Jessica, I agree, that one was even weirder.

{{{Tom}}} I'm so sorry; that is just horrible. Best of luck finding another therapist.

It’s nice to think that that guy is very unlikely to be published by the AMA, at least.

His novel is bad but

That did not go well. I did not handle things well.

And then it got weird.

I got a whole lot of pushback from him, and I agreed to one more session with him. He apologized profusely, and took full responsibility for falling asleep the other night. He rightly pointed out how damaging it would be if I just cut him off without expressing any feelings about it, which is pretty much the way every relationship in my life has gone. And that while he made mistakes, HE'S not abusing me, HE'S not actively trying to hurt me, and that's an important distinction for me to make. If I just cut him off, I would just be making any future relationships I have even harder.

But I also felt he wasn't being completely honest with me. The reason he gave, that he had a fever from a virus, and that he feels better the next day, is the EXACT excuse he gave the last time he fell asleep on me. And I mentioned to him that there have been plenty of sessions where he hadn't fallen asleep, but he didn't exactly seem all there either, and I often wonder which therapist was going to show up to our sessions. He flat out denied that was the case. I had a strong sense that wasn't telling me the whole story.

And then a couple of hours later, at 8pm, I get a call from him. I didn't say much, but he went on to explain to me that along with the fever and virus, the day he fell asleep on me, he had seen the results of a blood test, which indicated a serious kidney problem. (He said the next day his MD explained to him that the results weren't as bad as they seemed). I was confused--I don't know why he called me to say this, since it doesn't change the fact that he should have cancelled the damn appointment in the first place.

So now I'm wondering what else he isn't telling me about his health (I think chemo is a strong possibility), and why is he so desperate to keep me on as a patient, and why doesn't he cancel appointments with me when he knows that he should? Just how much of his is about the money for him? Because of past abusive relationships I've had, I am unable to tell.

I am obviously Not a Therapist.

And that while he made mistakes, HE'S not abusing me, HE'S not actively trying to hurt me, and that's an important distinction for me to make. If I just cut him off, I would just be making any future relationships I have even harder.

I see the importance of the distinction, but he doesn't need to abuse you in order for you to cut him off. You are allowed to control your relationships with people, especially people you're paying for a service.

So now I'm wondering what else he isn't telling me about his health (I think chemo is a strong possibility), and why is he so desperate to keep me on as a patient, and why doesn't he cancel appointments with me when he knows that he should? Just how much of his is about the money for him? Because of past abusive relationships I've had, I am unable to tell.

If he's got a serious health problem, that's a shame. But the reason is for his behavior is his issue. It's not yours to manage or even discern. You only need to take care of yourself.

Tom, please feel free to completely ignore this, but I feel that what he just said to you was very manipulative and bordering on abusive. You can't leave or it will affect you for the rest of your life is not an okay thing for a therapist to say imho. Maybe you could at least research finding another therapist while you continue to see this one? Sorry if I'm overstepping and again feel free to completely ignore me.

That's me paraphrasing; it's completely possible that isn't what he meant at all. And what is making this so difficult for me is that I am completely unable to discern what is and isn't abuse.

And I wouldn't be posting here if I didn't want you all to overreach.

Just how much of his is about the money for him?

It's primarily about the money because...

but I feel that what he just said to you was very manipulative and bordering on abusive

There's no way he should be calling you back the way he did. That's not professional.

He's being very manipulative and he's freaking out because he needs your money.

Please keep Dana's point in mind:

You are allowed to control your relationships with people, especially people you're paying for a service.

You're not responsible for his health issues. He doesn't sound like he's properly engaged with you as a therapist.

IIRC, he's a traditional Freudian analyst, and you've been seeing him twice a week for a decade?

I'm sure you've paid him hundreds of thousands of dollars at this point.

People are less inclined to go that kind of route anymore because Freudian analysis isn't really results oriented. It's designed to be an ongoing part of your process.

But I think (a) that makes it a huge cash cow for the analyst, and (b) not really incentivizing getting your patient better.

And I see his freakout being entirely about the financial loss it poses to him, and very little about your well being.

(Which is another way to say, I would hope you would consider a different form of therapy while looking for a new therapist.)

Tom, he is being manipulative. And he's supposed to be helping you; you don't need to push aside your mental health needs in order to help him. Do what's best for you. Offer sympathy and be as kind as you can without hurting yourself.