What is your desire for your practice, for your clients, and for yourself? It’s an interesting question, and I wonder how much time you have given to it.
How much detail can you create about your desire before you interrupt yourself with something. It might be, “I never get what I want,” or, “It will be too difficult,” or, “I have to settle for what I can get.” Or it might be any one of a myriad of other obstacles that we put in the way of expressing what our desire is. Read more
Some years ago, I worked with a coach who gave me a task, to ask people who knew me what they thought of me. When I read their feedback, at some level, I didn’t believe what was being said. I read it through distorted lenses, emphasising the negatives and diminishing the positives.
I reread the feedback recently, and was touched and humbled by the regard in which my friends and family hold me. I’m still reading it through those distorted lenses, but now I can allow in more of the truth of the positives, as well as seeing the negatives in a less exaggerated way.
We all see ourselves in a distorted way. We look at ourselves as if looking in one of those silly mirrors you used to get at fairgrounds when I was growing up, where our heads look enormous, we look twice as tall, or we look shorter and rounder. Or one of those apps that allow us to make silly pictures. We have these distortions in how we see others, and the world we live in too. Read more
Nothing brings up trust issues as quickly or as obviously as money! (Except perhaps sex?)
I have had several clients who pay me at the start of the session rather than risk forgetting to pay at the end. I’ve asked about it and the answer is always the same, they don’t trust themselves to remember. They fear the possible shame they might incur if they had to be reminded by me, and make the judgement that it is better avoided. And I feel for them.
I remember my own huge shame when, driving home after therapy one evening, I remembered I had forgotten to pay my therapist. I pulled over to the side of the road and called her. I was sick with guilt, embarrassment and shame, and was ready to drive back (almost 20 miles) to correct the problem there and then, if she hadn’t insisted on leaving it until the following session. Looking back now, I can remember the intensity of those feelings, though they seem curiously out of proportion to the mistake. The underlying fear for me was that the relationship could not hold such a huge issue, and that my mistake could have been the end of the relationship. My fear was on a catastrophic scale. My thoughts ran riot with questions about my motivation for not paying. What was I saying in that? Was some part of me angry with my therapist and refusing to pay? What was going on for me that I had forgotten? How could I have done that? How could I be so stupid? It went on and on.
A recent article in the Irish Times said that an average family spent between €45, 000 and €50, 000 between running their home and car, food, property and water tax, education and childcare. This figure does not include income tax, PRSI or USC, nor does it include provision for retirement. If we estimate that those taxes might reasonably amount to €15,000, a therapist who is the main breadwinner of a typical family of two adults and two children, would need to earn at least €60,000 after all expenses in order to support their family.
To put this in context, €60,000 equates to 1,000 hours at €60 per hour, or 20 hours every week for 50 weeks. This takes no account of any of the costs of practising (such as rent, insurance, supervision, professional memberships, or CPD), takes no account of holidays or sickness, and takes no account of cancellations or discounts. It also takes account of face to face client hours only, and ignores the time needed to generate those 1,000 client hours, or to do any of the other tasks of running a small professional practice.
It’s a big ask. Read more
At a recent workshop at the IAHIP offices, a group of newly and nearly qualified therapists brainstormed their associations with the word “Business.” After the course, I was reflecting further on our discussion and, in particular, on the question of cancellation fees (always a good topic for an animated discussion among therapists). I was thinking about the differences between a therapy scenario and a workplace one.
Imagine the scene. You go for an interview and are accepted for a job. A contract is discussed and agreed, including details about hours and pay. However, when payday comes around, your boss refuses to pay you on the basis agreed. Would you accept that? Probably not.
You’d be pretty miffed, I imagine. You might point to the contract of employment and say, “But we had an agreement.” You would probably be slow to commit yourself fully to continue working for that employer. I can’t imagine an employee feeling empathy for the employer, and pointing to the difficult circumstances they were experiencing as a reason not to expect their day’s pay. Read more
Most therapists charge their clients on an hourly or sessional basis. They sit with their clients for an hour or 50 minutes, and the client pays a fee based on the time. This is a fairly typical arrangement in professions generally, although, it is slowly changing.
One of the drawbacks of this approach from a financial point of view, is that there is an inherent limitation to what you can earn, as there are only so many hours in each week. Further, as a therapist, given the nature of the work we do and the impact it can have on us, there are only so many hours that can be spent sitting with clients. Read more
Being a therapist is different from having other jobs. Issues arise in therapy work that would be ignored in other occupations. There can be a belief in therapy circles that these dilemmas can restrict us in seeing a therapy practice as a business. Earning a living is often seen as much less important than the client work and sometimes there can be a negative attitude that suggests that being paid for our services diminishes their worth.
However, for some time now, the profession has been inching towards, well, greater professionalism. There are strict standards of training, the professional bodies have their rules and requirements, state regulation is getting nearer, and still, the perception persists that somehow doing it for free is virtuous while charging a fee is not.
In these articles, I don’t give much space to the clinical side of our work. Lots of more learned and wiser therapists than me do that very well. However, neither do I pretend that the clinical aspects of the work do not impact on the business side, of course they do. And it can be a challenge, to meet the dilemmas peculiar to our work as an opportunity to grow and enhance the lives of ourselves and our clients, rather than seeing them as restrictions and limitations. Read more
Where does the income in your practice come from? Well, obviously from the fees you receive from clients or organisations who pay on the clients’ behalf. But that’s only part of the story.
We none of us exist in isolation. There is a constant process from birth to death of interacting with our environment. Basic physical functions that meet our bodies’ needs such as breathing, eating, and sleeping all involve interacting with our environment.
In the same way we receive and pay out money in a constantly moving cycle. We may dislike money, but that is the medium that our society has chosen to make the exchange of goods and services easier. Money is a convenient way for us to give what we have in order to receive what we want. We are paid for giving our services, and we use that money to buy goods and services from others. Read more
I have said in many previous posts that if a therapy practice is not growing into the place you would like it to be, if it is not progressing past the early sapling stage into a mature tree, then there may be some underlying issues about money, wealth or deserving going on under the surface.
One of the really tricky things about looking at money issues in relation to establishing and developing a therapy practice is that money can be a metaphor for other things, such as love, security or power. Because of that, money issues can turn up as something quite unconnected to money, and other issues can express themselves through money. We are all aware of how a client can be talking about one thing, but there is another issue deeper under the surface which is also being explored.
I grew up in a Catholic family and went to Catholic school. I heard a lot about forgiveness. There was a lot of pressure to resolve differences and restore the equilibrium. Don’t get me wrong. I’m not against forgiveness, or the Catholic Church. However, people process experiences at different speeds, and sometimes an upset can be hurried towards resolution too soon. The danger in this is that the hurt goes underground. And unacknowledged hurt or wounding can fester in the shadow, until someone or something triggers it, and all the bile spews out.
When we have not received the apology or the recompense we feel is appropriate, some part of us is left feeling that we are owed. When this happens we can find subtle and well disguised ways of holding accountable those who we see are responsible for our hurt. In her book, The Language of Letting Go, Melody Beattie says, “Punitive damages are awarded in court, but not in recovery.” But the part of us that wants vengeance may not understand this.
If we are still holding on to an old wound, waiting to be compensated for the hurt we have felt, our bank balance may speak to the truth of that, even if the wounding had nothing whatsoever to do with money. “You owe me,” may be reflected in financial disappointments, investments that go sour, and unexpected costs or losses. In terms of our practices, we may experience clients not paying, or letting us down, being overly demanding or in some other way literally leaving us owed.
“You owe me,” can play out in small dishonesties, such as not fulfilling our responsibilities to an employer, or understating our income for taxes. It can be disguised, for example, by excessive generosity which leaves other people in our debt, or being excessively pedantic in money matters and counting each cent. If we have been selfless in a relationship and feel resentful that our needs are unimportant in relation to others, we may be holding out for our payback. “You owe me,” may also be recognised in having to invest more work or energy than others for less return. Or specifically in the context of a therapy practice, feeling demanded of by clients.
Another way to understand this is that we unconsciously equate money with love. A healthy bank balance symbolises that we are loved (by our paying clients). However, when we have unacknowledged wounding, it does not allow us to be loved, because our ongoing struggle is evidence of how much we have been hurt. To be financially healthy when we have unresolved hurts and wounds could be to minimise or even trivialise our past experiences. This can act as an unconscious bar to creating a practice that is financially viable.
Does any of this resonate with you? Remember, your unconscious is always looking out for your best interests, even if it doesn’t appear so! My wish is that you be kind and compassionate with yourself in exploring these ideas. And if I can help with any of that, I’d love to hear from you. Contact me here.