Cost of therapy

[lanya]

My DH goes to therapy twice a week. This is a very long term thing. He's been going for about 10 years once a week and upped it to twice a week last year.

This is now costing costs upwards of £7000 a year which is not a small chunk of our income.

I've needed therapy on and off too and I am in therapy at the moment, once a week, but I will stop when I am feeling better. I see therapy as something you do when you have a particular problem/ issue and the ideal is to live your life without it. He sees it as a long term thing.

I am really struggling with the amount of money we're spending on his therapy and I would like him to cut back to once a week but I feel I might be being unreasonable, as he does have depression and chronic health issues that he is dealing with.

He feels he needs it and it is helping, but I haven't seen any difference in him since he started going twice a week. He still gets just as depressed and seems to struggle just as much with life. I just feel like he is dependent on his therapist and it's a bit navel-gazing to be honest, I don't know if it's actually making a noticeable difference in his life anymore.

I haven't voiced any of this with him really because I want to be supportive and I respect that he feels he needs it.

We're not struggling to pay bills etc, it's just that we're not saving as much as we'd like to and this is probably our biggest cost. He complains about the cost if we get a takeaway etc. so I feel like we have to cut back on luxuries yet he is having huge amounts of therapy which cost a fortune.

AIBU to ask him to stop? What would you do?

What if therapy is what allows him to stay in his job and able to contribute fairly or maybe even more to the bills?

Ultimately, it sounds like he is using therapy as a friend who will listen endlessly without judging. It's not what therapy should be really, but ultimately you need to consider what would happen if it stopped.

Do you feel the therapist is intruding in your relationship or is it just the money that is an issue?

I suppose one way of looking at it is:

• is seeing a therapist a bit like employing a lawyer or a plumber - someone to help you with a specific problem, someone who knows what the fix is and can implement it in return for you paying them?

• or is a therapist doing something different, not delivering a "fix" but providing a space - both literally and in the sense of a space for the patient in the therapists mind - where the patient can explore and develop as a personality.

My view is that chronic depression is a deep seated personality problem not a quick fix problem. It can only be helped by long term settings that can find out what is going ON with your DH internally - and make this known and thought about.

You can't do that kind of work in a short course of therapy.

I'm assuming joint finances here.

I would have a chat with him about how he feels it's helping him, why it's 2x a week now and how long that will last for.

It's a huge, expensive commitment for him to have made without even discussing it with you.

I would also say that I would be getting a takeaway (or other treats) if I want one & it's not for him to unilaterally decide what our disposable income can be spent on.

Therapy does cost a fortune. I am a trainee therapist it costs a fortune privately as it’s costs a fortune to train, get supervision, pay tax etc. there are only so many hours a week you can work, as it is intense. Can I suggest you go for couples therapy about this.

I love that the therapist's response to a question about having too much therapy, is to have more therapy... 🤑

There was a recent study done by Oxford University which in effect said: The more you talk about depression the more depressed you feel. Becomes a self perpetuating cycle. I myself am deeply suspicious of a lot of therapists and the idea that everyone needs to be in therapy.
I will try to find a link later. On a train now.

I'm a therapist and it can be valuable to have long-term sessions if working on deep-seated trauma.

Short-term is more about fixing an issue, like anxiety or low mood. Trouble is there's often a deeper-rooted cause, so short-term may only be affective for a few years.

I would tend to agree with this. It's big business these days.

I had longish-term (2 years at a time) periods of both psychodynamic and psychoanalytical therapy on and off most of my adult life. The therapy that by far made the most difference to my life was a time limited solution-focused therapy (not CBT) I had with a psychologist on the NHS a few years ago, and I haven't felt a need to return to therapy since.

I'm like the person a PP described, who didn't have a safe space growing up, wasn't mothered or nurtured, lots of trauma and have had no parental figure throughout adulthood. It's tempting to pay for that space each week and of course at the time it feels good to be listened to and validated - who wouldn't find that attractive? But ultimately I don't think dwelling on these things is very helpful for me, especially not traumatic things. I appreciate others feel differently but I am sceptical of the therapeutic industry as a whole.

My very controversial opinion on therapy (and this is not for every case, obviously) is that it attracts a lot of personally types who love attention and validation for every little problem them have, and this this is exploited used by therapists to keep the money coming in. They are literally being paid to listen to your bullshit when everyone else around you has had enough.

The people I know who are in therapy who don't talk about it seem to be doing fine. The ones who make it their personality and share memes and TikTok's about 'my therapisssssssst' are in general attention-seeking and have fallen out with family and friends because their therapist said their boundaries weren't being respected and they are in more of a mess than before starting and therefore need to continue. The reality is that their selfishness is being enabled.

The 'trend' of neurodiversity is discussed a lot with people self-diagnosing and co-opting struggles that are genuinely faced by a group of people, but no one seems to be talking about the trendiness of therapy and the fact that many people receiving it probably don't really need it.

If people can believe that psychologists are profiting from throwing out ASD and ADHD diagnoses, then consider that the same is happening in the world of therapy.

its important to point out this poster is trainee therapist- not a qualified therapist.

But agree with the sentiment. More therapy is not the answer here imo.

Wow, a lot of cynicism on here.
What do both of you earn?
If he's earning a decent salary and he feels the therapy is required to keep him working then it can be justified.

I have suffered from cptsd and have had therapy off and on for 33 years. I am finally breaking through the block of pain and fear that has blighted my entire life.
I feel like a completely different person.

I have worked 24/7 on myself for many,many years so I can understand how someone might be in therapy for 10 years for something like cptsd.

If it was cancer treatment would people people be so cynical?

I'm not a therapist but work with therapists and understand the environment and the practice.

Most types of therapy are designed to be short to medium term, so if your DH has been seeing a therapist for ten years and has now increased his weekly sessions (which is also not best practice), it would suggest that the therapy isn't helping and that he has become reliant upon this to the point of merely feeding a habit.

I think it is funny that so many people, who have not been in therapy nor have any training in it, have such strong views and feel they know the A-Z of it as a treatment.

Would you tell a neurosurgeon that his approach to removing a brain tumour was wrong? Would you say "ah, this surgery isn't really needed, the surgeon is just doing it for his own benefit and to get paid".

Would you tell a lawyer that this contract drafting was not really needed, they were just suggesting it to be important in order to charge more money?

A training in psychoanalysis or psychoanalytic therapy is a long and specialised training.

Do you really think that the DH's therapist in this situation has encouraged him to come twice a week in order to line his own pockets and without any proper thought about DHs needs?

That, as a professional, the therapist has not upheld his professional duties to consider what is in the DHs best interests?

Do you know better than the therapist about when more intensive treatment may be indicated?

My own analyst talked to me about it for about a year before finally agreeing that more intensive work would help me.

It is as if all analysts/therapists are total charlatans.

It just illustrates how very defended people are against (a) being helped and (b) any kind of dependence (even the kind that helps personality growth and development).

as someone with a myriad of diagnosed mental health issues both with myself and with my family....I am a bit surprised he is having therapy twice a week.

I also had several years of therapy on the NHS and there was definitely a point where the research suggests prolonged continually therapy is not helpful - there needs therapy breaks to see how the person can digest and process things and come back for more therapy if need be.

My daughter has had therapy for years and it has always gotten to a point where both her and her therapists agree its worth her moving to someone new who might be able to offer some other skills / new perspectives.

It sounds like he has developed a dependency on his therapist and I can't see that as healthy - but I think you should get professional advice as we are all just giving you are uneducated opinions.

Or it could be the therapist just sees pound signs with the DH and wants a yacht...

Its unethical to have a patient become so reliant on them that they make no progress.

Counsellor here. Financial exploitation by counsellors in private practice is common, sadly. I bet your DH is using the space to vent (which is helpful to him) and no therapy is going on, which the therapist will be very aware of. Twice weekly therapy is also generally not advised, by the way. I think you just need to have an honest conversation with him - good luck.

I rang the BPS a few years ago when my daughter's school psychologist was questioning her physiatrists diagnosis of ADHD. They were very helpful. You can ring up confidentially and get their advice - like maybe asking them about this long term relationship he has that has moved to two sessions a week which I think most people agree seems a lot. At least you will get someone qualified's perspective on your concerns.
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If he’d been having any other kind of medical treatment weekly for a decade with no discernible improvement to his symptoms and no plan for seeking an alternative, we’d all be questioning the practitioner, the efficacy of their treatment, and advising him to seek alternative opinions elsewhere. This is no different.

Frankly I’d also want to establish what it is he actually talks about. You’re his life partner and he’s spending family money. If he’s spending every week wanging on about the usual sort of day to day troubles the majority of people have in their lives as if they make his life exceptionally depressing, with a therapist encouraging him to visit more frequently then yes, he’s just a self-centred navel-gazer and they’re a charlatan.

In what way was she questioning her diagnosis? What was her explanation for the symptoms? Was she implying they were MH related rather than ADHD?

Well put. This was my experience with a family member. NOT one with serious PTSD but simply one whose friends and family had got tired of listening to her moan about tiny things like losing her stuff or not being chosen for a job. She became completely co dependant with her therapist.

If it's working I'd be inclined to agree but £7k per year and ten years of therapy and not much in the way of progress?

Something isn't right. Time to look at alternatives.

I spend an insane amount on therapy too but it’s been life changing, I’m two years in and over two years I’ve had 60 sessions. They’re £90 a session. There was one week where I needed two sessions out of the two years. Otherwise it’s just too much for me to process. It’s been an exhausting time too and I need to take a break from it to process/put into practice and just rest as it’s intensive.

But twice a week for 10 years I’d struggle to get the benefit. Not enough time in between to process what you’re learning.

This.

He gets to talk about himself and be vakidated and soothed for 1or 2 hours a week. And has done for 10 years with no objective evidence it's helpful other than he says it makes him feel better.

Which is likely just the placebo effect. I'd imagine most people would feel better if they had undivided attention on their woes for an hour or more a week.

What matters is is it actually leading to any kind of improvement? Sounds like it isn't so it's just a very expensive habit.

Thanks everyone for the input/ ideas/ suggestions.

I am a believer in therapy generally (hence having it myself), and when he tells me it has made a big difference to his life over the past decade I don't doubt that. I just don't I have seen any difference/ improvement since he increased it to two sessions a week. In fact since we met about 6 years ago he seems to have been more or less the same. I think all the improvement probably happened before that.

I think the main thing he talks about is work stress, health issues and about childhood (but no extreme trauma) - it is psychodynamic therapy so that is all part of it. He talks to me about everything as well, and I really don't think there is any huge event I don't know about. I think he just values the space to offload and feel soothed.

I'm concerned people are saying it's not best practice to have two sessions a week and I do kind of agree that he is using it to soothe himself and it isn't really going anywhere or working towards anything.

One day his therapist will retire or move and I do worry a bit about what state he will be in then. I have talked to him a bit about that but no outcome really, he just keeps going.

I just don't really know how to talk to him about this without it seeming like I am not being supportive. He really, really values the therapy and I think would find it a huge wrench if I asked him to stop. I wouldn't want to feel responsible for him spiralling into a worse depression. But I just feel like it's becoming a very expensive sticking plaster.

You might become his soother if he cuts down.