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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by special_k on April 9, 2006, at 19:53:15
I mean... Talking in compared with income.
I guess it might be hard to figure...
I read somewhere that they suggest not spending more than 1/3 your income on rent.
But I guess it really does depend on how much money you are talking about...
But when it comes to therapy...
Is there something like that?If you are looking at spending almost 1/3 your income on therapy... Is that too much?
I'm spending a little over 1/3 on rent.
But power / water is included.I've heard it is possible to save the amount I'm looking at on the amount I'm earning (in the place I'm living). But the person who said that seemed to think that was in a good week and I've noticed that person really doesn't seem to spend very much at all...
And I guess it would mean I wouldn't be able to save anything (to travel around a bit and so on).
I dunno.
I guess I don't really want this to turn into people talking about how much their t's cost... Because I'm more interested in relative cost.
1/3 too much?
I think so. But then I'm not used to paying so maybe I'm just being cheap... Maybe I am... Talking about a specialist psychologist with experience with DID here...
BTW... That is her student rate...
I've emailed her back to tell her my income and to say that yes, I think it is looking cost prohibitive...
But I don't know.
Am I just being cheap?
Posted by littleone on April 9, 2006, at 21:12:49
In reply to How much is it appropriate to spend on therapy?, posted by special_k on April 9, 2006, at 19:53:15
You need to spend whatever it takes to get better.
You've had so much trouble finding a T. Don't let price be another hurdle. As long as you still have enough money to physically survive (eg rent, food, etc).
You *know* therapy is going to hurt your hip pocket. But there's no point turning it back because of the price if you're not even going to be around to spend money on other stuff. Sorry, I'm not saying you'd rather be dead some days, I guess that's just my own stuff coming through.
I really liked what someone else said once on here. And I will get this totally wrong. But it was like the money they spent on therapy went towards building a mansion in their head, rather than going towards physical material possessions. And the mansion in their head was worth so much more than what a real live mansion is worth.
Posted by littleone on April 9, 2006, at 21:15:15
In reply to How much is it appropriate to spend on therapy?, posted by special_k on April 9, 2006, at 19:53:15
Here's the mansion post. A belated thank you for sharing that story Pegasus.
http://www.dr-bob.org/babble/psycho/20050206/msgs/456003.html
Posted by special_k on April 9, 2006, at 21:51:21
In reply to Re: How much is it appropriate to spend on therapy? » special_k, posted by littleone on April 9, 2006, at 21:12:49
> You need to spend whatever it takes to get better.
Er... No guarantees on getting better... Possibility of getting worse...
> You've had so much trouble finding a T. Don't let price be another hurdle. As long as you still have enough money to physically survive (eg rent, food, etc).Wellllllllllllllllllll.
There is the rub really.
The less money I have the less I can be a socially active member of the department. Some of the other students have a lot more than me anyway (personal wealth, parental wealth, additional scholarships from their govt's etc etc). I already find I'm not in a position to do some of the social activities (flying around the country and going to conferences and stuff). There are social expectations... They pretty much expect you will participate... That is what is so amazing about being here... The number of visiting scholars etc etc. But you do need to be prepared to spend money on drinks and dinner and stuff like that to be able to talk to them in a relaxed environment (otherwise you need to be bold to ask them something in a more formal setting). I don't want to alienate myself completely... I want to fit in... I don't know.
> You *know* therapy is going to hurt your hip pocket.Well, it never has before... But then I never got much proper therapy before I guess lol.
> But there's no point turning it back because of the price if you're not even going to be around to spend money on other stuff. Sorry, I'm not saying you'd rather be dead some days, I guess that's just my own stuff coming through.
Ah. I don't know.
> I really liked what someone else said once on here. And I will get this totally wrong. But it was like the money they spent on therapy went towards building a mansion in their head, rather than going towards physical material possessions. And the mansion in their head was worth so much more than what a real live mansion is worth.
So then...You spend more than 1/3 your income on therapy?
How much of your income do you spend on therapy?I guess this is hard to figure...
'Cause sometimes husbands pay rent and food and stuff...
I guess this is hard to figure...
And kids can factor in as well...
Maybe I won't really get an answer to this.And as always...
Depends on the figures you start with I suppose.
Thanks for your response.
Posted by special_k on April 9, 2006, at 22:44:56
In reply to Re: How much is it appropriate to spend on therapy? » littleone, posted by special_k on April 9, 2006, at 21:51:21
sorry littleone
i didn't mean to sound unsympathetic.
is this the general view?i'm serious.
'cause if it is...
i don't know.
i don't know what to do.
down on some kind of wait list for some kind of public service... i dunno... don't have much faith... but i guess i'm overly fussy... and so that is my problem... because the people i'd probably be happy seeing are probably the people who can afford to charge whatever. maybe that was what she was testing... maybe the $$$ i'm prepared to spend is supposed to be some litmus test for how seriously i'm going to be taking therapy or something...
i don't think that is fair.
but oh well that is life i suppose.
i don't think i'm prepared to spend that much...
when it is going to take a good few months for us to even be talking the same language (in my experience).anyone who specialises.... is probably wedded to the post traumatic model...
and i don't know what that implies for us working together... for me not wanting to switch in sessions. for me not wanting to classify certain experiences as abusive and make a big deal of them. i don't know what that implies for them taking my views seriously and working with me instead of at me instead of trying to get me on board their stuff... i don't know how many people are prepared to really engage with me (not many in my experience) and i need someone i can respect there (and yes i find that formal education does go a long way in my book which seems to force up the price quite considerably)
crappy crap crap.
anyone who isn't wedded to the post traumatic model probably wouldn't prod me with a barge pole...
and this is stupid.
stupid stupid stupid
i don't know if it would be worth it untill i've seen them for a few months really.and most likely... i'll be spending money on a wild goose chase that will harm more than help...
i guess i would be prepared to pay that much for someone really good who i clicked really well with... probably... maybe... i'm not sure what it would imply for my lifestyle... i'm not sure...
i mean part of my problem is in fitting in and socialising... and that does involve money. and if i spend that money on therapy then my biggest problem in therapy is going to be that i feel socially alienated. and therapy will be sustaining the problem. so that will harm more than help.
i dunno.
city is too small i guess...
sigh.
Posted by Emily Elizabeth on April 9, 2006, at 22:47:23
In reply to Re: How much is it appropriate to spend on therapy? » littleone, posted by special_k on April 9, 2006, at 21:51:21
That is a very hard question. I think that a lot of the answer has to do w/ where you are in your life. Are you at the point in your life where you need to take care of kids or save for retirement? How much are you willing to go into debt? (In the US, lots of debt seems to be very common now-a-days, not sure if this is universal).
When I worked at a sliding fee scale clinic, fees were typically 5-10% of a person's income. Of course, the therapists were unlicensed trainees who were supervised by a licensed psychologist.
I love ya, so I'm going to share my own experience here, even though I'm pretty ashamed of it... Last year (and probably this year too) my income was EQUAL to my psychotherapy and psychiatry expenses. I am a grad student, so I was working 20 hrs/wk. My parents have kicked in the extra $ that I need (although not w/o a hefty emotional price). I have experienced an awful, unrelenting depression, so I believe that the treatment has been medically necessary. Also, since I can get some $ from my family, I do not have to choose between eating and therapy. If I did, I might have to cut way back on therapy.
My advice to you: consider setting a formal time frame (maybe 6 months?) after which you will re-evaluate how your therapy is working in your life and budget. Is it super-expensive, but also super-helpful? Is it a little helpful, but super-expensive? Is it more managable than you thought that it would be? I would be up front abt this plan w/ T from the beginning so that she knows it is coming and you can work to answer these questions together.
I don't know. I'm so burned out on school and my career that I would never choose having money to go participate in my department over having therapy money. I'm sick of sacrificing myself for my career. But I probably would have felt differently a few years ago. School has sort of destroyed my soul. :(
Okay, I'm in the midst of a depressive episode and I have been attempting to work on my dissertation all day. So, I will end my gloomy ramblings. I do hope that this will be helpful to you in some way!
Best,
EE
Posted by special_k on April 9, 2006, at 23:06:50
In reply to Re: How much is it appropriate to spend on therapy? » special_k, posted by Emily Elizabeth on April 9, 2006, at 22:47:23
thank you.
> That is a very hard question. I think that a lot of the answer has to do w/ where you are in your life. Are you at the point in your life where you need to take care of kids or save for retirement? How much are you willing to go into debt? (In the US, lots of debt seems to be very common now-a-days, not sure if this is universal).
i'm a grad student. just starting out (that is why the socialisation thing is so very important. it is about meeting people... so they remember you and the more people who view you favourably the more likely you are to get a job. being in a field where over half the PhD completers never find work in the field.. that is kinda important). the cost of lending / debt is prohibitive.
> When I worked at a sliding fee scale clinic, fees were typically 5-10% of a person's income.that sounds a lot better to me... i'd probably go to 20 or maybe 25...
but somewhere between 1/4 and 1/3 is starting to sound like a lot...
(i'm living on a grad scholarship - which is considered enough to get by if you are careful and i think that is a fair estimate really)> Of course, the therapists were unlicensed trainees who were supervised by a licensed psychologist.
i'd be happy with that (depending on how long they were going to be sticking around for though i guess).
sigh.
i don't know...
thanks for sharing... i think i've heard other people sharing similarly on this board... i can't ask my parents for anything more... i can't... maybe i could get a part time job... maybe i could... but i don't know... added stress... i don't know. i don't know.:-(
:-(
:-(
> My advice to you: consider setting a formal time frame (maybe 6 months?)she can't get me in until june anyways...
i think i'll keep looking...
maybe contact her again if i have some trouble...
i don't know
i don't know.
still sounds like a great deal to me...
too much really.
too much.> School has sort of destroyed my soul. :(
yeah. i'm scared of that. but i need help to really get into it and make it work. i'm scared i'll have an episode and do something stupid and get deported. i just don't want therapy to become another part to the problem...
thanks.
Posted by littleone on April 10, 2006, at 0:26:18
In reply to Re: How much is it appropriate to spend on therapy?, posted by special_k on April 9, 2006, at 22:44:56
I currently spend 46.9% of my wage on therapy. And I know almost everyone (if not everyone) I know would be horrified to see how much I spend on it. But then, they don't really know what life is like for me or the extent of the problems I have. So I can't let them be the judge on what is the "right" amount for me to spend.
I don't think there is a "right" amount. Only what is right for you. In my case, I have some major problems around my entire sense of self, so I would expect to have to fork out some big $'s to fix that. In fact, to be honest, I wouldn't trust that type of healing to a free community/uni/whatever it is service. Don't get me wrong, I'm not saying those things *can't* help us. I just think I'm more likely to get the kind of help I need from a more qualified person with the appropriate experience.
And you're really not getting anywhere by trying to rely on those services. If you really want help, it looks like you'll have to pay for it. Instead I often see you directing really strong anger towards those services instead of taking other steps to get the help you need.
Also, re the socialising - regardless of your diagnosis, it sounds like you may have some serious self issues as well. If that's the case, then the socialising aspect is waaayyy down the track still. There's a lot more important and urgent issues to work on.
Don't forget too, that there are ways to socialise for free. You don't *have* to go drinking or out to dinner or whatever to be social. I didn't really get what you were saying about the socialising you're expected to do. But to be honest, if you can't afford it, you can't afford it. Getting the help you need is more important than the impression you put forward to people.
At least, that's the way I see things. I know you think differently re the quality of help you would get from a T. I know you've had some bad experiences, but then, were they all with the free/cheap service?
Perhaps you could try a trial with a psychologist. For x number of months. See how they compare with the people you had before and whether you can maintain the therapy $ spend level needed for that type of service.
Or ignore me. I don't know why I popped up now. I'm gonna disappear again. Bye.
Posted by special_k on April 10, 2006, at 1:04:37
In reply to Re: How much is it appropriate to spend on therapy? » special_k, posted by littleone on April 10, 2006, at 0:26:18
I'm not horrified. And I'm glad you popped up again. I guess I'm just struggling a bit with this...
Sigh.
I don't know.
> I just think I'm more likely to get the kind of help I need from a more qualified person with the appropriate experience.
I agree.
I've had a mixed bag experience from public health. But then I've heard people get a similar mixed bag experience from private practitioners. The main limitation on public health is how they have to justify seeing you, justify their treatment strategies etc. The upside is... accountability. They won't keep seeing you if they aren't helping you. The downside is... how they measure 'helping'.
> If you really want help, it looks like you'll have to pay for it.Sure. I realise that. I guess I'm just getting to thinking about how much is reasonable.
> Instead I often see you directing really strong anger towards those services instead of taking other steps to get the help you need.
Ouch. Yeah I do feel quite angry about my lack of treatment in the public health service back home. To qualify my situation back home I was living on welfare. Basic needs would have been comprimised if I had to pay more than maybe $10 per week. Yeah I smoke... So hard to say I guess. $10 per week would have been about... 15% my total income. Less than 1/3. But I was spending well over 1/3 (well over 1/2) on rent. So it does depend on how much you are earning...
> Also, re the socialising - regardless of your diagnosis, it sounds like you may have some serious self issues as well.Sure.
> If that's the case, then the socialising aspect is waaayyy down the track still. There's a lot more important and urgent issues to work on.
I'm not planning on isolating myself in the meantime...
> Don't forget too, that there are ways to socialise for free. You don't *have* to go drinking or out to dinner or whatever to be social. I didn't really get what you were saying about the socialising you're expected to do.No. Think of it as... Business expenses?
> But to be honest, if you can't afford it, you can't afford it. Getting the help you need is more important than the impression you put forward to people. At least, that's the way I see things.
It isn't so much about 'impression' as it is about trying to situate myself so I can get a job. That will make a huge difference to me... The difference between getting a fairly high paying job (at which point I will be able to afford therapy) and not getting a job at all. Business investment if you like. And a neccessary one, yes.
> I know you've had some bad experiences, but then, were they all with the free/cheap service?
Yes. But then I have heard of people having similar problems with an expensive service... And I have also had a couple of really good people who I haven't paid to see. They moved on... That is a problem with public health yes. People move on... To a different country / region typically... Or they make the move into private practice.
> Perhaps you could try a trial with a psychologist. For x number of months. See how they compare with the people you had before and whether you can maintain the therapy $ spend level needed for that type of service.Yeah. I still think the present amount... Is too much. I had a chat to some other students... The science students get a great deal more than I do. People working part time get a great deal more than I do. If I was well enough to work part time I probably wouldn't need a therapist lol. Not so fair about science... They are getting maybe half as much again as what I'm getting. If I was getting that much then I could afford the rate. It would be more manageable.
I guess it is hard to talk about % of income. I mean what kind of income am I talking? Less than $20,000 per year. Maybe I should have been clearer on that... Not sure what difference that makes.
Posted by special_k on April 10, 2006, at 1:10:53
In reply to Re: How much is it appropriate to spend on therapy? » littleone, posted by special_k on April 10, 2006, at 1:04:37
and to clarify again...
the reccomended rates for private practice...
is just about twice the price she said she charges students.
of course i don't know what *her* standard rate is. but then i know the *standard rates* are typically part subsidised by medicaid or medicare or whatever the f*ck it is called and so i guess they inflate them a bit because of that and the part cost to the client is thus manageable and everyone is happy (I don't qualify for as international)
so i'm thinking that isn't much of a consession / discount.
but i don't really know...
she seemed to think she is the only one in this region who specialises in DID.
i know for a fact that isn't true (met someone when i was here last time - met her socially but she is a clinical psychologist and she said she was treating a case - but i don't want to contact her 'cause i met her socially.... and we got to drinking.... and i think she regretted spilling her guts about her clients as much as she did.... not that there was anything identifying or disrespectful.... or maybe i made an *ss of myself or something.... 'cause i think she avoided me.....)so anyway. my point is that i'm not so sure. i asked her if she could foward the email on to other people who might be in a position to meet with me. she said she was the only person. i know for a fact she isn't. you would think she would have heard of others. so i'm not so sure about her... maybe i do need to make a couple more inquiries...
Posted by special_k on April 10, 2006, at 3:45:51
In reply to Re: How much is it appropriate to spend on therapy?, posted by special_k on April 10, 2006, at 1:10:53
I just realised the header
'how much is it appropriate to spend on therapy'
kind of implied that other proportions / amounts / whatever...
would be 'inappropriate' to spend on therapy.
sorry :-(
i was more getting at the point of how basic in my living i should be prepared to go in order to get therapy.
sigh.
i messed up sorry.
sorry sorry.
it is more about me. my issues my sh*t. trying to figure if it is too much *for me* or not. on the upside... i got a response back from her... she suggested i check out rape crisis you see... so i replied about not having been SA and so she replied back to that.
a little speel about the traumatic model etc etc. and about how rare it was for someone to be dx'd with the disorder without that in their history and so maybe i should reconsider dx if the person who dx'd me isn't a 'registered' psychologist / psychiatrist. i think that is how she put it lol.
so i got the chance to say who made the dx (well regarded person). and about how she seemed to think there would be trauma too... and about how imo any trauma there might be is related to isolation / neglect... and about how i walked out on someone for *insisting* on history of SA. and about how i have been thinking... and i want treatment to be about improved communication (for me not between parts of me and a t) and stuff... so i said i was checking around for pricings etc... and i said i *might* be able to manage it but then the first thing we would have to work on would be getting me a part time job. lol.
so i feel better now.
she saw some more of me. what i think. what i want. etc. and so maybe i'll hear back from her or maybe i won't. if i don't then i'll see how things go... have an appt. with someone in the public service... if that turns to custard then i can contact her again. have sent out a couple emails to other people too and waiting to hear back from them (re pricing and so on).
so...
productive day.
sorta. need to do some real work.
Posted by pegasus on April 10, 2006, at 10:36:50
In reply to Re: I'm sorry..., posted by special_k on April 10, 2006, at 3:45:51
Hi special_k,
I'm glad to hear that you had a productive day. It sounds like you're exploring some reasonable options. And, IMHO it's totally valid to consider whether you can afford expensive therapy. It sounds like you're concluding that you can't afford it. Which is totally your call to make. Being a student can be very difficult. But at least it's a temporary financial difficulty, and hopefully you'll have more resources in the future.
It's easy to be angry at therapists or the mental health system, or whatever, for not making therapy more available for people who are struggling, isn't it. I really wish that everyone who needed therapy could have unlimited access to it.
And yet, I guess it's not fair to ask therapists to sacrifice their own financial health for it. Not that I'm saying that's what you're doing. This is just where my mind went when I started thinking about this topic. I want them all to offer free therapy, but I want them all to be financially comfortable too. I've gone off to perfectland here, haven't I?
As long as I'm here, I'll imagine you as a student with an independent income that allows you to have whatever therapy you want, and all the socialization with the big names you could want, and buying them drinks and . . . heck, why don't you subsidize their research or something too! Then later you'll get a fantastic job that you love, and that lets you afford a wonderful therapist who helps you overcome all of the difficulties in your life. I love perfectland. (I'm truly not being sarcastic here, if it sounds like that. Just imagining a better world.)
peg
Posted by cricket on April 10, 2006, at 13:32:00
In reply to How much is it appropriate to spend on therapy?, posted by special_k on April 9, 2006, at 19:53:15
1/6 of your income
Enough so that it is an investment and I expect some major results from it but not enough to compromise my basic needs.
Posted by special_k on April 10, 2006, at 18:17:14
In reply to Re: I'm sorry... » special_k, posted by pegasus on April 10, 2006, at 10:36:50
Hey.
> And, IMHO it's totally valid to consider whether you can afford expensive therapy. It sounds like you're concluding that you can't afford it.I think it is a bit too much...
> Being a student can be very difficult. But at least it's a temporary financial difficulty, and hopefully you'll have more resources in the future.
Maybe... Hard to say. Over half the people who complete never work in the field... If I don't get a job... I've decided to study medicine. Lol. That will take care of me for the next 10 years or so... And I'll be poor, yes... Though might have better luck with the public service in that region (maybe maybe...)
> It's easy to be angry at therapists or the mental health system, or whatever, for not making therapy more available for people who are struggling, isn't it.
Yes.
> And yet, I guess it's not fair to ask therapists to sacrifice their own financial health for it.
Of course. But then I also think it depends on what you mean by 'financial health'. I mean... 1/3 of my salary is going to be a whole heap less than 1/3 their salary I'm pretty sure of that... But I guess I'm fairly time / energy intensive lol.
Thanks for your response...
There must be a middle way...
I'm just trying to find it...
Posted by special_k on April 10, 2006, at 18:21:31
In reply to Re: How much is it appropriate to spend on therapy? » special_k, posted by cricket on April 10, 2006, at 13:32:00
> 1/6 of your income
> Enough so that it is an investment and I expect some major results from it but not enough to compromise my basic needs.
Thanks. Yeah. A little over half the amount she asked for... I would feel that plenty. I'd need to be a LOT more careful than I am now. And yes I would still see that as a significant investment that I would expect something for (thinking of all the other things that money could be going on and all...)
That actually sounds more realistic to me...
With the amount she asked for... I wouldn't be able to save anything on that. And I'd be pushing it every week to be able to pay her. And as for saving... I need some kind of emergency fund in case I need to go to the doctor or something. And I need to save something for a bit of a holiday at some point. Maybe to go to NZ for a bit... Maybe to go to a neighbouring city for a bit... But I think getting away for a week or so at some point will be fairly neccessary for my mental health lol. Of course I'm thinking backpackers... But must do it.
Gotta go - sorry. Be back later
This is the end of the thread.
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