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?

@newnamenellie He'd talked to his therapist about it quite a lot of times over the course of a year or so before increasing the sessions. The thinking was that he might make improvements if it was more regular, and the therapist told him that most other clients were coming more regularly.

I actually encouraged it at the time, because I thought it might be the push he needed to help him get better and eventually get out of therapy altogether.

I thought it would be a short term thing. I was wrong. There's not been any change I can see other than him getting more soothing, and the therapist doesn't seem to have even reviewed with him how it's going and when/ whether it might drop back down or finish.

I don't think psychoanalysis is always over several sessions a week - I know quite a few people who have it once a week. I think it's just if you are doing it very traditionally. But obviously most people don't have £100's a week to throw away on therapy, so they have to reduce it a bit.

Yes you are right. Thanks for helping clarify that.

This therapist appears sus, as my DD would say!

With all your updates about his attitude and unwillingness to make other life adjustments, frankly I’d be going for an ultimatum with a view to ending the marriage if he wasn’t prepared to engage with you on putting a hard stop on the therapy unless he can demonstrate it’s doing more than “soothing” him. I think therapy and “looking after your mental health” have morphed into these sacred cows which nobody should ever dare question for fear of being called unsupportive or contributing to trauma. If this was a man insisting that he needed a £500-a-month personal trainer and gym membership to look after his health - which quite honestly would probably do a lot more for his overall health, wellbeing, motivation and sense of pride and achievement in himself than all this talking - he wouldn’t be receiving the same level of defence.

I don't know. My DH obviously really rates him and the guy works for a larger organisation of fully qualified therapists. He has been working there for a long time and has all the relevant training and registrations and regular clients who also rate him. So he can't be that 'sus' really can he? I don't know.

I just feel like my DH needs to initiate some kind of review of whether he's actually improving and what the end goal is here.

It all seems like one of those wishy washy 'the journey is the destination' type things but I am just a bit more practical and I want to see a solid outcome for the £7000 a year!

That's so much therapy! He should definitely try to wean himself off it soon, it's not healthy to be that dependent on it. It should be a stepping stone not a permanent fixture in someone's life.

I suffered horrific trauma in my past life and was in a really bad way and had therapy for only one year.

I replaced my expensive therapist with exercise, going to the theatre, weekend travel and a cleaner. Worked better for me. Obviously that is not the case for everyone and won't work for people with trauma.

I don't buy into this Gen Z idea that everyone needs therapy. In my case my therapist was turning me into a moany navel gazing cow who blamed everyone else but myself for my circumstances.

@CharlotteRumpling I would love it if he did that and it is what I've tried to do to deal with some of my own mental health issues. He would say he's too tired. He does have health problems which cause fatigue. That's often his reason for not wanting to exercise or do much.

Sounds like dependency has formed with the therapist.

Which dependency is hard to guess.

Could be a 'figure parent' as another poster has suggested. Could be a stand in friend.

Either way it's not something that can go on forever. He needs to manage the input, what is he putting into his own therapy? Also what is the output? What is he getting from the therapy and what's the plan to move forward.

It's like a physical ailment..... rehab will only get you so far, someone needs to put the effort in outside of the sessions, the stretches and exercises, a good diet, the right amount of physical activity.

The problem is, if I give him that ultimatum, he will definitely stop the therapy, and if he then sinks into depression, I will feel immense guilt about that.

I feel like it has to be his decision.

And yet it would probably him a lot of good to get out of his head and more in to his body. It's a shame he won't try other forms of therapy, but also worth remembering that even if we can see what we think is a clear answer for someone else we can't force others to change or impose our views.

I'm not surprised you're starting to lose sympathy, and I think you are probably right about a lot of this. I do think it would be very reasonable to redraw financial boundaries together. But you also need to accept the path he's on - it's not yours to fix.

His therapist is now a very expensive emotional crutch - one I’m sure he is getting to be.

Twice a week and still no improvement? I’d be looking at changing ‘therapists’ tbh.

Totally agree

Hes addicted and the therapist likes the regular income

Psychoanalytic therapy is famous for expecting frequent sessions and for running over long periods of time.

As a tradition it descends directly from Freudian therapy where originally it was 5 sessions a week for long periods of time.

Some of the original Freudian school talked about how everyone needed therapy to understand their own mind and that eventually everyone would have their own therapist that they would see regularly for their whole life.

So the therapist isn't sus in the sense that he is fraudster, he is operating within an established tradition (one of the oldest traditions) of therapy and will be accredited etc.

Psychoanalysis is often criticised for the intensiveness and expense but it does have some good research evidence.

www.verywellmind.com/what-is-psychoanalytic-therapy-2795467

These days most people understand therapy as more akin to a short hospital stay if you are ill - you go in, get some input and get heaved out pretty quickly to cope or not on your own.

The psychoanalytic community see it as more like having regular health check ups with your GP - many healthcare systems will do a yearly bloods/activity/smear test etc.

The relationship that you establish with the therapist is crucial to the success of therapy - in general if you don't have the kind of relationship where you can open up then the therapy is unlikely to be successful.

Having said that, this is a really long term therapy situation even for psychoanalysis. You've said he has a stressful job and some health conditions - could the health conditions be driving this?

I have some (quite bad) health conditions and what the doctors call secondary depression and anxiety, ie I am depressed because I'm in constant pain and anxious because I don't know when the pain will flare.

If he has this then in my experience the nhs will not provide therapy but it is very very helpful in building coping strategies.

If his therapist isn’t a complete quack, once DH advised that he felt it was time to begin ending the patient-therapist relationship, they would spend a period of weeks doing a “handover” with him, encouraging him to use the resources he’s gained and the techniques he’s learned over the past decade to manage his emotions independently. They would arrange some less frequent sessions to check in and reinforce and reassure. They would provide him with contact details for if he genuinely felt he was spiralling yet encourage him to reflect on whether he needed this contact or whether he could manage himself. It wouldn’t (or shouldn’t) be a case of “well, goodbye, you’re entirely on your own now.”

I don't know. My DH obviously really rates him and the guy works for a larger organisation of fully qualified therapists. He has been working there for a long time and has all the relevant training and registrations and regular clients who also rate him. So he can't be that 'sus' really can he? I don't know.

My professional opinion is that, just like with any other profession, there are therapists out there who are working unethically and shouldn’t be in practice.

But the OP's DH doesn't want to end the relationship, so it would be down to the therapist to do this. I don't know enough about psychoanalysis to know how the ending normally works, but you're right in saying that it should be planned and worked towards.

@Octavia64 Thank you for that very informative post. I think that's why I'm questioning myself a bit and not just asking him to end it. I know that psychoanalytic therapy works a certain way, and it could just be that I have different opinions and need to respect the process that he is in that might be the right thing for him. Psychoanalytic has never been my choice of therapy and I have always gone for a person centred or existential approach.

I don't want to be responsible for making him end something that actually is helping. I love him so much and would hate to cause further problems. I'm just questioning it but he doesn't seem to. It's almost like he just accepts emotional distress as a state of being.

I am almost certain that yes his health conditions are part of it, I think they feed into his mental health issues and vice versa.

I just don't know what the answer is but I am finding it all really hard - both in terms of finances and also wondering whether he is ever going to get better emotionally.

@lanya It's hard living with other people's mental health conditions and I think, without meaning to be unkind, that sufferers can be very self centred and not see the impact that this has on those around them. I feel for you.

@newnamenellie Thank you, I appreciate that.

Also everyone on this thread who is being very kind. It's always a worry posting on AIBU but this has been a very supportive experience.

Yes I agree.

If it was meaning you couldn't pay the gas bill then fair enough. But would you really want savings rather than a DH getting support with his mental health?

Honestly? If you’re not skint then I have NO idea why you’re not supporting your husband in this.

Sorry, but I think you sound mean ( and tight) and a bit like a brat, therapy isn’t really a nice to have luxury! He obviously requires is - do you really think saving for a holiday / car / rainy day, having a takeaway is more important than your husbands wellbeing?

edited to add : imagine if you had posted the reverse of this ‘my husband thinks I spend too much on my therapy and thinks we should save and have treats instead’ IMAGINE THE RAGE OF MN there would be LTB’s all over the shop!

A very black and white view. If you've read the OP's posts, it's clear that she thinks the world of her husband. And I don' think MN would be raging if the OP had posted the reverse.

OP never said that he shouldn't have therapy and has clearly supported him for many years.

She is absolutely allowed to question things if the situation is making her unhappy. It seems to be very one sided if her husband is merrily spending £7000 on something that helps him/makes him happy, but then makes her feel bad for wanting a takeaway.

This the downside of therapy - people tend to lose sight of others' feelings and it becomes all about the individual.

I agree. I'd be very interested in how this is addressed in this therapist 's supervision.

There are a few different things going on here I think.

I think it's really for your DH to assess whether the therapy is helping him or not. And if it's a priority for him and he earns enough to afford it then I would agree that it's more important for him to spend his money on therapy than on takeaways. He has long term health conditions to manage and it doesn't seem unreasonable for him to have therapy forever if it helps him.

Although you don't feel you have seen any improvements these may just not be apparent to you but have made a difference to DH. What would he say? Also without the therapy perhaps he would have been much harder work to live with and have struggled more and maybe even lost his job or worse. Again, what would he say about this?

The next thing is the effect this has on you.
I think it's ok to question DH about the benefit he feels and what difference he thinks it would make to drop back to one session per week or to end the therapy. Perhaps he is unhealthily dependent on his therapist, it's a possibility. Maybe a change of therapists could be really helpful. Maybe though he doesn't want to make any changes to his therapy and also maybe he will never be any better emotionally than he is right now.

The last thing is for you to work out how you want to be in a relationship with him and where your own boundaries lie. Are you ok to continue like this forever with no improvement that is apparent to you and with a resulting lack of long term savings/short term takeaways? Many people in reality do decide to leave marriages when their partner has a long term health condition.

I don't think it's possible to resolve this by making it his/his therapist's problem. The situation may be pro- or anti-therapeutic or both at different times. It's impossible to tell. I say that as an integrative therapist with four years' experience in practice and in long-term therapy myself.

What I think you need to figure out is what you want and how you can get enough autonomy in this situation to make your own decisions and live the life you want.

That could be anything from splitting up with him to redrawing financial boundaries between you so your life is less impacted by his decisions. I find myself wondering (and apologies if I missed this info on the thread) whether he is the higher or lower earner?