Cheap Adjuncts to Therapy
When current rates for therapy might break the bank, there are alternatives.
Posted January 4, 2019
Perhaps this scenario is familiar. It’s the beginning of a new year and you’re finally ready to make some real changes. Sure, it sounds cliché to many, but once the hustle and bustle of the holidays are over, the new year really might be your chance to get some space and make some big changes. You get ready to check your mental health insurance benefits, and sure enough, your deductible has just started over again, meaning you are paying full-fee astronomical prices out of pocket. Or everyone who takes your insurance is not taking on new patients. Perhaps you go to your old therapist and they are already booked solid, or worse, moved out of the area!
While of course as a therapist I will always see the value in therapy, the truth is there are numerous adjuncts I regularly prescribe that are as effective—if not more so—than weekly therapy. For clients with anxiety, active tools must be practiced outside of the office. For clients with depression, sometimes the activities I suggest involve seeking out others and connecting even when it feels forced. The processing that happens in therapy can certainly be irreplaceable, but when it comes to lifting mood and getting back on track, there are countless alternatives worth considering.
1) Self-Help Books
While many feel cheesy perusing the bookshelves in the “self-help” category, fortunately online sellers such as Amazon allow you to be discreet and read reviews. The self-help category has truly blossomed over the last few decades in every genre and domain imaginable. Whether it is family woes, friendships gone sour, you’re looking for love or considering a career change or move, there is a book with your name on it.
As a writer of such resources, I can tell you that books written by experts are really written with you in mind. For example, I have a teen social media workbook coming out this spring; instead of just focusing on helping individuals get off of their devices, I was determined when writing the book to include the very best of every clinical tool I’ve ever used with clients, from sleep skills to finding the right exercise for your body type to cognitive behavioral therapy skills. It takes time and patience to read such books, but so does therapy. In fact, many times when I am unable to meet with a patient for a week due to a scheduling conflict, I ask clients to reserve what would have been our therapy hour and read a recommended self-help book instead. For a list of some of my favorite resources, click here.
Although I started practicing yoga back in college, it was actually a therapy client who introduced me to the free online videos of Adriene Mishler, known for her Yoga with Adriene series. While of course there are numerous others out there, I have been struck by the variety of tools provided by Mishler. She has yoga sequences specifically for depression, anxiety, trauma, loneliness, Seasonal Affective Disorder, as well as meditations. Her videos are often quick and highly accessible to all body types and she provides modifications in her instruction.
Ideally, one would go to an actual yoga studio with hands-on instruction and the psychological benefits of being around others; for many who are not feeling up to the task, a home practice can be a beautiful thing. In her narration for videos such as on loneliness and depression, Mishler allows space for emotions that may come up; this can be highly healing for one to do in the privacy of their own home without fears of breaking down in tears in a public studio (which teachers are in fact equipped to handle most times!). Again, yoga is another one of those interventions I am frequently recommending to clients, and finding the right fit and establishing a home practice can be very therapeutic.
3) Aromatherapy and Essential Oils
In recent decades, the “business” of essential oils has been booming. Companies such as DoTerra and Young Living are the modern-day equivalent to the Mary Kay multi-level-type marketing involving plentiful neighborhood women as representatives, offering samples from the insides of their purses or trunks of their cars. Of course, I do not promote, represent, etc. any of these companies. I name them only to say that as a part of their marketing strategy more light has been cast on researching the actual efficacy of essential oils. Of course like any drug-sponsored “finding” they will often be cast in a positive light; this has, however, led outside third party agencies to start examining essential oil efficacy. It is important to check with your medical provider regarding use of aromatherapy (especially the “therapeutic grade” oils which are highly potent, with a drop going a very long way).
However, the principles of aromatherapy stretch back to antiquity when botanicals were used from everything for healing a cut to hydrating the face. The calming properties of lavender and peppermint have been well-established as well as the mood-boosting elements from citrus scents. Oil diffusers are readily accessible on Amazon as are oils. Again, it is important to exercise caution; while we are not discussing illicit drug experimentation, the principles are not actually that disparate. Scents taken in through the nose connect directly to the brain, so being careful and consulting a medical doctor is important. Additionally, workshops can be a great introductory experience; I attended a few from my local yoga studio that were highly instructive (with no pressure to purchase anything!).
4) Spiritual Communities
In December, I finally had the great pleasure of completing Brené Brown’s Braving the Wilderness. As I slowly took in her wisdom and reflected on her messages, one of the concepts that really struck home with me was the idea of collective joy. She discussed the overwhelming feelings that overtake us whether we are at a music concert or worshipping en masse. While it can be unpopular to discuss matters of spirituality as many equate them with “religion,” the truth is that there are many positive houses of worship and forms of spiritual connection. I have chanted in yoga classes, sung in Catholic churches, prayed in mosques, and run in the forest and felt intense spiritual connection to the greater world in each setting. Some of these were group experiences, others solo. But Brown is right that communal joy is infectious and such an important part of the human experience.
When feeling depressed or disconnected from the world at large, it is even more important than ever to consider reconnecting to some form of spiritual community. It is worth noting that for some, traumas and negative experiences informed their earliest spiritual practices. This is of course heartbreaking. However, it does mean that individuals need to revisit those places and practices. Maybe chanting "Om" is the most natural thing, or the most out of place experience. Finding what works is important. Communal joy of course is not just experienced in spiritual settings; perhaps that is why some sports enthusiasts call their team or sport their “religion.” Regardless, consider community and consider spirituality.
5) Consider Coffee…Dates
It was only recently that I’ve had the incredible joy of reconnecting with my friends from around the country face-to-face and every month. It started with another one of my favorite authors, Mary Pipher, whose Reviving Ophelia it is safe to say inspired a generation of young female therapists. I was reading Pipher’s Writing to Change the World, and she repeatedly referenced her writing group. I was quite intrigued as she discussed her group of Nebraska women, together over the years, supporting one another, always each other’s cheerleaders. I tried starting a therapist consultation group a year ago, but that flopped.
I reached out to two of my best friends from graduate school who were both in the MFA program when I was getting my PhD in psychology. Although they are actually trained as writers, I crossed my fingers that they would take me into their club as an honorary member, and that we could have a monthly virtual writing group. Indeed, it has been a success so far! Once a month, we brew up our own cups of coffee or tea, adjust our cameras and do a Google chat. And it has been amazing! I say this as an introvert and as someone stuck in the 'burbs with no real professional or social community outside of the neighborhood moms, who although very kind are in a very different place in life.
A similar narrative is in fact one that many patients also report: They don’t want new friends necessarily (or can’t find them), and they have old ones that truly know them, but they have lost touch for any number of reasons. Meanwhile, research is constantly touting the benefits of social connection for everything from mood, to recovery from surgery. And yet, loneliness is at epidemic proportions. One of the easiest things that can make a huge impact in mood is taking that first step to reconnect with others.
6) Eat Healing Foods
Healing foods, not to be confused with comfort foods, is another important aspect of maintaining emotional well-being. Often when therapy patients see me for the first time, many aspects of their lives are out of balance. They aren’t eating properly, able to sleep, or exercising. In reality, all of these factors work together. Eating an ice cream sundae before bed may feel comforting, but the sugars are sure to keep you up all night. A restless night then naturally leads to grogginess, and any chance of making it to the gym is lost.
This is an over-simplification, but you get the point. When we are feeling badly about life, comfort foods are often the first go-to, but they also create a vicious cycle. That batch of cookies made more than one serving, and well, why let perfectly good food go to waste? The key is making changes that involve adding nutrients back in in the form of good old fashioned vegetables. Yes, not too exciting, but recipe developers and those hardcore vegans actually have some pretty good ideas on how to get you to eat more of your greens. Maybe you don’t have the energy for a total dietary overhaul, and that’s ok. But even if you just start with a healthy breakfast or add in a green smoothie, that’s still a big step.
Finally, don’t negate the importance of getting a good old-fashioned checkup with labs drawn. I’ve had many patients with sluggish energy and low mood that were not only suffering from depression, but also dangerously low levels of Vitamin D or iron. Food and vitamin supplementation can go a long way in boosting mood.
Although no one likes to hear it, there really isn’t any substitute for getting the heart rate elevated through some exercise. The problem that many struggle with (myself included) is they want to do too much too soon or are so perfectionistic that they don’t do it at all. For former athletes especially it can be a major ego hit when they quickly get out of breath or can barely touch their toes. Putting ego aside and celebrating even a quick 20 minute walk on the treadmill is an excellent place to start. Better yet, if you have a dog, get the bonus impact of fresh air and mood-boosting puppy love with the heart-healthy benefits of exercise. Slow and steady is really the key here. Some exercise is always better than no exercise.
At the end of the day, psychotherapy can be essential and life-saving, especially in crisis situations. Crisis hotlines are free and confidential and can often provide excellent low-cost referral options. Further, many therapists offer sliding scale services and waitlists eventually open up. So while this article aims to provide some options to use while waiting, it certainly does not intend to minimize the importance of regular psychotherapy and its benefits. Also, online therapy options and programs are becoming more widely available and accepted. Companies such as BetterHelp and TalkSpace provide low-cost therapy options for potential clients. So whatever circumstance you may find yourself in, there is always help available whether it is through therapy or one of the ideas listed above.