A fresh telling of the story, with fresh questions to change the way you tell your story and hear your story as you tell it, creates fresh discoveries.
Everyone needs some help once in a while to solve a tough situation in new ways. Ask around. It’s smart to ask for help to see into your blind spots.
Try asking for a fresh idea.
12
Therapy is expensive
I’m biased and I know it.
I’ll be transparent about my opinion of the cost of therapy at the outset:
I think the value of therapy is a little like those credit card commercials where they show how much the beach mat cost, how much gas cost to get to the beach, the hotel rate, how much the umbrella and sand toys cost, announce the price of the overpriced hot dog and lemonade and then they show the unbridled joy in the toothy grin of a preschooler whose body has sand in every conceivable crevice. All this is wrapped up with the caption: “Priceless”.
You can’t put a price on therapy when it changes your life course, gives you peace of mind that you haven’t had before, or decreases the tension in an important relationship. The value of therapy is priceless.
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Some of you will be fortunate to have low cost or free counseling services available to you, perhaps through your Employee and Family Assistance Plan (EFAP) at work, or through the school counseling services or the local clinic. Some of you have the patience of the biblical figure of Job and will wait a ridiculously long time in the queue until your name comes up at the local free clinic.
There will be others who have the financial abilities to invest in good therapy as chump change. When you don’t have to budget the cost of therapy into your life, that is indeed, a privilege!
But for everybody else, therapy is pricey! The rest of us, should we choose to invest in it, do some serious budget development as part of figuring out how to make it work. And sometimes, for many of us, the cost of therapy is exorbitant. And it may be simply too much.
Years ago, when my children were in elementary school, my husband at the time went through a fall on the ice, had a difficult winter, and at the end of it, decided he needed to make his own home away from me.
I felt like I had been hit by a bus. I craved a six-month coma as I sought to avoid the intensity of the pain and terror I felt every second of every day. I was facing life without the man with whom I fully intended to grow old. The distress took a toll on my body: I lost 30 pounds; I woke up with a pit in my stomach at about 4 in the morning most days and couldn’t fall back to sleep.
My life frightened me.
I was single parenting children who were experiencing their own real turmoil. I was in over my head. I needed some perspective that a therapist could give me.
I was working in private practice as a therapist at the time. Trust me—I did my best to pull myself together during the day to give my clients my very best therapeutic work. Every day I worked with people who paid me good money and invested time to do quality therapy. I took that seriously and was deliberate in putting my troubles off to the side to enter the world of my client for the hour. I like to think I became more compassionate towards the pain of my clients.
And every day I thought to myself: “I desperately need a therapist of my own right now. But—I can’t afford me.” I had expenses for a house purchased with two incomes in mind, children who had music lessons and growing feet, and now lawyer bills. That was a stark reality for me when I knew I couldn’t pay for the counseling services I needed and that I provided to others.
I got resourceful and looked at alternatives. It was an undeserved grace to be allowed to work with an excellent therapist that had public funding. I could only go about every 6 weeks, given the heavy demands of his schedule. But the therapy I received that season from him over about a half dozen sessions provided some real grounding and support. My fantastically loyal friends couldn’t and wouldn’t have had those conversations with me.
Sometimes, you need people to express the hard things to you—which supportive friends may shy away from. My therapist challenged the way I saw things in ways I never would have heard the same way from my friends. It was wonderful to have had several sessions with him. Priceless, really. There were a few comments he made that helpfully echoed in my head for years.
I am grateful. And my gratitude has shaped my practice. I provide a lower cost option at my private practice. (We engage an intern for that work.) Personally, I provide a limited number of spaces myself for reduced rate therapy as part of paying it forward. I think it’s important for a therapist to make therapy possible for people who lose their jobs or suddenly find themselves looking after a full family on half the income when a spouse leaves.
Most of us have to make sacrifices to make therapy fit in the budget. Fewer meals out. A cheaper vacation. Maybe even no vacation. We need to plan and budget because good quality therapy isn’t cheap. There may be times and places where the therapy is funded, but someone is always paying hefty amounts for therapy.
Therapists go to school for many years to develop and hone their craft. After graduation, there is ongoing professional development. Therapists spend many hours of clinical supervision with a more experienced therapist to further develop their expertise and uncover blind spots as they are working. Therapists are expected, ethically and often legally, to be a lifelong learners. This means that therapists sign up for professional development courses online, locally, or sometimes across the country. This keeps your therapist fresh and invigorated, up to date with the latest evidence in the research and current with the latest developments in clinical models. Therapists work to be at the top of their game to better serve the client.
In short, therapy is expensive because therapists receive training at great expense—and they have mortgages, grocery bills and utilities like anybody else. Add to that, the therapy almost always happens in a room that requires heating/cooling, lights, rent, and administrative support. There are few therapists that are dripping in diamonds and I don’t know any with yachts or private islands. The therapists I know have worked hard, often at great sacrifice to do the meaningful work that they get to do.
(As an aside, there are lots of professions that may be more financially lucrative. However, I am honoured to have a front-row seat in the lives of folks who yearn to connect more meaningfully with themselves and others. I have a career I wouldn’t trade for anything!)
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With the substantial cost of therapy, often folks work to get by without it. They talk to friends, read books, surf the internet for good resources. These can be excellent and be the assistance some individuals require.
However, when:
your marriage is falling apart
your son barely acknowledges you exist
your depression is so crippling you may soon not be able to get out of bed at all
your anxiety is so high you now have anxiety about how much this is stressing your body
you are new in town and don’t have deep friendships to share hard stuff with
relationships of depth are something you want, but don’t know where to start, and you’re lonely and there is no one you can talk to about it.
Self-help resources may not be enough, and it makes sense to figure out a way to get yourself on a therapist’s couch. We were meant to work through our internal stuff in connection with another. We do better in community.
You might be doing the best you can, and it may even be working to some extent. The relationship is struggling, but often folks are creative, and do some work-arounds:
Your wife really isn’t happy with you, and is threatening divorce, but you take on extra projects at work. By working more, you increase your income which makes her happier. Your being out of the house decreases the tension that exists when the two of you spend too much time together
The relationship with your son is lousy and the only time the two of you seem to talk is when he feels that you are criticizing him
for something. So, you stop harping on him, and let him play video games until all hours of the night and sleep all day. He rarely leaves the house.
The depression feels terrible, but if you stay busy and productive enough at work, it pushes those feelings of feelings of self-hatred away. The boss likes your work and the odd tidbit of praise can keep you from drowning in the sea of hopeless and helplessness—as long as you find a way to stave off complete exhaustion.
The anxiety feels oppressive and full-on anxiety attacks often seem at the edge of possibility. However, when you smoke weed, the edge of it gets taken off and life is liveable again. There is no risk of anxiety attacks when high on pot, which is nearly all the time now. There’s not much chance of getting employment either.
Sometimes something works but isn’t a sustainable or realistic solution.
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I was at a parking lot in a shopping center a few years ago, when a Good Samaritan passing by let me know that the passenger side rear tire was low. I don’t go around that side of the car really and so I really appreciated his noticing and telling me.
He was being polite. It wasn’t just low.
I think it was close to flat. I drove slowly and carefully to the gas station close by, and they filled it up for me. They checked to make sure it had the right pressure. The gas jockey let me know I should check it frequently over the next while in case it had a slow leak. The other tires had normal pressure when we made sure they were OK. (Well, not we, it was actually him.)
I checked that freshly pumped tire several times over the next few days and it looked OK—for a while.
About 5 days later, the pressure had dropped to about a 1/3 of what it should be. I went to another gas station and filled it up again. I knew what to do this time.
The next day, the air pressure was visibly lower. So, I searched for a gas station filled the tire up with air.
The car was good to drive. It was perfectly safe to drive, except this filling up the tire with air was getting to be a bit of a pain.
It started to need me to pump air every day and a half or so.
As I was going about my day, I was driving slowly by gas stations to check to see if they had an air machine. My thoughts while driving, even while listening to the news, or singing tunes, or chatting with the person beside me, frequently went to that passenger side tire.
That tire preoccupied my thoughts. I was wondering about the tire pressure whenever I was in the vehicle: "Was it low? When had I last checked? Was I being overly pessimistic and concerned? Was I being overly optimistic and had overlooked the sponginess of the tire?” I started circling the car every time I got in. The car was safe to drive, and I was keeping it safe to drive, but this was no way to live.
The tire was where it should be—it was full and operational—but the strategy I was using was costly. It increased my vigilance and created hassle as I searched for the tire gauge and found a pump.
It worked, even though it wasn’t really working.
I took it in to a tire shop, and the mechanics there had it fixed in a couple of hours. They found a nail. They patched it. Done. $22.
I could have just kept filling the tire with air when it needed it. That was free.
It would’ve been cheaper. But it would have been more expensive to my mental and physical health to keep filling it with air. This occurred in the middle of a Canadian winter! Who wants to be filling tires in snowy weather?!
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By now, you understand that this story isn’t about tires.
I work with couples who have been filling the air in the tires of their marriage desperately—trying to make it move forward safely, but at great personal cost. It’s difficult to address a marital flat tire with Band-Aids, though I’ve heard stories of people trying. They put in a ton of effort for not-a-lot of results.
A husband hears his disgruntled wife grumble about him, and so starts spending more time with the guys. He stays home one night a week with the kids so she can go out with her girlfriends. It sort of works. She’s happy when she gets out with her friends, and he really enjoys the stress-free time with the guys. But the disgruntlement between the two of them always returns.
A wife sees her husband pulling away and is distant. She buys a new negligee, gets a babysitter, and gives him a night he won’t soon forget. He likes it but it doesn’t last. Two days later he has pulled away as far as he has ever been.
I’ve worked with individuals too, who solve slow leaks in the tires of the lives in ways other than finding the leak. They bump along with a strategy that makes it better for a bit by
going shopping—all of life’s troubles disappear when you rock a new pair of pumps
going on-line to view endless amount of porn, fantasizing about intimacy with another while completely pulling away from real connection in the real world,
drinking too much
using perfectionism to drive away that “not enough” feeling
Ultimately any of these leaves a person feeling lonely and empty and back where they started. The tire of life is still leaking fast—or flat.
What do you do to deal with the pain, anxiety, depression, loss, fear, trauma, or broken relationships in your life?
What strategies do you use to get through the day?
How much do your strategies actually cost you financially? Psychologically? Relationally? Emotionally? Spiritually? Physically?
Is it worth it? Can you afford not to go to therapy?
The patch cost $22—the air was free.
It cost me an afternoon—instead of 5-7 minutes at a time (multiple times).
To be clear, in the long run, when I measure my quality of life, the patch was immeasurably cheaper.
A therapist might truly be priceless. Especially because that way you’ll be able to stop spinning your tires.
(Sorry, pun was intended!)
13
I might cry
There is something about our culture that has people feel that crying in front of others should not happen. Typically, when someone feels the urge to cry when someone else is around, they seek to stifle the feeling. A person feels the lump at the back of their throat, or senses tears at the back of their eyes and the automatic feeling is to push it down. Maybe that person distracts themselves by changing the topic either in their head or out loud, or by forcing themselves to switch from that which triggers tears to something that is lighter or more neutral.
Then, if that the person is unsuccessful, if a person’s eyes fill with tears that threaten to spill over despite their best efforts, what happens next?
Yes, you guessed it—the apology. Almost immediately people express an apology for crying.
A person, starting to cry in the presence of others, almost always says: “I’m sorry”, as if they have made a mistake with crying. It is as though the tears are offensive and hurtful to the other. As if crying is wrong.
Many people avoid crying even when they are by themselves. Even when there is no one to watch, they stand in judgement of themselves. Somehow, many view crying as a flaw, or a weakness and something to avoid. Crying is somehow seen as frightening. It is as though the act of crying will somehow create cracks in a person’s wellbeing and create mental instability.
If the world sees crying as so dysfunctional, I can understand why people wouldn’t want to go to therapy.
Fear of tears is one reason people avoid counseling. A person often has an inherent awareness that once they allow themselves to go to internal places long ignored, the tears will materialize. Clients let themselves acknowledge the pain of hurts long ago—of schoolyard bullying, the judgement of a parent, or moving away from childhood security. When, at last, a person give voice to the sadness that is otherwise pushed down every other minute of every other day, tears are freed to emerge. Somehow saying it out loud heightens their impact. When you talk about what’s inside, it’s as though you give it permission to be. When you name an emotion, it is a gift to
the part of you feeling that emotion. The act of naming a feeling often gives that emotion permission to be more felt.
It is not uncommon, even in the first 5 minutes of the first therapy session, as I acknowledge and honor the courage of the client sitting across to me, that chins wobble. As I let people know that doing the difficult work of showing up to name and process something in their life that isn’t working is admirable and courageous, their eyes get red. If the light is just right, I can see the extra glistening in their eyes of tears collecting at their bottom lid.
Immediately, I can see the steely-faced efforts to make the face to stop the chin wobble and put the tear ducts on ice. People look up to stop the tears from escaping their eye balls. They look away to decrease the intensity of the moment, to allow themselves to regain their composure.
Yes, that’s it. Composure. What’s so scary about crying in therapy is that a person might lose their composure. Even the term, losing your composure sounds vulnerable. No one likes to lose anything in front of anybody. How much do people hate losing their ability to look like they have it all together?
Enough to make sure they don’t cry in front of others—including a therapist. For some, that’s sufficient reason to say, “Nope” to therapy.
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Don’t we all hate when other people can see us struggling? Is there a bigger indicator to struggle than tears? It feels so vulnerable when other people can see our softest, most tender spots. Crying leaves a person feeling so exposed.
Hell No to Hmmm, Maybe Page 10
