That Extra $100

I’ve been thinking about Nikki a lot this week.

The day after I walked out of session, she called me. When I didn’t pick up, she called me again, and left another message.

“Hey, you. It’s me again. So, I’ve tried you twice. I hope you’re doing okay – you know to go to emergency if things aren’t okay. But I will try you again in 45 minutes, and after that you know what to do – I assume you don’t want to talk to me. Take care, bye.”

I felt a sharp pain and a tightening in my chest, tears came to my eyes, and I tossed my phone onto my bed a lot harder than I should have, considering I have $60 in my bank account and a tawdry history with destruction of electronics.

She was right; I didn’t want to talk to her. I was still upset that she hadn’t been able to help me in session the day before, and I was pretty sure speaking to her would just make me feel worse. But I wanted her to keep calling me. Anna would never have let me get away with just not picking up, I muttered to myself, sulkily.

I’ve been pretty frustrated with myself for being upset. You’re such a diva, Rea. What’s next? Are you going to demand she sort a bowl of m&ms by colour for you?  I wondered whether I was playing a game with her, and if so, how I was supposed to win. I’ve realised now, though, that what I wanted was to know that she was worried about me, that she understood the urgency of the situation, and that she cared about the fact that I was about to cut myself until I passed out on the bathroom floor, and wake up soaked in blood.

If her message had said “Hey, Rea. I’m calling to check in because I’m really worried about you and I want to know if there’s anything I can do to help you get through tonight. I care about you and I don’t want you to hurt yourself. I’ll call you back in about 45 minutes and I hope you pick up, but if not then I’ll assume you don’t want to talk to me. Take care, bye” then I think the need would have been satisfied. I might have even picked up the next time she called. But because I didn’t hear care and concern in her message, I needed her to prove it in another way, by keeping trying to contact me.

When she called again the next day, I didn’t pick up, but I sent her a text to let her know I was okay. That was two weeks ago, and she’s still on vacation.

I really want to talk to her, in a “Hey mommy, look at this painting I did at school today, the teacher gave me a smiley face sticker!” kind of way. Since she’s been gone, I’ve actually been making a lot of good, healthy decisions. I called a meeting with my boss, and asked for an apology for the things he said to me that breached the Disability Discrimination Act, and for a $20,000 raise (I got both). I’ve started swimming laps every second day, eating better, and spending more social time with my colleagues at work. I’ve gone 14 days without hurting myself. Hell, I even did some laundry. And I can’t wait to tell her ‘Look what I did!‘.

Except when I think about actually sitting down across from her, I get a sick feeling in my stomach, and I feel the urge to retreat into myself. The idea of actively reaching for connection with her doesn’t feel okay. And I think a big part of that is the uncertainty about how much longer our relationship is going to last.

Our ten subsidised sessions just ran out, and I can’t afford to pay the full $200 fee. I’m financially supporting my brother (who’s currently homeless and destitute), and my other brother who is more than $20,000 in debt, and my cousin who has seven children and another on the way. I could swing it for a while, but it’d just be delaying the inevitable, and I really need to see someone twice a week anyway. $200 is a stretch but vaguely possible. $400 is ‘not unless I win the lottery’.

When she asked a few weeks ago, and I told her (with no small amount of shame) that I couldn’t afford to keep coming, she offered to halve the fee.

Honestly, Rea, I think you need to keep on coming. I’ve reduced the fee for people who have less severe stuff going on and I honestly am very happy to halve it. Don’t let any kind of guilt get in the way of your decision.

Immediately a whole bunch of voices started popping up, and I was torn between two reactions: THANK GOD and HELL NO.

  • Nan’s voice: If you can’t afford it, you don’t buy it. When your mum was a child we had to handmake all her toys from scraps of wood because we didn’t have the money for new ones
  • University student me who was so poor she had to dumpster-dive and boil pet bones for food: But if I’m not paying the full fee, then none of my money is ever going to belong to me. If I buy name-brand cookies at the grocery store or pick up a magazine, then I’m ‘wasting’ money that I could have paid to Nikki. I’d rather be destitute than feel guilty all the time.
  • Virtuous, practically angelic me: If I don’t pay the full fee, I’m disrespecting all the years Nikki has spent studying and all the effort she puts into her work – I’m basically saying she’s not worth $200. And if she reduces it because I’m financially supporting my family, then she’s essentially buying groceries for total strangers – it isn’t morally right for me to let her do that. I have to decide on my own priorities, and if therapy isn’t one of them, then I have to deal with the consequences of that.
  • Suspicious me: If she does this for me, what’s she going to expect in return? I don’t want to be in her debt.

But most of all, I feel like that extra $100 buys so many things that are essential for therapy to work. How can I ever tell her I’m mad at her for something if I’m paying less than any other client? How can I ever reach out between sessions if I’m not even paying her enough for the 50 minutes I see her? How can I ask her to make phone calls or referrals for me? How can I be withdrawn and hard to reach and sarcastic?

If she is being so generous to me, I feel like I have to be a ‘good’ client. And I’m not. I’m a difficult client. I’m high-maintenance, and I’m challenging, and I refuse to pick up the phone when she calls. And that’s okay – I’m struggling a lot, and it’s just where I am right now – but if I’m not financially worth the effort, then it feels unfair, and I’m scared she’ll just ditch me. I know a lot of this is shame-based, that it comes from feeling like I’m not worth time and care, but accepting her offer just seems so wrong.

On the other hand, the part of me that will happily shoplift a chocolate bar to save $1 is desperate to accept her offer. It’s SO MUCH MONEY. Even if she halves the fee, it’s more than double what I’d pay to see a psychiatrist.

So I don’t know what to do. I need some advice. Nikki has told me so many times that she hates talking about money, and she’s glad that it’s out of the way because now it’s talked about and done and we never have to discuss it again – I don’t feel like I can work through this with her.

Five more days until I have to make a decision. Maybe I should flip a coin.

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That Extra $100

30 thoughts on “That Extra $100

  1. A few things stand out to me (and HI): okay, great she called to check in, though “I am going to assume you don’t want to talk to me..” Hmm, not thrilled with that comment. She was making an assumption that sounded a tad defensive (not sure what her tone was?) and also, you’re hurting and struggling, that doesn’t mean you don’t WANT to talk.
    Besides that, re: the money and sessions. That you help out your family is so loving and admirable and shows how generous your heart is. That is a very lovely quality. What will happen when you do cut yourself till you bleed to death on your bathroom floor? (assuming you don’t have a large life insurance policy designated to one of them, but even with that, I bet not all you support you get a piece). What happens when you break another bone and end up out of work? What happens if you die or are unable to work and bring in income? I say that not out of any shaming, but really, without therapy (despite some of her comments, 14 DAYS without self-harming??!), your long-term health is still a question mark. What if you subsidized some of the $100 by giving $30 less to family each week? Subsidize it for yourself?
    Just a few thoughts. And if Nikki cares that little about money, I think all of your concerns about not paying her enough to “put up with you” aren’t so big concerns, she genuinely seems to not care.
    In Buddhism, the definition of generosity includes discussion of generosity being about what a person stretches themselves to give, versus what they actually give. Someone well-off paying $200 a session is actually showing less “respect” for Nikki’s training than you, with your income and other family financial obligations, paying half the fee.
    Nice job on all of the self-care, I smiled reading that. I would give you a sparkly purple star 🙂

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    1. Oh, yeah – very much defensive, and even more so in her last message of the night. Understandable, given I’d walked out without telling her why, dismissed her offer to Skype during her holiday, then proceeded to screen her calls. It’s hard to be warm and open in that situation, but it would have made a difference if she was. Do you think it’s okay to tell her that I respond to texts when I’m not feeling up to talking on the phone? I found it odd that she didn’t try texting, but maybe there’s a reason she doesn’t like it.

      I love that definition of generosity. My struggle is to decide what counts as a stretch, because my upbringing and my situation since I moved out of home have led me to feel that anything other than bread, water and a floor to sleep on are luxuries. I’m worried that she’s willing to reduce the fee because she doesn’t feel like she’s helping me and it’s coming from guilt. And Nikki has said that she “honestly” doesn’t mind so many times that I almost feel like that the lady doth protest too much, that she actually DOES care, but this is another thing I know I have to work on – letting other people take care of themselves and trust them to set their own boundaries and express their needs.

      Thank you for sharing your thoughts. It really helps while I try to figure this out. I have been thinking about meeting in the middle and paying the fee she gets when she bulk-bills clients ($125), so maybe giving $30 less to family and paying that amount is an option.

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      1. I love the idea of paying the bulk bill fee. That does seem like a very fair (but according to your values) compromise.
        The conditioning is hard. I also think “I asked my parents for money but am spending gas and permit fees to do this backpack. I shouldn’t do that, if I REALLY couldn’t afford it…” Life is more than bread and water, for our psychological health. We were just raised by people who didn’t teach us that.
        The text convo does seem worth having – she can choose if she wants to text or not, but letting her know where you stand, what to expect (that you won’t pick up a call but will a text) might smooth communication? Also, I don’t care how you acted, a compassionate response (even compassionate confrontation) is the only therapeutic response. That shows lack of skill on her end, not any marker of what you “deserved” from your behavior. You are wounded, like a wounded animal, sometimes we lash out. We don’t need someone to strike back.

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      2. A scary conversation, because she’s definitely a lot more boundaried than anybody else I’ve ever seen, so lots of scope for me to fall off a cliff of rejected feelings if she says she doesn’t want to text, but you’re right, knowing where we both stand would probably smooth things. Will have to see how brave/grounded I’m feeling, I guess.

        Are you heading off on your trip soon? I’m always sad when I know there will be a few days without your posts, but I hope you have a wonderful time.

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      3. Ideally she would also be inquiring and sussing out the non-answering, so it all doesn’t land on you. But either way, when you’re ready, absolutely.
        On the road now! Grocery store pit stop. You don’t post often (as often as I’d like) so wanted to reach out. That is sweet of you to say, I get little sadness pangs when I leave too. And know I will be offline. Hope you have a good weekend yourself 🙂

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      4. You are welcome! Let us know what you decide and how it goes. Hope the therapy break hasn’t been too tough. I know how difficult they can be.

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      5. We ended up haggling at the reception desk, with her next client waiting behind us. It wasn’t a good session so I was even more reluctant to accept anything from her, but we eventually settled on $150. And I was completely obnoxious and ungrateful about it.

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    1. I think Nikki would claw her face off if we had to talk about it any more – she literally physically shudders when the subject of money comes up. You have a good point, though, that if I decide to take her up on it it doesn’t have to be forever, I could do it for a bit until I can think more about it. Thanks Ella 🙂

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  2. I’m glad that you posted. You are definitely not a diva for feeling frustrated or upset – you are looking for a connection and it’s scary and phrasing is important.

    And I totally get the wanting to sort of be like “I did these awesome things!” Because I want T to (oh man) be proud of me (that was hard to write.)

    Having uncertainty about the relationship is a huge barrier to feeling secure – I hope you are able to work something out financially that works for both of you.

    Sending warm thoughts to you.

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  3. I’m so wary of therapists halving or taking their fee lower and I actually have to stop and think about it.

    I don’t think $100 for an hour is an unreasonable thing – I have had therapists who charge just that. I think that if she is offering this, she knows that when and if you can pay her her full rate, that you will. Maybe if you shift your thinking to a sign that this is her trusting you to pay her what you can, and to her willingness to be there for you, and try it for a while, it may end up being worth it?

    My two cents, and feel free to disagree of course – I hope that you two find what works for you because it seems like things work between you. May you find what you need.

    And you are not being a diva in any way, and I want A to be proud of me EVERY day – so you are definitely not alone there!

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    1. I really appreciate you stopping to think about it, and offering your thoughts. Truly, it is so helpful. And that is something I need to get better at in general – shifting my thinking from doom and gloom.

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  4. I agree with Rachel and the other commenters. I think your therapy is important. Nikki isn’t going to short change herself or you no matter what you pay (she actually went up a little in my estimation- not that my estimation matters!). Around here most therapists charge around $100, and often less for clients who are cash paying (ie no insurance to bill) so her halved fee seems very reasonable. Is she a PH’d level? I know you are having a tough time connecting with her, but I do like that she has stronger boundaries.

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    1. The recommended fee set by the psychologist association is $240, so she actually charges less than she could be. Maybe I should move to your area!

      Boundaries are good – I think what I’m mostly struggling with is that she’s much less ‘touchy-feely’ than Anna and Aisha (who were always telling me how great they thought I was and how much they cared etc) so I want less boundaries because I want evidence that she cares…not because I actually WANT less boundaries.

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      1. can you see a clinical social worker or MFT if psychologists are so pricey? $240 is more then the psychiatrists charge… Yes. You should come here. You can play with my dogs!

        I can see how not getting those positive affirmations when you are used to counselors giving them would indeed feel like she doesn’t care. But (and hopefully this comes across ok) Anna and Aisha were not really that helpful… and they were really lame in the end. really lame. I’m still on the fence about Nikki but maybe if she is boundaried she won’t end up being so lame….

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    1. Thank you, E! I’m at 24 days now. For some reason it feels okay at the moment not to want to self-harm…I mean, I have the urges still but I don’t really WANT to hurt myself, and instead of getting mad at myself and making myself do it anyway I’m doing other things. Like yoga or swimming or just getting into bed. It’s been a nice break.

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      1. So proud of you Rea! And that won’t change even should you turn to it again. And umm I thought I was the only one who made myself do it so feeling a little less abnormal now. Thanks!

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  5. Hey Rea, I think it’s okay to accept her offer of halving the fee. Money really can be an uncomfortable subject, and if she doesn’t like discussing it I can undermine that, but I do wonder if saying to her you accept her offer, but you want to maybe, I don’t know, contract some things, like that the halved fee doesn’t mean you have to be a perfect client. I don’t know.

    I totally get how needing those positive messaged and not getting them can hurt. You aren’t being a diva. Maybe once she gets to know you better, she will know more what you need and how to provide it. She seems like she has very good boundaries though, and that might be a good thing.

    Two weeks is a really long time to have no support and no therapy. Does she have email or text? Maybe you could connect that way if a phone call or Skype is too much right now.

    Sending hugs and support xx

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    1. I’m still struggling with this – I keep going back and forth and I just can’t decide what’s right and ethical and a good decision. I really like the idea of a contract. It would make me feel much more secure, and also more accountable I guess – I’d actually like it if she imposed requirements like I have to push myself because then I’d feel more like I was “earning” the reduction. I don’t know, I don’t know what the answer is but your thoughts and your support help so much.

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      1. Oh Rea. I know this had been a hard thing for you. I think if she said you had to push yourself then that would not allow the therapy to unfold as it needs to. Does that make sense? I think the idea is you don’t need to earn anything.

        I’m glad the idea of a contract was helpful. Xx

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      2. It’s crazy that I’m torturing myself over this when it genuinely doesn’t seem to matter to her…ugh. I know you’re right, but it seems to be too hard to accept right now.

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  6. I hate everything that has to do with money, especially when it feels like I’m having a negative impact on someone else’s financial situation (whether that impact is true, or just perceived), for the exact reasons you’ve stated.
    I want to say, you are not a diva. You are worthy of love and respect, from Nikki and from others.
    I think Nikki offering to halve the fee is a way of reaching out to you. I do understand why you are hesitant to accept that offer in that you will have to be a “good” client – that is exactly how I feel in my DBT group (when my insurance refused to pay enough money, they let me keep coming without me having to cover the difference, which is about 200 dollars a week). It’s probably something that I should discuss with the therapist – the constant fear of what will happen if I do act up?
    The thing is, you’ve had some sessions with Nikki by now. You call yourself a “difficult” client but remember, though Nikki doesn’t know everything about you, she probably knows enough by now to know that you’re not the “perfect” client (who is?!) and she’s offered the fee reduction to you anyway, because she wants to help you.
    I like Rachel’s idea of budgeting money. I also want to add – if Nikki hates talking about money – who cares?!? I don’t mean that in a mean way, and I know you care about her, but what I do mean is that it’s Nikki’s job to talk about whatever would be helpful to you, and if talking about money and how it affects you (no matter what decision you make) would be beneficial to you, she should get over the fact that she hates money and talk about it with you.
    I hope that didn’t sound too harsh. I just want you to know you don’t have to make this decision alone.
    Sending hugs to you xxx

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    1. Thank you, Lily – I was actually quietly thinking the same thing, but Good Me wouldn’t say it. Why is my therapist making it hard for me to discuss something I need to work through? I appreciate the validation. And yep, you’re right, she’s experienced her share of eye-rolls and sarcastic eyebrows and sullen silence, so she definitely knows at least some of what she’s getting herself into.

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      1. Not to defend her, but maybe she doesn’t know she’s making it difficult? Like maybe she thinks money is getting in the way of stuff you need to talk about, and she doesn’t realize that it’s actually something important to address?
        Good Me (I think for most people’s Good Me) hates talking about money. Probably her Good Me does too. But it’s necessary, and I hope that she’s able to get over it and talk openly about it with you, because that’s what you deserve – for her to be open and honest and kind and compassionate with you.

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  7. Hi Rea,

    I also want to show my drawings to E and have her say, “Ooh, that’s so wonderful!.” In fact, I have done that before (not with drawings usually but other things, including art work), and when she says, “wow!” I am immensely gratified. As my good friend Paula says, “We all crave our therapist’s admiration and approval.” I’ve decided to permit myself to want that, even though I sometimes cut off my urge to chase after it yet again. It’s just normal given the intimacy of the relationship.

    And congratulations for speaking up to your boss and for the raise! Good for you!

    Regarding money and therapy: Therapists sometimes cut their fee for some clients. She even told you she has done it for others. I had a therapist (Hannah, I’ve written about her) who even saw me for free for a while when I was literally broke. I imagine that they get some tax benefit and/or moral satisfaction from it. They chose this work above all because they care and because helping people become stronger and healthier is enormously meaningful to them. Whatever they get from it, they want to do it. How can I be sure? Because if anyone has worked on their boundaries, it is an experienced therapist. If she offers, it is okay.

    To me, accepting the offer is not disrespecting her time and expertise. Disrespect would be not showing up, not trying to stretch yourself, lying to her, those kinds of things. If I try hard most of the time (giving myself the right to be tired or hopeless or stuck sometimes), then I am respecting E and the therapeutic relationship. You may not see if this way, but it’s the position I have come to and what I try to hold myself to. I am also counting on E and any other therapist to examine themselves and their needs and not to offer something they can’t willingly provide. That’s part of their job.

    I wonder if some of your reasons really boil down to this: “I don’t deserve this generosity. I’m not worth it.” I can just imagine there might be some of that there, since I have seen that self-loathing in you before. And I want to tell you Rea, really, that you have such a loving heart. Your comments to others are insightful and caring. You are smart and articulate. You are extremely generous with your family. You really deserve the care. She wants to provide it to you (even if at moments she seems stern or irritating). If there is anyway you can bring yourself to accept that care, I hope you will. Sending hugs to you, Q.

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    1. Much as I may want Nikki’s admiration and approval, I think I chase yours even more, Q. It means a lot to me when you take the time to write to me, and say such lovely things. Thank you for the congratulations: it was a very big thing for me, to believe in myself enough to say “I think I am worth the same amount you pay this other person”.

      You’re completely right about my reasons, of course: it boils down to unworthiness. I don’t believe I deserve care, full stop. I certainly don’t believe I deserve care when I’m not paying the full amount for it. And if I pay $200, then I get to avoid the moment where she realises I’m not worth it, and she tells me that (or worse, doesn’t tell me, and just quietly resents me).

      We settled on $150. More than I can afford, and less than I feel comfortable with.

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