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?

I don't think it matters that he earns more, certainly not from the POV of him then getting to decide how to spend things. You have joint finances so it should be a joint decision.

I would try to bring it up from the point of view that you're worried as you haven't noticed any improvement since he started the 2 sessions per week and how does he feel it's helping. It's not really a health need it it makes no difference compared to 1 session per week.

Sorry, OP, just read your clarification there he is the higher earner.

Could you get more work and keep your pay to even things up?

Oh I wasn't suggesting he try psychedelics.

Just that as you confirmed, he seems to think that this is part of his identity, that he is 'a depressed person' and possibly sees therapy as just necessary maintenance as a 'depressed person' but doesn't have any motivation, desire or maybe even hope to actually get better or recover in any way.

Which isn't helpful for him or you, and if his 10 years of therapy haven't helped him to improve in any way for at least 6 years despite him increasing sessions, it's not likely to help him going forward if he is so entrenched in that thinking.

It's worrying that he's so attached to this therapy and the therapist despite there being no real evidence it's helping him to move forward even slightly.

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.

Is he on anti-depressants? If not he should see his GP. If he is on them already he should be going back to the GP to discuss changing dose, type of medication etc.

I also thought a therapist was to help with a particular issue and that, with the therapist's help, you change your mindset or develop coping mechanisms so you don't need the therapy forever. Out of interest what happens at Christmas or other times when the therapist is away or when you go on holiday? How does he cope then?

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.

It sounds like the therapist is doing what a friend would do. Listening to him and sympathizing. Has he got any mates who don't mind talking about feelings that he could go to the pub with? (Slightly light hearted reply but £7k a year buys a lot of beer and pub grub to talk about work stress)

@Choux Hmm I don't think it's quite the same as a friend. A friend would not sit and listen for two solid hours a week whilst you exclusively talk about yourself and not offer their own advice/opinion on the situation, or eventually direct the conversation to themselves or other subjects.

That's not how I view friendship anyway. Friendship is a two-way deal and there has to be lightness and fun as well.

Just to put across the view that this DH is not totally hopeless, depressed, passive, dependent and weak.

Actually, he holds down an "important" job and he earns most of the household money.

I agree with PP that this doesn't mean that finances are not joint, but this DH is providing financial independence for the household, despite his depression.

The OPs concern is not that they can't afford the therapy, just that they are not saving as much as she would like.

The way some posters talk about him it is as if he is a heroin addict, hollowed out by his addiction to therapy, drained of all agency, capacity, getting thinner and thinner as the addiction takes deeper hold.

Actually, he is creating wealth and providing.

I wonder what it is, that allows him to do that, even as someone with significant depression?

Let me see .... one thing is clear, it certainly can't be that absurd long term therapy relationship with a charlatan bent on lining his own pocket, for sure ...

Yes my DH is resilient and capable despite his depression/ health issues and almost certainly that is partly due to the therapy.

I just struggle with the fact that there is no talk of how he might move towards being able to eventually manage without it. It's just a status quo.

What happens when the therapist retires for example (he is in his 60's already) - I don't think my DH is developing any coping strategies to handle life without therapy, or any recognition that there might be ways he could manage his own mental health.

Also like I said, I haven't seen any difference to him having two sessions a week rather than one and it has been over a year.

Reading all OPS updates, I'm going to be 'that person' and reiterate he's taking the piss and just getting an emotional gain from having undivided attention to offload to and be soothed by weekly or twice weekly.

DP sounds incredibly self-absorbed and his therapist seems to be enabling his dysfunction and zero improvement or moving forward.

The fact that OP is worried that without this expensive 'therapy', which seems to be doing nothing helpful, her DP will sink into a deeper depression and it would be her fault for suggesting he stop is a major red flag.

He's had the same therapist for 10 years? Or has he had several?

OPS most telling post was this.

"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!"

It's not even being practical, it's just having some sense and realising a 'treatment' should have some tangible benefit.

Or if not mates, what about looking into local initiatives such as Men in Sheds, The Proper Blokes Club, or MenWalkTalk? Meeting other men and discovering that there are other men out there who feel like he does, that he isn’t exceptional, learning that other men are finding ways to manage their feelings and focus on recovering, would be a lot less isolating than one-on-one talking without much perspective.

I don't think he feels there is anything to 'recover' from.

It's almost like he's just resigned to it and he's put himself in a box as simply being someone who needs long term therapy and that's all there is to it.

He thinks I need long term therapy as well but I disagree and I have bursts of it when I feel it is useful.

Yes, the same therapist for the whole time.

Most counselling on NHS is limited to about 6 sessions so I doubt anyone suggesting this as a possibility has ever needed any long term MH care. The NHS MH provision was crap even before all the austerity years cuts.

Being married I guess it's all one finance pot if you divorce but perhaps if don't already it would feel fairer to have separate accounts so you have equal share of disposable income (post bills & agreed saving portion) then you needn't feel guilty if want to spend your share on what he see's as frivolous things and he will be more aware of what his counselling uses up which as he sounds a bit tight it may make him appreciate affordability of these 2x sessions more.

I've had long term counselling, it's one of few things that helps me manage in life and I work through past and present issues. It's not the same as talking to others as you can't be truly open when need to consider their feelings, possibility of being judged or privacy on what's discussed and they are trained not to let their own issues impact how deal with client, how to listen and respond to help. People also tend to find it draining and selfish if someone appears to need to offload too much or frequently and may offer unhelpful suggestions or thoughtless comments and may get empathy fatigue and avoidance of the relationship altogether.

I'd only have 2 x weekly sessions when in crisis. I have had to change therapists couple of times due to their circumstances and when this is planned they have series of sessions dedicated to managing the exit and possibly would recommend a replacement. If it was sudden guess he would be forced to find another counsellor and use them to help manage the change or get by on his own.

It may well be your right and his job is causing this unnecessary stress but people often struggle with change especially the longer they've worked somewhere so it's understandable they may have a 'better the devil you know' reluctance. Sometimes work is so intertwined with their own identity too.
You can encourage him to discuss options in more detail with therapist as they should be helping him think his way through the problems and work out why he feels the way he does so can make better decisions which should then help him to communicate reasoning to you.

I hate to suggest spending more but you may benefit from some couples counseling sessions just to help you sort through these concerns for the longer term and perhaps it would benefit him to interact with a different therapist.

It maybe worth him checking he isn't also neurodivergent I.e autism/ADHD as it's still overlooked especially in adults and poorly understood even by medical professionals. These can make life harder to manage and the depression/anxiety which gets diagnosed and doesn't ever fully resolve is actually symptom from coping. If they've found a suitable niche they can appear on surface to be successful so are even more likely to go unnoticed.

*@Choux Hmm I don't think it's quite the same as a friend. A friend would not sit and listen for two solid hours a week whilst you exclusively talk about yourself and not offer their own advice/opinion on the situation, or eventually direct the conversation to themselves or other subjects.

That's not how I view friendship anyway. Friendship is a two-way deal and there has to be lightness and fun as well.*

What I meant was, if he had friends to talk to about his problems and stress and worries and they also told him about their problems and stress and worries he would realise that everyone has some problems and stress and worries and that's completely normal and doesn't require 10 years of therapy.

Is he a perfectionist? If he knows himself very well and knows he isn't perfect then maybe he feels he needs to keep doing long term therapy to try and become perfect. He knows his wife very well so thinks she needs long term therapy to become perfect. He doesn't know other people to the same extent and, as they don't reveal their problems and stress and worries to him, he thinks they are perfect and he is therefore lagging behind.

In psychoanalytical therapy the patient initiales the ending, not the therapist (unless they are retiring or moving away).
To those saying it encourages a victim mind set, that is not true; the therapist will challenge the person about why they see themselves as the victim/what role they play in allowing other people to take advantage of them etc.

@Choux I do get what you're saying but I don't think it's quite on the mark in his case, but thanks for the thoughts - he has plenty of friends who he talks to.

He has a job with a good income.

That doesn't mean he isn't self-absorbed and spending money on a clearly ineffective 'therapy'.

He'd possibly carry on in his 'stressful job' without the therapist soothing him every week because that's his source of income.

The point is, he hasn't tried. And won't exercise or do anything else that is proven to help depression. Or get another job which may be less stressful. Or try any other therapy or therapist.

He wants to offload to someone every week for 10 years and be soothed by them while spending all his free time on the sofa watching TV because he's 'depressed and in therapy'.

He's a drain on the OP and their finances.

OP isn't being a bitch wanting to see some kind of benefit from the drain on their finances.

How does he cope when the therapist goes on holiday or it's Christmas and he doesn't misses a couple of weeks of therapy?

I have been accused of saying this too often on MN, but my god, he sounds hard work. I assume you don't have DC or he wouldn't have time for all this navelgazing. Do you ever plan to?

I am not saying you should leave him but all this narcissism and self absorption must leave very little time for you.

Why are you so attached the idea that DH cannot have therapy forever if that is what he wants to do OP?

@Choux Usually we're away at the same time if it's Christmas etc and he's distracted. When we're not away, it's pretty rare and always for such a short period that I don't think it really bears any impact on what it would be like for him to actually stop therapy.

I'm not 'attached' to any one idea, I'm simply exploring and discussing.

Effectively though it's surely for DH to decide himself how best to manage his health.

But is he talking to them the way he talks to the therapist?

I don't think I said it wasn't at any point?

But if he has a therapist who is recommending more sessions than he needs, and he is not benefitting from that, and he is vulnerable/ predisposed to thinking there is something emotionally wrong with him that he needs therapy - that puts him in a pretty vulnerable position.

You have to explore, discuss, and have conversations which is what you base decisions on. Currently he's only really getting advice from one person and that is his therapist.