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December 2014

Why should I pay for counselling?

This is a good question, why should we pay?

Here is a list of reasons why and below is an interesting article published in psychology today.

10 reasons why we pay for therapy

1. Its a professional service like dentist, doctors, hairdressers, etc etc

2. The therapist has paid an awful lot of money to train and they have bills to pay

3. Its a commitment which prepares one for the seriousness of the task ahead

4. It sets boundaries. One of the most important factors in a relationship especially a therapeutic one

5. Fees can tell you alot about a therapist level of training

6. Fees can tell the therapist alot about their level of self esteem and self worth!

7. It adds value to the service

8. Its halal, ok, ethical and lawful to charge for a helping service as its more than just help!

9. there a many costs within this fee such as supervision, room hire, insurance, professional membership and marketing

10. Because I’m worth it and your worth it, so its priceless when therapy changes your life for the better!

 

Paying for Psychotherapy

How and how much do you pay your therapist? Does the fee effect the outcome?

Dissonance theory would predict, with some caveats, that the more we pay for something the more we value it.

We happily pay for many services we require. We pay doctors and dentists, hairdressers and physiotherapists, car mechanics and consultants. But what about those who offer “the talking cure”. How much should you pay your therapist and why may one more than another?

It has been observed that, since Freud, many psychoanalysts have argued that patients do not get well unless they pay for their treatment.

Therapists have written about money in analysis: how they “charge” their patients. Unlike sex and death, money does seem to remain a taboo subject. The analyst’s complexes and practices about money can clash badly with those of the client, causing particular problems.

The agreement about fees, the presentation of bills, the charging for cancellation, the increases of fees, can all present problems as well as opportunities to understand how the relationship is progressing.

So higher fees mean better work? Yet payment is received for work in progress which cannot guarantee results. Therapists’ fees also confirms their self-esteem, professional status and belief in efficacy. Thus when this is challenged by patients, the therapists have to confront their own attitudes to money and then negotiate that meaning with the patient.

Some Freudians see money as a vehicle for favourite concepts like transference and counter-transference. Other issues include therapist, unhealthy, pathological greed where they use the defence mechanism of reaction formation to deny their entitlement to an adequate fee and ‘healthy’ greed where the fee is a normal entitlement to the position, role and task performed. Money it is argued can help therapist and patient understand the therapeutic boundaries of treatment.

Inevitably a patient’s fee restricts both the entrance and continuance oftherapy. There are emotional and financial issues regarding the fees that both client and therapist need to confront honestly. Issues need to be discusses early and frankly so that expectations are made clear. There is conflict but it needs to be discussed.

The psychoanalysts have also looked at the heads and tails of money: its good and bright side vs. its bad and dark side. Hence the interest in how the words gold (in German) is related to guilt in English and how gift and poison are related. The psychoanalysts are interested in how people manipulate their bad feelings by ‘injecting’ (projective identification) into objects.

Feelings of despair, rage, guilt, need for love, are too dangerous to experience consciously and are “injected” into money which becomes a poison container.

Therapists “lease their time”. It is interesting to note that Freud wrote about and worried about the adequacy and unevenness of his income from therapy. He seriously focused on money. He felt greed and cynicismtoward some rich patients and benevolent and paternalistic condescension to poorer patients. Yet he argued therapy was a bargain because it restored health and economic efficiency.

Many professionals charge for their time (doctors, lawyers). Their mental labour fee is a sign of their professional status and an index of authority, privilege and power. It is important that psychotherapy is bought and sold under conditions that heal and not ‘dis-ease’.

Analysts usually want to see themselves as beneficent purveyors of good rather than involved in commerce. They sell their services to make a living.

Therapists have written about money issues with interesting case studies. Barth (2001) discussed four case studies where she used “money-talk” to discuss and negotiate separateness and connectedness in therapeutic relationships: “In matters of money, questions about fees, insurance arrangements and payment style, for example, can lead to significant information about issues of dependency, deprivation, envy, longing, connecting, and other aspects of relationship – both within and outside of the therapeutic interaction.” (p. 84).

Three positions on paying for therapy:

(a) It is beneficial to therapeutic outcomes

Seeing a therapist involves an explicit or implicit contract. You ‘buy’ expertise, help, advice. But are therapy patients buying love or friendshipand how does that influence the relationship?

Many people argue that psychotherapy should be available for those in need of treatment for their mental disorder, funded by the state. Yet you could argue that some fee is necessary in order for psychotherapy to be effective. Paying increases a sense of worth and commitment. Things given free are often seen as worthless

The two interesting questions in this area are how, when and why does the fee affect the outcome (if at all); how can or should we interpret patients’ payment style and methods (timing, cash vs. cheque). Some suggest there is a connection between successful psychotherapy and a client making a sacrifice (being the fee paid to the therapist).

Indeed a fee providing a stable boundary for the patient and therapist, as opposed to it being beneficial due to money’s sacrificial effect.

Paying a fee for therapy adds to the dissonance created by the effort required to engage in psychotherapy. This leads to increased motivationfor the patient to achieve the goals set in therapy in order to remove the dissonance.

(b) It is detrimental to therapeutic outcomes

Thirty years ago researchers conducted a study confirming this view, with volunteers being randomly assigned to either a fee or no-fee counselling session. After the treatment session all participants reported reduced levels of symptoms and distress. Yet interestingly, the no-fee treatment group were found to benefit from greater symptom reduction than the fee-paying individuals, completely contradicting research suggesting paying for therapy enhances the outcomes. Interestingly, those paying for treatment had greater expectations of its results, but these did not materialise.

Another study supported this finding in a study of 434 patients assigned to one of five fee-assessment categories (no payment, welfare, insurance, scaled payments, full fee) based on the individual’s ability to pay. The study concluded that fees had no significant effects on outcome, appointments or attendance.

Reasonings behind the beneficial effects recorded as a result of free treatment have been offered by numerous authors. Some suggest that in a no-fee environment a patient’s therapist is regarded as more caring, which is received positively by clients and facilitates positive changes. Alternatively, it may be that those paying fees have higher expectations of treatment which results in them underestimating the beneficial effects of therapy in self-reports following treatment.

Perhaps therapists involved in billing and collecting fees improve clinical practice. Such findings suggest that fees have an impact on the clinical relationship through impacting the therapist as opposed to the patient.

(c) It does not impact the outcome of therapy

Neither therapists nor patients often talk about their personal income or financial resources. On the other hand therapists often report how many patients dream and fantasise involving money. Some, like Freud, note associations with dirt and faeces, others with semen and love. Inevitably some therapists think that some therapists say patients lie about their money (underestimate their income) in the hope of having their fee reduced.

Clearly therapists who work in institutions as opposed to those who work privately have different attitudes and behaviours with respect to fees. It has been noted that some corporate therapists do not report sessions and invoice clients or departments, expressing their rebellion against and resentment toward authority.

One issue is the sensitivity and compassion of therapists and their identification with the economic plight of patients. Somehow fees seem to go against the whole humanitarian ideals of therapists and enterprise of healing.

There are all sorts of issues for the therapist. First they know that there is a strong subjective belief that worth and price are linked. If you charge little you are seen to be of less skill, efficacy, and helpfulness. Next, there is the issue of charging patients not according to their needs but their income. Some ponder on the fact that if they know some patients are paying much less than others that they treat them differently. Then there is the issue of whether the fee should be related to some outcome. Also, how the fee is paid and to whom.

So is payment a minefield with all sorts of dangerous hidden devices or a field in which to mine important beliefs and feelings of both patient and therapist?

Furnham, Adrian, (2014). THE NEW PSYCHOLOGY OF MONEY. London: Routledge,

 

Nafs Ammara – The commanding Self – The Narcissist

‘It is the goal of Man to overcome ones Narcissism’ (Fromm, 1964 p85-86)

Exploring the Islamic definitions of Narcissism

Nafs Ammara -The Evil Commanding Self

In this first level of the development of man, the rational self and human conscience have been overtaken by carnal desires. At this stage, our self does not recognize the rational or moral limits on the way to achieve what it wants. This first level expresses itself in selfishness, arrogance, hardness of heart, oppression of others, lack of gratitude, ambition, stinginess, envy, anger, cynicism, laziness and stupidity etc. It is the lowest level of the self. In ithis level, there is an extreme desire for immortality and sovereignty.

Thus, the self on this level is attached to the worst of characteristics against which we have been warned by Allah and His Prophet, for instance; self-admiration, arrogance and pride, hardness of the heart, oppression of creatures, fondness for exposing the faults of others, lying, gossip, back-biting, envy, jealousy, criticism, undeserved self-praise, bitterness, attachment to what belongs to others even if it possesses something better, lack of contentment, constant complaining, lack of gratitude, blindness to blessings, wishing for increase without effort, extreme selfishness, greed and covetousness that knows no limit, love of control, and love of self and its desires, hatred for those who criticize it even if it is for its own good and love for those who praise it even if it is in hypocrisy, rejection of advice and counsel, and only talking about itself.

Originally, the nafs (the false ego) was one of the Creator’s gifts to man. But because we allow the nafs to lean towards material values, to take pleasure only in worldly life, our nafs has become almost animal-like, while its shape remains that of a human being.

This nafs is our worst enemy, who is living inside us, dominating and tyrannizing us and keeping our human soul imprisoned and forgotten in the depths of our subconscious.

On the level of commanding nafs, influences are very heavy. Unless somebody wise and strong holds you by your hand and takes you out, it is very difficult, if not impossible, to get out of these influences.

When we follow our rational decision and are rescued from our misery by a strong teacher, then we may rise to the second level- Nafsi Lawwama (the blaming self). Thus, the soul is pulled out from the dark dungeon of the ego to the light of conscience, and we will see our arrogance being transformed into humility, vengefulness and hate into love, anger into kindness, lust into chastity. If Allah so wills.

The remembrance that is appropriate for its treatment is La Illahe Illa Allah (There are no idols, no gods except Allah).

The Levels of the Nafs
The Levels of the Nafs – An overview
1. Nafsi Ammara -The Evil Commanding Self
2.Nafsi Lawwama – The Blaming Self
3.Nafsi Mulhima – The Inspired Self
4.Nafsi Mutmainna – The Secure Self
5.Nafsi Radiyya – The Content Self
6.Nafsi Mardiyya – The Gratified Self
7. Nafsi Safiyya -The Complete Self

* Reference: sourced at http://www.rifai.org/

5 Misconceptions of Backbiting and How To Respond To Them

Muslimah

5 Misconceptions of Backbiting and How To Respond To Them

Backbiting is one of those Islamic topics that often gets sidelined. Appearing as one of the frequent tarbīyyah topics in common circles and gatherings, the issue may be forgotten or ignored. This is severely problematic, as backbiting is one of the most devastating sins a person can ever commit, and not keeping ourselves reminded about it can lead to grave consequences. To make it fresh in our minds again, let’s tackle the issue in a practical way. Here are 5 common misconceptions that we ourselves or others you encounter may have about backbiting, what is misunderstood, and how to respond to them.

1) I’m not backbiting, I’m just saying:
When people respond with, “I’m just saying,” they’re telling themselves that what they’re mentioning is not something so bad as backbiting, it’s just “saying” things as they are. In other words…

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7 Reasons Why People Backbite

Muslimah

7 Reasons Why People Backbite

1) Satisfying Anger: This is done by backbiting the person who kindles his anger. Every time the person makes him angry, he subsides it by backbiting about the person. Through this (the backbiting), he feels he is getting even with the other person. The cure for this is the advice of Rasulullah (SAW) when a man came to him and said advise me: “ Do not become angry.”
2) Wanting to Make or Keep Friends: In order to maintain friendship with others, a person indulges in backbiting. As he is afraid of losing their friendship, he does not reprimand them when they backbite, but indulges in it with them. To cure this he must remember the saying of Rasulullah (SAW): “Whoever seeks the pleasure of men by displeasing Allah, Allah will abandon him to the people.” (Tirmidhi)
3) Playing Around, Joking and Making…

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Diseases of the Heart–Narcissism

Margari Aziza

I just read that today’s college students are more narcissistic than their earlier counterparts (Study: College Students More Narcissistic ). It reminds me of a talk that Dr. Robert Frager, a noted pyschologist and Sufi, gave last year about the diseases of the heart. During that lecture, I remember a deep fear sinking into the pit of my stomach. It was not for me, even though I have a whole bunch of personal work, but for a friend that I no longer speak to. Frager mentioned that a person with a diseased heart hates criticism even when the criticism is to help them actualize the person they are truly meant to be. Frager also stated that this type of person is afraid of intimacy and therefore cannot get close anyone. After hearing this talk, I really wanted to be there for my friend. I really wanted to have…

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Filling some gaps in my attachment hole – Day 1!

Day One. Introduction

Our attachments are formed from the moment we are conceived. Allah swt says our attachment begins in this life as Alaq, a clot clinging or attached (v2 Surah Alaq). We attach to another human being within a rahma (womb, also translated as mercy), of protection, warmth, substance and love. So the attachment begins to this life and each encounter the new human formation receives through blood, nutrients or the senses; the development of the body, mind and soul begins.

As we cling to our mothers within the womb we forget our natural inclination to remember whom created us first, but this is the purpose of our existence, to reunite us. The caregivers, chosen and created to teach us how to reunite us with this innate knowledge sometimes do, sometimes don’t and this is their test amongst many.

Early attachment is so integral to forming a relationship with Allah swt. If the attachment is damaged so to our journey is to him. Over the following weeks, months and how ever long it takes me, I will attempt to piece together my journey so far as a person who has an a attachment hole. My aim is to try and fill this hole with something I think I know it needs, but that somehow I find the most difficult to achieve ; certainty, servitude and fulfilment of my heart to the one who created me, Allah swt.

Im sure i will make mistakes, and if i write with an air of certainty know that its there to convince me not you!

This is why ending a relationship with a narcissist was so hard!

The Relationship Between Sensitive People and Narcissists

By Deborah Ward on May 15, 2013 – 4:12am

Many highly sensitive people have asked me why they so often end up in relationships with narcissists or other negative types of people, who take advantage of us, drain our energy and take our kindness without giving anything in return. Whether these people are co-dependents, addicts, abusive, or narcissists, they disrespect our boundaries, blame, criticize and make us feel so bad about ourselves that we don’t have the energy to leave. So what is it about sensitive people and narcissists that creates such an attraction and leaves such a trail of destruction?

HSPs are compassionate and empathetic by nature. We feel other people’s pain instinctively and want to help. In addition, narcissists are experts at manipulation and control, so they will use your big heart for their own ends (see my post The Highly Sensitive Person and the Narcissist). HSPs can feel such intense love and compassion for people that we can believe our love can heal others. And often other people are so amazed and relieved by receiving this much love and understanding, they respond with enormous gratitude and often flattery. Sensitive people respond to this praise by feeling good about ourselves and feeling needed and so we give more. But as this pattern continues, we end up giving until we’ve got nothing left and getting nothing in return, under the mistaken belief that if we just give a little more, it will be enough. But it’s never enough because the narcissist is an empty vessel, a bottomless pit of need.

What’s important to remember is that it’s not your love they need. It’s their own. You will never be able to ‘fix’ anyone. What’s more, you shouldn’t. Everyone has their own path to follow and to become a whole and healthy person, everyone needs to walk that path on their own, making their own mistakes, learning to pick themselves up, and discovering how to love themselves. Without those valuable lessons, a person will never have enough love to give to someone else. Trying to get a narcissist to love you is like carrying a baby around in your arms and waiting for them to start walking. Sometimes helping too much can leave the other person crippled.

Unfortunately, without learning to love themselves, hurtful people spend their lives trying to get the love they’re missing inside from someone else. That someone else is often a sensitive person because we have Compassion written all over us. But don’t let it be you. You are not responsible for someone else’s journey. What you are responsible for is your own journey, your own feelings, your own life. You don’t need to feel good about yourself by depending on others to tell you you’re a kind person or thanking you for helping them or making you feel needed. Relying on someone else to make you believe these things will only make you dependent on them, and then you will become a victim once again. You need to give all that to yourself. Show up with everything you need in your own back pocket. Know that you are a good and kind person, know that you are capable of enormous compassion and love and know that you are deserving of love yourself. If the other person doesn’t reflect that in the way they treat you, it’s time to leave.

The following are further reasons why HSPs are often attracted to narcissists:

1. Our giving nature means we often put other people’s needs before our own.

2. We’re so open we take on other people’s stuff like emotional storage containers.

3. If you have low self-esteem you can overlook the signs that things aren’t right, that you aren’t being treated right and so you ignore the injuries to your self and let it continue.

4. If you feel like a victim or have been victimised in the past, you will project that belief outwards. Narcissists will pick up on it and home in on you as a target. (See my postFeeling Like a Victim)

5. HSP’s sensitivity to other people’s feelings means it can feel wrong to say no. We think since we can feel it, we must do something about it. But we are not responsible for other people’s feelings.

The way to stop attracting narcissists is to change your beliefs about yourself and the way you feel about yourself. Here’s how:

1. Set up boundaries to keep yourself safe. Learn to let in people who will be there for you and keep out the people who only want something from you. I highly recommend the book Boundaries for specifics on how to set and enforce your boundaries and keep negative people out of your personal space.

2. Focus on your positive qualities and feel good about yourself, by yourself. Write in a journal to get your feelings out and develop an awareness of who you are, your feelings and your beliefs. Read back over what you’ve written over a period of weeks or months to see how you’re responding to situations and you’ll begin to see patterns in your behaviour and your beliefs about yourself and your relationships.

3. Learn how to use your sensitivity and empathy for the good. Two of the best uses are helping other people in a volunteer or charitable role and channelling it into a creative pursuit. Using your creative energy, in either volunteering or creative ways, will help you to feel grounded. You will feel a sense of belonging and connection to the wider world, and that you have an essential place in it. By shifting your energy into an activity you are passionate about, you will also give yourself something positive to focus on so that you’re not focusing solely on giving to someone who is making demands of your energy and attention. At the same time, you will be filling your life with positive feelings. Without this connection, you can feel frightened and alone and afraid to let go of what’s bad for you and too easily forget that you are connected to everything and that you are loved and safe.

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