What to Expect from Low Cost Therapy

Finding good low-cost therapy is often more meaningful than simply nailing down a good price. For many people, sliding scale psychotherapy represents a lifeline. But it can also represent a potentially awkward topic undertaken with their therapist:

Gutheil and Gabbard write, "Money is a boundary in the sense of defining the business nature of the therapeutic relationship. This is not love; it's work" (1993, p. 192). Thus the fee and fee arrangement are important determinants of the nature of the therapeutic process and the boundary of the patient-therapist relationship.

Reaching out to experienced analytic therapists is the easiest way to avoid a protracted negotiation over price. Many of them will have worked out similar arrangements in the past, and become adept at sidestepping some of the difficult and embarrassing parts of this conversation. You may even come away feeling better understood and supported than you did going in.

Working out a good system to evaluate and agree on pricing is a tricky process, but once it’s done, you can move forward with the really fruitful work of psychotherapy. Just watch out for a few familiar pitfalls along the way:

As with any fee arrangement, therapists should try to clearly articulate, preferably in writing, and agree upon the arrangement. The concern with the sliding scale is that it can put therapists and clients in a conflict of interest where clients may have an investment in presenting a scaled down financial picture in order to obtain a lower rate. If this negotiation takes place at the beginning of therapy, it can contaminate the therapeutic relationship. Some factors, such as retirement investments, upcoming inheritance, etc., cannot be easily factored into the equation of the sliding scale.

The moral: be open, speak clearly, and don’t be afraid to ask for what you need. At PPSC, we proudly offer sliding scale therapy for patients across New York. Start here to learn more.

Navigating Transference in Psychotherapy

Most of us who work in psychoanalytic psychotherapy owe a debt to Sigmund Freud, whose first steps defining the field shone a great light on the role of our unconscious minds. Freud’s body of work is not without its flaws, but his insights across a broad diversity of subjects have more or less stood the test of time. One of the issues Freud took particular interest in was the dynamic of the therapist’s office. Analytic therapists are generally discouraged from revealing too much about their personal lives, for fear of staining the therapeutic process with unwelcome details. As a recent New York Times piece described it:

In psychoanalysis, there is a specific rationale for this rule. The theory holds that patients tend to re-enact with therapists the relationships they had with their parents. This is called transference. By paying careful attention to this unfolding drama — as it plays out, right there in the office — the therapist and patient can uncover and resolve childhood conflicts. If a therapist interjects information about herself, she clouds the mirror and compromises the process.

Follow this story to its conclusion, however, and you can see how the benign neutrality of the therapist might come to be seen as a hindrance in some cases, even an act of hostility. In the case study within the piece, a patient desperately needs a sense of reciprocity, even a shallow one, in order to build the trust necessary to do the work:

As therapy continued with her, I heard how flat and tinny I sounded whenever I attempted to analyze what was going on between us. When I lapsed into too clinical a mode, our connection would wobble, and her alienation became palpable.

No two talk therapies are the same, and of course every psychoanalyst develops her own approach and rhythms. Learning and adapting is part of what makes an effective therapy worthwhile, for patient and therapist alike. If you’d like to embark on a journey to address longstanding feeling of depression, anxiety or loneliness, please contact the expert NYC therapists of PPSC today.

Should Psychotherapy Live Inside an App?

Is therapy is simple as asking short questions and receiving pithy answers? Some entrepreneurs seem to think so, including the founders of Talkspace, a text-messaging app that facilitates contact between patients and therapists via short, anonymous messages. Advocates of texting therapy point to the many benefits of this approach, including its potential to help patients reach out from remote locales, its anonymity (which could help some patients get over a fear of being judged), and its extreme affordability:

"Some users suffer from self-harm — cutting — so they can write to our therapist and say, ‘I have an urge to cut myself now, what should I do?'", says Roni Frank, a former computer scientist turned therapist. "There's nothing else out there like that." She thinks the immediacy that's built into the app is beneficial for people in crisis.

Yet dire emergencies and instant advice are not exactly the stuff of substantive therapy, which relies strongly on intimate connections and extended sessions. Indeed, any therapy which can be reduced to 160 characters or less is probably closer to the purview of life coaches than to the process of investigation and discovery that analytic therapy is for.

Most new products arise to fill a need, of course, and there is no doubt that Talkspace has struck a nerve for of its simplicity. Here at PPSC, we understand it isn’t always easy to find a therapist who suits your needs, and whose rates you can afford. That’s why we offer a number of ways for patients to find low cost therapy, and to explore convenient hours in their day.

If you’d like to learn more about the many benefits of old-fashioned face-to-face psychoanalytic psychotherapy, please contact us today.