Is my therapist nuts?
September 20, 2005 12:08 PM   Subscribe

TherapyFilter: I am currently in traditional analysis meeting three times a week every morning for the last four years. (I know, messed up childhood.) My therapist has decided for whatever reason/need to limit her office hours to 9:30 to 4:30. No mornings and no evenings. Is she unreasonable?

She has offered me three time options: one would put me in to my work office at 10:30, another at noon, and the third I'd have to leave at noon and return to work at two. In her view, I would then make up the time at work by coming in earlier or staying later.

What I see as a disruptive and impractical scheduling issue, she sees as a personal flaw and an opportunity for more analysis, i.e., "You don't want to come in because you think I have all the power and this is your way of resisting."

To complicate things even further, she's right that I do tend to rebel when pushed. Plus, I could conceivably manage the schedule, though I'd inccur some wrath from my boss and I believe it would be disruptive to the rest of my life.

I'm really torn as to how to proceed. Suggestions? Advice?
posted by captainscared to Human Relations (31 answers total)
Get a new therapist. Anyone dealing with people who need therapy needs to be a little more sensitive and a lot less into those bullshit banker's hours.
posted by Optimus Chyme at 12:11 PM on September 20, 2005

Three times a week for four years? Is there light at the end of this tunnel? Maybe you should find a therapist that wants to get you through therapy more?
posted by grouse at 12:14 PM on September 20, 2005

Seconding Optimus. You're not there to please the doc, btw. You're there to "get well" or solve your problems or get to the bottom of it all or whatever. It's about you, not her wish to get home at 4:45.
posted by scratch at 12:15 PM on September 20, 2005

I used to work for a therapist who didn't work weekends or Wednesdays, and then "made up the time at work by coming in earlier or staying later" on the other four weekdays.

If yours is not making any schedule concessions, she does have all the power, does she not?

As for whether or not to switch therapists, it depends on how important therapy is to you (and whether you'd have to start over with the course of therapy with someone new). I let things in my life trump work or traditional scheduling all the time, but those things are very important to me.
posted by xo at 12:17 PM on September 20, 2005

I agree with Optimus. You won't come in because the schedule is inconvenient, not because you're rebelling. Not knowing you, that still sounds like a b.s. analysis on her part. After 4 years, she should be a lot more flexible with you. Also, I think grouse is right. Not knowing the details, I can't really comment on the specifics of the time you've spent with this therapist, but therapy is really intended to have an end. If this therapist is using your reluctance to interrupt your work schedule as an excuse for even more therapy... that's a warning sign. On both counts, it may be time to end this relationship and find someone who is willing to work with you scheduling wise, and who has a real plan to progress towards that light at the end that grouse mentions.
posted by unsweet at 12:21 PM on September 20, 2005

Another vote for getting a new therapist. This sort of rigidity (that is then apparently being turned around to be all about you!) is not something you have to put up with -- it's just inconsiderate, plain and simple (not only to you but to her other patients). I like how she assumes, too, that changing your work schedule would also be just fine for your boss and coworkers, to boot!

I also tend to believe therapy should have either an endpoint or -- if you indeed think it would be beneficial to be in therapy indefinitely -- a goal of a less-frequent "maintenance" schedule. For example, I see my therapist twice a month, after seeing her twice a week for the first year or so, then once a week for a couple of years after that.

But yeah, bottom line: she's unreasonable. Find someone else.
posted by scody at 12:43 PM on September 20, 2005

I find her response really frightening, the way she's using her position to manipulate you. She's changing her business hours, and as a client, you're unhappy about that, just as you would be if your grocery story decided to close at 6PM or as I was when my bank no longer opened on Saturdays. Just as I wouldn't expect those people to deal with customer complaints by saying 'Just rearrange your whole life around us, and by the way, this just shows that you really have problems', I don't think it's appropriate from her. In fact, I think it's even *less* appropriate from her. Good god, what kind of evil bitch therapist are you seeing?
posted by jacquilynne at 12:49 PM on September 20, 2005

I second the above comments. The therapist's attitude is completely ridiculous.
posted by matildaben at 12:51 PM on September 20, 2005

I would like to note that rebelling when pushed is not always a bad thing! You have very good reasons for wishing to work a normal work day; it's not pathological at all. Taking six hours out of your weekly schedule is inconvenient, to say the least.

Try cognitive therapy...
posted by footnote at 12:54 PM on September 20, 2005

I do not find the therapist's curtailing of her hours unreasonable at all (there's a caveat coming so stick with me). It is her life and if she wishes to only treat people between 9 and 4:30 then that is her perogative. There is nothing INHERENTLY ridiculous, evil, mean or unprofessional about that. HOWEVER, what is ridiculous is her insisting that your being inconvenienced by it is somehow rooted in your issues and that your objection has no rational, common sensical basis.'ve been going to her for four years, you can't just pull the plug on that one day and then shrug your shoulders and say 'you don't like it, well that's obviously because you have ISSUES'. No. Any normal person would be upset at such an abrupt termination. She should feel obligated to provide some help in finding a reasonable solution (referring you to a colleague, slowly reducing hours while offering phone therapy for a period of time, etc) while she transitions to this new schedule. Given that she hasn't, it is perfectly reasonable for you to abandon her. Parituclarly since she tried to pull a power play on you with that ridiculous psycho-babble.
posted by spicynuts at 1:07 PM on September 20, 2005

maybe she's trying to get rid of you?
posted by elle.jeezy at 1:18 PM on September 20, 2005

Best answer: I'm a therapist who understands analysis and how it's supposed to work, which is to say that while I may not agree that it's necessary to go into analysis, I think that deciding to engage in an analysis is a legitimate personal choice. I also know that the limitations and boundaries of analysis (of any therapy, really) are often a place where many issues get expressed and (hopefully) resolved. Therapy costs in money and time, any way that you cut it. But, what's not legitimate is for your analyst to change the rules of the game on you and then claim that the problem is yours. If you had brought up issues of time, well then, the problem would be yours; as it is, I think elle.jeezy's comment is a good one, and worth considering. Turn the tables and ask her what's causing her to so radically disrupt your treatment contract at this point?

I have much more to say about this subject, about therapy in general, and about the place and proper place of analysis in therapy. My email is in my profile and if you're interested in discussing some of the options and alternatives I will guarantee confidentiality.

(Oh, cognitive therapy works no better and no more quickly than many other forms of therapy.)
posted by OmieWise at 1:40 PM on September 20, 2005

THe therapist knows the effect of this change on his\her clients. You can bet that your responce is expected. That said . . how can you use this situation as a lever to confront personal issues?

Aslo, the teraputic relationship is a two way street; always. He\she may have valid reasons for altering her office hours. She\he does have a life too. A good relationship, in this situation, is a constant negotiation of boundries and fulfillment of needs.

If you are unable to alter your schedule to fit, then you only have one choice and it's not a bad thing - get a new therapist. This happens. It is hard to loose the relationship but it does happen.

If the therapist is not helping you handle the office hours change, then I would wuestion your progress and your choice of helpers.

In the end, I would seek the advice of another therapist on this issue. It may well be that it is time for you to make a hard decision.

(I'm in therapy too and will be for a while, and I patially manage my issues with a few medications, i might add, and even i dont have to go three times a week.)
posted by johnj at 2:07 PM on September 20, 2005

On review . . What OmieWise said.
posted by johnj at 2:11 PM on September 20, 2005

She has decided she needs to constrain her hours -- there's nothing wrong with that. You are not happy about this, which there is also nothing wrong with feeling. But then, you are being stubborn about her being totally unreasonable when your request would have her breaking her hour limitation three times a week, thus having her constraints being nulled 30% of her work week. Have you even asked her why she needs to limit her hours? Is it childcare? Health? She may have been pointing out to you that you're being a little too intractable when you are refusing to concede at all, and she may have very good personal reasons for changing her business. She is providing a service to you, and you have the right to decide that her terms won't work for you (and go elsewhere), but the therapist isn't bound to bend to the desires of the patients all the time. The patient isn't always right.
posted by dness2 at 2:13 PM on September 20, 2005

(Oh, cognitive therapy works no better and no more quickly than many other forms of therapy.)
posted by OmieWise at 1:40 PM PST on September 20 [!]

Can you cite any studies on that? Because I'm pretty sure I've read the opposite in several places.
posted by footnote at 2:23 PM on September 20, 2005

It seems that you had a gut sense that this is not right, or you wouldn't have posted. You don't say what the previous schedule was. I think it's reasonable for you to ask for a time that does not affect your work and life adversely. 3 times a week is a lot. I think she should help you find a new therapist who will be able to accommodate your schedule.

I have a family member who has seen the same therapist for over 15 years. Seems pretty dicey to me.

In any case, good luck.
posted by theora55 at 2:24 PM on September 20, 2005

If you feel like you're getting a lot out of working with your current therapist, ask her to recommend someone whom she respects and who can accomodate your schedule.
posted by Sara Anne at 2:52 PM on September 20, 2005

Best answer: Everything an analyst does has both a reality element and a fantasy element. Analysts typically are trained to interpret the fantasy element, and by entering into analysis with a traditional analyst, you are agreeing to play the game a certain way, that is, to emphasize the fantasy element (fantasy taken to mean your understanding or fantasies about an interaction). This is dealt with in much of the analytic literature as a contrast between the "real" relationship versus the "transference" relationship. This latter meaning the ways in which your relationship with your analyst is embedded with all kinds of elements that derive from your upbringing and early relationships. Thus, if you mistrusted your mother/father/caretaker, you will come to mistrust your analyst, because that's the issue that you need to deal with.

Traditional analysis as it has been practiced in America from the 50s on, STRONGLY emphasized exploration of the transference relationship (though this has changed somewhat). Because of this emphasis, reality elements (time, money, etc.) are rarely taken for what they are "in reality." They are always interpreted for what they say about the transference relationship. This can take the form of various bizarre sounding interpretations - say if the analyst fell asleep, or would come in late for the appointment, etc., the interpretations would typically not include apologies, explanations, etc., but might include statements asking how the patient felt about it, whether the patient was trying to do away with the analyst just like he/she did with his/her mother/father/etc. If the analysis costs too much, it's taken to be a statement about how you feel yourself sucked dry by people, etc., rather than an a statement about economic realities. I know one person who now travels over 1000 miles for her analysis (3 consecutive days a week, during which she stays in a rented room for those 2 nights), as the analyst moved to a different community. I've known of analysts who were dying of cancer, and would not respond to direct questions about their failing health, but would only interpret the patient's concerns for what they meant about the patient. I know this sounds strange and like it embodies everything that's weird about psychoanalysis, but I just want to emphasize that it's a legitimate form of therapy - it's not to my liking, and many contemporary analysts do not subscribe to it as completely as they might have in the past.

The point is, in my view, that this kind of analysis is a closed system - the analyst is always right. If you trust the analyst enough to work it through, good for you. You'll be entering a period of a bitter fight with your analyst in which you'll be proclaiming that she doesn't care about you, doesn't understand your reality problems, etc. You can go to the analytic literature and bring in articles by respected analysts about how important the reality relationship is, so you'll have some backup of authority (Greenson is usually credited with inventing the concept) - or you'll show her this thread. And she'll be interpreting away about how you're resisting her and how this is just like you felt with your parents. Heck, the fact that you've come here to the internet to talk about this will be seen as a major piece of acting out. And you'll both be right!

Your question is where you want to go from here, and whether you want to do it with her, which sounds like it means on her terms, and then explore what it means that you submitted to her. Or, to decide to go on without her, which means you can explore what *that* means!
posted by jasper411 at 3:18 PM on September 20, 2005 [1 favorite]

It seems to me that if you're in to see your therapist on mornings three times a week, your therapist has to have known that this move on her part would affect you in a fairly major way. She's known you for four years, right? So, while I think she has the right to do whatever she wants with her hours, you have the right to be inconvenienced and, if necessary, switch therapists.

Count me in as someone saying that her turning this back on you is not kosher at all. She should have seen that coming [you both seem to agree that you're likely to "rebel when pushed"] what did she think was going to happen? If you can't work out an accomodation that works for both of you, then you should move on. I know it's not that simple, but at the end of the day it's your time, your job, and your money and you need to choose where to put all of those without feeling like you're being pushed into some sort of corner.
posted by jessamyn at 3:39 PM on September 20, 2005

I think asking yourself a few questions at this juncture is needed. none of us can definitively say if the situation is right for you or not. I am not a therapist, and I am not in therapy, but have dealt with many clients and professionals and work in a related field so there is a soiled basis to what i say.

1) Are you happy with this therapist?
2) Is she genuinely helping you with your difficulties?
3) Are you substantially better off now then when you started?
4) What is your goal in therapy? To achieve functionality? To stay out of the hospital...?
5) Is this indicative of other behaviors by said person?
6) Do you trust her?

Be honest, if the answers are less then great then perhaps you should seek different help. If on the other hand you like this therapist, it is helping you, this is an isolated incident, and you have a clear goal that she is helping you achieve perhaps accommodation is the best rout.

Having said that, her response to you sounds out of proportion to a normally worded objection to such a change. Provided it went down just as you said it should raise red flags of some sort.

therapy is about trust, you are in a vulnerable state during these times, and often the situation is set up in an implied power structure with the therapist having the balance of power. Be careful, be safe, and trust yourself to make the right choice.
posted by edgeways at 3:45 PM on September 20, 2005

What I find...infuriating is the switching of a policy for a client that you're supposed to be servicing (and it sounds like at very short notice).

Tell her that you accept her changing her life for her needs. Tell her that this does not serve your needs. That it isn't any sort of rebelling of authority, nor does it compromise your commitment to therapy - you're there three freaking times a week

She may be getting rid of you (or not.) What she is doing is putting you at conflict with your prior commitment called work. (Which indirectly pays her therapy costs). She may tell you that your not putting your commitment for work ahead your self improvement needs. This is bull. Again, you're going three times a week. I don't know how much more committed you can be.

So, ask her for a recommendation for a colleague. If not...ask your GP.
posted by filmgeek at 3:56 PM on September 20, 2005

This Woody Allen quote came to mind and seems so much funnier in light of this: "I was suicidal as a matter of fact and would have killed myself, but I was in analysis with a strict Freudian, and, if you kill yourself, they make you pay for the sessions you miss. "
posted by geoff. at 5:39 PM on September 20, 2005

Everyone's being unreasonable in this thread. I haven't heard a single reasonable thing yet, except the joke. Everyone's right, too. That's because the heart has reasons, which Reason does not know. Or something.

Work through this the best you can. Our opinions don't matter one whit.
posted by ikkyu2 at 7:33 PM on September 20, 2005

My God, can you stand one more response--As one who was a therapist for a number of years (and now employees a number of therapists) albeit no psychoanalysts ( I doubt if any one employees analysts--after all most of us are grounded in reality and have to make payrolls) I think a number of the posters were right on--particularly spicynuts and jessamyn--My thoughtful and professional analysis leads me to conclude your therapist is full of crap--regardless of the transference issues and role of fantasy her response was childish, rude, thoughtless and characteristic of one who has spent way to much time with patients who are in a subordinate and dependent role--in other words she is taking herself way to seriously and has spent way to much time surrounded by persons who take her seriously--Of course she has every right to adjust her schedule to meet personal or changing professional needs--she also has a responsibility to do this in a planned and thoughtful manner that reflects her historical commitment to her patients--I could go on--but others speak eloquently and clearly on the matter--ask her if you make a commitment to work through your resistance and lose your job if she is committed to continuing to see you with out compensation--if she says no I would suggest to her that you kept your commitment to transcend your adolescent rebellion--is she not willing to transcend her parental control and embrace you for what you are--broke. Sorry for the rant but something about this just pissed me off--having said all this--everything does need to be taken in context and I really do not know the full context--
posted by rmhsinc at 7:49 PM on September 20, 2005

It's not crazy for her to pick those times, though it seems like it's rather inconvenient if she treats a lot of clients with 9-5 jobs.

Four years is a lot of time for therapy, though depending on exactly how messed up your childhood was it's not out of the question. I guess you just gotta decide whether they've been a good four years and she's been helping you enough to work your schedule around this.

I recently got work hours that meant the times I'd be coming in to see my psychologist were more inconvenient for her. But she's cool with that and we work around it. I've been seeing her for about a year-and-a-half. Maybe she's extra-awesome--and she is awesome--but I feel like if she's cool with working with a schedule for a patient she's seen for less than two years, a four-year patient has gotta get some slack.
posted by Anonymous at 8:55 PM on September 20, 2005

I don't know, I'm not a thearapist. But I think this woman sounds unethical, and you should consult whatever board she is licensed with. She sounds abusive to me, and like she is the one not living up to her commitments.

As I understand analysis, if you dump her, you loose time you already invested heavily in. This has got to cost her more than simply loosing you as a client. That's simply a cost she will have to deal with. Reality bites!
posted by Goofyy at 10:20 PM on September 20, 2005

i look at things simply. she's had a commitment to you for four years three days a week, she wants to unilaterally change it. She is communicating, albeit badly, that you are ready to move on.
posted by vega5960 at 6:53 AM on September 21, 2005

footnote writes "Can you cite any studies on that? Because I'm pretty sure I've read the opposite in several places."

Sure, read The Great Psychotherapy Debate by Bruce Wampold. Meta-analyses of existing studies of therapy indicate conclusively that the things that work in therapy are not tied very directly to the type of therapy practiced. (Only somewhere between 1% and 5% of treatment outcome can be attributed to therapy modality.) In addition, the variation between therapists practicing the same modality, and whenever I use that word I'm including Docs prescribing meds, is greater than any variation between modalities.

I think the confusion on this issue stems from the fact that cognitive therapy is easy to study because it's easy to systematize. So cognitive therapy is studied against, say, medications, and is shown to do very well. (As well as meds.) But this does not mean that cognitive therapy per se is the only good therapy, and what're really needed are studies that evaluate therapy against therapy, general outcome vs. general outcome. Since these can be hard to run, Wampold's meta-analyses are quite helpful.
posted by OmieWise at 7:04 AM on September 21, 2005 [2 favorites]

i think you need to look at the situation for what it is .... a scheduling conflict ... getting into her motivations or your possible reasons for "resisting" her isn't going to solve the real problem ... you have a job ... and your therapy now conflicts with your job

you have 2 options ... ask your job to work around the therapy (or get another job) ... or get another therapist ... which option is more likely to succeed and not cause trouble for you?

don't spend time on the possible symbolism or motivations, like your therapist is trying to get you to do ... it's not about you or her or your boss ... it's about a practical problem ... find a solution that works ... you can ask your boss or your therapist to change, but you can't expect it ... and if the answer's no, then treat it as you would any other scheduling problem

it could be that a fresh start with someone else might be worthwhile ... you haven't wasted 4 years of therapy if you feel different than you did when you started
posted by pyramid termite at 7:12 AM on September 21, 2005

Meta-analyses of existing studies of therapy indicate conclusively that the things that work in therapy are not tied very directly to the type of therapy practiced. if that's true, I wonder why anyone would chose the type of therapy that involves six hours a week of apparent mind games? What Jasper411 describes sounds like a cult, not like help.
posted by footnote at 9:59 AM on September 21, 2005

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