Archive for the ‘analysis’ Category

You’re Going To Charge Me For Missing A Session?

Thursday, May 19th, 2011

Yeah. I am. Can we reschedule? Let’s talk about that later.

I hear ya. Yer doctor just lets you call and say you’re not going to be there and everything is fine. Same thing with the dentist and some other health professionals. Everything is jake. You call up, say you’re not getting there, they cancel your appointment and then you reschedule when you get the chance or whenever what’s bothering you kicks up again.

So what’s this about? Making sure that I don’t lose income? I’ve heard that before and the answer is, “Yes, but that’s not the main reason.” Some people stop at “Yes” and don’t hear the rest. Unfortunate. I do own up to it being, in part, about my income. Your fee is my income. I can’t double book the way physicians and dentists do so, when you don’t show, I don’t get paid for that period of time that I’ve reserved for you.

Ah, there’s another part of the “…not the main reason.” I’ve reserved the time for you. In most cases I can’t rebook the time. I realize this isn’t your problem, except that you want me to keep this time open for you every week, right? If you want me to release the time to someone else, I can do that, but then it’s that person’s if he’s willing to pay for it on a regular basis. Then you & I have to decide on a new schedule and, guess what, it’s still a regular appointment and, you guessed it, you’re going to pay for that missed session.

“Missed” session. Hmmmmm. Yeah, about that. If you don’t show up and you don’t pay it’s not a “missed” session. It becomes a “missing” session. What’s the difference. “Missing” sessions don’t exist. They didn’t happen, there’s nothing to note their passing and there’s nothing to talk about. I know you think there’s nothing to talk about if you miss a session, but that’s not true. There’s plenty to talk about and that’s why it needs to be “missed,” not “missing.” I’ll go further with that another time. Please just take my word on this one for now. If you want to think about it and tell me the difference please feel free to post a comment.

Now, about that rescheduling of our appointment. What are you asking of me with that request? Your asking me to fulfill your wish that you get a Mulligan. The “caring one,” as Harry Stack Sullivan labeled the infant’s primary care giver (often mom but not necessarily,) will do what is wanted. Your wish to be taken care of will be fulfilled no matter what the cost to anyone else. What are you asking of me? You are, in effect, asking me to cut my fee in half by giving you another session (the one you missed plus the”rescheduled” appointment) for the price of one session. Two for one. You’re presuming that I have the open time that will match yours and, maybe, that if I can’t match your time you won’t have to pay because you can’t reschedule and it’s my fault.

That doesn’t answer the question about rescheduling a session. That answer is, if I have time open and it matches your availability then, yes, I will reschedule. Once. Please.

Long ago in a galaxy far, far away I dated a woman who said, in response to my saying I felt “used” about something “Everybody uses everybody. Don’t abuse anybody.” Please.

Comments? Please feel free to post them below.

Consumer, Client, Patient, Analysand: What’s in a Name?

Thursday, April 28th, 2011

Willy Shakes asked the question in Queen Lizzie’s time (the first one, not the current monarch.) At that time he was asking because, to the questioner, a name was something that made no difference in the person to whom it was attached but made lots of difference as to how the person was perceived and accepted by others.

Insurance companies have renamed everyone who is receiving health care services. No longer are we “patients,” “clients”or, in the case of psychoanalysis and or psychotherapy “analysands.” We’re now “consumers,” according to the insurance companies. Those of us who are delivering health care services are no longer “doctors,” “analysts,” or “psychotherapists.” We’re all lumped under the title”provider,” again by the insurance companies. What does this mean? Don’t we still get treated the same as we did when we were patients and therapists, Analysts and analysands, etc?

Well, no. Not really and, on top of that, I don’t like being called a consumer when I’m on the receiving end of health care, nor do I much care for being called a provider when I’m on the giving end. Why? I’m gonna tell ya (with a nod to Dino. RIP.)

A consumer is someone who uses/purchases a good or service, which is considered a consumable. Very general. Doesn’t separate someone who is in treatment from someone who’d buying a toaster. Are you using my service? Yes. Does that make you a consumer? No. Our relationship is more personal than that, or, at least, is intended to be more personal than the relationship between someone buying a toaster and the salesman at an appliance store.

“OK. So I’m not a consumer,” you say. “Then I’m your client, right?” I’m not so sure. The dictionary on my e-reader says that a client is “a person…using the services of a lawyer or other professional person or company” (New Oxford American Dictionary.) I guess that sounds closer to the mark. I am a professional. Are you “using” my services? Well, yes and no. You have engaged me in my professional capacity. Maybe client does work but it seems to me that it misses something. It’s like chicken soup without the parsnip and dill weed. It’s may be good but it’s missing that geschmeck that makes it delicious.

What’s missing? You got it? No? Sure you do. The helping relationship. The (hopefully) healing relationship. So what’s the word now? Patient, right? Same dictionary gives the first use of the word patient as a noun to be “…a person receiving or registered to receive medical treatment.” Woah! Shazaam!, as Gomer was wont to say.) Shazoom!, as Captain Marbles said. “That’s it,” I hear you say. Well, yea and nay. Far better than consumer,  more better than client but still….

Analysand? What the hell is that? A person undergoing the process of psychoanalysis with a trained psychoanalyst. A very specific word that honors the relationship that exists in the room between us.

As for “provider….” Dad (in the stories of how family life used to be) is the “provider.” “Your father’s a good provider.” Can we talk about transference and countertransference here? I thought so.

So, what do you prefer to be called? What do the implications of “consumer” and “provider” mean to you? Add a comment and let us know. Keep those ol’ cards & letters rollin’ in (Dino, we miss you. Lots.)