Can you hear the crickets chirping from all the way over here in the southern United States? I’ve been quiet for a while now, I know. Sorry about that. Things have been hard lately, much harder than they need be, but I’ve been struggling over some changes in therapy. They’ve had way more of an impact on me than I feel like is justifiable but, it is what it is, and I can’t help the feelings that I have been battling. And believe me those feelings span a full spectrum. I’ve been depressed, angry, sad, tired, apathetic, momentarily hopeful, confused, and now sick. I think all of this feeling and thinking has worn my body down.
I went into therapy thinking that I would get better, that I’d start seeing things in new ways, that my walls would come down, and that I would get back out into the world and start letting people in. I thought I’d feel less sad, less lonely, less of that persistent longing for the end. These days that stuff seems like the stuff of fantasy. I don’t know if those were realistic hopes or goals. I don’t know if any of what I have accomplished is because of the therapy relationship or if it is because I forced myself toward progress. Right now, I can’t see any of the good of that relationship. I’m just so angry at her.
Last week, with only 24 hours notice before my next appointment I got an email that said:
I’m writing to inform you of updates that I have made to the initial contract that we discussed when we began working together and to share with you revisions in fee schedule and consultation policy. These updates formed out of additional ethical training throughout the year and an objective to standardize client communication and provide enhanced treatment services.
[…] Due to corresponding ethical guidelines regarding contact outside of session any consultation or communication outside of session via text message, phone, email or other platform beyond exchange of resources or scheduling clarification will be charged at the session rate in quarter hour increments. This adjustment is to maintain the ethical requirements that all contact between therapist and client remain within the context of a professional relationship.
Yadda, yadda, yadda. She goes on to attach the 2011 code of ethics, which mind you is not the most recent code of ethics for our state. That changed in 2017. And, there were no changes to any of the codes that apply to the professional relationship, technology, or outside communication. When asked about the changes (in addition to the cited change, the session fee raised from $120 to $135 an hour) and why they came about now, I was told that she was working on an article with other counselors and they were examining the ethics surrounding the professional relationship. Or some such madness. She said that the standard fee raised because she was charging clients at the rate they started out and that could show favoritism. (Okay, I’ll buy into that one). She said that all outside contact needed to be charged because otherwise she was working for free and that didn’t support the notion of a professional relationship (as a teacher who is constantly expected to “work for free” this one to me was pretty much a shit excuse, but okay).
The issue I take with all of this is not the fact that policy changed. It is how the policy changed and how it was implemented. I felt blindsided. I felt like she spent this whole time encouraging me to text only to later take it away. Because, let’s be real, I can’t afford my normal sessions and “outside consultation” if I should find myself triggered and needing contact. She already gets a larger percentage of my take home money than I get to live on. I just don’t see how that change is ethical given that there was no communication about it beforehand and that it is going to put significant financial strain on me (which I have brought to her attention, she ignored that I mentioned money at all).
She knew this was something that would trigger me; she said that she knows she could have handled it better but that she “rolled out the changes the same with every client.” Well, hell-fucking-o, not every client is the same, not every client has the same wounds. How can I continue to trust her when she makes me feel like something is okay, that it is encouraged, only to later take it away? And, I am not exaggerating this. Our texts began like this:
I mean, can you see why I’m confused now? I spent months cautiously testing the waters. I knew how dangerous it could be to open that door and she always encouraged it. The things she said led me to believe that it was an okay boundary for her and a choice she wanted to make. Then when I finally started to let myself trust that this was something secure, she pulled the rug out from under me. She changed her policies and didn’t give me any heads-up that it was coming (aside from a text, just before the email came through). The next hour and a half session was spent processing my anger at her for destroying my trust. I felt like she was lying to me and being disingenuous with this change and she said that if I already didn’t trust her then it didn’t really matter what she told me because I wouldn’t believe her anyway.
She has made me feel like my reaction is entirely based in old wounds. But, she has been teaching me how to be mindful, to notice things, and what I notice points to this being a self-serving decision. It feels like she couldn’t stand by the boundary she set. It feels like, based on things she has said about being sad these last few weeks and having difficult days and “difficult conversations” with her boyfriend, that maybe her job was interfering in her social life and she needed to find a way to exert control over the situation. Maybe she felt like this was the way to do that without causing so much damage. I don’t know. But, adding a fee? That feels like just a self-serving money thing to me. If something happened in her relationship (just speculation since she sent a text at the beginning of the month asking if I wanted a session because her travel plans with her boyfriend and family had changed and she’d be back early, this corresponding with the time that she was “sad” and having difficult days) and she lost the ability to do all the traveling and luxury lodging she loves so much, maybe she would find a way to start making more income (gotta support that travel blogger hobby some how). That isn’t so far-fetched is it? I feel like a cash cow. My utters are being milked dry. I mean, am I wrong? Am I completely misreading things? I know you can’t completely say for sure because all you have is my interpretation and presentation of the information. I know I might be overreacting but my gut tells me that she didn’t make this decision in the best interests of her clients.
How do I not listen to my gut? It’s almost never been wrong, despite the fact that she has been trying this whole time to get me to open up to different perspectives when my intuition is yelling at me. Part of me feels like maybe that was a whole part of this. I’ve often felt like she was playing mind games. But, I would lead myself to some grand insight, so I’d let her off the hook, give her the credit. Now I don’t know. I know the policy change seems like something small but it has made me call into question every aspect of the relationship. Especially the other “boundary crossings” that she has allowed. Hugs, for instance.
For a while, at the end of sessions, if I ask for a hug she will give one. But only if I ask because it has to be my choice (since I’ve not had a whole lot of chosen touch in my life). I’ve come to appreciate those hugs and would probably take it very personally if they were taken away. She says that they aren’t going anywhere but how can I believe that? She said that the texting was good, that it was progress, that it was okay, that it was a choice. Then it was taken away. So, how can I know that anything is safe? I thought therapy was the one place I could go to find consistency, security, and safety. I thought it was the one place I could count on someone to set and maintain their boundaries, not change them willy-nilly. Especially not do something that she knew would trigger me. How can I see her as caring when she did something knowing that it would trigger me and she insists it is in the best interest of her client?
I am just so damned confused. I am raging. I am sad. I am deeply, deeply sad. I let myself get close to her. I let myself start trusting and opening up. But, now I don’t know if I can get through this with her. I don’t know if I should. I can see things that she is good at, that have been helpful. She was great at reassurance and validation. She was perceptive. But things have been off lately. I wasn’t getting any of that in session, so I was looking for it outside. That’s probably how we ended up in this mess. I don’t want to have to start over with someone new. But I feel almost abused. I feel like my past hurts are being used against me, which makes me feel even more crazy.
Gah! Surely therapy shouldn’t feel this way. I’m just lost. I’m open for suggestions, input, guidance. What would you do?