My journey began when I was nineteen as a sophomore in college. I was taking a midday study break in my apartment when — in what seemed like half a second — my heart rate doubled and I got severely dizzy. I had no idea until later that I had just experienced my first panic attack, but I was frightened nonetheless thinking to myself, is this it? If you’ve never had a panic attack, I’ll put it this way. It’s like experiencing two dimensions of the same life simultaneously: one is the one you’re living IRL and the other is like the Upside Down from Stranger Things; except the Mind Flayer — the proper and oh-so-appropriate name for Shadow Monster — who somehow got in the passenger seat unexpectedly reaches over and belligerently grabs hold of reality’s steering wheel. For anyone in the driver’s seat, experiencing this kind of hostile takeover and complete loss of control is terrifying. I had to get help. My roommate was in the other room but I couldn’t confide my internal armageddon to him; mainly because that’s what it felt like and I imagine if those were the words that had come out of my mouth, ten bucks says I would have gotten an anomaly of wutface. So I rushed out the door and headed straight for the school’s Counseling and Psychological Services (CAPS), signing in as both a crisis situation for someone to see me immediately and for what would be my eleven-year quest for good therapy.
I loved CAPS and I’m grateful to this day that the University of Michigan offered this free service (although a $45,000 tuition should). What I didn’t love was that at the time, CAPS ironically had a cap of ten sessions per student and I was only told this on my sixth session. While the panic attacks had subsided, I felt like I needed more therapy to address the sudden end of my current therapy on top of what may have been causing my anxiety. The therapist I was seeing for ten weeks recommended I continue therapy and had offered two recommendations: I could see someone outside of the school’s free network, meaning that I’d have to pay out-of-pocket; or I could serve as a volunteer client for graduate school psychology students. With the zero budget I had for this, I chose the latter. Anything would help, right? Wrong. No offense to the psychology department, but I wasn’t a great candidate at the time. The mere fact that I felt like a guinea pig under a microscope — considering that one of my fears was feeling as if I was constantly being watched — wasn’t working. I lasted a few sessions before calling it quits.
I took CAPS’s other recommendation of seeing an out-of-network professional and forked the little cash I had weekly to sessions with an older woman in the dimly lit living room of her Ann Arbor apartment. I’m not sure if CAPS had transferred my records over to this new psychotherapist, but in understanding my background after just a few weeks, she confirmed that a childhood situation I was conditioned to believe was my fault actually wasn’t — the details of which I’m grappling with sharing publicly (maybe later). Mind you, this was about three years before I came out as gay, so neither of us knew (well, maybe she did but felt it was too soon to explore) about the gay tendencies I was subconsciously suppressing, let alone me comprehending what gay actually was. I had no idea.
You can tame a caged beast for only so long until it starts to rage in fury from confinement: you have to let it out or it’ll implode.
My panic attack months prior was my implosion to the (kind) beast of my truer self I was trying to tame. I was curious to better understand this theory I had devised for myself, but as money does when you’re a broke college student, it quickly runs out. I couldn’t afford to see my out-of-network therapist again, but was thankful for little time I had with her and the light she had shown on some of the darkness in my past. While the awareness didn’t necessarily solve anything, it made me feel a bit better getting a glimpse at what was beneath the covers I got in the habit of tucking in.
I didn’t see another therapist for about five years until I had settled in New York City well after graduation. It was still a money problem. I graduated with student loan debt during the tail-end of the 2008 recession, so my measly $32,000 salary and the terrible medical insurance it came with couldn’t justify seeing a professional, especially one with New York City rates. Thankfully, I had a group of (mostly now former) friends to confide in and explore this new gay life I had come out to right before my twenty-third birthday. I was out all the time and honestly enjoyed myself, but I was also drinking a bit more than I should have. Knowing that talking about your feelings helps, I tried to do so with my friends (as you should with your true friends). It worked, but only for so long until I felt as if my brief doing-so was becoming a pain in their ass. I had also developed several degrees of FOMO, which I now know is a sign of poor friendship (number 4), and shortly began experiencing panics in the middle of the night. I had to see someone soon.
My next therapist in 2013 was a recommendation from an acquaintance. His office-slash-home was on the twelfth floor of a Battery Park City apartment complex and the only time he had available for what I could afford was 7AM on Tuesdays before work. I appreciated something he had referred to his pricing as ‘sliding scale,’ which means that you pay for what you can honestly afford given your means, a structure I’d forever be grateful for until the end of time, or at least until better and more affordable health care (more on this later). His minimum was $60 per hour and considering that my bank account was still going negative on occasion, my maximum was $25; which, of course, I didn’t disclose out of desperation for seeing someone and met him at his minimum (the rest of my life would go on credit and I’d sacrifice a few meals here and there). I recall one early morning at 6:30AM trying to get myself to therapy on time when my metrocard had run out of funds. In trying to add more funds at the machine, I realized my current credit card was maxed out, I only had $2 in my checking account, and payday wasn’t until Friday. I almost broke down at the 42nd Street subway station until I realized I had just paid the minimum on my other maxed out card, giving me a little credit to afford my ride downtown. Surely enough, I broke down crying in therapy as a result of thinking I’d miss session and realizing how penniless I was on top of what we were already discussing.
We met weekly for several months, but something just wasn’t clicking. I couldn’t connect with him and I wasn’t necessarily feeling relieved of anything just yet. Realizing that money was a growing concern of mine, he made the recommendation to transition me out of private sessions into group therapy sessions he held weekly on Monday nights, which would fit my now nonexistent budget of $25. I didn’t like the idea of group therapy and I loosely held it against my therapist to not have known me well enough to see that I was an incredibly shy introvert. If I couldn’t talk much in private therapy, what do you think was going to happen in group? I summoned up the courage to go one evening and I was floored by how open the other young adults were so eager to talk about their feelings to a group of strangers (something I’d vie to one day do myself); but when my therapist focused the attention on me to ask how I was feeling about a personal topic, I sure enough froze and didn’t say a word. Crickets. I simply replied “I don’t know” after what seemed like ten minutes of my worst fear transcending to a real-life nightmare. It was middle school all over again when the teacher would cold-call on me in class to analyze a scene from a summer reading book that I sure as hell didn’t read; but this time it was about my life, albeit a life that I sure as hell couldn’t read either. I was angry. I was mortified. I was embarrassed. I was ashamed. The session finally ended, I paid my $25 cash, and I left to never see him in group or private therapy again.
I felt hopeless about therapy and my need for figuring out my mental state, but I focused my life on my career and the creative outlet that was my newfound blog (the one you’re reading now). I jumped a few companies and ultimately ended up working for myself in 2015. While money was much better than it had been and I had paid off some credit card debt, I only had catastrophic health insurance and didn’t want to spend extra money on a therapist. I felt that I had some degree of personal awareness, but by 2017 with a few months left before hitting 30, I was growing more and more concerned about my complete lack of fostering a romantic relationship.
By this time, I had Oscar Health Insurance and was surprised to see that mental health was in-part covered with a $50 copay. I researched some therapists with good reviews that took my level of health insurance online and found an older gentleman with a ground-floor office in Greenwich Village that had 5 stars on ZocDoc and availability less than two months away. Perfect, I thought to myself, and looked forward to my first session on a beautiful spring Thursday afternoon. His assistant called me into his office, I sat across from his desk, and we began. He was old, but elderly therapists don’t bother me. Remember my first out-of-network therapist in Michigan was elderly, but she was very interested, curious, and engaging. This guy’s kind of old, however, came with a sense that he just didn’t care anymore. In my first session, he drew my family tree on his notepad, trying to make relational distinctions between what I know of my extended family with who I am today. In our second session, he asked about my history with previous relationships, to which I replied “none,” and he flat out couldn’t believe it. Dumbfounded. “What? Huh?,” as if my prior experience being in relationships was a prerequisite for his family tree diagram that would somehow spit out the answer to his psychological x + y = you’re fixed equation; but in my instance, there were two variables that had to be solved for and if y doesn’t equal previous relationship history, then you’re fixed can’t be solved. Also, based on the number of prescriptions on this guy’s desk, turns out that the reason why he had 5 stars was probably because of how easy it was to get him to write you one. While I believe medication is useful when needed, I didn’t want to go down that route and I certainly didn’t want to be with anyone who firmly felt like that was a necessity as part of the process. Needless to say, I didn’t see him again.
Several months went by and I was getting desperate again to find a therapist I could connect with. Since the online route felt either fickle or overbooked, I realized that the only way I was going to get good therapy was if it came with a solid recommendation and if I paid full price out-of-pocket for it, an unfortunate revelation for my former broke self who so desperately tried to take care of himself on empty pockets. Shortly after my 30th birthday, a dear friend of mine recommended his therapist to me and I got my first appointment within a week. We clicked after a few sessions. I felt comfortable with him and felt like I had finally met someone who is equally patient and understanding, yet firm. Several revelations and an ugly cry later, I feel way more aware than I’ve ever been; and if I don’t personally see the results of my therapeutic work, then I get affirmation from my close friends who’ve been around me long enough to notice a rise in my confidence and general peace. It wasn’t overnight. It never is. It’s ongoing work that’s been (almost) occurring for two years; and we still have a lot of work to do.
My therapist is also sliding scale, but I didn’t have it in my heart to cough up saying $60 per hour where I had left off. We settled on a fee that’s much higher than $60, but still below his normal rate. I was making more money now and I shifted some categories around in my budget to prioritize this expense. Plus, I had finally understood the importance of sliding scale and the impact of its communal good. I find myself so blessed to be in a position to slowly keep scaling upwards in what I pay so that it can ultimately contribute to a pot that allows for him to see others in need of therapy, but can’t fully afford it. That was 2013 me. Even though things didn’t end well with my Battery Park therapist, I’m grateful for the clients that were able to pay him his full rate or more — whoever you are, thank you — so that he could see people like me who couldn’t truly afford him.
Does this mean you need to pay full-price for therapy, too? Not necessarily. I’m confident in the number of fantastic therapists out there who try to work with the ever-changing health insurance system to make mental health an option for as many people as possible (thank you). It just may take some time and I’m simply encouraging you to be patient if therapy is something you’re considering. There are some insurance plans that may be able to reimburse you some percentage of the full-price out-of-pocket fee, but all of this will take some research and filtering on your part. If you find someone you click with that charges full-price, understand that the long-term benefits of being in a better mental state will improve your life, which may correlate with a financial improvement as well. Of course, that doesn’t do anything for the now, but it’s a good way of looking at the price tag along with understand why therapy can be expensive (this article helps explain it). If you can afford it, fantastic; if not, see if your therapist can do sliding scale; or (and this isn’t great, but it’s something), see about bi-monthly sessions instead of weekly ones. Last but not least, there are online resources like Talkspace or BetterHelp that offer text or video chat counseling for less than seeing an in-person therapist.
I still get panic attacks here and there and yes, I’ll admit that it feels and looks like Miranda’s experience in episode five of Sex and the City season two (minus the being able to type out “single” and them magically going away); but therapy has increased my awareness to stay curious about what I’m feeling. A panic attack in August of last year led me to write this poem in 30 minutes in the middle of the night, which is something I quickly memorized and continue to recite myself when I start feeling anxious, something I don’t think I would have done prior. Therapy sessions last about 45 minutes and sometimes on the 44th minute, you feel like you’re just getting started only to be left hanging for seven days. Don’t give up and don’t feel discouraged, especially if you are connecting with your therapist. I highly recommend supplementing good therapy sessions with self-improvement reading, meditation, and conversations amongst close friends — and this is important — who know how to listen. A few books that have helped me in and out of therapy include Alan Downs’ The Velvet Rage and Brené Brown’s books (I started with Daring Greatly, then Rising Strong, and then Braving the Wilderness; I’m rereading Rising Strong now).
Therapy can be a powerful catalyst but because it’s only 0.5% of your week, the 99.5% left is all you. Therapy can be your seatbelt, the transmission, and the foot pedals — all the tools needed to safely get you in motion — but ultimately you’re the one who has to turn on the ignition; you’re the one who has to apply the gas; and most importantly, you’re the one who has to take back control of the steering wheel.