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.
And what is making this so difficult for me is that I am completely unable to discern what is and isn't abuse.
I understand how that complicates things. I really, really do, and it fucking sucks.
But I'm going to echo Dana and say that, in this scenario, you don't have to determine if your therapist is being abusive or not. If (for the sake of argument) he's not abusive, you still aren't ever obligated to remain his client. You can just stop because it's not working for you any more.
Teppy and Dana are wise. Therapy is about you and your needs not your therapist.
Or just because you would feel more comfortable with another therapist, regardless of results with this one. The "and another thing" call strikes me as crossing a line, and one thing a therapist should definitely be mindful of is maintaining healthy boundaries.
IIRC, he's a traditional Freudian analyst, and you've been seeing him twice a week for a decade?
I wanted to go back to this, too. It really might be time for a different therapeutic modality. Sensorimotor psychotherapy can be very effective for trauma. (It can be a rough process, because I'd still rather repress everything and not acknowledge my shit [hey, I am what I am], but I cannot deny that it's helped me a lot.)
And also, my brother has had a lot of success with ketamine-assisted psychotherapy for his C-PTSD. (So much so that he's getting trained to administer ketamine-assisted psychotherapy, because there are very few providers in Colorado who do that right now.)
you don't have to determine if your therapist is being abusive or not. If (for the sake of argument) he's not abusive, you still aren't ever obligated to remain his client. You can just stop because it's not working for you any more
This. Hell, I’d want him to refund me for any session where he fell asleep but whatever. Find a new therapist.
I'm going to echo Dana and say that, in this scenario, you don't have to determine if your therapist is being abusive or not. If (for the sake of argument) he's not abusive, you still aren't ever obligated to remain his client. You can just stop because it's not working for you any more.
Thirding this - the line for "should I continue paying this professional for his services" can be set way, way lower than manipulation/abuse. If he's falling asleep during sessions, he's not providing the service you're paying for, and you, the client, can end that relationship for that reason alone.
