Therapists’ cancellation policies/Ts&Cs…

barefoot

Sponsor
Instead of thinking of it as "a rupture", would it be more useful to think of it as "a communication issue"?
Well, yeah, it is a communication issue…and an inconsistency issue. But then, if her being inconsistent and not communicating transparently leads to me feeling unsettled and unsafe (I hadn’t thought about that word before you mentioned it, but I think that’s probably right) and dents the trust…that’s a rupture really? Not trying to label it that and make a big deal out of it or make it into something bigger than it is. But I really don’t feel good about it.

I’m sure she didn’t have any intention to have the impact she’s had with this. And I said that to her in my email. I know she won’t want me to be feeling upset and stressed about this. But I do feel that, regardless.

I think I'd pay the invoice but include something like, "Would you fill me in on what your cancellation policy is? I don't remember discussing it and, since this is the first time I've gotten a bill for cancelling a session, I'd like to be clear on what the rules are in the future.
I might do something along these lines, thanks. I suppose I just feel a bit awkward emailing her again when she hasn’t responded to the other one. And hasn’t responded to my request for a session this week either (that I requested when I cancelled)

I may wait til I can see her before I ask what her policy is, just to see if I get a rabbit in headlight look that suggests she doesn’t know! (Ha! Joking/not joking!)

Sorry I didn't realise this is the first time she has invoiced you in 8 years at a short notice calculation. That does add a very confusing spin on it.
Yeah, exactly.

Do you think there was some sort of mistake?
I don’t see it can be really. She wrote that she hoped I was feeling better, so was aware she was writing it to me specifically…she wasn’t just blanket invoicing a bunch of people with the same message. She obviously just decided that last week’s cancellation justified being billed for it, even though she’s never done it before. So, I’m not sure what’s different/why the change?

Do you feel able to ask for this? Sounds a reasonable thing to ask, a quick call to under the cancellation policy, and why this time has differed from other times, and what the expectation is moving forward.
I don’t know. Maybe. It doesn’t sound unreasonable, I don’t think. And it’s certainly info I’d like clarified. I’ve just never asked for a call before and I don’t know how she’d respond if I did. A bit of a risk that if I asked and she said no, or didn’t acknowledge the request at all, that I’ll just end up feeling more wound up than I do now!

We have had a few brief phone calls out of sessions but she has always offered them. A few times I accepted her offer…but then, having said yes, she sometimes then didn’t call. Which didn’t go down well! Though that was a long time ago and I think she is better organised these days.
It adds a financial 'ouch' to the emotional one.
Yep!
I'm sorry you're in this situation @barefoot. I remember your previous ruptures and how at certain points it feels like she brings her own stuff into it which doesn't help to make the repairing of ruptures easy.
Thanks. Yeah, it’s stressful. And I think we both have stuff that takes us back into this pattern every now and then. Sigh…
 

barefoot

Sponsor
As an aside, I think she’s actually cancelled short notice on me way more times than I have on her over the years. Not something I have said to her because I don’t want to get into to-for-tat and I appreciate that I am the paying client here. But respecting each other’s time should work both ways.

Her cancelling short notice has costs for me (including financial ones as if she’s in my diary I don’t book work in around it, so I’ve potentially lost money if she cancels at short notice)

But we have always seemed to just have mutual understanding and trust that, whatever the reason, if one of us was actually cancelling at short notice, it must be something unavoidable. And so we have always both been compassionate and understanding with each other about it.
I guess not now!
 

mylunareclipse

MyPTSD Pro
Sorry you are feeling hurt @barefoot.
I think it is one of those situations where maybe both things can be true. It is ok for her to bill you and it is ok for your to feel hurt.
1) it’s ok for her to bill you as she might have some sort of 24 hr cancellation policy - needs the money etc
2) it’s ok for you to feel upset as “losing” money is not fun. You were sick and instead of your therapist holding you and giving you soup she gave you a bill. That doesn’t seem fun. And unfortunately when money is involved it’s also a reminder of the fact that you pay for this relationship.

With current T I have only cancelled once and it was a little over 24 hrs.

With a previous T I had a situation where I was in a similar situation to you and to cancel last minute and he billed me. He actullat billed me double the amount he would usually make for one of my sessions . He charged me what his standard rate should be and not what the insurance normally paid. Which felt extremely f*cked up. I still paid though.

I think you should pay the invoice. It sucks now but eventually it will be ok.
 

Movingforward10

MyPTSD Pro
And it’s certainly info I’d like clarified. I’ve just never asked for a call before and I don’t know how she’d respond if I did. A bit of a risk that if I asked and she said no, or didn’t acknowledge the request at all, that I’ll just end up feeling more wound up than I do now!
Yeah it is a risk.
Is it one worth taking or is the potential fall out not worth it?

Best case, how would you like this resolved?
And if that best case isn't possible, what would be the next best way for this to be resolved?
 

barefoot

Sponsor
I think it is one of those situations where maybe both things can be true. It is ok for her to bill you and it is ok for your to feel hurt.
Yes, you’re probably right. Though, as I’ve mentioned, I don’t have a problem with her having and enforcing a cancellation policy. The thing I’m struggling with is that, in 8 years, she has never mentioned a cancellation policy, she has never charged me for a cancelled ssssion and she has actually explicitly said she’s fine with me cancelling whenever I need to, it’s not a problem (not that I do short notice cancellations often, so it’s not like I have taken advantage of her saying this) That’s what feels very confusing about this. If after 8 years you’re going to start enforcing/changing your policies, that’s totally fine. But I think it’s only fair to let your clients know, rather than just invoicing unexpectedly after the event.

You were sick and instead of your therapist holding you and giving you soup she gave you a bill. That doesn’t seem fun. And unfortunately when money is involved it’s also a reminder of the fact that you pay for this relationship.
I’ve had two years of chronic long Covid illness/symptoms and she has been very compassionate and shown lots of care during that time. So, it’s not that I think she doesn’t care, or that she doesn’t show compassion.

I know what you meant about when money is involved. But I am not confused about the nature of our relationship. I like her and we get on well. I have become attached to her over the years. But I am very clear about professional boundaries. I work with clients 1:1 myself so I understand what a professional relationship means and I set boundaries with my own clients.

This is also why I especially understand from my own experience of running my own business that people not showing up to sessions or cancelling last minute is an inconvenience, which can result in losing income. Hence, I get having a policy where you charge clients for no shows/short notice cancellations. I have a policy around this though also exercise discretion based on factors like whether this is a regular occurrence with this particular and what are their circumstances around the cancellation. So, I don’t charge everyone for every cancellation - but it’s in my terms that they may be charged the full session fee.
He actullat billed me double the amount he would usually make for one of my sessions . He charged me what his standard rate should be and not what the insurance normally paid.
Wow! That’s terrible! To be honest, I think that’s really cheeky of him! I know you said you paid it but did you push back or question him about it?
Is it one worth taking or is the potential fall out not worth it?

Best case, how would you like this resolved?
And if that best case isn't possible, what would be the next best way for this to be resolved?

All good questions…not sure about my answers at the moment, will have to mull further…
 

joeylittle

Administrator
I would encourage you @barefoot to take a slight step back, only in that you may be spiraling a bit into some aspects of what happened.

Personally? I get extremely frustrated when people make choices that affect me, that I also genuinely think are ethically or logically wrong. And I see that's what bothers you about this - not that there's a charge (you've made that clear), but that it's been 8 years and this is the first time she's charging you for it. All the reasons you've given for why it's feeling wrong to you - those are understandable, and I really recognize the thinking, it's something I do as well.

But what you need to remember is: the only way to know her thinking will be for you to allow her to explain her reasoning. And in order to allow her to explain, you've got to allow space in your mind for a few things:
-- she's capable of making mistakes
-- the therapist client relationship is unlike any other relationship in one's life, and as such: can stir up some complicated feelings
-- even the hard things are worth working through, for the sake of the bigger picture of what you want - in this case, to continue a working relationship.

There are two things I'm seeing, that might help you. The first is a likely answer to your question of, "why the change?"
Because I’m still unclear about that. Especially because, in her email, she said she tried to fill the time with another client and couldn’t. Hence she was invoicing me? So was I charged because it was 90 mins notice? Earlier on the same day cancellations have been fine - so when’s the cut off point? Or is it now that any time on the day are not ok? And, however short notice it is, if she does manage to have another client take that slot, so I then not have to pay?! It’s still all very unclear to me.
She obviously just decided that last week’s cancellation justified being billed for it, even though she’s never done it before. So, I’m not sure what’s different/why the change?
My guess is, it's what you said in the bit I bolded. If she can fill the time, she doesn't consider it wages lost, and therefore doesn't charge. If she can't fill the time, she charges. I think it's sloppy of her to have never communicated that to you - and it's fair to be frustrated. But I don't know that it's more complicated than that.

What seems to be happening with you, is - you feel betrayed by what you're experiencing as a shift in the relationship. That's less about the policy/unclear policy/practice, and much more about this:
So, it’s this uncomfortable time when there’s no next session date in the diary and there is tension between us…that’s when we seem to struggle and get into a bit of a stand off. It always feels like we’re both waiting for the other one to make a move. And, it is always me who does it at some point. Which is quite difficult to do when I’m the one feeling upset and I’m just getting radio silence from her.

Who knows - maybe she will prove me wrong and respond sometime next week?!
If you remove the mind reading you're doing - your interpretation of her side of the exchange - hopefully you can see that you are waiting for her to make a move, and then, you feel like you are the one who 'gives in'...you are projecting onto her the role of a person in your life who stonewalls you.

It's unlikely that she is engaged in some kind of emotional tug of war with you, giving you 'radio silence'. It's more likely that she's maintaining an appropriate distance, and giving you the space to decide whether or not you want to reengage. But you experience this as manipulation on her part.

It's extremely important for you to tell her this - because she's the only one who can tell you if that's what she's doing. But if you don't think she's likely to be that emotionally manipulative and utterly unprofessional? You might ask yourself, "who in my personal life/history has had this kind of power over me, to make me upset like this....where else does this dynamic show up?" Because that's probably the useful insight to gain, here. And working through this with her will be hard - but easier if you can understand that this isn't actually about her, it's about you.
I don’t actually want to lose the current momentum, so I’m frustrated about this. And I actually hate talking with her about ruptured/our therapeutic relationship! I don’t want to draw this out because that’s really stressful and exhausting and I actively want to be picking up where we left off. Hence asking for advice here about next steps,
You are avoiding her because you truly dislike the topic of the therapeutic relationship/alliance. But, you want to go back to session.

What I can say from my own experience - also having been with my therapist for 8 or so years - is that, every time I've felt like he's let me down, or betrayed me in some way - bringing it up has always been very hard, but it's also led to some extremely productive discoveries for me. And it's let me start to work on the part that's really about me. My best advice really is to say - write again, to schedule your next appointment. Plan to talk about what's happened. But to prepare for that - try and put some distance within yourself, between your judgement of how she runs her business, and your experience of feeling like she's pulled the rug out from under you with her unexpected action of charging for the missed session.

Having worked with her for 8 years and getting to know her s bit in the process - including how she works - I actually would not be surprised if she won’t be able to clearly articulate her cancellation policy. Because I would not be surprised if she hasn’t actually got one written down anyway and just sort of goes with the flow and does what she feels is the right thing to do at the time.
That's quite possible.

Even if it is - it doesn't mean that she can't articulate for YOU, how cancellations will apply to you, specifically.

What I'm trying to say, is - that part is fairly easy to work through, especially because you aren't bothered by paying. What's bothering you is what you feel is a betrayal in the relationship. That will not be solved in a waiting game over email - in fact, that'll only intensify your feeling frustrated and upset. Instead, set up the session, and focus on organizing your thoughts on identifying your thoughts/feelings, and how this has activated some dynamic that exists in your OTHER relationships in your life.

I'm not sure I'm making any sense, I just really feel connected to what you are going through, and went through something similar recently - so I hope there's something useful in what I'm attempting to share.
 
@barefoot I see that you’ve gotten a lot of replies with great perspectives here, but having been on both sides, I’d like to offer mine. I know ethical guidelines and policies very by country, territories, and states, but your T’s behavior, or lack there of honestly, raises red flags. Considering the situation at face value, without the length of your relationship, informing clients of financial policies during a consultation or initial appointment is standard ethical practice. This needs to be discussed both verbally and in writing, and can be done at any time by either party. If a provider makes changes to policies, the same applies, including the revision date. As part of the informed consent process, a client (you) have the right to make an informed decision about moving forward and/or terminating therapy based on the new information. In one of your replies to another member, you stated that you were not given formal paperwork at the beginning of your therapeutic relationship, and I was taken aback, as the initial paperwork is considered a large, essential part of the informed consent process.

Since the therapeutic relationship is important, and it can be hard to find the right fit, I strongly suggest discussing your feelings and reservations with your T before terminating altogether. Oftentimes, a cancellation policy alludes to giving 24-hour notice except in cases of illness and/or emergencies. At the very least, you’re T could have shown some consideration for the sudden sickness and offered to reschedule or even a quick check-in call. While finances are an important part of running a business, such as a private practice, I strongly believe this particular situation calls for considerate compassion, which was not given on her part. I wish you the best with whatever you decide.
 

Defaultxlove

MyPTSD Pro
I'm sorry I couldn't read everything. Just figured I'd share two examples quick.

1. Primary T. Sometimes we say "we will talk Thursday and we will text in the morning about what time" never have been charged for cancelling. Barely cancel.

2. Marriage T. Sometimes I feel like she wants to get rich off me missing appointments. But really she messed up her schedule and confused me with another client once in billing stuff.

Vehicles engine blew on my way to drop the kids off to the sitter, I couldn't make it to a session. I told her exactly when it happened. She still charged me for "missing" . I wanted to drop her then. But she's very very good. So I paid it and moved on.

Hugs.
 

lostforgottensoul

MyPTSD Pro
1) I’m curious about what cancellation policy your T has and how/when they have communicated their T&Cs to you.
My therapist charges $60 for a same day cancelation. They have that in their initial paperwork that you sign before the therapist sees you and they have it posted on the glass between you and the office staff.

Over the years the office staff has offered me a reschedule or a phone appointment (before Covid) to avoid the $60 charge. But, my therapist does apply this charge if I cancel same day and don't reschedule or take a phone call session.

Since Covid and since my therapist is still working from home, I haven't needed to cancel same day just because it's a phone call that I can do anywhere. But we've talked about it before and from my understanding, he looses money if a client cancels same day. So, I understand fully why.

If my therapist was nice and didn't charge me, I'd feel grateful. And he has done that over the years a few times. But I fully understand that he does and would charge and understand why. And it doesn't matter why you are canceling and I don't know if the office staff even tells him why. They may. But I know if I cancel same day for any reason, that I will be charged $60 to do so. In the almost 13 yrs of being in therapy, I have canceled same day maybe 4 or so times. It's not common, at all. But he does have patients that cancel same day all the time. And he has even said that if it becomes a habit of people canceling same day, that he will ask them if they are committed to getting help. Because I think he looses more then $60 and he has a slot where someone that really wants help could of taken but when it's same day, it's not common for someone that really wants help to take. If there is a few days of advance, he maybe able to fill that slot but when it's same day, it's not likely that he will be able to fill thst slot. So, if it's common, he will have a talk with that patient if they are committed to seeking help.

That was a long answer to that question. Sorry about that.


The thing is, in eight years, my T has never shared any Ts & Cs with me. She’s never told me what her cancellation policy is.
Thats not cool. I would ask her what her cancelation policy is and ask for it in writing. As that's what every doctor I have does (including medical doctors). They have you sign it, first off, which I think is common as they are billing you for something and you have to agree to be billed for whatever you are being billed for. At least here but even in Kansas, every doctor (medical) I had, they all had me sign their same day cancelation policy and given me a copy. I think it's common for most doctors to have a cancelation policy and to give that to their patients and have their patients sign it and agree to be billed for it. It's a cover their ass sort of thing so they can legally bill you as you signed it, agreeing to be billed for it. So, I'd most certianly ask for a copy of the cancelation policy.


Any thoughts? Would you pay it now?
Or have no intention of paying it? Or want to talk to her about first? Or…???
If I didn't know they had a cancellation policy and didn't sign anything stating I knew and if it was a policy change that I didn't know existed, then I would have trouble paying it. I would ask for the policy first. I would also tell her that I'm not going to pay for something I knew nothing about. That I understand why that policy would exist but that I didn't know it existed and that I didn't sign anything to state I knew it existed. I don't even know if that's legal. To try to bill someone for something after the fact that you didn't tell them about nor have their signature stating they were told. Maybe that is my cheapskate part of me coming out but, I'm sorry, if you don't tell me that it existed and offer me a paper about it and I didn't sign something stating I was told, then you don't get my money. Just saying. I have a ton of doctors and have had a ton of doctors in multiple states. Both my therapist and my medical doctors all had their same day cancellation policy as part of their intake paperwork that you must sign and they offered me a copy of it to take home. Then, I'm told, sign that I was told, and was offered that policy to take home. Then, I'm cool with being billed. But if I knew nothing about it and didn't sign that I knew about it, then no!

If it were me in this situation, I would set up an appointment to discuss it for sure. Before I paid. If they won't see me without paying, I would tell the office staff that I didn't know such a policy existed and that I want to discuss that with the doctor before I paid. If they won't see me still before paying then they aren't being ethical and possibly being illegal (don't know that but just my opinion on that) and they would loose a patient over that. But again, that's just me. I would, however, explain my thought process to everyone involved. Those that make the appointments and my therapist has a billing rep. Would explain my position to them. They would then discuss it with my therapist who would make the call on seeing me before paying, or not. But if not, then cool. They loose a patient. But, my therapist would never just not see me before I paid if I truly didn't know and he would probably waive it. But you don't know if you don't call and explain your situation to them. You know?


But this happening out of the blue has just really blindsided me. And whether she says she’ll waive the fee or not (I’m not expecting her to) I’m not really sure where we go from here and how we pick that work back up. I feel that trust has been damaged a bit as her invoicing for a cancelled session when she had never once mentioned that that could be a possibility just feels like she’s not been transparent and straightforward. And that doesn’t sit well with me. And has surprised me. And makes her less trustworthy.
This I understand 100%! If my therapist did that, he'd loose my trust too. And I'm sorry, I just wouldn't pay for something I knew nothing about. I'd call, explain my thought process and would try very hard to get a session in without paying to first explain that I won't pay for something I didn't know anything about and second, to get the policy in writing. If he didn't do that, then he'd loose all my trust and I wouldn't be able to work with him anymore. My therapist has credit me over $300 before because of how his office staff treated me when I dropped my dad's car keys in the elevator. The space between the elevator and the floor. No one could reach it on the first floor. Someone had to come out to get the keys and that was $300. His office staff caused an entire panic attack and was basically abusive to me. He credited it to me towards his own bill. I say that to say that it's a therapist. They are usually understanding when it comes to trust and such. So, why not call and talk with those that make appointments and try to get an appointment with her to discuss it before paying?

Sorry, I didnt read any of the replies so if you already paid or already addressed it, I apologize!
 

barefoot

Sponsor
you may be spiraling a bit
I think I’m ok. Don’t feel like I’m spiralling. But do realise that I’ve repeated myself a few times to get the context across because I realise a lot of posters only read the OP and then post a reply. So, I realise I’ve repeated the same few things because I want people to be clear that I’m not just an idiot who doesn’t understand why someone would have a cancellation policy in place whereby they charge for late cancellations! I think I have perhaps gone OTT in trying to demonstrate that I’m not being an unreasonable arse! But repeating the same few bits all the time probably isn’t a look either as might be making me look like I’m getting fixated. Or, as you say, spiralling.

I get extremely frustrated when people make choices that affect me, that I also genuinely think are ethically or logically wrong. And I see that's what bothers you about this - not that there's a charge (you've made that clear), but that it's been 8 years and this is the first time she's charging you for it.
Yep.
And in order to allow her to explain, you've got to allow space in your mind for a few things:
-- she's capable of making mistakes
-- the therapist client relationship is unlike any other relationship in one's life, and as such: can stir up some complicated feelings
-- even the hard things are worth working through, for the sake of the bigger picture of what you want - in this case, to continue a working relationship
Yes, for sure, on all the above.
I think it's sloppy of her to have never communicated that to you - and it's fair to be frustrated. But I don't know that it's more complicated than that.
I’m not sure it’s more complicated than that either? I don’t think she’s gone about this very well, which has not landed well. I don’t think she’s intentionally set out to send me into any kind of tailspin, even though it has caused some upset.
you feel betrayed by what you're experiencing as a shift in the relationship.
I’m not sure that’s quite what it is. It’s not really betrayal as such, I don’t think. Because, for me, that implies that I think she is deliberately and intentionally doing something (not sure if that’s actually a true definition, but that’s how I think of betrayal) It’s more that…because she hasn’t just been straightforward about her policy, and because she hasn’t communicated something before the event…because these things feel inconsistent and not straightforward…And that then makes her feel less trustworthy and make me feel unsafe…

I’m not sure whether, hearing that explanation, you still think that it’s betrayal I’m ferling? To me they feel like different things? But I don’t know, perhaps they are connected?

T and I have discussed countless time how I can’t bear if people are not straightforward and how it really rattles me and how important it is for me to feel that people are consistent and that I know where I stand with them…so it’s just a bit frustrating that we’re back here again, with me feeling that she’s not being straightforward and transparent and consistent…and that then I feel rattled and stressed and unsafe. It’s a common theme in our ruptures but, so far, even though we’ve talked about the ruptures (sometimes at great length over several sessions) we haven’t managed to find a way to stop the pattern or for me to have a different emotional response.
hopefully you can see that you are waiting for her to make a move, and then, you feel like you are the one who 'gives in'...you are projecting onto her the role of a person in your life who stonewalls you.
My dad was a stonewaller when I was a kid. If he was in a bad mood, he’d just ignore us all for days. Just wouldn’t speak to anyone. It was like being invisible. Have spoken to T about this. And she actually said her dad used to do the same. I think that’s why it then frustrates me more when I email her expressing something important and then she doesn’t acknowledge it and just ignores it. My dad doesn’t do it to me anymore. And it’s not something that I think caused me great psychological hurt or harm, T always makes a big deal of it, saying how hurtful it is to be ignored. And yet, she will ignore an email for weeks. And I don’t see how she won’t know that that will drive me nuts!

I can’t really think of any other person/dynamic where stonewalling shows up. Just my dad sometimes when I was a kid. He doesn’t do it to me any more.
It's unlikely that she is engaged in some kind of emotional tug of war with you, giving you 'radio silence'. It's more likely that she's maintaining an appropriate distance, and giving you the space to decide whether or not you want to reengage. But you experience this as manipulation on her part.
No, I don’t think she intends to cause upset. I acknowledged that in my email. At the same time though, she knows straightforwardness is huge for me. And that I don’t cope well with being ignored. So, I’m this situation, she hasn’t been straightforward, in my opinion (but I don’t mean she’s chosen to do that intentionally. And she knows that being ignored is something I find difficult to handle…and she always hangs on about how hurtful it is and how emotionally abusive and punitive it was of my dad to behave that way…and then I email her expressing how I feel about something that’s important to me…and then she just tends not to reply. So, again, I’m not suggesting she is doing it on purpose. At the same time, I don’t understand why she would think just ignoring the email for weeks is going to land well and help us to get things back on track.

I did say to someone else earlier on this thread that she has said before she has not replied as she is wanting to give me space as I am upset. I trust that she’s being truthful on that issue. But, that said, it’s not actually an approach I find helpful. I actually find it very stressful. She may think she’s helping my giving me space…but I would prefer even the briefest reply just to acknowledge that she’s read it, just so I don’t feel ignored and so I know I’ve been heard.

And someone else said earlier that not replying to my email seems manipulative on her part. I don’t see it that way. I don’t think she’s being manipulative. But, as I just said, it’s more that, even if she is well intentioned (not replying so she gives me space as I am upset), it’s not an approach I find helpful as it creates a lot of stress and distress. I’ve told her this before. And she has said she understands that. So then it just frustrates me whenever it next happens.
You are avoiding her because you truly dislike the topic of the therapeutic relationship/alliance.
I’m not planning on avoid her. Hence I was asking about suggestions for next steps. I end up in a waiting game on email because, if I’ve emailed her to share how I feel about something and then she doesn’t reply (even after three weeks have passed) it feels like I can’t really email again. Because, if she hasn’t responded to the first message, which would have been about something important to me, it feels like emailing her again would be unacceptable and unwelcome. So, I wait for her to respond to the initial email. And get rising anxiety as time passes and there is still no response…and it feels awkward…and I start to think I did the wrong thing by emailing and I think I shouldn’t have…so I can’t then rectify that mistake by emailing again.

And if I email again to just say ‘when are you next available for a session?’ it feels really odd. Because it feels like the important think I first emailed about that was important to me…if I just email again trying to schedule another session without getting response from her on the first one…it feels like I’m saying the important thing I emailed about doesn’t actually matter now.

I think all of this but is perhaps making me sound a bit nuts! And I’m sure I’m overthinking it. But when the emailing and not getting a reply and me then emailing again scenario creates such anxiety…and when we’ve talked about it several times before…it actually makes every time it then happens again feel more difficult to deal with in a way. Because, if she knows this is the impact it has on me and this is where I go with it, it feels difficult to find ourselves back there, both doing the same thing again.

‘But, you want to go back to session.’

Sorry, I messed up my quote formatting there ^^^
I don’t want to terminate our work together because of a miscommunication about cancellation policies! And I want to pick up on what we were doing before, because it felt like we were getting somewhere. But when she doesn’t reply I find it incredibly hard to find a way forward to get back into session and feel ok enough with her to dive back in.

every time I've felt like he's let me down, or betrayed me in some way - bringing it up has always been very hard, but it's also led to some extremely productive discoveries for me. And it's let me start to work on the part that's really about me
Yes, we’ve always discussed our ruptures to. And sometimes that has been incredibly hard. But, yes, we always find ourselves in s better place together, relationally, afterwards. But then, we find ourselves back there again. So, I think I have some frustration about that…that we don’t tend to ever get into digging into the stuff that’s actually about me, rather than the bits that are about the head and now of us (eg a miscommunication between us)
Even if it is - it doesn't mean that she can't articulate for YOU, how cancellations will apply to you, specifically.
Yes, this is true. I definitely want to seek this clarity.
focus on organizing your thoughts on identifying your thoughts/feelings, and how this has activated some dynamic that exists in your OTHER relationships in your life.
I need to think about this more because, at the moment, I can’t really think of a relationship dynamic where this shows up outside my relationship with T. Apart from my dad ignoring us sometimes when I was a kid. Which honestly doesn’t feel like it was that big of a deal.
I strongly suggest discussing your feelings and reservations with your T before terminating altogether.
Yes, I’m definitely not going to finish working with her over a miscommunication about a cancellation policy. It’s just hard to think about best next steps…how best do I move forward when I feel annoyed and when I doubt I will hear from her so it will be down to me to make the effort to reach out to her to try to get things back on track. She when I feel annoyed and taken aback by her action.
I strongly believe this particular situation calls for considerate compassion, which was not given on her part.
Yes, this was a surprise to me.
Sometimes we say "we will talk Thursday and we will text in the morning about what time"
Ooh, that’s pretty vague and open! Not sure I would like that - I like to be clearer about knowing what I’m doing when, so I can plan and work around things. But it’s good if it works for you both.
I wanted to drop her then. But she's very very good. So I paid it and moved on
Yes, definitely a situation where weighing up the hurt/annoyance on one side and the fact that they’re good and helping on the other is called for. Exasperating though some of these things can be, I don’t want to tell her we’re done over the sake of paying £100 for a late cancellation.
he looses money if a client cancels same day. So, I understand fully why.
Yes, me too.
So, if it's common, he will have a talk with that patient if they are committed to seeking help.
That makes sense, definitely.
I'd most certianly ask for a copy of the cancelation policy.
Yes, I definitely want to get clarity on this so that I know what to expect going forward.
Maybe that is my cheapskate part of me coming out
Ah, I don’t think it’s about being a cheapskate! :)
why not call and talk with those that make appointments and try to get an appointment with her to discuss it before paying?
She works alone in private practice, so all communication and scheduling etc is fine direct with her. So, unless I hear from her (which I’m not expecting, but she may surprise me!) the only way of moving anything forward Eli’s for me to text or email her. Or phone her, but I don’t tend to phone her.
 

ninja

MyPTSD Pro
I just think, just reply to my email!
Ahh yeah. Maybe a way around that is to discuss the above with her (i.e., why doesn't she reply)? And maybe also - because she doesn't reply, you are sometimes/often left feeling like the two of you are in a standoff where you're hoping for a response (any response) that she does not give? It just sounds as though it is a repeated area of tension between the two of you (and pain), and I'm wondering if she's addressed it/how she's addressed it (I realize these are personal questions, so please don't feel obligated to answer), or if she hasn't - why not?

Please disregard if not helpful!
 
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