This is session 137 with EJ, a 29-year-old man suffering from narcissistic personality disorder. This will be our final session.
“Hiya, Doc. How are you doing?” “I’m well. How are you?”
“I got you a present.” “Oh?”
“It’s a bottle of Rustenberg Cabernet Sauvignon. It’s from South Africa, so it’s got eucalyptus notes.”
“Well, thank you.”
“I don’t know how much you know about wine pairing, but this is a wine you want to eat with steak or a dish that has a heavy buttery creamy sauce. It makes the wine earthier because it neutralizes the tannins.”
“I appreciate the tip. Please have a seat.”
“Yeah, sure, of course. I love this part, you know? Where I get to sit on your couch.”
“Yes. Listen…”
“It’s a nice one too. Real leather. You must make the big bucks, Doc. You probably don’t even need me buying you bottles of wine! And you don’t even take insurance.”
“Yes. Actually, that’s what I wanted to talk to you about.”
“About what? Insurance? I haven’t used that. My mom has been paying for all the sessions.”
“That’s the thing. She hasn’t. I have explained to you multiple times that she feels you have not made enough
progress during these sessions and she doesn’t want to pay for them anymore, and as you know, I don’t take insurance.” “But I disagree. I feel like we have made a lot of
progress. This really helps me, you know? I like coming here.”
“Whether or not you have the potential to progress during these sessions, it’s reasonable that she doesn’t want to continue paying after you have been coming to me for over two years.”
“Well, that’s dumb.”
“Regardless, this is her decision. And as I explained to you in our last several sessions, I have not received payment for two months now.”
“Oh. I get it. This is about money.”
“Unfortunately, this is a business. I have bills to pay. And if you’re not compensating me for my services—”
“But I don’t have the money, Doc. You’re expensive, you know? Who can afford that? I’m not rich like my parents. All I get is this tiny allowance that barely even covers my rent and car.”
“We have spoken multiple times about how beneficial it would be if you looked for a job.”
“Doc, I’m trying, okay? I can’t get a job. It’s not that easy. I don’t have a bunch of fancy degrees like you do.”
“You’re a college graduate.”
“Yeah, so what? Everybody’s a college graduate. Look, I’ll pay you eventually. You have my word. Can’t I have a tab?”
“I’m afraid that wouldn’t be fair.” “Fair? Fair to who?”
“Fair to the people who pay for these sessions.”
“That’s bullshit, Doc! And it’s not like you need the money. I mean, you had that bestselling book. I bet you made a fortune. Look at this place you got here. You should pay me to hear all my interesting life stories.”
“That’s irrelevant.”
“Sure it is. I bet you could write a whole book about my life. You would probably make a million bucks off of it. That would pay for my sessions, wouldn’t it?”
“It doesn’t work that way.”
“So you’re just going to cut me off because I can’t afford your sessions anymore? Goodbye and good luck?”
“I’m sorry. I have spoken to a colleague of mine who accepts your insurance, and he would be happy to take you on as a patient. I’ve got his number right here.”
“So that’s it. You’re dumping me.”
“I’m not ‘dumping’ you—I’m referring you to a colleague. If you’re able to pay for my sessions in the future
—”
“Yeah, I’ll bet. My money is good enough for you, but I’m not.”
“That’s not true at all. I just can’t—”
“I should go to the papers about this. I can just see the news story. Big fancy Harvard-educated psychiatrist cuts off a patient in need because he doesn’t have enough money.”
“I don’t think the newspapers would be interested in a story like that. But do what you must.”
“This is all an excuse, isn’t it? You don’t actually care about me.”
“What are you talking about?”
“You’re probably thrilled about this. You were just waiting for an opportunity to dump me as a patient.”
“That’s not true.”
“Bullshit. You were pretending to care about me this whole time. You never cared though.”
“I care about you. But I can’t provide my services for free.”
“You’re a real piece of work, Doc. I can’t believe you.
And after I came here with a gift for you.”
“You can have the wine back if you want it.” “I don’t. Keep it.”
“As I said, I’m sorry.”
“Sorry? You don’t know what sorry is. You’re going to be
really sorry you kicked me out of here.” “…”
“You hear me, Doc?”
“I’m going to have to ask you to leave now.”
“Fine. I’ll leave. Now that I know what you’re really like, I wouldn’t keep coming to you if you begged me. And I bet anything, someday you will beg me.”
