Demystifying Therapy

Deciding to go to therapy or to return to therapy can be incredibly daunting. This is a talk I give to my students at the beginning of every semester. It’s on my syllabus. I tell them how important it is to give as much attention to their mental and physical health as they do to their work and studies. Of course everyone’s situation is different. Some of my students are working anywhere between one and three jobs while attending college full time. Others are care-taking relatives, especially now that college happens in their childhood homes. But even before COVID re-shaped the learning environment and burdened us with an entirely new set of challenges, I asked them to consider where mental health care fit into their daily lives. “Many people wait until they are already in crisis to find a therapist, which makes doing so much harder,” my syllabus says. “Having a therapist already established is a great way to avoid the stress of having to find one when you’re most in need.”

There are a whole slew of reasons people give for not going to therapy, and those reasons are VALID. There is stigma around therapy and mental health care, and that stigma takes different shapes in different families, for different genders, and for different racial, ethnic, and cultural backgrounds. There are financial costs. Sometimes you don’t have insurance or your insurance won’t cover therapy. Some therapists don’t take insurance. There’s time costs. The time it takes to even find a therapist can be reason enough not to look. Some of my students, friends, and family members have expressed to me that they don’t have time for therapy in their busy schedules. There’s also fear. Fear of facing what you work so hard to avoid. Fear that you might discover unpleasant truths about yourself. Or about the people you hold dear. There’s also trauma that can come from having been in therapy in the past. I’ve experienced first hand and heard through friends about therapists misdiagnosing patients, urging them to see a psychiatrist and take medications, urging them not to take medications. Also, not every therapeutic modality is for everyone and it can be hard to know what kind of therapy works best for you. I am not an expert on the mental health care provider side of things, but I do have a lot of experience on the patient side. Finally, and I think in some ways most importantly, a lot of modalities in therapy do not address how whiteness and white supremacy have shaped mental health care professions. So between stigma, financial and time-based costs, bureaucracy, fear, trauma, different modalities, and a lack of racial and cultural awareness in the field, there’s a lot of reasons to just say, you know what? I don’t need this. Or, I need this, but it’s not worth (fill in the blank).

I started going to therapy when I was 18 years old while attending college in the city 30 minutes from my hometown. I didn’t have a car. My therapist was about twenty minutes south of me. There was no good bus route. Instead, I’d walk from my Denver apartment to my mom’s office building two blocks away and I’d borrow her car every Friday. I’d drive to my therapist, a nice white woman named Dr. W who was around my mom’s age. Her office was in a medium-sized generic office building just off the interstate near the Dave & Buster’s I used to go to as a kid. My parents were paying for me to see this therapist. That is an immense privilege, and one that meant I didn’t put in much work to find the right fit for me or someone in my insurance network, because it wasn’t my money I was spending. I just needed someone to vent to. But venting is what friends and family are for. Why pay someone $150 to do what your support system is supposed to do? I had no idea what I was looking for in a therapist or what a therapist was supposed to do. I just know I was very anxious and often depressed, on the tail end of quitting an unhealthy work environment full of sexual harassment at the restaurant where I waitressed, and always always always in toxic romantic relationship dynamics. I remember almost nothing from my sessions with Dr. W except that she told me orgasms could help ease the pain of menstrual cramps. That bit was useful. Not much else stuck. Eventually I stopped seeing her, graduated college, and moved back in with my parents and began a job as a caretaker for elders for a year while I applied to grad school.

The thing about being a caregiver to seniors is that a lot of your clients die. This is supposed to happen. They are nearing the end of their lives when you begin working for them. But it wasn’t easy for me. I get very attached to people. I was also in a less-than-healthy non-relationship relationship, so I decided to return to therapy. This time I wanted to find a right fit, still with no idea what I was looking for. I did some research and made some appointments. I talked with one woman over the phone for a free 10 minute consultation and all I remember from that phone call is deciding not to go with her. Then there was the very expensive therapist on the south side of Denver. She was much, much older than me, and her office was gorgeously decorated living room in one of the big victorian style homes in that area. She cost $250/hour, but the first meeting was a slightly reduced rate and a slightly longer session time. She listened to me for awhile and then told me that my (non) partner and I, the one I’d come to her to discuss, exhibited a dynamic that is common between twin siblings. She was very fascinated by this. It all felt super Freudian. The whole time I kept thinking, I can’t believe how much this shit is costing me. I never called her again.

Finally, I met with a male therapist. Mr. C. He wasn’t a psychologist. He was either a licensed clinical social worker or held a masters in social work. I was 21 and hesitant to see a man for therapy, but he seemed open to accepting the complexities of life in a non-pathologizing way. He talked to me about meditation, something I was not interested in hearing about. About mindfulness. Yoga. Breathing. His office was small with a little water fountain that I would stare at when I didn’t feel like making eye contact, which was often. I only saw him for a few months before I moved to Salt Lake City for grad school, but moving to a city I’d never lived in where I knew no one was too scary, so I did Skype therapy sessions with him for the first couple months after my move. During one of these sessions, he thought our connection dropped and that I couldn’t see him on the screen (I could), and after I’d said something that challenged his little speech to me about Plato (why were we talking about Plato?!), I saw him put his face in his hands and shake his head in dismay. His voice betrayed no distress, but I could see his reaction and I felt judged. I also felt like he had no idea what he was talking about, and I lost all respect for him. That was our end.

Salt Lake was challenging. Grad school was hard. My non-relationship ended. I had to start a whole new life and make all new friends. My old friend group was going through changes. Divorce. Moving out of the country. Suicide. Alcoholism. Drug addiction. Everyone was struggling. It felt like I was trying to build a life out of sand. So after a year without therapy, I began, for the third time, the search for a therapist. At this point, I was in a very dark place so I went with the first therapist to return my phone call. Dr. A. She cost $150/hour. Hers was a small, bright office on the second story of a well designed little office building on the east side of town. I saw her every two weeks. I loved the routine of my 17 minute drive over there. I loved how warm she was, how she was younger, maybe early 30’s, much closer to me in age and experience than any of my other therapists had been. She was relatable. We both loved mid-century modern design, the mountains, and all things aesthetically interesting. She asked me for a list of books to read. I was honored. I wanted to be her favorite client. I demanded that she tell me I was her favorite and she did. I stayed with her until the end of my time in SLC, after which she gave me a card she’d wrote me and then took me to lunch up in Park City. I loved her so much, sometimes I wondered if those feelings were more than doctor/patient platonic on my end.

When I moved away from SLC, I stubbornly refused to find a new therapist. Instead I did phone therapy sessions with Dr. A. She sent me scans of an article about Marfa, Texas, a place she knew I was interested in. They arrived in my mailbox in Los Angeles, wrapped in a brown envelope. Sometimes she’d charge me for phone sessions. Sometimes she wouldn’t. Sometimes she’d cut me off mid-session to go care for her crying child. Sometimes her call would drop when she was driving through the canyon from the city back to her mountain home. When I was 24, my mentor died suddenly, and two months later, my five year non-relationship ended for good. I tried contacting Dr. A. She stopped being responsive. She disappeared. Eventually I gave up trying to reach out. Until eight months later when a very heavy thing happened in my family and I was desperate for professional help and this time she answered. She’d had a miscarriage. That’s why she’d disappeared. She apologized for not letting me know she’d be unavailable. We talked a few times after that before I finally realized our relationship wasn’t healthy and I stopped calling and she never reached out again.

What I know now at age 32 is that Dr. A and I had terrible boundaries with each other. I was 23 when I met her. I still didn’t really understand what therapy should be. I wanted a friend who favored me above her other patients and who would demonstrate that favor by treating me differently. And that’s exactly what I got. What I did not get was therapy. Not really. There was the time that she talked me down from an anxiety attack I was having on my bike ride home from work in LA because I had a friend who was constantly threatening to end his life and who made me feel like I was responsible for whether or not he made good on that threat. Dr. A talked me through hard things, but to this day I don’t really know what her modality was, what her approach was as a therapist, or if any of it really helped me. She casually mentioned once that I was maybe bipolar II. She didn’t say much more. I was left to google the non-diagnosis myself, to try and determine if it fit, if understanding myself in that way would save me from my increasing distress, anxiety, drinking, and recklessness. And it did, for awhile. Finding a label helped me accept myself a little more. But bipolar II is no joke and mental health diagnoses are no joke and casually adopting them because of a bad therapist and a few google searches is dangerous and disrespectful and even more marginalizing to those who actually live with such diagnoses. I was put off therapy for quite some time after that.

Eventually, again in a period of endless anxiety attacks and at a time when I had been put out of my rented apartment by circumstances I won’t get into, I got a therapy referral from a friend of mine. Dr. P’s office was in Pasadena, about 30 minutes from me on a good day. She was kind, like my previous therapists, but unlike my previous therapists, she was explicit about the modalities and techniques she used. She would make me little cognitive behavior therapy (CBT) worksheets with which I was able to become a bit more conscious of my patterns, habits, and feelings so that I could rewire my brain to conceptualize things differently. She also suggested that we use eye movement desensitization and reprocessing (EMDR) to work through my past traumas, the traumas that were the root of what was, at this point, my debilitating anxiety around suicide and other kinds of sudden deaths of loved ones. We did a few EMDR sessions and my anxiety went through the roof. I stopped being able to function. To do work. To do anything but the bare minimum. I was on fellowship at the time (time in my PhD when I was paid my salary but didn’t have teaching duties or class to attend), but I certainly couldn’t read or write. I could barely feed myself. My family was worried about me enough that they were considering flying to LA to be with me, they told me later. Turns out Dr. P was not certified in EMDR. She was in training. She did not make me aware of this when I consented to her treatment. I stopped seeing her. She told me to reach out when I was ready to start scheduling sessions again and I said I would but I never did. All of my therapy relationships ended this way. I’d say I’d make a next appointment and then never did. I was unsure how to say, “this isn’t a good fit” or “you have done more harm than good here” or “I’m ready to move on.”

The last time I wrote in this blog was December 31, 2018. I wrote about how, at the beginning of that year, I had finally and for the first time in my life made an explicit commitment to my own mental and physical health. I talked about how 2017 was the hardest year of my life, how I barely survived, how I began 2018 in the darkest, scariest depression I had ever faced after a year of civil unrest, relentless organizing, and exiting my most toxic relationship to date. I talked about the steps I took to find my way out of that place an into somewhere lighter. I talked about how, for the fifth time, I set out to find a therapist. My fifth therapist in ten years. I still didn’t know what I was looking for in a therapist or how to know if someone was a fit, but I knew what I wanted to accomplish. I wanted to be free of anxiety (LOL). My desire to shift my relationship to my anxiety was strong enough that before I even found a therapist, I altered all of my habits and patterns by sheer force of will. I cut out alcohol, cigarettes, and caffeine. I started tracking my daily mood. I started meditating. I started exercising regularly. These are the things well-meaning people who haven’t been to therapy tell you to do when they don’t want you to be depressed or anxious or struggling. “Have you tried drinking water?” “Get outside more!” “Eat less salt!” (I’m sorry, what?). I will reluctantly admit, these things did help. But not because they are an ends unto themselves. They only would have helped for so long if not for the most important thing I did, which was finally find the therapist I’d always needed.

Here’s how I found Dr. K: I called my university’s counseling center and told them I needed a therapist. They scheduled a consultation for me. A week later, someone from the counseling center talked to me for 20 minutes about how I was feeling and what I was looking for in therapy. They followed up by sending me a list of names in my insurance network (I am fortunate enough to have insurance through the university I work for even though it is despicable that in this country health care is tied to employment). I googled the names on that list. All of them. I read as much as I could about each therapist. I had been so traumatized by bad therapy that, even though I didn’t know what I was looking for, I certainly knew what I was not looking for. I knew I wanted to see a woman. Someone who specialized in anxiety, depression, LGBTQ identity, trauma, and relationships. These are pretty broad parameters and many of the people on the list were a fit. So I dug deeper. I read their statements about their own approaches. I was also looking for someone nearby whose office I could access easily without having to drive too far or face too much traffic (this is a big ask in LA). I called a woman, Dr. K, and left a message. She called me back within a day or two and we talked for 15 minutes about what I was looking for. We made an appointment.

Dr. K’s office is in an old art-deco building in downtown Los Angeles. I take the train to get there from my apartment just a few miles north of the city center. If I’m coming from the campus where I work, I also take the train. I never have to fight traffic or pay for parking. This is important because it ensures that I won’t give up on therapy because of the logistics of getting there. Dr. K is also in my insurance network. She cost me $10 per session. (Of course COVID changed all of this and we now do Skype sessions and the insurance company has waived the co-pays so I pay nothing). Dr. K. is probably not that much older than me. She is always very stylishly dressed, but will not tell me a thing about herself. Our sessions are about me, not about her. My therapist before her, Dr. P, used to compare the sudden death of my mentor to the death of her very old cat, so I was ok with having a therapist who didn’t try to relate to me personally. But Dr. K would make the faces at me when I told her about my past. Sometimes I’d say something with ease, something that maybe should have been painful, but that didn’t make me feel anything, and Dr. K’s face would contort. Why are you so upset about this thing I said? I’d think but not ask. It bothered me for awhile. How upset she’d get on my behalf when I wasn’t upset at all. How awful, she’d say of things I didn’t think of as awful. At first she made me feel like I was far more traumatized than I thought myself to be. I told her about the school shooting that happened in my hometown when I was young. About the other various highly publicized violences that happened in the place I was from. She made the same faces about these as she did about the benign things I’d never even considered to be trauma. Once, she teared up at something I said and I thought, ok I can’t see this woman anymore. But slowly, after weeks of this, of seeing her face reacting so emotionally to something I hadn’t even let myself feel, I softened.

I don’t know how many of you have seen the Randall Goes to Therapy episode of the TV show This Is Us, but I found it highly relatable (though not without problems). Randall has pretty bad anxiety but is also very smart, cerebral, resolute, and resilient. He thinks he knows exactly what’s “wrong” with him. He thinks the therapist doesn’t get it. Because she wants to talk about stuff that’s different than what he wants to talk about. He wants to talk about his anxiety. His dead dad. She wants to talk about his mom. He does not understand what the issue is. He wants her to stop talking about his mom. This is how I felt with Dr. K at first. Like she was trying to take me to all these irrelevant places in my past. Like she was trying to amplify experiences I had never considered traumatic instead of talking about the traumas I had marched into her office with and declared on day one.

I’ve been seeing Dr. K once a week for two years now. With the help of my oldest best friend, who is now herself a therapist, I came to understand in more explicit terms what was happening in my sessions with Dr. K. She was attuning to me. To the emotions below the surface that I wouldn’t touch. She was making a space in which it was safe for me to come out of my shell. I am incredibly skilled at performing vulnerability in order to deflect from my realest, most vulnerable self. This is a survival mechanism. Dr. K was saying, your mind is very good at solving problems but you can’t solve the problem of trauma. She was saying, you need to go on this journey with yourself but I will be there to mirror you, to hold your feelings with you, so you can learn to hold your feelings for yourself.

Dr. K practices attachment-based, emotionally-focused therapy. She approaches our sessions with an understanding of relationality. She helps me connect to my younger selves, all of them, so I can ask them what they needed in moments of disconnection and trauma and so I can reparent myself in order to heal. If you are unfamiliar with therapy words or frameworks, this all might sound confusing or totally absurd. But in my experience, it is just the opposite. Dr. K’s approach to therapy is one that is well-studied and highly effective. It is one that is rooted, too, in my understanding of the world as a place of interconnectedness. Often when I’m in therapy, I think about abolition, about mutual aid, about the systems we live in and how harm in one part of the system affects the whole system. About how you can’t heal a trauma you won’t acknowledge. About how, with the right kind of support and resources, people won’t need to resort to the things our culture now classify as “crime.” How in a world where everyone’s needs are met, the system isn’t a place of harm. I have a whole other little essay I’ve been writing in my head about the relationship between emotionally-focused, attachment-based therapy, abolition, astrology, mutual aid, and transformative justice, but I won’t do that now. Maybe someday.

I went to therapy to deal with my anxiety. I thought I just needed some tools. Things I could say or do when I was anxious that would make the anxiety go away. But as it turns out, anxiety is a symptom of trauma. And without getting to the roots of the symptom, no amount of exercise, mediation, healthy eating, or self-discipline will heal me. I cannot will my way out of the things that have happened in my life. To heal, I have needed therapy. I have needed a doctor who will set boundaries with me, who will treat me like a patient and not like a bestie, who will make safe space for me to be curious about my patterns, my reactions, my coping mechanisms, and who will ask questions that lead me to the places in my past and in my relationships I’d rather not visit. To heal, I have needed a doctor who understands that at the bottom of everything is a feeling and that that feeling didn’t just appear from nothing. That if I am anxious about a change in my partner’s pattern of contact with me, it is because I grew up without the kind of emotional stability and consistency in my intimate relationships necessary for trust to flourish. To heal, I have had to accept that I am terrified of abandonment and not because I am broken but because I have been abandoned many times in many ways by many people. And that I continued to be abandoned because we often seek to unknowingly repeat our traumas in an unconscious attempt to heal them. Maybe this time it will be different. Maybe this time I can get them to stay. People like me, we repeat patterns instead of choosing people, relationships, and situations that are stable from the get go.

I thought my romantic relationships were about the people I was with but I was only with those people because of the people I have been. Every time we pull on a thread in therapy, it leads somewhere I didn’t expect. And every time I shine light on that thing I didn’t expect, I feel a pain I didn’t realize I carried. But being able to feel that pain and to acknowledge it for the first time is the thing that heals that pain. Someone once asked me if it was scary to do this, and the answer is absolutely. It is terrifying. While the rest of the U.S. was facing mandated lockdowns mid-March, I was almost entirely checked out from the COVID situation because I was barely surviving the most painful deep dive into the oldest, most unaddressed trauma of my life. I was drowning. I woke up every morning at 5:30/6am suddenly and with a feeling of sheer terror. I felt like I was dying. This went on for weeks. My relationship was falling apart. I was falling apart. And, coincidentally, the world was falling apart, too. There was no ground. Everything was water. Murky water. I didn’t want to make it out alive. Because what in the fuck would that even look like.

But I stayed in therapy. Week after week while we brought me back ashore. My partner did what he could to be there for me. He called me every morning at 6am, acting as my alarm and also my anchor so I wouldn’t wake up alone and in fear. I confronted my therapist for not warning me how awful it would be to “do the work,” as people have begun to say when they talk about therapy. And look, I know this is supposed to be a blog post about why you should go to therapy and I know we have taken a very dark turn but I don’t want to lie to you. It is hard. Doing the work is hard. It does not look the same for everyone because not everyone has the same issues. Some people live with different diagnoses, with different chemical imbalances that require medication, with different kinds of trauma. There is no one size fits all approach to therapy. But when people ask me what to look for in a therapist, I want them to find what I have, because on the other side of my drowning has been a kind of living I’ve never known. Things are still hard because life is hard, but the hard is a different kind of hard. I have the tools now to communicate, to navigate conflict, to be radically self-loving, to come back to myself when I forget how to communicate or navigate conflict or be radically self-loving.

I’m writing all of this now on the off chance that even one person will read it and will make the choice to face themselves, to face their patterns and behaviors and traumas (if you feel comfortable calling them that). And I’m writing it because so many people I love have come to me in the last year with their pain and I have been able to tell them things that I can only tell them because of the therapy I’ve been through. I have had to explain over and over what kind of therapist to look for and what modalities to look into. So now I’m just putting it all in one easily sharable—though admittedly way too wordy and overly personal—place.

Therapy is a hard thing to talk about it because even having access to therapy is a kind of privilege. This must be acknowledged if we are to change that fact. But therapy is also something that many people DO have access to, they just refuse to go there because of any or all of the reasons I mentioned at the beginning of this post. I think that for those of us who have the ability to go to therapy, it is our ethical duty to do so. This is probably one of those radical opinions people laugh at me for having. Or get mad at me for having. But I stand by it. When you heal your own shit, you stop making other people carry your trauma for you. When you heal your own shit, you learn to take true responsibility for yourself and therefore accountability for your actions. You learn how to have conflict in healthy ways, which in turn leads you to having healthier relationships at work, with your family, with your partner, with your communities, and with yourself. Therapy hasn’t just helped me deal with my anxiety, it’s helped me become an organizer, it’s helped me be a better anti-racist, it’s forced me to contend with my own race, gender, sexuality, with my Judaism. It’s helped me to become a better writer. More honest. More unafraid to stand in my values. More clear about what those values even are and where they come from. It’s helped me take accountability. It’s helped me understand how to navigate the systems that leave us with few choices in order to feel like I have the ultimate say in what my life looks like.

This is what I wish for everyone I love and for everyone I don’t even know. Healing. Accountability. Honesty. Emotional integrity. The ability to know that none of these words or their accompanying implications are 100% stable. And that that’s ok. I don’t know who said this first, but “constant vigilance will not keep you from getting hurt.” And nor, I might add, will it keep you from hurting others. The kind of therapy I described above might not be for everyone. I like to think it is because I like to simplify things and generalize even when I know better. But I do know many people of different backgrounds at this point who have taken this journey and are healing through it. This is how we remain in responsible community with each other. This is how we respect each other, our relationships, and ourselves. None of this is meant to be dogma. These are just the things I feel to be true because of what I witness in me and around me. I hope that if they feel even possibly true to you, too, that you will find yourself a therapist. If you need help with that process, please reach out. Even if we don’t know each other. I can’t do much but I can walk you through the basics. Sometimes it can help just to tell someone else you’re going to do this. It’s a way of holding you accountable until you learn to hold yourself accountable.

All people deserve healing. No one is disposable. These are tenets of the therapeutic frameworks I’ve experienced, and they’re also tenets of abolitionist understandings of the world. Aligning myself with these truths, however imperfect that alignment sometimes is, has made it possible for me to keep living.

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