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Health

This Is How One 28-Year-Old Manages Pain and Anxiety

To cope, I go on shopping binges. I work myself past exhaustion. On the positive side, I go dancing with friends. I host a drawing night to build community and foster creative energy. I make art, I listen to music.
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Image: Lia Kantrowitz

Ah, 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.

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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.

To submit your experience to the therapy diaries, answer a few questions here.

Robin Borre, 28 Austin, Texas

Are you in therapy now?
Yes, I am. I’m in individual psychotherapy for myriad reasons, including anxiety, reimagining coping strategies, unpacking past trauma, gender dysphoria and pain.

How often do you go, and how much does each session cost?
I go once a week. I pay between $30 and $50 per session. She offers sliding scale. She also works with a collective of sliding scale counselors called Open Path that requires a one-time membership fee ($50) to offer a lower tier of sliding scale. I researched extensively to find a counselor with expertise in the areas I needed guidance, who I could afford.

Does your insurance help pay for this?
They do not. She is out of network. The network offered is limited, and I would still pay more per session [if I used it].

Has the cost ever deterred you from seeing a therapist?
Absolutely. The financial cost as well as the convoluted process of finding the right therapist has been a significant barrier. Presently, the burden to accessing care is placed on those who are seeking care, who may not have the emotional energy to find affordable options, much less cross the threshold and begin the actual healing process.

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What alternatives have you turned to in the past?
I have developed many coping strategies, some of them harmful and some healing. Drugs and alcohol are relatively inexpensive and accessible. I go on shopping binges. I work myself past exhaustion. On the more positive side, I receive sliding-scale acupuncture for pain and anxiety. I go dancing with friends. I host a drawing night to build community and foster creative energies. I make art, I listen to music. I go hiking or go for walks. These work for me, but presenting in public as gender nonconforming always carries a risk, and with that risk, stress.

What would you be spending that money on instead, if insurance actually covered therapy?
I spend about $300 per month on counseling and acupuncture. If I had that money to spend otherwise, I would begin occupational therapy (similar to physical therapy) to reduce pain. If insurance covered that as well, I would spend my money on fresh local produce and food. I would nourish myself and my friends. Whatever is left over I would save so that I could send it to friends or use it myself on an emergency.

When you're able to do it consistently, how does being in therapy make you feel?
When I’m consistently seeing my counselor, I feel grounded. I feel connected to myself and to my loved ones. I know I can support the people I love. I feel I can make choices and be adaptable to the situations that arise. I am beginning a new career entirely outside of my comfort zone. Having the support of my counselor, I know I will succeed.

This interview has been edited and condensed for clarity.

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