#MentalHealthMatters Part 4: Why To and How To
The largest disconnect in getting mental health taken care of is not seeing mental and emotional health as crucial to our overall health. When we hear the word health, we all imagine different things. Some of us probably picture the absence of aches and pains throughout our bodies. Others might think of being able to have a peaceful night's sleep free of pain or insomnia. Furthermore, others picture being in perfect shape with toned muscles. In this same way, we might see our mental health in different ways. Different types of conditions can affect us mentally in the same way they can affect us physically, either acutely (temporarily), or chronically (long-term or permanently).
The Spectrum of Mental Health Problems
It is helpful to think of mental health problems as a spectrum that ranges from unhealthy relationships and thought patterns, all the way to acute, life-threatening issues. Here are the various stops on this spectrum:
Poor Relational and Emotional Health
These may not be specific diagnoses, but would be like an unhealthy relationship with a significant other, friend, or family member. The physical equivalent to this might be knee or back pain that bothers you occasionally, or allergies. Some simple, brief treatments can bring relief in a reasonably short time. Some mental health diagnoses here might be mild depression or mild anxiety.
Mental & Physical Disability
These are tangible structural problems in the brain or body that significantly limit the ability of a person to function in the way that most people are easily able to function. (I.e Intellectual disabilities, down syndrome and physical disability such as Cerebral palsy.
Chronic Mental & Physical Illness
These are diseases which make us susceptible to our environment or limit how we can live our lives. Mental examples of this can include Schizophrenia or Bipolar Disorder. Physical examples of this include Sickle Cell Diseases or Diabetes.
Acute and Contractible Mental & Physical Illness
These are conditions that can develop over time due to a variety of adverse circumstances which can become life-threatening if left untreated. Mental examples include strong suicidal thoughts and plans in Depression or Bipolar disorder, and physical examples include pneumonia following a cold or flu.
Emotional and mental health require hard work just like our physical health does. We can grow emotionally "out of shape," which can result in poor or declining relationships, or mental illness on the spectrum listed above. This begs the question, how can we get into good mental and emotional shape? What is the emotional equivalent of going to the gym? How does one go for an emotional power walk? This is where therapy comes in. When one commits to therapy, it takes the same decision and commitment to results that one would be need to get into good physical shape.
We have all seen the scene of the leather couch, and the image of telling our deepest darkest secrets to a stranger scribbling on a notepad, asking about our mothers. We wonder how can it be useful to have someone stare and you and possibly judge all your deepest fears or sins. There is large scale mistrust of this image in our society. We are often wary of therapy, largely because we are afraid of the process, but mainly because it involves vulnerability.
Vulnerability is largely considered a sign of weakness in our culture today. Being emotional is looked down upon, and we often look up to protagonists in shows and movies who refuse to grieve or cry at a loss and keep on fighting. It might help to think of vulnerability like surgery. When your body is open on the operating table, you are ultimately vulnerable. In this moment, the slightest microscopic infection can kill you. There is great risk, but very often, cutting you open and creating this vulnerability is necessary to save your life. Therapy is just the same. Your heart is open in session, but this needs to happen in order to heal you, repair your injuries, and evens save your life.
Barriers to Therapy
What are some of the things that prevent people from going to therapy? Some of the practical barriers include the following:
Many don't go to therapy simply because they are unable to afford it. Depending on your insurance, copays per session can be as high as $100! Furthermore, not too long ago, most insurances did not cover mental health services whatsoever.
Some solutions to this can include seeing a therapist that offers a "sliding fee scale." A sliding fee scale is a way of charging for services based on income, where the less money you make, the less you would need to pay per session. I have seen out of pocket costs as low as $5 per session as a result of this scale.
Another option is an online therapy service like Talkspace or Betterhelp. These services can be much more affordable than your copay.
Finally, find out if you are eligible for Medicaid. If you have Medicaid, then you will be able to receive mental health services at little or no cost. It's hard to say if you are eligible as requirements vary from state to state.
More of us than ever have access to affordable therapy, but what about time? Between work, children, and other obligations, many of us aren't able to attend therapy sessions every week between 9am and 5pm.
Some options once again include online counseling. Some options include counseling by text, which you can do while working on other things, or video counseling, which is often available on your smartphone. There are more options than ever to help you fit self-care into your busy schedule.
A more traditional option would be to find a counselor who is available after hours. Many private practices and agencies are open late one or more nights per week, often to 7pm or 8pm. A search on Psychology Today may help you find a therapist with a convenient schedule for you.
How to find a therapist
Most studies state that the biggest indicator of success in therapy is the quality of the relationship between the client and the therapist. This obviously makes it important that you be able to find a therapist that you are comfortable with. Feel free to ask for recommendations from people you trust, who may have told you about good experiences they have had with therapy. Psychology Today is the biggest resource in finding a therapist that allows you to filter by gender, specialty LGBTQ-affirming and other filters.
What to expect
Most therapists or agencies will take some basic demographic information such as name, age, gender, and insurance, if applicable. The first appointment will be an intake or assessment where you discuss what brings you into therapy. Some therapists will ask questions from a checklist in order to fill out a form, while others may do so in a more conversational manner. At the end of this session, which usually takes about an hour, you will then schedule for your desired frequency - weekly, biweekly, monthly, etc.
Each therapist varies in style. Many will simply sit back and follow your lead. Others may be more directive and will lead the process. What happens depends on the diagnosis, the therapist's theoretical background, and the therapeutic practice being used in your case.
How to engage in therapy
You get out what you put in. So, how can you put in as much as possible? Be as open as possible. Don't hold secrets or tell only a portion of your stories. If you are worried about being judged, remember that you are literally paying them not to judge! Even so, if you feel judged, address it with the therapist or get a new one. Do your best not to let your discomfort keep you from using this resource to improve your life.
How to heal
Healing is a long, winding road. But, by asking your mental and emotional health a priority, and taking the steps to be free from negative thought patterns and past hurt, you can live a healthy life. You can live a great life. We would be excited to hear about your journey. Contact us on Instagram or Twitter. We wish you the best in your journey!
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