TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: Can I talk to you about billing a little bit?

THERAPIST: Yes.

CLIENT: James is trying to work things out and asked me to talk to you.

THERAPIST: Sure.

CLIENT: Okay, so there's like you bill $150 a session and then when Blue Cross sends their claim summary they say, 'well the allowed charge is somewhere between $90 and $100.

THERAPIST: Right.

CLIENT: And as far as I can tell this is them pretending that that's all you bill.

THERAPIST: That's right.

CLIENT: Okay. (Laughs) So when you were a provider with them who paid that?

THERAPIST: So when I was a provider with them the main reason I'm no longer a provider with them is because now the allowed amount is just pretend.

CLIENT: Now you can actually charge what you charge?

THERAPIST: Right. Whereas when I was in that work I could only bill Blue Cross the allowed amount.

CLIENT: Okay.

THERAPIST: Which is what I did. Although the recording was a separate thing.

CLIENT: Yeah.

THERAPIST: So, does that make sense?

CLIENT: It does. So I don't think this is the case, but (unclear). Anyway, so do we like owe you for the allowed amount from that time? From when you were a provider for the extra money there?

THERAPIST: No. No. The recording covered it.

CLIENT: Okay.

THERAPIST: So like back in the day I was on Blue Cross like last year. Yeah, they would reimburse me whatever it was, like 70 bucks 74 bucks. And if we were recording I would have charged you a co-pay, which would have been, you know, 16 bucks or whatever the difference was between what they were paying me in the allowed amount.

CLIENT: Okay.

THERAPIST: But the recording covered that.

CLIENT: Yeah. Okay. Thanks.

THERAPIST: Did that clear it up?

CLIENT: I think so? I think so.

THERAPIST: What your concern was that like I hadn't billed you for enough?

CLIENT: I think James's concern was that we were going to -

THERAPIST: You were going to (cross talk)

CLIENT: Okay. No, no, no. Okay.

THERAPIST: No. The only thing you owe me for is like my bill last month minus what you pay me since.

CLIENT: Okay. Thanks.

THERAPIST: Yeah.

CLIENT: I do not know why that was such a hard conversation for me to have but it really was. But, oh well. I had two interviews today.

THERAPIST: Oh, congratulations.

CLIENT: Yeah. One couple I think I think both couples are going to offer me the job although one sent me an e-mail saying they wanted to hire me but they couldn't afford to pay me as much as I asked them (unclear) do I take it or not? The hours would be like three days a week, 10 hours a day which would be better for me than five days a week in the afternoon which are very hard to do. Both couples I really, really liked.

(Pause): [00:04:21 00:04:51]

CLIENT: So I need to talk to James about what we can afford to do. I'm sorry. I (unclear) talk to you like we, I guess, basically had a fight about it which consisted of me being like, 'oh, no it's absolutely like I need to talk to Chad about this, clearly, like it's very reasonable for you to ask me this, but I'm freaking out about it when you bring it up and I can't help it. And James saying, 'it's reasonable for me to ask about it for me to ask you to talk to Chad. Why are you freaking out? It doesn't make any sense. (Chuckle) So you know, we got over that, but I just get so anxious.

THERAPIST: If it would be easier for you to e-mail me questions like that -

CLIENT: Yeah, that probably would be a lot easier.

THERAPIST: that's fine.

CLIENT: Okay. Thanks.

(Pause): [00:06:15 00:06:25]

THERAPIST: (Unclear) for like other clinical stuff, it's probably good to talk about it, but -

(Pause): [00:06:25 00:06:35]

THERAPIST: if you e-mail me about that stuff, that's okay.

CLIENT: Okay. (inaudible)

(Pause): [00:06:38 00:06:47]

THERAPIST: I don't want to say that it's not okay even with the other stuff, too.

CLIENT: Yeah, I know.

THERAPIST: Okay.

(Pause): [00:06:52 00:07:03]

CLIENT: I it's very strange feeling like I've stumbled into the job market where I'm the best looking candidate out there. (Laughs) I'm sort of like, 'what's wrong with this job market?' (Laughs)

(Pause): [00:07:24 00:08:09]

CLIENT: It's been kind of a long day.

THERAPIST: I imagine there's something else that's very scary about the money.

CLIENT: (Crying) Yeah, probably. I don't know what it is but it's like I don't know why I get so scared about like I get very essentially scared about talking to you about money, but like I freeze up when people ask me how much I'm charging. Like I didn't ask them, whoever runs the tutoring center, for a raise when she added another kid to the session because I was too chicken. Are these just things more than I wanted to deal with? I don't know. You know, and maybe if I'm bringing up these other things just to like cloud the issue with you and me but -

THERAPIST: (inaudible)

CLIENT: I'm sorry?

THERAPIST: You say just with us.

(Pause): [00:09:24 00:09:42]

CLIENT: My immediate response to that is, 'but that's not good enough.' (Laughs)

THERAPIST: As long as we're clear about that.

CLIENT: (Laughs) Well, you asked for my thoughts.

THERAPIST: You're right. That's another one. (Laughs)

CLIENT: It was on the list. (Laughs)

THERAPIST: (Laughs) You're entirely right.

(Pause): [00:09:58 00:10:17]

CLIENT: You know this is actually a lot better than I expected to happen. It didn't ruin the entire two days.

THERAPIST: Oh, you were going to (unclear) two days?

CLIENT: Yeah. I said I'll deal with that when I have to and I did.

THERAPIST: Uh huh [yes].

(Pause): [00:10:46 00:10:59]

THERAPIST: I guess something you'd be really scared like because it's hard to pay me.

CLIENT: Yeah. I mean it's with cases like it's not clear yet how we're going to pay the $17 a session that is left over between (unclear) pay and the recording. It's really hard.

THERAPIST: Yes.

CLIENT: We're really poor. (Laughs)

THERAPIST: Yeah.

CLIENT: But I was doing some calculating last night and I realized like if I can be making $600 a week which is what I'm aiming at, that will be more money than I've ever made in my life. (Laughs) Hurrah for grad school! (Unclear) (Laughing) You know, for a while I was feeling really anxious about asking for $20 an hour and then I went to their houses and I didn't feel anxious about it anymore. Like, 'they'll be fine.' (Laughs)

THERAPIST: Do you want the 30-hour a week job?

CLIENT: I do. I like the people. The kids seem really great. It would mean that we could only work three days a week. I would be going three days a week but it would also mean that we would have two days a week that is non-weekend time to start working toward an education degree or like take on tutoring jobs or sleep in.

THERAPIST: What would the hours be? Do you know?

CLIENT: 9:00 to 7 on Tuesdays and 8 to 6 on Wednesdays and Thursdays. She said 8 to 6 all three days at which I couldn't come in until 9 on Tuesdays and she worked it out with the place that she's going to be going back to work at that she could work those hours.

THERAPIST: I see.

(Pause): [00:13:17 00:14:16]

CLIENT: I'd like to have just one job instead of trying to juggle two jobs and you know, and we have travel and (unclear) it's just a lot of complicated managing and like it's been complicated just like figuring out interview times. Getting to them on time. Which is bizarre because I have like acres of free time at the same time everyone wants to meet at the exact two-hour window.

(Pause): [00:15:00 00:15:22]

CLIENT: Yeah, like I guess I'm embarrassed to tell you that like this is a real financial hardship for us. And I'm also worried that you're going to be angry with me about it and I don't know why.

(Pause): [00:15:36 00:15:44]

CLIENT: And I guess I'm sort of upset that this is so hard financially and I don't know what to do with that and -

THERAPIST: Upset as in angry with me?

CLIENT: Yeah. I guess so.

THERAPIST: Un huh [yes].

(Pause): [00:15:59 00:16:06]

THERAPIST: Like I'm charging you too much?

CLIENT: Yeah, except I'm not because I mean, rationally I'm not but at the same time I am. But then I'm like rationally I'm not upset with James for asking me to talk with you about this but I am still upset. And I don't know how to deal with that. And then I feel like I'm trying to mediate between you and James somehow and that is bizarre and I don't like it. And I worry that like James is upset with me for needing to see you five days a week or for I don't want to (unclear) he is but it's like the internal standards. It's like I should be this much better by this point and I'm not, so clearly then it's wasting your time and I'm (crying)

(Pause): [00:17:17 00:17:39]

THERAPIST: (Unclear) leave you no room to maneuver and impose really overwhelming complaints because when you think about it the three of us -

CLIENT: (Chuckle) I'm upset with myself because this would be much less of a problem if I were not unemployed and so it's really my fault anyway. (Pause) Yeah, I'm really angry with Blue Cross for being like, 'oh well, we're just going to pretend that your provider is not charging what he's actually charging.

THERAPIST: I see.

CLIENT: I mean, what the fuck. (Laughs) It's completely ridiculous. You can't say you're going to pay 80% and then pay 60%. Like you can't do that, but they do. And it doesn't do any good to be angry at them because it's a giant corporation that I can't do anything about. I have to call them constantly just to get them to process my claims which they're fucking supposed to do anyway. Like, that's their job. Their one job is and (crying). (Pause) So I have to call them next week and say because they haven't processed the last month's claims and they also left out a bunch of the claims from the batch that they did process and I don't know where those went. I can't control that at all and -

(Pause): [00:20:03 00:20:33]

THERAPIST: I think -

(Pause): [00:20:35 00:20:42]

THERAPIST: I imagine sort of, kind of scary fears to be on a little tear like that.

CLIENT: Yeah. It's not as scary as I might expect. But yeah.

THERAPIST: I think that's one of, I think it makes you feel like you have no room to maneuver and I'm not saying you have much room to maneuver in all of this but is I think you're really afraid of like how frustrated with it you are over expressing that and instead of let's say no to me, that I think you're so scared that I'm not going to react well to that that it makes you very anxious to feel that way, to feel so frustrated and angry and in some ways I think, critical.

CLIENT: Yeah.

(Pause): [00:22:27 00:22:42]

CLIENT: You know when I think like why am I anxious about this, like why am I freezing up? I keep thinking about (Pause) and trying to remember specific, key people, and I keep thinking about my dad like yelling at me when I asked him for money for something as a kid.

(Pause): [00:23:41 00:23:55]

THERAPIST: Yeah, I think you mentioned something about how much he gave you when you were at school and it was like a total (unclear).

CLIENT: Yeah. I think my allowance.

THERAPIST: And he seemed to have no idea of how oh, my God, it's all I can do, I know it's not enough, blah, blah, blah, it's sort of like (unclear) in debt.

CLIENT: Yeah, you know. I think he just didn't quite realize how much I was how much of my life I was going to need to be responsible for at that time. Yeah, I think my allowance was like $40 a month. Like shampoo was like $7.00. And I'm a girl. Like I'm more expensive. (Chuckles) That's what it costs. It's like I could never get my haircut because I couldn't afford to. (inaudible) But you know, I decided that.

THERAPIST: Yeah. Yeah, yeah, yeah.

CLIENT: Yeah.

(Pause): [00:25:20 00:25:31]

CLIENT: Yeah, I think he just had no idea. You know, we'd go shopping and he just also didn't want to have any idea. I was then really angry about that. You know? It just really sucked to be in a private school and not be able to afford clothes. Like it really sucks and makes your life miserable. Like people made fun of my clothes all the time, all the fucking time and there wasn't anything I could do about it. And every time we went shopping he would talk about when he was a student and he had like one suit that he wore to class and one suit that he washed the next day. Well, first of all I don't believe you. Second of all, that was 1960s. Things are different now. It doesn't apply. I should say, rural 1960s.

(Pause): [00:26:37 00:27:08]

CLIENT: I felt selfish, ungrateful and demanding. You know.

(Pause): [00:27:15 00:27:42]

CLIENT: It's funny how important clothes got to be in my I mean I guess clothes are important anyway but, yeah, I didn't really feel like I was, like I liked the way I dressed until I was like a senior in high school or in college and I was just so proud of that. Like, and am just so proud of that.

(Pause): [00:28:00 00:28:27]

CLIENT: So (unclear) half an hour trying to figure out what to wear. Just because I've been in a place of not really liking my wardrobe right now. Not feeling like I have anything to wear. Like not having to wear flats, what I wear everyday. Everything matches, like I don't have shoes that I like that match anything. (Pause) (Crying)

(Pause Crying): [00:29:11 00:29:43]

CLIENT: Sorry about this. I've decided to become financially independent as soon as possible when I was like 14. It took me a while, but

(Pause): [00:29:53 00:30:05]

CLIENT: I had work/study jobs and that was good.

(Pause): [00:30:07 (Crying) [00:30:53]

CLIENT: It really sucks being unemployed. (Crying) It really sucks.

(Pause): [00:31:03 00:31:15]

CLIENT: Papa used to tell me you can't have champagne tastes on a beer budget. Have you heard that phrase?

THERAPIST: Sure.

CLIENT: Laughs.

THERAPIST: I'm not sure you have champagne tastes.

CLIENT: (Unclear) does more than I do. She kind of I think we dealt with my dad differently. I kind of (unclear) well it's not really appropriate for me to want anything so I'm just not going to want them. And she went more with thinking and planning and saving and saying, 'this is what I want.' And she asked for a Northface jacket for Christmas when she was like 15 and, you know, it was like a $300 jacket and it was the jacket that year. And she kept telling my dad like she would wear it every day, she would wear it forever, like it would last forever, like it would be great. And she got it. And like she wore that for 12 years, like that was her jacket for the next 12 years. She wore it until we went we were on a Canada trip and it rained like, it just rained constantly during that trip and she realized like the jacket was not waterproof anymore and (unclear) jacket was not waterproof anymore and Papa's main jacket also was not waterproof anymore so we were all basically just like wet for a week straight. I tend to go with asking for things that are going to cause father to blow up by their being different.

But then not really liking them very much.

(Pause): [00:33:33 00:33:44]

THERAPIST: Oh. I guess I'm a little concerned with your proving that that's true. I think you're off a little bit. I mean I think I understand that she wanted like an expensive jacket but I wouldn't call that champagne. It was a popular jacket. I understand if a kid wants that stuff, you're growing up, but she wore it for 12 years. That's not champagne.

CLIENT: Oh, I know. Yeah.

THERAPIST: I don't think that when you said, you know, I just want a thing that (unclear) I think most that's not wanting things at all or that you didn't feel you had a right to ask for more expensive things, as much as you think that you didn't feel like you had the right to ask for anything at all.

CLIENT: Yeah.

THERAPIST: And you couldn't get a haircut through high school or any clothes much less champagne clothes or like nice clothes. That was almost anything.

CLIENT: Yeah.

THERAPIST: At a private girls' high school (unclear) it mattered anywhere.

CLIENT: No. No. It mattered more at a private girls' high school. (Laughs)

THERAPIST: Girls who go to a private high school it's like, yeah -

CLIENT: I think, so that's like that's the thing. You say like $300 is not actually that much for a jacket. Like it comes in the normal range, right?

THERAPIST: For what a jacket costs.

CLIENT: Yeah. And so like for my father that's the completely outrageous price like anything over $50 is a really outrageous price for it. And so that's kind of what I thought.

THERAPIST: Right.

CLIENT: So I thought -

THERAPIST: So that's where he gets (unclear) "champagne taste on a beer budget."

CLIENT: Yeah. Because no, we didn't have champagne tastes. We had normal taste. Like (laughs) -

THERAPIST: It sounds like actually you were incredibly yielding and (inaudible).

CLIENT: I tried but it doesn't feel like that.

THERAPIST: Yeah.

CLIENT: But at the same time like I like really resented the fact that Amanda was more able to ask for what she wanted and sometimes get it.

THERAPIST: Sure.

CLIENT: That was -

(Pause): [00:36:45 00:37:21]

CLIENT: It seemed like it wasn't okay to, for it to cost anything for me to live like that wasn't okay.

(Pause): [00:37:32 00:38:01]

CLIENT: It doesn't seem my dad really likes skiing. Like he really loves skiing. Yeah. We all do. Like it turned into this very funny thing with James he's never been skiing and in the school like I grew up Friday afternoons they'd end early and then there was like a nearby mountain and like we'd go and everyone had ski lessons until I learned to ski, right? Which is (unclear). And to James, it's like why the fuck would you ever spend that much money on that? Like, yes it's fun, but like it's so expensive. And you know, I think like my dad's like that's what's worth spending the money on and I'm a little pissed about that.

(Pause): [00:39:03 00:39:21]

CLIENT: Or like being with the 13 to 15 range and like how was I supposed to tell my dad that like bras cost like $50 to $70 for a good bra? Like for one bra. And I need a lot of them and like I couldn't talk to him about it at all. Like I got all my bras at Target and they didn't fit at all and -

(Pause): [00:39:47 00:40:07]

CLIENT: Like I'm really angry about this and I feel so bad about being angry about it but it's not -

THERAPIST: It sounds sort of like another issue thing as though being angry is kind of equivalent to having a right to things.

CLIENT: That's crazy talk. (Laughs)

THERAPIST: (Laughs)

CLIENT: You see how I did that. Sorry. (Laughs)

(Pause): [00:40:45 00:41:16]

CLIENT: So now it's like I don't know how many times I had to say, 'okay, this is what it costs for me to be taken care of and I should be taken care of.' Like I don't believe it. I'm shocked that everyone else seems to believe it.

(Pause): [00:41:39 00:43:00]

THERAPIST: It seems like and I'm not saying this is because a lot of the anger and guilt and the (unclear) information you feel around this is probably anger at him that wasn't safe to show around him and probably still isn't. More so, but clearly more so.

CLIENT: I look back and there is no way we were that much in need and if we were there is no way that a private school education is worth your children not having basic clothing. Like that's just there's no way the public schools in our area were that bad. (Laughs) You know, if anything happens in the wonderful, wonderful place for me but still was a fucking nightmare. Like it wasn't worth it anyway.

(Pause): [00:44:05 00:44:44]

CLIENT: I think that I have a right to do things. And I'm pretty pissed about that.

(Pause): [00:44:56 00:45:18]

THERAPIST: We'll stop. Oh, let's see Fridays what would be good for the near future, like 1:30 or 5:15?

CLIENT: It doesn't matter to me.

THERAPIST: Okay.

CLIENT: I'll let you know what my schedule turns out to be, if I work Tuesday, Wednesday and Thursday, it won't matter. And if I work every day I won't be able to take either one so, it also won't matter.

THERAPIST: What are the hours for the other job?

CLIENT: (Cross talk) other job shouldn't be it's like two or three (unclear hours) but from 2 to 6.

THERAPIST: Okay. Yeah.

CLIENT: So probably -

THERAPIST: Two to six every day. That would get in the way on Thursday and Friday but not the other days. All right. I can I'm pretty optimistic about being able to make something else work on this.

CLIENT: Okay.

THERAPIST: It sounds like there's a reasonable chance you'll know in the next week or so?

CLIENT: Yeah, I'm hoping to know by early next week. I've got five interviews over the next like three days and I'm pretty sure it will lead to one of the jobs.

So, yeah.

THERAPIST: All right. So.

CLIENT: I'll e-mail you when I find out? Or just -

THERAPIST: Either way is fine. Yeah. All right, so good luck with all that (unclear).

END TRANSCRIPT