Why is therapy so expensive?

You have been feeling stuck and stressed. You have tried to fix your problems and asked for support from friends or family, but it feels like you only get temporary relief. You’re tired of being on the hamster wheel of trauma, anxiety, or depression and have decided to try therapy or counseling. You hop online and start to search for professionals in your area, and you find some that you think would understand you and be able to help you with your problems. However, it feels like all the good therapists you like aren’t affordable. 

You start to add up the costs in your mind and begin to feel frustrated and hopeless. This therapist must be making a killing! Isn’t this person supposed to help people? How can anyone afford this? Know that these thoughts are totally normal, but let’s take a step back and consider what you’re paying for. Remember, the service you get from a discount store is different from the service you receive at a high-end boutique.

Therapist’s background and training

A Licensed Masters Social Worker (LMSW) has a master’s degree in clinical therapy and counseling. Some clinical social workers even have a doctorate.  After receiving an undergraduate education, this degree required at least two years of schooling and fieldwork (working without pay). After receiving a Clinical Masters in Social Work (MSW) degree, professionals have to become fully licensed within seven years of obtaining their degree in order to practice in the State of Michigan legally. To tally up the years required to be fully licensed, we have four years of undergrad, at minimum two years of masters’, and an additional 2-7 years of on the job work. So, your social work therapist has experienced 8-13 years of training to obtain their full license. In addition to school and training, MSWs are also required to have supervision, state exams, background checks, and licensing.

After becoming fully licensed, there are continued costs of supervision and continuing education. You want your therapist to be educated on the latest research and practices to be sure you are receiving the best care. Some therapists go through additional training to earn certifications to provide specialized care to their clients. Training can cost thousands of dollars per year, and during this time therapists cannot see clients. Therapists also keep up to date on best practices through purchasing books and journals. So chances are a therapist you are interested in has trained long and hard to be able to provide the best care to you. 


Dedication to your healing

We have all had experiences of seeing health professionals and felt we did not receive the best treatment. Maybe they were running 30 minutes late and then made you feel rushed during your appointment time. Perhaps you did not think that your needs were met, that you weren’t heard, or that you didn’t get the best treatment. It is crucial that you feel respected, understood, and that you are receiving the best services.  

A good therapist will be choosy about whom they see for therapy. Therapists should only take on the people they know they can help. No therapist specializes in everything, and so choosing clients who are a good fit is essential to make sure you meet your therapeutic goals as quickly as possible. If someone isn’t a good fit, a therapist will often try to provide you with resources and referrals to be sure you do get the help you are looking for. If you feel disappointed that a therapist does not feel you are a good fit, it can be helpful to reframe this experience as, “This therapist cares about me and my wellbeing, and feels there is someone who will help me start feeling better.” This is actually an act of love and respect and not rejection. 

It may seem like you’re paying a lot for a 50-minute session, but there is a lot of behind the scenes work that goes into your sessions. Outside of your session, your therapist may be engaging in supervision, working on your treatment plan, and tracking your progress. Also, if a therapist takes your insurance, there is additional documentation needed that is required in meeting insurance standards. So even when you’re not in the office, your therapist is working for you. 

Finally, seeing too many clients, feeling overwhelmed, and having trouble making ends meet can cause therapists to resent their clients. This would result in a waste of your and the therapist’s time. A therapist that understands and respects their own needs will be able to provide better services to clients. 


Multiple hats: Being a therapist and a business owner

Therapists who own their practices are also entrepreneurs and wear the hats of managers, billers, receptionists, administrators, and other office staff. Therapists who run their practices are also responsible for the overhead of a business, including rent, liability insurance, phone, Internet, fax, websites, marketing, electronic medical records, and assistants or medical billers. Solo practitioners have more control over the care they provide, which allows them to focus on specialties and offering unique services. Although this may seem like an extra burden, those who venture out as a solo practitioner often feel very passionately about the care they provide and do not want the constraints of working for someone else. For example, if you were interested in walk-and-talk therapy, you might have to find a solo practitioner because it might not align with the values of a group practice and insurance may not cover it. So, a therapist might cost more than other therapists due to the level of service they are trying to provide. 

Your comfort is the foundation for healing

Your comfort is a priority when it comes to healing work. If you don’t feel comfortable, it’s going to be incredibly difficult to get the desired change you want. Here are some things to consider: How does the office look and feel? Does the therapist have any extras in their office to make you more comfortable such as coffee or tea? If they have a specialty, do they have any specialized equipment, furniture, or other items that other offices might not provide? Any amenities that offer you increased relaxation and comfort are helping to create the space for you to heal. Also, when therapists have specialties or certifications it can help give you the peace-of-mind that you are seeing someone who is trained, experienced, and passionate about the work they provide. 

More about Elizabeth Eiten, LMSW, CCTP

I want to give you a better understanding of my education and dedication to your healing journey. I am fully licensed in the State of Michigan as a Clinical Social Worker, and I am also a Certified Clinical Trauma Professional. I am passionate and dedicated to the work that I do and the people I chose to work with. All my practices are evidenced-based, solution-focused, and individualized to your unique strengths, values, and needs. To read more about me, check out my bio. I am also a solo practitioner, which allows me to provide unique services such as meditation training and outdoor therapy at our office. Outside of the therapy office, I also offer meditation workshops and training. 

In my office, I see fewer clients because I want to make sure those who seek my services are getting my full focus and attention. I could see more clients for shorter therapy times, but you wouldn’t be getting the best care (I also might have trouble remembering you!). However, when I charge slightly more and see fewer people, I have space to honestly know and understand you while providing the best care possible. With this said, I care very much about the people who visit me in my office and want to make sure they feel safe, respected, and that I am giving them my best energy. 

If you are ready to commit yourself to getting unstuck, contact our office today for a free 15-minute phone consultation at 248-291-7322. 

For Those Who Don't Celebrate Mother's Day

Dear brave soul,

You feel the mixture of sadness, anger, guilt, and dread that comes this time of year. It starts with the ads: flowers, brunches, treats, and presents. The pressure is on with so many ways to cherish your mother.  Someone asks you about your plans with your mother for Mother’s Day. It feels awkward and embarrassing to share that you’re not doing anything with your mother. The shame starts to swirl within you. You wonder if there is something wrong with you for not talking to your Mom. You start to feel the impending day quickly approach. A day where everyone is busy and you’re stuck wondering what to do with yourself. You’re stuck oscillating between wondering if you’re really the one to blame for not having this relationship, or if this is how you can stay safe and sane.

Many others don’t understand the pain that you have experienced in the decision to not have your mother in your life. For you, it is a choice of safety and survival, and not one of spite. Your mother may have been painfully cruel and abusive, and remaining in contact with her could cause psychological and even physical harm. Our “get over it” culture is toxic. You are not expected to sacrifice your feelings for others. It’s not your job to sooth other’s discomforts about your completely healthy decision. Anyone who is uncomfortable with your decision needs to look within and ask themselves why they would ignore your pain and suffering. Your energy should be focused on your healing and wellbeing.

If you are someone who does not spend Mother’s Day with your mother because you have made the decision to heal, you are doing the right thing. You are making the decision to do something your mother never did for you by showing yourself love. Setting the healthy emotional boundaries you need to honor yourself is an act of courage. Not many others will understand it, but this is an act of self-love. The universe bows to you, honoring your healing and your unique path. Keep walking that path and you will meet others who will walk with you. The longer you walk this path the more the pain will seem like a dream because you have woken up—woken up to the wonderful, tender, and compassionate person that you have always been but never noticed.

This Mother’s Day, take the opportunity to nurture yourself in the ways you have always needed. Make a list of ways you would like to practice loving yourself more. Maybe you decide to replace your criticizing self-talk with gentle encouragement. Maybe you cook yourself a delicious and healthy meal. Maybe you take a walk and notice the beauty of the world through your five senses. Loving and treasuring yourself is a practice, and in this practice you share this love and generosity with others (even if it isn’t immediately obvious). The universe has many ways of saying “I love you” if we can pause and take a moment to notice.

If you know someone who is no-contact with their mother…

If you have someone in your life who has chosen to not have a relationship with their mother—honor that. Validate that they are wise, dedicated to their truth, and doing the right thing. Not only do they have to deal with the recovery from abuse, but also recover from the societal stigma of excluding that person from their life. It is harmful to live in a culture that puts more value on self-sacrifice than self-love. This value causes depression, anxiety, trauma, relationship problems, substance abuse, and suicide. If their experience with their mother makes you uncomfortable, take a moment to be compassionate toward that discomfort—maybe this is a way you can get a glimpse into this person’s painful experience and respect it. 

 

If you have a painful relationship with your mother, therapy can be an opportunity to develop love toward yourself, feel positive, and gain confidence. To go from surviving to thriving call today for a free consultation at (248) 291-7322 or email me for therapy and counseling in Bloomfield Hills, Michigan.

Free Yourself from Anxiety's Web

Most days you wake up feeling exhausted and on edge. Your overwhelming thoughts are causing you to be distracted and worried. You're really hard on yourself and feel defeated. It feels impossible to control your worry. Throughout your day, these feelings continue to escalate to agitation, sadness, and even panic. You feel tense and struggle with other health problems caused by anxiety. People in your life see your struggle, but they don’t know how to help you. You’re not interested in taking medication and you are wondering if there are natural ways to deal with your anxiety.

You can overcome anxiety. Our thoughts are just thoughts. They are not the truth or reality, and anxious thoughts are your brain’s way of avoiding danger or discomfort. The truth is, our anxious thoughts were used for tens-of-thousands of years to keep us safe. The same anxiety that taught us to run from a lion is the same anxiety that comes up in our modern world. Our society has progressed faster than our brains evolve. Our brains might treat our fear of social situations the same way our brain would treat outrunning a lion. Sometimes our brains are just not very helpful when dealing with modern anxieties. Your brain is a tool for problem solving and uses language to problem-solve. If we are having anxiety about going to a party our brain might tell us, “Maybe I should not go because I have anxiety about meeting new people,” or, “Everyone is going to notice I am _____________ (insert negative self-talk here).”

Not only are you the only one experiencing these thoughts, but you are also feeling them! Anxiety thoughts start to trigger your body’s stress response and can send you into fight-or-flight. Your body can experience anxiety on the spectrum of mild tension to full blown panic, which would be helpful if you saw a lion but is in no way helpful in going to this party. These anxious thoughts are now invading your body making you desperate for any sort of relief.

In our search for relief, all of our unhelpful coping strategies come into action. Here we might be wringing our hands, biting our nails, or canceling our plans. At this point we are just running on the hamster wheel of anxiety plagued by our untrue thoughts, stress response, and unhelpful coping skills. All of this because our brain was trying to problem-solve our discomfort!

The truth is we can’t control our anxious thoughts, and trying to avoid or fix them can make things worse. Humans often try to grasp onto perceived “good” experiences and avoid uncomfortable “bad” experiences. This black-and-white thinking causes suffering. If we want to overcome anxiety we can’t do so by avoiding it or desperately looking to feel good, we have to learn to accept it.

Learning to accept anxiety does not mean accepting the distress that it causes. When we learn to accept something we are no longer fighting with it in our habitual ways. Imagine if you were standing in quicksand and you were trying not to sink. The worst thing you could possible do is to start frantically moving trying to escape the quicksand. Anxiety can be viewed in exactly the same way. If we are in the quicksand of anxiety and we are avoiding it, fighting it, and grasping for safety we end up just sinking faster. So, how do we stop sinking? To survive quicksand we have to do the opposite of what we instinctively want to do, which is to stop moving and lay down. To overcome anxiety, we have to do the opposite of what it is telling us to do. We have to start thinking about our thoughts, feelings, and actions as part of the anxiety web we get caught in.

There is no magic pill for fixing anxiety because at times we do need it to stay safe. Anxiety has a job and can be helpful when we are able to manage it effectively. Walking alone to your car in the dark and feeling a little nervous? This is not a bad thing; in fact, it is just a thing our body does on its own. If we can tell ourselves, “I feel nervous walking to my car, but right here right now I am safe,” we can start to ground ourselves in reality and calm our anxiety. Instead of watering the seeds of anxiety we can teach our brain how we want to respond to anxiety.

Here are some helpful strategies for working with thoughts, feelings, and actions:

  1. Having an anxious thought? Label it a thought. If your anxious thought is, “Everyone at the party is going to think I’m awkward.” Try, “I am having a thought that everyone at this party is going to think I’m awkward.”
  2. Implement calming techniques that promote loving-kindness toward yourself. Focusing on our breath literally calms the fight-or-flight area of your brain, so doing some mindful breathing or a guided meditation can help calm your brain and body. If focusing on your breath doesn’t work for you, then get into one of your other 5 senses. Maybe you have a healing stone you like to rub or enjoy the sound of ocean waves. Focusing on one of our senses can help us focus on the present moment and be less caught up in our thoughts. If your thoughts distract you, just notice you are thinking and return to your concentration.
  3. Get moving! Movement can be an excellent way for eliminating anxiety in our bodies, and exercises like yoga and aerobic workouts have been shown to help reduce anxiety. Feeling creative? Maybe you’d rather pull out the journal, guitar, or paints as a mindful activity to work through anxiety. Anxiety might be present while we are doing an activity, but it does not need to control what you are doing.


Although these strategies can be incredibly helpful for managing anxiety, sometimes we need some extra help. If you feel like anxiety is uncontrollable, overwhelming, and causing distress in your life, you can overcome it. Sometimes we need extra help from a professional who specializes in conquering anxiety so you can feel confident in working through anxiety when it arises. When we have healthy coping skills and feel confident, acceptance of anxiety comes naturally and overtime becomes easier to manage. Those who see me for anxiety often feel at the end of their therapy that their mindset is different in how they approach their anxiety. In their lives anxiety is less intense and more manageable, and they feel positive about themselves and their future.   

If you are ready to start feeling confident about managing your anxiety, call me today for a free 15-minute consultation at 248-291-7322 or e-mail me.  

 

Overcoming Childhood Emotional Neglect: The Path to Resiliency

Overcoming Childhood Emotional Neglect: The Path to Resiliency

If you have experienced emotional neglect, therapy can be an opportunity to nurture yourself in ways that were not provided to you in childhood or in current relationships. You can develop a positive sense of self, confidence, and know you are worthy of love and belonging. Just because these skills were not given to you in adolescence does not mean that you cannot develop them in adulthood with the help of a trusted professional.

Healing Trauma: A holistic mind-body approach

Those who experience trauma struggle with a combination of problems due to unwanted, abusive, and/or traumatic experiences. After trauma, survivors may experience depression, anxiety, PTSD, trouble caring for themselves, and relationship issues. Recovery from trauma does not necessarily result in being “free” of the traumatic events that affect you, but the opportunity to live in the present without feeling flooded with thoughts and feelings from the past. Trauma is not a mindset, but rather a physical, emotional, and spiritual illness.

In Bessel Van Der Kolk’s, The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma, he explores the biological effects of traumatic stress on the body including how trauma rewires the brain. As Van Der Kolk describes, “Trauma is not the story of something that happened back then. It’s the current imprint of that pain, horror, and fear living inside people.” For those struggling with PTSD the trauma continues to live in their body after the event(s). Trauma affects us psychologically, physically, emotionally, behaviorally, cognitively, relationally, and spiritually. With that said, psychotherapy needs to be holistic and incorporate mind-body therapies.

Dr. Nadine Burke Harris, who wrote The Deepest Well, explores how adverse childhood experiences can have lasting effects on human health. Childhood adversity changes human biology, which results in increased rates of heart disease, diabetes, asthma, and other illnesses. When our brain is constantly in fight-or-flight we produce toxic stress in our bodies. This toxic stress affects our mental health as well as our physical health.  Given this, treating trauma requires an integrative approach.

Survivors of trauma can exhibit the following symptoms:

  • Hypervigilence: looking out for danger, trouble sleeping, easily startled, angry outbursts
  • Avoidance: of certain spaces, thoughts, people, or objects
  • Reliving: nightmares, flashbacks, and triggers
  • Dissociation: feeling disconnected from the body and/or amnesia
  • Feelings of shame and problems with mood

Other symptoms of complex trauma may include:

  • Difficulty regulating emotions: feeling “out of control” when experiencing strong emotions
  • Trouble remembering large parts of personal history
  • Low self-worth, chronic feelings of shame or guilt, and negative self-talk
  • Not feeling a sense of self, or sense of self is dependent on another person
  • Trauma bonding, which is a strong attachment between an abused person and their abuser formed as a result of the cycle of abuse
  • Emotional numbing
  • Self-harming
  • Addictions

Healing from trauma is possible.  Occasionally, individuals may experience post-traumatic growth in the final stages of recovery. Working with a skilled and experienced therapist who incorporates a mind-body approach is essential to recovery. There are three stages of recovery in trauma therapy explored below, which are adapted from Judith Herman’s Trauma and Recovery.

Safety and Stabilization

The first step in this stage is developing an understanding of the effects of trauma and treatment. There are three main types of safety that are strived for in this stage:

  • Feeling safe in our bodies
  • Feeling safe emotionally
  • Feeling safe in our environment

This work includes learning new coping skills and learning how to manage overwhelming emotions. This stage practices living in the here-and-now. Survivors are learning to remember trauma as opposed to reliving it. This involves developing a safe living situation, a safe and stable job, and a support system. Creating safety is the foundation for future stages of trauma work.

Overcoming Traumatic Memories

There is grief related to experiencing and overcoming trauma. In this stage, we process trauma by putting words to experiences and emotions. It is not necessary or required to discuss details of traumatic events, however, memory processing can help eliminate triggers we continue to experience related to specific memories. Also in this stage, mind-body therapies are the most effective because trauma lives in our bodies as well as in our minds. When we make space and time to grieve our experience we can move past it to live more fully in the present.

Integration and Living in the Present

Over time, we begin to develop shame resilience and create meaningful lives. At this stage, survivors start to reconnect with the present moment and make choices about how to engage in their lives. Survivors challenge themselves in healthy ways to increase resiliency and create meaning in their experience. This is an opportunity to reconnect with people, activities, and other parts of life. As survivors start to live life in their healthy and present selves trauma feels further away.  Survivors develop an understanding that trauma has been part of their experience but is not who they are.