Arguments – Therapy with Dr. Stoneface, part VIII

My memory of the two years with Dr. Stoneface is fairly weak. I remember certain incidents, certain things he said, and the general mood. I´m having a hard time putting these things into context or into a clear time line. It is something that bugs me a great deal because that way anybody could say that maybe my memory is very selective or distorted – and I couldn´t really prove him wrong. And how could I, given that not even I myself trust my own perception and memories? Sometimes I wonder if what I am doing here, writing this blog, making him look so bad, being so sarcastic and vicious – is highly immoral. Sometimes I feel like a witty lawyer who can twist around the truth in order to cast his client in the best light, a lawyer who might have the superior arguments, but who is still wrong. I feel like there is a deeper truth that I don´t tell my readers; a truth I cover up with clever arguments. And I feel like while on the surface, that is, on a rational level, I might convince everybody that I am right, their gut feeling will tell them that this is not the entire truth. That I´m hiding something. Something that would completely change their view on me if only they knew about it. A hidden evil inside of me that justifies Dr. Stoneface´s behavior.

This taken together, my weak memory and my feeling that I´m being dishonest makes writing about my time with Dr. Stoneface a little difficult. I do, nonetheless, want to finish my account. Today I will write about arguments we had about the general setting of therapy. Next, I will write about the destructive dynamics that developed between us – my “bad behaviors” and his reaction. Then, I also want to write about my general issues with therapy – emotional as well as intellectual issues.

So now for today´s topic: The arguments about the general setting.

Money, Missed Sessions and Responsibility

While my therapy in general was payed by my health insurance, I had to pay Dr. Stoneface a fee whenever I missed therapy. His policy was that when I told him in advance the fee would be smaller than if I simply didn´t show up. He had also told me that if he managed to use the session for something else, like another patient, or supervision, I wouldn´t have to pay the fee. When I asked him if I also had to pay if I was ill, or if I told him months in advance, he said yes. I told him that I didn´t think it was fair, and he, with some irritation, responded that “everybody” handled the matter like this. When I spoke to a patient who was seeing a different therapist, I found out this wasn´t true.

Now, in my second year in therapy Dr. Stoneface suddenly told him that I still owed him a fee for a session I had missed by the end of July. I´d like to mention that by the time he told me so it was October or November. At first I was shocked – I felt like a thief or a crook – but then I got angry. Why hadn´t he told me before?! Did he assume I had done this on purpose?! I had simply thought that if he didn´t mention the fee it meant that he had been able to use the session for other purposes, which wasn´t unlikely since he had known I was going to miss the session a few weeks in advance. I told him it was a misunderstanding; that I had thought he had been able to make use of the session, and I asked him why he hadn´t just told me earlier. His reply:

“If you miss a session, it is your responsibility that I get my money!”

Another of those sentences that both leave me helplessly angry and deepen my self-doubts. On the one hand, I simply knew, knew that this was bollocks. When people don´t pay their debts, you remind them of it.  You cannot expect somebody to give you money if he doesn´t know he owes it to you. Therefore, you write him a bill, and if he doesn´t respond to that, you remind him of the bill.  “Everybody” handles it that way. So what Dr. Stoneface did here is a textbook case of passive-aggressive behavior. Don´t remind the patient of the money she owes him, wait a few months if she realizes it, then suddenly bring up the subject and: Make her feel like shit. Like she cheated you. Like she doesn´t accept her responsibilities in life. And here´s my “on the other hand”. I immediately felt like it was my fault or might be my fault somehow, on a deeper level which is somehow not touched by rational arguments.  I still feel like I need to justify myself, clear myself of the accusation that I´m a person who doesn´t accept her responsibilities. I can never win that internal argument. I always find some way in which I could have known, could have thought of, should have made sure. It is driving me crazy.

There was another occasion when the roles were more or less reversed. I had overslept, woken up only five minutes before the start of the session, called him and canceled. In the next session, he demanded the full fee. I told him I only owed him the reduced fee since I had canceled the session before, if only five minutes. He had never told me, after all, there was a certain deadline before which I had to cancel a session. My argument was fairly indecent; while I had not broken the letter of the law, I had not conformed to its spirit. The point of giving him a warning in advance, was, after all, that he wanted he chance to make use of the session in another way. It illustrates, though, our style of communication. We were arguing as if we were in a court room. While he grudgingly agreed that I only had to pay a reduced fee, he next grilled me about the deeper meaning of my oversleeping. My point of view was that sometimes people oversleep, full stop. His point of view was that it was no coincidence that I had overslept and missed therapy (!!!), thus indirectly making me responsible for oversleeping.

The third incident I want to talk about happened shortly after my aunt had died. I had caught a cold during the funeral and when I was sitting in Dr. Stoneface´s office I realized I probably had a temperature. Quite frankly, I was feeling miserable. We were, once again, arguing about something, and at some point I stated that I probably should be at home in bed anyway. He told me it was my responsibility to show up for therapy in a state that made therapy possible, and when I told him I hadn´t wanted to pay a fee again, he said it was my responsibility not to get ill.

I can see how on some level he had a point. It happens that people get ill, it might be none of their fault, but still they have to deal with the consequences. It´s a sad fact of life. He didn´t present it as a sad fact of life, though. He said it in a seemingly matter-of-factly way, but there was also a trace of self-righteousness, even satisfaction in his tone. We were still in the middle of an argument, and I was the one who was about to lose.  In turn, I angrily told him that I had caught that cold on the funeral of a relative, feeling that this should shut him up. Even make him feel a tad guilty. I was sort of ashamed of my behavior, though, since I hadn´t been very close to that aunt after all. And of course my outbreak didn´t affect him in the slightest.

Something Dr. Stoneface was completely lacking was benevolence. He was never ready to accept that any kind of failure on my part (not paying the fee I didn´t even know I had to pay; oversleeping; getting ill) was a coincidence, or down to a misunderstanding. I probably made the first mistake by being late to the first session. He might have seen it as a sign of resistance – I, on the other hand, see it as a result of me having been in a state of crisis, confusion and inner chaos. He never showed any kind of empathy, leave alone sympathy for me. He never treated me as a person who is suffering. “Can´t you look at yourself with some compassion,” he once asked me, “can´t you look at your flaws with some leniency?” Well; could he? It is not enough to assure the patient that nothing the therapist says is to be taken as an insult because, after all, it is just unconsciously  that the patient is being irresponsible, sabotaging therapy or oversleeping on purpose. If the therapist seeks any deeper meaning behind those failures, the patient can´t help but feel like he must have done it on purpose without knowing it. And feel responsible for things he cannot do much about, like oversleeping or being ill at times. How does that help anybody to be easier on himself?

Timing and frequency of sessions, taking breaks 

Apart from money, there was another thing Dr. Stoneface and I were frequently arguing about in the first months of my second year with him, and that was both the timing of the sessions, and their frequency.

One year after I first consulted Dr. Stoneface, I had started studying. My schedule changed frequently and I asked Dr. Stoneface if we could re-schedule my appointments with him in accordance with my university schedule, just to make sure I could attend all the classes I wanted. Dr. Stoneface, predictably, declined, and in a way that made me feel as if I was impertinent for even asking. There might have been a million reasons why it was impossible, but he didn´t give me a chance of respecting those reasons because he didn´t tell me even one of them. And so I once again arranged my life around my therapy and not vice versa, which is ironic, given that therapy actually should help you lead a more fulfilled life.

Around Christmas I was sick and tired of Dr. Stoneface, of our sessions and of therapy in general. I was very unsure, though, if I could really do without therapy. I was feeling better, but wasn´t I highly disordered, even on a personality level? Wasn´t I sure to mess up my life again as soon as I left therapy?

I started to ask him tentative questions, like: “Are there people who are incurable, who cannot be reached through therapy?” Dr. Stoneface would typically agree with the general statement, but he was not willing to agree that I was one of them. With some kind of circular reasoning he told me that you only knew a person couldn´t profit from therapy when that person dropped out. As long as the person was still in therapy, there was still a chance it would help. So – the only people who cannot profit from therapy are those who drop out? That was probably very much a therapist´s point of view, but it didn´t help me make a decision. How could a patient know, after all, that he wasn´t profiting from therapy? How could he make the decision it was time to drop out? One has to look at the consequences of this twisted logic:

1) You never know if a patient is incurable unless he drops out and refuses to undergo therapy.

2) In order to drop out, you have to make a decision to do so. It doesn´t just happen. And you will want to base that decision on the justified true belief that the therapy you´re currently undergoing doesn´t help you and very likely won´t help you in the future.

3) It is impossible to determine that therapy isn´t helping you or won´t help you in the future. Unless you drop out for good, there is always a possibility that therapy will change your life for the better.

4) You cannot make the decision to drop out.

Faced with this dilemma, I tried to find another way to see if maybe I could do without therapy. I asked Dr. Stoneface if maybe I could take a break to see if I was really capable of going on without him, and if it didn´t work out I could start seeing him again. Of course he refused. I learned since then that this, too, is not how “all therapists” do it. There are therapists who allow their patients to take breaks, or who “ease them out of therapy”.

What I tried next was that I asked Dr. Stoneface if maybe I could just see him once a week?  I didn´t feel like I needed to see him twice a week, and I wanted to get slowly used to coping without therapy. At first he was completely against it, but after a long and tedious argument which I do not remember he finally gave in. From January on, I would see him only once a week.

More to follow.





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