h, therapy, the elusive grande dame of mental healthcare. It has been shown to help for a wide range of mental health issues, but for so many people it’s inaccessible.
First of all, it’s expensive. Often, insurance doesn’t cover it. Other times, insurance does cover it and it’s still too expensive. Or maybe you just can’t find a good therapist. Or you did, but you feel weird about telling your boss and family you need to carve out time to see them.
Here at Tonic, we wanted to know: How are people making it work despite all these challenges? How are they paying for therapy, and how do their lives change when they do actually make it to the couch? Welcome to Therapy Diaries, where we explore all this and more.
Alecia, New York City, 28
Are you in therapy now? What type and for what reason?
I am currently in therapy for an amalgamation of neurocognitive and emotional disorders; including depression, anxiety, ADHD, Insomnia, and more. My therapist and I are trying a mixed model, containing aspects of psychotherapy and Cognitive Behavioral Therapy (although the CBT has had to take the back-burner recently).
How often do you go, and how much does each session cost?
I am lucky enough to have awesome insurance through my job, so I have unlimited sessions with no co-pay, but I spent my first year in New York City on my grad school insurance. It took me a year and a half, and four awful clinicians before I found one that I could actually build a therapeutic relationship with. Not all clinicians are created equally, and even if a person does have access to other options, we’re not conditioned to recognize and/or advocate for ourselves when mental health practitioners aren’t meeting our needs.
Does your insurance help pay for this?
My insurance covers all of my psychotherapy treatments, but even with my above-average coverage, I’ve had my insurance deny functional brain imaging scans ordered by my neurologist for suspected undiagnosed neurodevelopmental delays because my symptoms present and are misdiagnosed as mental
Has the cost ever deterred you from seeing the right therapist?
Yes, it’s almost impossible to find an occupational therapist that works with adults with my problems and is covered by my insurance. And no insurance will cover the emerging technical diagnostics like neuromapping or biofeedback, which could drastically decrease the risk of misdiagnoses, and shorten time in treatment.
Have you had to turn alternate strategies, good or bad, for dealing with mental health?
I actually almost had a breakdown when I began to rely on self-care and routine habit changes instead of proper treatment to manage my symptoms. I’ll never forget, I was sitting in my room doing my nightly guided meditation before bed, and this sudden feeling of doom and dread sucked into my chest and I realized it wasn’t gonna work. I’ve never felt so hopeless.
What would you be spending that money on instead, if insurance actually covered therapy?
I finally have proper insurance and a great therapist, so I have begun on the road to recovery (hopefully), but if I think back over the last decade on all of the money I’ve wasted with negative coping strategies like alcohol, drugs, and binge spending… I’d still be in crippling debt because I chose to go to grad school, and this is America.
When you’re able to do it consistently, how does being in therapy make you feel?
Hopeless. I am a social worker, so I know all of the techniques and strategies and models (and when they’re implemented poorly). I think what most people don’t realize is that treatment does not equal recovery. I’ve known friends that were in therapy for years with no
This interview has been edited and condensed for clarity.