A Rough Patch

It can’t be all smooth sailing, I guess.

Overall, I have a strong, positive relationship with my therapist of many (many, many, many) years. For the first maybe four (?) years, things with E progressed very smoothly, maybe because I limited how deep we went with our work together.

Then we went deeper, and E encouraged me to trust her with my most painful stories and vulnerable emotions. It was hard, of course. And then, I took a risk one time–a small one really–and she reacted a little awkwardly, and it led to a rupture that it took me a months to recover from. That experience shocked me; I never would have thought I could feel so desperate and crushed by that broken connection. At the time, I was consumed by it, like a love-smitten teenager who had been rejected.

We eventually recovered, but to be honest, when I think about it even now, some 20 months later, I still feel hurt. E apologized back then for her part in making it worse, and at the time, I brushed over that apology because I so urgently needed everything to be fine again. Now I wish we had explored it more thoughtfully, but it feels weird to bring it all up again now, not to mention painful.

Since then, we have had a couple of smaller ruptures that have upset me but not destabilized me for months like that first one. I have come to honestly believe that she never means to hurt me and is willing to go back and talk through things that didn’t feel right.

That doesn’t mean she will always go along with what I want, of course. She never did give in about comforting touch in therapy. In the end, we agreed that I wanted it and could be mad she wouldn’t give it. She would accept my frustration and help me try to find comfort elsewhere. It’s not entirely satisfying, but I can live with it.

That’s really all backstory leading up to this week. During our Monday session, we just didn’t connect very well. I felt she was talking a lot, kind of giving me advice in a way that wasn’t speaking to me at all. I needed something else, something that I couldn’t name at the time. In retrospect, it was probably just affection and reassurance. It’s so hard to admit, even to myself, that I need that.

I was also thrown off when at the beginning of the session she gave me a slip of paper. “The billing company says you owe $275,” E told me. “They left a message for me to tell you this. You might want to call them.”

First, I was surprised, because I write the check for my co-pay before I enter her office and give it to her immediately, so it’s done. My co-pay is $20/session with my current expensive insurance, so it would take a lot for me to owe her $275.

Second, I was disturbed when I glanced at the slip of paper. It had my name, the amount, and two statements in quote: “No more bills!” and “Collect at time of service.” I immediately felt scolded: bad client, delinquent on my bills.

So I’m sure it was a mixture of shame, frustration and confusion that partly interfered with the session. The topic was hard, too. She and I have been talking, again, about how stuck I feel in my sexual relationship with my husband. I feel stuck there, and I’m not sure E knows how to help me get unstuck. .

I told her that the week before I had brought it up with C, the mind-body therapist I see once a month. E knows her; they work in the same building.

I explained that C and I had talked about how I needed to take the connection I have between arousal and shame and replace it with something more positive. C had suggested I start with concentrating on different but related sensations in my body, like focusing mindfully on the the stretching of my inner thighs in certain yoga poses. I like this idea–I actually think that maybe the route into a solution may be through my body.

I can’t say that E disapproved of this suggestion. I know, for sure, that she wants me to do my healing in whatever way I need to do my healing, using any combination of her tools and other approaches. But I wonder if my interest in body-based approaches is part of what interferes sometimes with our understanding of each other?

Or maybe I was simply too tired and grumpy.

Towards the end of the session, E, too, realized  that we weren’t connecting. “This isn’t what you are needing, is it?” she asked.

I shook my head but reassured her, “That’s okay. I’ll see you Wednesday, and we’ll keep going.”

She was warm to me as I left her office. Yet I felt disconnected from her and soon wanted to text for some reassurance. I didn’t, though. She had also told me that day that her beloved cat was very sick. She and her husband were going to put him to sleep the next morning. I know how hard it is to make that decision about a pet, and I really didn’t want to interrupt her grieving and letting go process with a series of texts about my emotions. Besides, I thought, I have more skills now to soothe myself.

And I did okay with that, mostly by journaling. But on Wednesday, things didn’t get better. I slept poorly the night before and was more tired than ever. E was still sad about her cat. She asked if we should talk about our failure to connect on Monday. I thought, yes, we should, but I didn’t know what to say. Sometimes frustration and lack of energy make me draw into my shell.

I did manage to say that I was grappling with the tension between needing quiet time because I wasn’t feeling well and needing connection because I felt lonely. This is a recurring issue for me, I’ve realized. I create my own loneliness because I tuck so much of myself away, in my safe, private cave. I struggle to find a way out that doesn’t feel overexposed.

Anyway, I left again feeling far, far away from her. Then at home I checked my statements from her billing company, where I saw they hadn’t credited me with some of my co-pays. I left them a message and texted her about it too.

“It’s not really okay,” I wrote to her, somewhat crabby. “because getting a note from you, no matter how gently delivered, that says “no more bills” and “collect at time of service” is confusing at best. It definitely threw me off on Monday. and it underscores the transactional nature of our relationship, which of course is always there, but which I have to ignore to feel connected to you”

“Anyway, it’s not your fault of course, and I’m sure they will fix it. And I will be polite when I talk to them, but I will also tell them I am not happy.”

She texted back that it was weird and she’d call them too. Then two hours later, I had a long phone message from her billing service, saying it wasn’t an issue of my recent co-pays but rather that I owed the money from back in 2016 and should have paid it ages ago.


I feel I’m ranting about something minor. I mean, if I truly somehow owe her $275 from two years ago, I’ll pay it. But right now that question is all tangled up in this lack of attunement and my sense of isolation in general. And it’s a big fat reminder that although she’s personally very important to me, to her, I’m a client who provides her with a portion of her income.

Today, I remind myself that we’ll be okay, that E does care about my well-being, and that it’s normal for our sense of closeness to ebb and flow sometimes. But damn, I hate these rough patches.


Photo credit:  Ruslan Valeev on Unsplash





  1. Rough patches are the worst. It’s just so painful. I think these ruptures feel worse after a big rupture that wasn’t fully repaired happens. Now is probably not the time, but it it may be helpful to try to bring it back up and work through it. I know that the two giant ruptures I had with Bea still come up at times, and we need to do almost a mini repair— or maybe I just need reassurance that this time won’t be like last time— and it always feels painful and awkward, but it does help. I’m sorry things feel so bad right now. I do believe that you and E will find connection again. Be kind to yourself and take care of you. 💟

    Liked by 1 person

    • Hi Alice, thank you for your comment (and sorry I took so long to respond). I am doing better now. I never did bring this back up with E, but I think I will, at some point. Right now we are deep in the midst of re-processing some older stuff, which feels more pressuring at the moment.

      I appreciate your kind tone and understanding in this comment–and in all your comments over what is now literally YEARS. xxoo


  2. When I read about people’s experiences with insurance, I tend to be glad of the straightforwardness of just paying privately, despite the obvious expense. The issues around payment can feel so personal and painful.

    I relate to mentioning different approaches/books/ideas, and having the T react just a tiny bit defensively. Although one of my T’s very good points is that he is not defensive when I say something angry to him, or criticize something he’s said, he does seem a bit put off when I say I’m interested in this or that approach, like somatic experiencing for instance. Theoretically, he’s accepting of different approaches, and yet, his reaction is kind of off if I mention any. He too starts talking a lot, very theoretically.

    I’ve decided therapists really are very human. I think you’re right on the money that E cares deeply about you and that closeness does ebb and flow to some extent. At the same time, you get to keep bringing up what bothers you. Take care

    Liked by 1 person

    • So right, therapists are human. And often this is a strength, because it means they really get how hard it can be to be human and uncertain and suffering. But it is also frustrating when it means they can’t show up for us in exactly the way we need in that moment. Or sometimes they can’t fully show up for us in the way we need at all, like your T’s inability to consider incorporating an approach you think might be helpful, and E’s absolute refusal to offer comforting touch in therapy. And yet, when I’m not right smack in the middle of the pain of some sense of loss, I am filled with gratitude for the many, many ways in which she does show up for me. It’s just incredibly complicated, the therapy relationship.


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