestly, now I don't know how to trust my T again, she is only contingent on money. I would not want her to treat me for free because of boundaries. I like paying for services rendered. I am a sa survivor, and rules, fair and square are great.
How do you deal with that feeling that you are paying to be loved? (Therapeutically speaking).
She would not do that. She tried insurance in the beg of her career and felt frustrated.
She said tha...
Omg! That sounds exactly like how I get with my therapists!!! They don’t even have to be psychodynamic for that to happen. At least with me. Thanks, I feel less alone.

I mentioned above this feeling of paying my T to love me. I don't know how to get around this.
I know...
For the question at the end, you trust that they do this because they care. That it will never be what you ultimately want it to be but that that’s ok. It can be what it is and that’s enough. It hurts and will hurt but it’s still good enough. The perfect situation is to go back in time and get a new childhood. A perfect one. We can’t do that. So we do the next best thing. We talk it out with someone who is choosing to spent their time with us. Think of it as time and not money so much. Your t could make money in easier ways. She’s taking a percentage of her life and giving it to you. To have that therapy hour be all about you. That’s huge. And in order for them to be able to sleep in a warm bed we need to give them money. Money is energy. When someone listens to us outside of therapy we generally pay them back in some way, like listening to THEM. So they give us energy, we give them energy. In therapy you don’t have to listen to her talk about her life so there needs to be some exchange. Every relationship there is some exchange but there is still care. I don’t know, that’s how I rationalize it. Don’t know if that helps.
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Yes! I was going to say the same thing about money being a form of energy.

And, Scarlett13, you already understand how important safe boundaries are for us. Therapists are not in this work for the money. Try to let yourself receive her care and regard. You are worthy.


Youv'e done some amazing work here as getting to the core of your feelings about this and your husbands behaviour. It might be a good thing discussing some of these things with him too.

I too struggle to spend money on therapy. Think mine is self esteem, avoidance, shame, trust. Its wonderful you are have a great t. That's priceless.

I hate the relational stuff in therapy. :( Its excruciating.


I tend to look at my relationship with my T as the same way I look at any other person I pay for services. One professional to another. However, there is more to it than that.

I pay for dog training workshops, my house to be painted, may car to be serviced, my hair to be cut etc etc. Just those 4 examples could be about money. But they're not. My training instructors totally want my dogs to be the best they can be. My painter takes great care and pride in his work, sanding, filling, painting and doing a bunch of other jobs for me because he's a really nice guy. My mechanic looks at my car for no charge, tells me not to bother fixing it and to start looking for a new one. My hairdresser doesn't push product too heavily, takes great care listening to what I want and following through, plus if I don't need a colour that day, for example, she'll swap it out for a treatment which actually saves me money.

My T is the same. Yes I pay her for a service. But I have no doubt she has been scrambling to find what works for me because I think we were both surprised with how things progressed from needing some strategies to cope with stress to full blown dissociative flashbacks and losing time in session. I am finding it very difficult to cope with all this and I'm feeling quite resistant. Just a smidge in denial perhaps. But that's where I'm at. She could have kept pushing me to go where I wasn't ready to but instead she's backed right off, focussed on stabilisation and less frequent sessions to allow me time to settle in between. I just realised that the last few sessions she's actually changed her language too - rather than pushing me to name dissociation as an actual thing I do (did I mention denial?) she talked about energy and "flattening" when I was starting to drift then brought me back with a change of subject. I felt genuine empathy, validation and interest. The ability to understand what I needed in that moment is priceless.


My therapist is disenchanted with insurance too, but she has applied to be an “authorized non-network” provider for me. We are waiting to see if this goes through so that I will be able to get reimbursed for about half of her session fee. The application was ridiculous, but this will hopefully maintain her professional autonomy while easing some of the financial burden for me.
I just wanted to echo this. I don't know if you have discussed this option with your therapist, @Scarlet13. The right place to start would be to call your insurance company and ask them to talk you through what your options are, when you need a specialized provider. You'd want to look and see how many people in-network actually have the same degrees and certifications as your therapist - not that you are going to go to them, but that it can work to your advantage if there aren't any.

Calling insurance companies to get info like this is a bit of a roll of the dice. I've often had to call a few times before ending up with someone on the phone who was willing to really try and solve the problem with me. There may not be a solution - but it can be empowering even to go through the process and learn more about what the possible options are.

(It can also be really stressful and upsetting...but could ultimately help you in accepting that you can make the choice to be out-of-network because it's the right choice for you, and help you diminish the thoughts that lead to guilt)


So, I do have out of network benefits. I am using them. They cover the cost at 60 percent, but only after a 2,500 deductible has been met.
The other issue is that they will deny claims over and over again before accepting them.
I am going to use an app that handles this claim process, but then takes 10 percent of the payment which may be worth it.
In the end, I will likely get 1,500 or so back and there is no given/control over this process.
I will continue to look into seeing what else I can do.
She really is the right way to go for trauma work. I need a PsyD who can do EMDR and who is psychodynamic and who I like, so I am just going to spend the money. Thanks for the suggestion.
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