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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Dinah on February 3, 2012, at 17:11:45
In precisely the way I spoke here. Using the words resentment and whore, etc.
He said he was angry. I think he may have even said "f*cking" angry. But that just as it was ok for me to say those things, it was ok for him to be angry.
It was all very civilized.
I *did* get the sense that he thought that if it upset me and upset him, I really shouldn't bring the topic up. But he didn't say so in so many words.
I suppose it was interesting.
Posted by sleepygirl2 on February 3, 2012, at 18:55:08
In reply to I spoke about it., posted by Dinah on February 3, 2012, at 17:11:45
Brave girl :-) good for you
money is a funny topic isn't it?
So much can be wrapped up in it.
Posted by Twinleaf on February 3, 2012, at 19:30:23
In reply to I spoke about it., posted by Dinah on February 3, 2012, at 17:11:45
Dinah, it's easy to see why you would be angry, because the fee , or lowering of it, seems to have gotten connected up with the value you feel as a client - your self-esteem seemed to be threatened, and that is a horrible feeling..
But why is he so ******* angry? I mean, he seems to have been before any inflammatory words were ever spoken.
Posted by Dinah on February 3, 2012, at 22:39:04
In reply to Re: I spoke about it. » Dinah, posted by sleepygirl2 on February 3, 2012, at 18:55:08
It's nearly as difficult as body image. :)
I'm a bit surprised I'm not upset. I'm less upset than last time. We did end the session on a more cheerful topic, and he gave me a hug before I left. And said that everything would be ok.
Posted by Dinah on February 3, 2012, at 22:47:08
In reply to Re: I spoke about it., posted by Twinleaf on February 3, 2012, at 19:30:23
Well, technically speaking, it is rather insulting to have to pay more than other clients in order for him to see me. He told me that his private pay rate is now $10 more than I pay, so I'm not top of his pay scale. He also explained why he took less from the insurance panel. And while what he said made sense, it still boiled down to the fact that he valued the association so was willing to take less per hour to maintain it. While for me...
He said I was cheapening the relationship. I agreed that money as an integral part of a relationship *did* cheapen it. He said he felt insulted and angry. I pointed out that I also felt insulted and angry. He said that I always had the option *not* to pay him. I pointed out that that response was what had me upset to begin with. He asked me why I bring this up. I responded that I brought it up because it keeps coming up externally. And that he had asked me to tell him why I was upset, so I was offering him the truth.
Sigh. I'm a bit sad, but like I said, it was all dreadfully civilized.
Posted by emmanuel98 on February 4, 2012, at 3:02:06
In reply to Re: I spoke about it., posted by Dinah on February 3, 2012, at 22:47:08
It's such a fraught topic. But I also don't see why he got upset. I've had this conversation with my p-doc and he has been very calm about it. I mean, I can't be the first person ever to have talked about this with him. Any therapy client is going to feel this way at some point. Especially if you're paying out-of-pocket. It is true for all docs and therapists that they get less from insurance panels than they do from self-pay clients, because the insurance panels bring them volume and have negotiating power that individual clients don't have.
Posted by Dinah on February 4, 2012, at 7:28:35
In reply to Re: I spoke about it., posted by emmanuel98 on February 4, 2012, at 3:02:06
Well, I believe it was the part about whore and feelings of contempt that made him angry. However politely and detachedly I said it.
I know I don't have any negotiating power (obviously). He wants them more than they want him. I want him more than he wants me. (i.e. Well, if it's too expensive for you, you can choose not to come.) But I like to think I bring volume. All these years, and occasionally for periods of time he wasn't even worth the HMO rates, and at least one period of time when I was about the only client he had.
I wouldn't have taken the reduced price, most likely. I know how he feels about money, and I wouldn't have liked feeling beholden to him. I was just upset he wasn't willing to offer it, as he had done in the past.
It underscored a truth I prefer not to examine too closely or too often.
Posted by Twinleaf on February 4, 2012, at 10:56:43
In reply to Re: I spoke about it. » emmanuel98, posted by Dinah on February 4, 2012, at 7:28:35
I'm not sure, but it sounds like there is residual anger on both sides. Yours seems completely justified, but I would have preferred to see him remain in a therapist's role more, and empathized with whatever feelings you needed to express.
I am expected to keep on saying how angry, anxious etc I feel even hundreds of times, if need be, until it's "over". I can only do that if I know he will remain professional each time. The basis of my therapy is interpersonal, so much of the hardest work is dealing with what goes on between us.
Your therapist has been such a good fit, and so helpful over the years, that I don't like to see him behaving in an unhelpful way now.
Posted by Raisinb on February 4, 2012, at 16:28:24
In reply to I spoke about it., posted by Dinah on February 3, 2012, at 17:11:45
I agree with twin leaf that he could have been more helpful and empathetic, but it's awesome the way he ended with a hug and reassurance.
I think therapists might get tired of being compared to prostitutes; it is a very common feeling, but also a little degrading to them and the work they do. I have said something similar to two of them, and they both looked pained.
It sounds like the money thing brings up questions of value for you--(which sounds pretty obvious, but bear with me)--I think it is more helpful to think of the money part as totally unrelated to how much you two value each other, which cannot be quantified or represented by a number. Maybe not as easily done as said, I know.
Posted by emmanuel98 on February 5, 2012, at 19:43:15
In reply to Re: I spoke about it., posted by Raisinb on February 4, 2012, at 16:28:24
Well I guess the whore thing was a little over-the-top. But I have been writing a memoir (which he has read) and in it, I talk about feeling like the client of a prostitute who believes she really loves him. Somehow, I don't think if I said this outright, he would get angry. I mean, he's got to have heard this before. I can't be the first patient he's ever had (in forty years of practice) who's ever felt this way and brought it up.
But, it's funny. Once I told him that he seemed perfect to me and he said he has a lot of flaws. That he's quick to anger and can be hurtful at times. I don't see a lot of this, but on the few occasions where he's gotten angry or hurtful, it has seemed out-of-the-blue. Then I bring it up at the next appointment and he apologizes for being harsh and abrupt. He always told me that it's okay to get angry as long as you can talk about it and sort it out. I never could talk about it with people. Would just get angry and walk away. So it's helped me -- even when he's been unreasonable -- to learn to work through anger and hurt feelings.
Posted by Dinah on February 8, 2012, at 7:56:35
In reply to Re: I spoke about it., posted by emmanuel98 on February 5, 2012, at 19:43:15
Or rather he said he had something more to say.
He told me that he'd already told me that if we needed to work something out with regard to fees in order for me to continue to go twice a week, we'd do that. We'd do what was needed. He said he hadn't repeated it during the last two discussions because he didn't realize it needed to be repeated. And he said he had considered the last discussion to be more abstract and philosophical than he now realized I considered it, so he wasn't as careful in what he said as he should have been.
I told him it had felt like he was saying the insurance panels were more valuable or important to him than I was, and he said that was silly.
I'm paraphrasing. I don't necessarily remember the particulars.
I'm not sure if he really remembered his previous offers or if it was a polite fiction after I had called and told him what was really bothering me. But I suppose the important thing was that he made a firm commitment to make it work.
I think I made the anger thing seem worse than it was. I told him that I sometimes saw him as a whore and felt contempt for him in a conversational tone, almost apologetically. And he responded that he was f*cking angry in a conversational tone as well. Which I don't think is a bad thing. He was letting me know how my words were affecting him. He said at the same time that he can be angry with me without it harming our relationship. That's always been a lesson he tries to teach me, as I tend to overreact to anger in a relationship. My therapist thinks it can be healthy.
As I said, it was all very civilized. But he was warmer and kinder this time. I suppose he realized that I had been personalizing some of his comments that he meant as impersonal. Or perhaps he had had time to reconsider his defensiveness and react to the insecurity in my words.
The money will always be a sore spot in our agreement. Partly because of his attitude towards money. He really really likes money. He admires the things that money can buy. A lot of people have shared things their therapists have said about money, and it's not the same as what my therapist conveys. I'm sure there's good reason for his attitude. I know he's always considered therapy to be an unstable source of income. But still... Money will likely always be a tender spot. And maybe it should be. The reminder that he is performing a service for a fee isn't a bad thing.
Posted by Twinleaf on February 9, 2012, at 16:59:26
In reply to We spoke again, posted by Dinah on February 8, 2012, at 7:56:35
It sounds like you really made progress; it was great of you to tell him what was really bothering you.
The anger issue (a tough one for us all): I think it's wonderful when we, as clients, can dare to express anger, and find that it is received with understanding and respect. I'm not so sure about the therapist getting angry, because his feelings are not supposed to be the focus the way ours are. Still, however you did it, you seemed to have faced the problem and, at least partially, restored some of the closeness and trust to your relationship.
Posted by Dinah on February 10, 2012, at 9:34:34
In reply to Re: We spoke again, posted by Twinleaf on February 9, 2012, at 16:59:26
I think it might depend on the type of therapy and the reason we're in therapy. I have difficulty with anger, both my own and others'. It's been a focus of therapy to help me tolerate that. If he had yelled that he was angry, it wouldn't have helped any. But for him to say it calmly, and with reassurances, was helpful in the context of *my* therapy. What wouldn't have been helpful was if he was angry and didn't admit it.
Posted by Twinleaf on February 10, 2012, at 15:26:54
In reply to Re: We spoke again » Twinleaf, posted by Dinah on February 10, 2012, at 9:34:34
That sounds reasonable. Whatever works so the two of you are back in business again!
This is the end of the thread.
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