Counselling Can Be Expensive (An Update)

Now that is a truism. Sometimes I tell my clients that I can’t even afford me! (I am never sure how they take that.) But how you feel about the expense of counselling depends a lot on what you get out of it.

My fee is $180 per hour (Carole’s fee is $160 per hour). I usually see someone for about 10, 1-hour sessions, so the total is about $1650 over several months. That is a lot of money. And then you take your car in for a tune-up (actually they don’t tune up anymore – they download computer upgrades) or sign up for a course at Capilano U.

Here is what I do about fees:
• I charge $20 per hour less than the going rate for Psychologists ($200 as of January, 2015). I charge less because I want to give back to you.
• Many of you will have your fees covered under an employee assistance plan or an insurance program. Make sure that you check your coverage for “Psychologists” before you visit with me.
• By the way, both you and your spouse may both be covered under your EAP or insurance program. This means that you can have twice the number of appointments for couple counselling. Imagine how many family appointments you can have!
• Keep your receipts for your income tax – some of it may be reimbursable. Ask an accountant.
• I also create my own assistance plan with your church or community group. You pay half the fee and they pay the other half for a maximum of 10 sessions. You would be surprised how many caring people want to provide financial assistance.
• I also reduce my rates for those who demonstrate a pressing need. Please let me know.

I am happy to say that most of my client-friends consider therapy to be good value and many recommend their family, friends and work associates. Counselling can be a valuable investment and worth much more than it costs.

(This blog is an update from one in January entitled “Counselling Can Be Expensive.”)

When Life Happens: A + B = C

“Julie” had a lot of anxiety about most things. Relationships seemed to paralyze her. Her husband complained about the embarrassment of leaving parties before everyone else, or having to make excuses for declining business events that he wanted to attend. Sometimes Julie would even avoid contact with her own adult children if it involved meeting in a public place, like a coffee shop. Her behaviours at church were routinized so that incidental contacts were almost eliminated. Coming to church late and leaving a bit early allowed her to cope with her anxieties. She needed to sit on the aisle to lessen personal contact.

As she talked, I listened and doodled a simple psych formula: A + B = C, where A is the activating event (the “trigger”), B is the belief or beliefs (often unconscious) about that trigger, and C is the inevitable consequence or predictable outcome.

I made three columns for Julie on the whiteboard and listed the As (activators), the Bs (beliefs) and the Cs (consequences). The As were obvious: involvement with people where she might feel looked at or measured against others. Her beliefs (Bs) spilled out. “I am never good enough.” “I am too tall and boney looking.” “I am afraid of being seen as foolish when I talk.” The consequence was that she avoided people and shut down most relationships. She felt friendless and lonely, and saw her life getting ever worse.

Initially Julie was reluctant to talk about the Bs (her “beliefs” about life) – she “knew” that the problem was that she was an “introvert” in an extroverted world (see blog: Renewing Our Energies) and she really felt that she could not fit in her husband’s social and business milieu where “everyone is more competent than me.” As Julie examined her unexamined misbeliefs she discovered that “nothing but perfect is ever good enough,” that “failure is never an option,” and that “anything but exceptional is mediocre.” This was the harsh and compulsive environment of her growing-up years.

Examining prayerfully, thoroughly, and in scribbling her thoughts in the 3 columns, she adjusted her Bs – just a bit. Her inner urgencies softened. She became less abusive toward herself. Therapy was now testing her new self-evaluations. She saw how unimaginative and thoughtless she had been in incorporating outdated belief structures into her ever-emerging life. Her re-written beliefs were truer to life and more representative of who she was and who she wanted to become. And just bringing her beliefs into the daylight of conversation reduced their hurt and harm enormously.

Social events are hard for Julie still. She has to do hard thinking in most every encounter – not just run. Our goal was simple: reduce 70% of the curse caused by irrational beliefs and then see what happens. Life happens.

An Anger Parable

There once was a little boy who had a temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the backyard fence. The first day the boy drove 37 nails into the fence. Over the next few weeks, as he learned to control his anger, the number of nails hammered gradually dwindled down. He discovered it was easier to handle his temper than to drive those nails into the fence.

Finally the day came when the boy didn’t lose his temper at all. He told his father about it. His father suggested that the boy pull out one nail for each day that he was able to handle his temper. The days passed. Eventually the young boy was able to tell his father that all the nails were gone.

The father took his son by the hand. He led him to the fence and said, “You have done very well. Now look at the holes in the fence. The fence will never be the same. When you say things or do things in anger, they leave a scar just like those holes. You can put a knife in a man and draw it out. It won’t matter how many times you say, ‘I’m sorry,’ the wound is still there.”

An interesting parable for me. Anger and wounding is a big part of the therapy world, especially in working with couples and families. The wounds that have been collected fuel future anger. And the anger ventilated becomes a rehearsal for future anger dumping. The question is, “What do you do with the anger and hurt that are inevitable in any intimate relationship?”

Vocation – The Work a Person is Called To

Frederick Buechner writes: “It comes from the Latin vocare, to call, and means the work a person is called to by God. There are all different kinds of voices calling you to all different kinds of work, and the problem is to find out which is the voice of God rather than of Society, say, or the Superego, or Self-Interest. By and large a good rule for finding out is this: The kind of work God usually calls you to is the kind of work (a) that you need most to do and (b) that the world most needs to have done. If you really get a kick out of your work, you’ve presumably met requirement (a), but if your work is writing cigarette ads, the chances are you’ve missed requirement (b), on the other hand, if your work is being a doctor in a leper colony, you have probably met requirement (b), but if most of the time you’re bored and depressed by it, the chances are you have not only bypassed (a), but probably aren’t helping your patients much either. Neither the hair shirt nor the soft berth will do. The place God calls you to is the place where your deep gladness and the world’s deep hunger meet.” (Frederick Buechner, from his book, “Wishful Thinking”)