After my first Ask V post back here, I — whoops! — forgot about the series for a little bit. As you know, I had some other shit going on, but we’re back! Today’s topic isn’t from one individual question I received, but rather, is a compilation slash advice post based on real conversations I’ve had with friends (and even colleagues) over the last several years. I get enough questions and curiosity about this topic, that a roundup was the better way to tackle it. Ready?
We’re gonna talk about therapy. Yes, therapy.
Let me preface everything I’m about to say with: when it comes to mental health, there is of course no single solution for everyone. What works for me might not be the right fit for you, and that’s cool. I’m also not a professional, and my experiences are just that — my own. All that being said — if you’ve always considered seeking out a therapist but felt terrified, or have tried it once and thought “This just isn’t for me,” read on!
The other reason I decided to focus today’s edition on this particular topic is there is so much talk about wellness these days. I love a kale salad and a yoga class as much as anyone else, but I can tell you nothing has shaped the course of my life and well-being more than therapy. This isn’t an exaggeration — it has been instrumental in changing how I see myself, how I relate to others, how I think about the future and of course the past, even changed parts of my personality. More on all this below.
Fair warning this post will cover some personal, honest, even heavy things, but I genuinely hope my experiences help anyone who’s ever considered talking to someone about what’s weighing on them. To be honest, I penned a few different versions of this post and was a little nervous to publish it. But if it is a resource to even one person, then it’s worth it to me!
Whew, okay. Let’s dive right in. Here’s what I get asked most about therapy:
Q:
So therapy, huh? When did you first start seeing a therapist?
The very first time was circa 1994. I was 9, and my family started seeing a therapist together when my father was terminally ill (though at the time, I don’t think I realized this was why we were going). I remember two specific family sessions, though maybe it’s all the same meeting and I’m parsing pieces of it out in my mind. Whether they realized it or not, that my parents had me participate in this experience at such a young age was instrumental in my seeking counseling at other points in life. I think it helped me to see it was completely acceptable to ask for help and to talk about your feelings, if you needed to.
Since that first therapist, I’ve actually seen a bunch of others throughout the years, inclusive of the awkward “therapist dates” I’ve been on to find a good fit. I saw that same therapist from my childhood one other time, when I was in college, then eventually found someone through my university’s counseling center to chat with throughout part of my time in school.
Q:
Are you still seeing that one SF-based person you mentioned a while back?
Yes, believe it or not! I started seeing my current individual therapist in July of 2012. Even when I moved to New York, we would Skype! She da best. I can’t believe I have seen her for over six years now.
Q:
How often do you see your therapist?
For many years, I saw her once per week, almost without fail. Since around spring 2017, we dropped it down to monthly, though with recent Korea stuff, I’ve been going a little more.
Q:
Do you really still find stuff to talk about after going for so long?
Actually, yes. In fact, after a couple years of seeing her, I realized the weeks where I would walk in and think to myself, “Ugh, I don’t know if I really have a lot to discuss, but whatever,” were always the weeks where some of the most interesting thoughts, worries, stories, or threads would come up. Something about letting your mind wander as you talk about anything surfaces things chillin’ just below the waterline.
I’ve also found the longer I go, the more clearly I can see myself. So now I’m under no illusions the work is ever really done, haha! On the weeks where I feel like there’s nothing major to talk about, I try and take a step back and really think about something weighing on me, or revisit old things we’ve touched upon but I know aren’t resolved. Recently, I felt like I was able to really voice things that have bothered me for years, but that I couldn’t even admit to myself for a long time. It actually kind of amazes me how much you can uncover if you start poking around and opening doors inside yourself.
Q:
I tried therapy once and it was just so awkward. I don’t think it’s really for me.
Dude, I’ve been there. I’ve been on some AWKWARD AF first therapy sessions in order to find “the one.”
One time, probably about ten years ago now, I was having a hard time in life — worrying about work, family, all types of stuff — and I made an appointment at a counseling center with someone who online sounded like the perfect fit for me. I remember showing up after work one day and just unloading. I was probably ugly crying; the real good type where you hiccup and can’t breathe. To provide some context, I knew the therapist was young and only recently accepting clients for their practice. But they made it kinda clear I’d overwhelmed them, and they didn’t really know what to say to me. I was so put off by it I didn’t try finding a therapist again for four more years — and this from someone who had already seen two other therapists in their life! I have other, similar stories, but the point of all of them is this — finding a therapist can kind of be like dating. I know that probably sounds exhausting and daunting, but if you’re on the hunt, go into each experience with an open mind and heart. You’ll probably know pretty quickly whether you jive with a person or not. Don’t be discouraged by a meeting in which you really don’t like the person. That just means they’re not a great fit for you.
Some therapists will offer phone consults to learn more about you and why you’re interested in working together. This can be a great way to feel out how easily it is to converse with each other. I should add in nearly all cases, I have not paid for an initial consult session, or if I did, it was pretty affordable.
If you really want to find a long term therapist, don’t give up. Keep asking friends for recs, schedule phone consults, and do the work. I promise, once you find the right fit, it is 100% worth it.
Q:
Who has the time to date around and find a therapist? It just seems like a lot of work.
I guess I might’ve said the same thing several years ago, especially when I was so discouraged after therapist dating. But being on the other side of things many years in, I’m glad I made the effort. My life really is all the better for it. If you are feeling stuck or know you have some things to work on or through, make the commitment to yourself and see what happens.
Q:
I really want to see someone regularly, but it seems so expensive!
I feel you on this one. Therapy is definitely an investment in yourself — maybe the biggest one you can make, depending on the circumstances. But it also doesn’t have to be expensive, and fortunately, I’ve noticed many professionals in the field feel the same and make an effort to help people regardless of their financial situation. So, a couple things you can do here.
One, some counseling centers will offer reduced-rate sessions with new therapists who have recently completed training, or are completing an internship prior to being licensed. Even though these folks are newbs, it doesn’t necessarily mean the quality of care you’ll get is less — so give it a try and see what you think. I’ve also noticed many therapists can provide sliding scale rates based on your income, so be sure to ask about that too. Additionally, some therapists will give you a reduced rate if you’re coming regularly (think: every Thursday at 5pm), because they can fill that slot long term. Don’t be afraid to ask how they can help you get the care you need within your means!
Finally, while it’s pretty rare that a therapist will accept health insurance, nearly all of them are happy to provide you insurance codes so you can ask for reimbursement from your insurance company, if your plan covers therapy or counseling. So if you happen to have such a plan (lucky you!), be sure to mention this to your prospective therapist.
Q:
I’ve been meaning to look for someone, because I really want to talk about XYZ. But I just haven’t.
Maybe you can talk to your future therapist about what’s been holding you back. ;)
Q:
But, like, how does a session even work?
It’s pretty simple. With every single therapist I’ve ever had, I walk in, plop down into a big comfy couch or chair. Then I start talking. I’ve never laid down (I actually wonder if any therapists have anyone lay down, as I’ve never seen or heard of this in real life!), but now that I think about it, I totally could and it would be fine.
For me, a great therapist will let you take the lead in terms of what you want to talk about. Some weeks when I’m not sure, I might start talking about what I did the prior week, or how I felt about something (seemingly) small that came up. Sometimes even venting about something that annoyed me has opened up insights into how I’m feeling about another topic more broadly. Some weeks, I have major updates (like when I got back from Korea) or very specific acute events I want to discuss (like a visit to see family, haha!). There have even been instances where I really felt like I had nothing to say, so I asked my therapist to ask me questions. She’ll usually circle back to something she’s been curious about, or wondered how something got resolved, and then we go from there. I like it!
In terms of advice giving, this is actually less common than you think. Sure, you might get nudged in a particular direction, but for the most part, my therapist has always let me arrive at things on my own time. They can’t always turn the lights on for you; that bulb has to go off in your own head, you know? She will occasionally challenge me if she knows I can handle it; she is always careful not to put words in my mouth or recast a narrative. I’ve heard from friends who also see therapists that a common refrain is, “I don’t want to put words in your mouth. To me it sounds like you’re saying XYZ,” or something similar.
There was one challenge/piece of advice my therapist gave me probably 3 or 4 years ago which I had never been able to execute until very recently. I was really excited when I was able to do it. Without going into too much background, it had to do with being suuuper vulnerable. For years, what she had challenged me to do felt like the world’s hottest fire. Getting too close to it felt painful, scary, like it would burn. When recently I was able to go through with it, I was really proud of myself. I only share this because I think sometimes people end up putting pressure on themselves when they’re seeing a therapist, in the sense that if they don’t see change or feel differently after a couple sessions, they feel like they’re failing or it’s a waste of time. It took me YEARS to do this one tiny thing and for it to not feel scary anymore! So give yourself a break when you are starting out!
Q:
Do you think therapy has helped you? How so?
Yes, immeasurably! Without boring you all with the intricacies of my neuroses (haha), here are two examples.
A surface level thing is that I am a lot more laid back than I used to be. I tend to get less anxious about things that were triggers for a long time. Or, I’m very clear on how to manage those things in a productive way, so the potential for anxiety is eliminated (or at least reduced).
A very deep thing can be described with an anecdote. The first day I ever walked into my current therapist’s office, having only spoken with her on the phone, I didn’t even say hello before blurting out, “Surprise, I’m not Irish.” That I felt the need to even justify having an Irish last name but was clearly Asian was of course telling. She asked me about my adoption about half way through that first session, and recently she told me I responded with something like, “Oh, it’s not an issue for me, I’m over it, no feelings around it, don’t care, it’s fine.”
I can hear you laughing from here.
It took a few years, but eventually we circled back to the thing I brought up the minute I stepped through her office doorway. And now here I am, having been to Korea, met my birth family, the whole shebang. Doing all that — and the emotional work leading up to my decision to go to Korea, and now after — would have been unthinkable six years ago. Like, completely nuts. Would not have been able to touch it.
Q:
You’re different than you were a few years ago.
This is kind of the inverse of the last question, but I have in fact had friends (and even Joe) tell me I seem different than I was a few years ago. My response, always: therapy!
If you’ve been thinking about finding a therapist, I hope this post was helpful for you. I enjoyed putting it together, nerve-wracking as it was! If you have any other questions for me, or feel comfortable sharing your own experiences, leave me a comment below.
Thank you so much for sharing this, Victoria! I have been thinking about finding a therapist for years now, but even moreso recently. Did you look for ones that specialized in adoption counseling?
You should! At the time, I did not look for an adoption counseling specialist, but I lucked out that my therapist has worked with families of all types (including all types of adoptee dynamics) through another organization. I actually can’t recall ever seeing adoption as a specialty listed on any therapist’s site, so if you go that route, it might be a good idea to reach out to Marriage/Family Therapists and ask what type of experience they have working with adoptees or other types of blended families. Hope that helps!
I 100% agree that therapy is so valuable. I consider it the biggest gift I’ve given to myself! Thanks so much for sharing.
That’s awesome, Rachel!
Hi Victoria! Thanks so much for sharing your journey and being vulnerable. I’m in the sf Bay Area and looking for a therapist and I wondered if you might be willing:able to pass your therapist’s info along to me? I’d so appreciate it!
Hi Jenna! Absolutely, happy to pass that along. May I use the email address you left when you commented?
Thank you so much for this post! As a mental health professional, I think that it’s so, so important that more of us start having these conversations and working to de-stigmatize mental health.
I do want to push back on your assertion that it’s rare for therapists to accept health insurance. Many highly qualified, highly effective therapists accept insurance, and I worry that stating otherwise reinforces the narrative that therapy is prohibitively expensive. A good starting point to finding therapits who accept a certain insurance can be to check your health insurance’s provider database for behavioral health providers.
Thanks, K! It must just be the providers (and bleh insurance plans) I’ve come across, so I definitely appreciate you chiming in! Other than clients going through their insurance directly, do you know of any other great resources that would list providers by city who take insurance? I’m also curious if you have any insight as to why a therapist would or would not accept an insurance plan. Thoughts?
Great questions! Another good resource for finding a therapist who takes a particular insurance plan is Psychology Today’s online therapist finder, which lets you search for therapists in your area and filter by the insurance that they take.
The question about why a therapist would/wouldn’t take insurance is also a good one. Going through insurance companies involves substantially more paperwork than simply having a client write a check at the end of a session, and for therapists who are self-employed (and don’t work in some kind of agency with support staff), it means additional unpaid administrative duties. Additionally, therapists who do not take insurance can set their own hourly rates, whereas insurance reimbursement rates are fixed (and, full disclosure, often lower than what a therapist might choose to set for themselves). In my experience, it’s pretty common for a provider to be on one or two insurance panels — meaning that they get paid directly by the insurance company, and the client is only responsible for the co-pay — and then supplement with clients who are willing/able to pay directly. Like you mention above, those clients are either going to foot the whole bill themselves, or will be responsible for getting a bill from their therapist to submit to their insurance company for partial reimbursement — in my experience, insurance rarely covers the full cost of reimbursement for out of network providers, unfortunately.
Thanks again for this excellent post :)
I would also love if you could email me the contact info for your therapist. You can use the email on this comment. Very much appreciate it!
I just emailed you!
Love! This! Post! My decision to start therapy in my late 20’s was such a struggle. I wrestled with starting to see a therapist because I was worried what other people would think of me, but mostly I was so judgmental of myself for not being able to “handle” my generally privileged life. When my anxiety reached a breaking point, I finally sought help. I was amazed at how much I learned about myself from my very first session. Nothing has taught me more or been more valuable to me than ongoing therapy. I thought I would see a therapist a handful of times to “fix” my anxiety and that would be that. But the journey of self-discovery continues, and now that I am in a much better (an awesome!) place, I actually find it just as valuable. Most importantly, I feel equipped to ride the roller coaster that is life without fear that I may become derailed again.
I would also like to add a note about medication: If it was hard for me to walk in the door of a therapist’s office, it was 10x harder to come around to the idea that medication may help alleviate some of my problems. No other illness (or any illness, really) attaches so much stigma to medication. That said, the improvement in my day-to-day life once I agreed to start a low dosage antidepressant was incredible. I took it for two years and weaned off of it once I reached a point where I no longer felt it was needed. If you work closely with your care providers to discuss your options and monitor your progress, medication can be a wonderful resource in managing your mental health.
Hi Julie! Thank you so much for sharing your story here! I think it’s really valuable that more people share their stories and struggles, and more importantly, what has worked for them. I am so happy to hear that you found what you needed.
Thank you for sharing Victoria! I’ve seen a few different therapists at different points in my life. I am open about it and always tell people everyone should see a therapist at some point. No one is perfect and there are things everyone can work on.
I saw a therapist when I was going through my divorce. She was wonderful and I wouldn’t have had the courage to make the decisions I did without her. A year or so later, I went back to her for another issue that was weighing on me. Her tough love wasn’t a good fit for me at that time and I eventually found someone else. All this to say that a therapist may not always be a good fit. It’s okay to acknowledge that and find someone else.
Thanks for sharing, Erica! I’m with you about outgrowing a therapist or working with one previously who might no longer meet your needs. If you have to “date” therapists to find the right one, the nice thing is that the “breakup” should be (theoretically) pretty painless, because with any luck, your provider will totally understand. :)
This is an amazing post, thank you for sharing. I think another important thing to note is that you can also outgrow a therapist. I started seeing my last one for some just kind of general work/life anxiety stuff…but in the course of seeing her, my mom became sick with cancer and then passed away and I feel into an incredibly deep depression, and what she was able to provide me with/help me through was no longer enough.
Also—I am also adopted, and have met my birthparents, and ALSO walked in to my last therapist saying I was all good and had no issues surrounding my adoption…and also, LOL.
Yes! I completely agree with you. Therapists all have different skillsets and experiences that they bring to the party too, so it’s totally ok to move on and find someone else you can meet you wherever you are at that point in your life.
I didn’t know you were adopted! I guess the one day we met in New York we never got around to discussing :) And yes—LOL.