Money Matters Again

I am aware of feeling annoyed as I go to the waiting room to greet Philip. It’s been five weeks since I’ve seen him. Each of the last four weeks he cancelled three or more days prior to our session – well within the time required by my 48 hour cancellation policy to avoid being charged – with various excuses, mostly related to business. Philip is a successful import/exporter. It’s not unusual for him to travel, but we’ve usually been able to reschedule during the week or arrange to talk by phone, even when he’s out of the country.

“It’s been a while,” he says greeting me with a broad smile that enhances his already handsome face. “I’ve been incredibly busy. Business has really picked up. Not that I’m complaining. I know lots of people are hurting, so I’m more than grateful. Other than that, not much is happening. Things are going okay with Serena, although she hasn’t been too pleased with all my traveling. I have been able to keep up with my kids, although I can find myself squeezed between time with Serena and time with the kids.” 

“And us?” I ask.

“Us?”

“We haven’t seen much of each other the past several weeks either and now you seem to be saying that there’s not much to talk about.”

“Truthfully, I haven’t had much time to think about myself. I just keep on truckin’.”

“Does that strike you as strange? You’re someone who usually spends a lot of time reflecting about yourself, trying to understand why you do what you do and now you’re being kind of flip and indifferent.”

“Maybe I’m just tired of spending all this time ruminating on myself. Maybe it’s time to just start living.”

“Philip, what’s going on?”

“What do you mean?”

“First you disappear for over a month …”

“I didn’t disappear,” he interrupts. “I called every time to say why I couldn’t come. Gave you enough advance notice too.”

I find myself confused, annoyed and stymied. When Philip kept cancelling, I thought about our last several sessions trying to understand what might have triggered his desire to keep away and hadn’t come up with anything. Now he’s being disinterested, dismissive and even hostile and I have no idea why. Was he feeling too close and needing to get away? And what was that comment about giving me advance notice? Philip is a wealthy man. Money never seemed to be an issue between us.

“Was it important that you gave me advance warning?” I ask.

“Yeah. Wouldn’t want you to be charging me for a session when I’m not here, especially since you just raised your fee.”

I try to keep my surprise from registering on my face. I raised Philip’s fee by $25, an amount I thought would be insignificant to him.

“Philip, what did it mean to you that I raised my fee?”

“Nothing. You’re entitled. This is your job. You deserve to make a living. And $25, it’s no big deal.”

“Seems like it is a big deal, Philip.”

“Don’t be silly. I can give $25 to the valet when I leave my car at the airport.”

“Except I’m not the valet,” I say quietly.

“I didn’t mean to insult you,” he says quickly.

“Philip, let’s stop a moment. I feel like we’ve been sparring all hour and I think I do understand what’s going on. I understand that the actual $25 an hour increase is inconsequential to you. But I think what it did is remind you that we have a professional relationship, that in addition to our human relationship, in addition to the caring interaction that goes on between us, you do pay me for my time. It reminded you, as you said, that this is my job. And I think that made you feel uncared about.”

“I never thought of that. At least not consciously. But now that you put it into words, I think you’re right.” He pauses. “Know what I just thought about? I thought about the time when I was a kid and my father and I had baseball tickets. I’d been looking forward to it for weeks. And then sometime before the game a delivery guy arrived with an electric guitar I’d been wanting and a note that said, ‘Sorry, kid, can’t make it. Enjoy. Love, Dad.’ I never did play that guitar. I realize it’s not the same thing …”

“But it felt that money, material things were taking the place of time and caring and that’s how it felt with me too.”

“I guess. I’m sorry. I know that’s not fair.”

“Nothing to apologize for. I’m glad our relationship matters to you. It matters to me too. And I’m glad we were able to figure out what was going on.”

Money Matters

I’m not good about money. I never have been. Managing my own finances has never been a problem, but setting patients’ fees is an entirely different matter.  

Early in my career I was treating Sharon, an artist, who told me how much she made yearly from her art. It wasn’t much. My regular fee wasn’t much in those days either. Still, I reduced my fee. Several months passed. In the course of one session she began to talk about the apartment buildings she owned that had been left to her by her now deceased parents. I was shocked, and angry, too angry to say anything at the time. The next session I was ready. 

“Sharon,” I said, “Last session you talked about being a landlord. Can you say why you didn’t tell me you owned apartment buildings when we first discussed your income and your fee?” 

“It never came up,” she replied. “We were talking about the money I made from my art.”

“That’s true. But don’t you think not mentioning your other income was dishonest?” I asked. 

“No,” Sharon replied blithely. 

“Really? You don’t feel you were hiding your rental income so that I’d reduce your fee?”

“My father used to say never offer any information you’re not asked for,” she said.

“You experienced your father as a ruthless, indifferent, uncaring man. And now you’re modeling yourself after him?”

“I never thought of it that way. It’s not something I decided to do. I guess I just do it automatically when I deal with something business related. I’m sorry. You’re right. It wasn’t fair of me.”

So that situation had a satisfactory ending both financially and therapeutically in that we were now able to explore Sharon’s identification with her father.  

More recently, the result wasn’t as positive.

I receive a call from Jackie, referred to me by a former supervisee. We set up an appointment and as we are about to get off the phone she asks my fee. Although I prefer to discuss fees in person, I answer her question and tell her my regular fee is $250 a session. She gasps. Without a moment’s hesitation, not knowing anything about her finances, I offer to see her for $150. She agrees and comes in at the designated time. 

Jackie sought treatment because she and her husband just learned that he is sterile and are now wrestling with whether or not to adopt. Jackie is also trying – not very successfully - to not be angry with her husband for a medical condition beyond his control. Being a mother has always been Jackie’s dream. Her mother died when she was only a year old, leaving her to be raised by rigid, rejecting grandparents. We discuss her desire to give her own child an experience she herself cannot remember ever having. She understands, but remains focused on her anger at her husband and his failure to give her what she has always wanted.

As the therapy progresses, I learn that their marriage has never been fulfilling for her. She describes her husband as both withholding and an inadequate lover. She stays in the marriage because she’s dependent on him. And for financial reasons. She has a seven-bedroom home on three acres of land, horses, a cook, and a housekeeper.

I am not happy. I reduced my fee for a woman with huge financial resources! And it’s my own doing. She hadn’t lied to me. She hadn’t withheld information about her wealth. All she had done was gasp and I lowered my fee! 

As we approach the new year, I tell Jackie that come January I will be raising her fee to $250. I understand that a $100 increase is a lot, but given her financial circumstances, it doesn’t seem unreasonable.

“Well,” she says, “I was planning on stopping anyway. All this talking isn’t getting me anywhere. My husband is still sterile and I just have to stop being angry at him and decide whether or not adoption will work for me.”

“Do you think your decision to stop is related to my talking about increasing your fee?” I ask.

“No, not at all. You’re right. I can afford it. But I don’t think this is helping. So why should I bother continuing?”

“Can you say, Jackie, how you felt about my raising your fee or, for that matter, how you felt when I lowered it when we talked on the phone.”

“I don’t know. I didn’t think about it.”

“Can you think about it now?”

She shrugs.

“Do you think you felt given to when I lowered your fee, given to in a way you haven’t experienced much in your life and that now you feel I’ve deprived you yet again?”

“You’re making too much of this. You always do. You over analyze. It’s just time for me to leave.”

And so I lost Jackie. As a result of my difficulty dealing with money.