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Page Contents: When you feel uncomfortable with your psychotherapy because of managed care.                    


I’ve been seeing a therapist for six out of an allotted nine sessions. From the beginning, I’ve been uncomfortable with him. First it was his decision to stop me from talking about my childhood because he felt we didn’t have enough sessions to “get into that.” Then I felt that he was judging me when he told me that I was dependent (struggling financially) because there was a payoff in it for me, rather than looking at how I was taught the behavior from an early age and helping me to understand why I do what I do. Now, today, when I asked him how to build my self-esteem in business rather than constantly doubting myself, he told me that he thinks I need to “struggle so that I’ll learn how to hustle.” None of this feels good to me and I want to quit therapy with him. Am I in transference, or is my discomfort with his style reason enough to terminate therapy with him? I’ve been to many therapists in my life and this is the first time I’ve ever questioned leaving a therapist, which makes me wonder if I’m just being pushed to my edge, or if I’ve found a condescending therapist?

You are not being pushed by a condescending therapist, you’re being pushed by the managed care system. And what an uncaring system it is!

If you have been to many psychotherapists in your life, that means that you have some deep, unconscious issues to resolve. And the fact that you have some deep, unconscious issues to resolve means that the managed care system wants nothing to do with you because it will cost them too much money to treat you properly. Their attitude is, “Stop whining and get cured already!”

So the managed care companies tell all their treatment providers to “cure” their patients in just a few sessions—or else. And what is the “or else”? Well, the managed care companies will stop referring clients to any psychotherapist who doesn’t give the companies what they want.

Your psychotherapist, therefore, is probably scared to death that his income will dry up if he doesn’t meet the standards demanded of him. In that sense, he’s not serving your best interests, he’s serving his own best interests in order to serve the interests of managed care.

So what can you do? Well, if you want to ensure that you receive competent treatment that serves your best interests, pay for it out of your own pocket.


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Raymond Lloyd Richmond, Ph.D.
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A Guide to Psychology and its Practice



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