I might, sometimes, be a good enough psychotherapist – although there are certainly those for whom I have not been good enough.
But I am most certainly a terrible business woman. I dread doing my professional accounts each month, my financial books are shaggy and unkempt.
And an interesting unconscious habit, a persistent black out, a fiscal “tick” has stuck with me from the moment I hung out my shingle: I spend hours making up bills – and I forget to hand them to my clients to collect my fee.
I have even (and this has happened repeatedly) written up a statement in the last five minutes of a session, for the client sitting in front of me, said “Goodbye! See you next week!” walked them to the door and listened to the elevator doors closing behind them – and looked down to find a monthly statement: the CPT code and session dates, any previous balance (from the month before when I also forgot to give them their bill) the total due and my license number – still in my hand.
I’m a shrink, right? I am trained to think about such things – so of course I do, and I have – for the past twenty years – and I still haven’t cracked it.
I’ve tried all kinds of behavioral interventions and mnemonics – set alarms, and organized visual reminders – nope.
I’ve set up rituals, which I adhere to, of reviewing the bookkeeping tasks for the day – uh-uh. Nothing penetrates the blank-out.
I’ve even held the remaining bills for the day in my lap, and forgotten to distribute them.
I mean, I get them distributed eventually. Some by hand, some electronically –but in fits and starts and herky-jerky – and in the end I feel very valued and valuable to my clients – and I am grateful that I usually get paid, and paid well enough to care for my family. But this odd billing disorder isn’t born of complacency. There have been many years where I was scraping by, or short on rent – and still found myself with a stack of undistributed bills sitting on my office end table at the end of the day.
I own my worth. I can set my fees at a rate that reflects my value and training and expertise. Sure, there are lots of therapists in NYC who have a higher average fee than I end up with as my sliding scale and flexibility with clients in crisis, and pro-bono cases drag my averages down. But that is not unconscious. That is my choice, those are my values, and that is what helps me to curate a healthy and diverse generalist caseload.
I’m not inhibited about talking about money, and I like getting paid. I can talk openly, and even enter into conflict about my fees – I make sure to manage fees in a way that protects my clinical relationships from resentment or overextension. My fees are high enough to require a significant, if proportional, commitment from my clients, and to meet my own needs for reimbursement for what I have offered up.
And so I dig deeper than that:
I sit in a room of my very own, and the world comes to me.
Seekers, from every walk of life, from every profession, from many different cultures, come to my door.
They bring with them, each of them, hundreds and hundreds of stories to tell. Thousands upon thousands of myths and dreams, narratives, of hopes and heartbreak are laid at my feet. The more still I sit, the more stories are offered to me.
Like gifts. Like precious offerings.
These stories, priceless and sacred, are left behind with me, a pile of totems, charms and talismans to protect and instruct me as I move through my own story.
Like a safe deposit box I am filled with other people’s treasures.
If I am very very lucky, and I have held still enough and said the magic words, whatever they may be, often enough (I am very very good finder of magic words) I may be allowed to become a part of these stories, and to help create their meaning and influence their outcome in some small way, and hopefully for the better (but you never know for sure with magic words, what forces you will unleash).
There are boring bits. Long periods of exposition or sometimes endless description of the landscape – but I’ve learned to rest during those patches because soon enough – the tale will pick back up and we will be facing demons and dragons and rescuing royalty and sitting on the edge of our seats and escaping by the skin of our teeth.
And each session there is a new and amazing hero, in a new story, and I am their trusty side kick, or their genie in a bottle, the village fool, the scape-goat, the ugly step-sister the crone in the hut at the edge of the forest, or the princess they have yearned for, or the Queen on her throne or the wickedest witch of all.
And the protagonists move through their tasks so heroically, with such courage and fortitude, I am continuously stunned and surprised by each new trick, each riddle solved, and every feat of strength.
And the story is so engrossing, so compelling, and it offers me so much even as I play my delimited part within it, that I am swept up and satisfied and filled. And like all big stories, big myths and dreams, I have been transformed myself by the tale.
And I think what happens – is that I just forget.
I forget, and sometimes it just makes no sense to me,
that I am actually supposed to be paid at this point in the adventure, as I wait, dangling in suspense for next week’s installment.