It’s Black History Month still! And I want to introduce you to a sex therapist and sex educator whose work you may already know. She and I talked not about race but about therapy. What is it, who is it for, what happens, and should you try it?
The first thing to know about therapy, says Dr. Oriowo:
“It doesn’t mean there’s something wrong with you, it means that the way we have been living is very adaptive… until it’s not.”
And it can help with non-romantic/sexual relationships, including non-family relationships. Yes, you can go to therapy with a friend, to help resolve a problem between you, and that’s one way that therapy can improve your friendships. But therapy is good for your friendships in another way:
If you’re experiencing intense distress over a problem and you just cannot find a solution, there may be a limit to how much support your friends can provide. Maybe the problem is beyond their knowledge and expertise. Maybe they’re already overwhelmed and they can’t take yet another conversation that just goes around and around and never gets anywhere. It’s okay for a friend to set a limit and say, as Dr. Oriowo puts it, “I don’t have what you need right now. No, I don’t want to talk about this for the 1,682nd time.” That’s a healthy boundary for the relationship, and if it leaves you still needing more support, then: THERAPY.
That clinical knowledge and the one-way dynamic make all the difference between just a conversation with a friend and therapy. “You get to talk about those deepest darkest things that you feel like you can’t say anywhere. It’s the place you can say the thing, whatever it is, and you can ugly cry, and no one is rushing you. In here, your trauma is not a burden, it is a privilege for me to help you with it. But a therapist is not a person who’s just offering friendly conversation or even sisterly advice. Therapy is work.”
So what actually happens in therapy?
Well, the first session (or two or three) is what Dr. Oriowo calls “the getting-to-know-you space.” She told me, “I ask about a client’s expectations. I have to determine whether or not I can meet the need you bring into therapy, not just the problems but also the way you would like it.”
Therapy is very much about “fit,” whether or not this is the right person to help you in this moment. Therapists are trained in this process and will never take it personally if you decide they’re not the right person for you. In that case, they’ll often be able to refer you to someone who might be a better fit for you.
And when you find a good fit, then you get to work.
A surprising amount of the work is not about solving problems or “fixing” a client, but about helping the client to see themselves with compassion and kindness. As Dr. Oriowo puts it, “My job as a therapist is to help people stay still and be with the greatness they already have. Because what would you do with the extra time if you already knew you were the shit? What if you already didn’t have to earn it?”
And when there’s more than one client? “When it’s a couple or a polycule or friends, the processing looks essentially the same, but you get real life, in the moment, coaching about how to have a disagreement. You say the thing you want to say, they get to hear it, and sometimes you say it to me and I’m going to ask you to say it directly to them.”
And then eventually therapy ends. When?
“When you’re done with therapy,” Dr. Oriowo said playfully. “Because we’re having a conversation about you getting the fuck out!”
We should talk about the money part of therapy. Oftentimes people think of therapy as something that rich, worried white people do, because they can afford the time and money to pay someone to sit there while they complain, or else it’s for institutionalized people who can’t fend for themselves in the world. Both are true sometimes. But therapy is also for middle- and low-income people who are struggling in their lives.
Are you worried about not being able to afford therapy? Many therapists offer sliding scale fees, and you don’t have to have appointments every week. If once a month is what you can afford, you and your therapist can find a schedule that works for your mental health and for your budget. Therapists like Dr. Oriowo participate in collectives like OpenPath.
And let me add to that: Medicaid. After I finished grad school, I needed several months without a job to recover from my exhaustion. During that time, I had no insurance. With my mom’s support, I got signed up for Medicaid, which covered therapy, psychiatry, and medication. This was long before the Affordable Care Act and the extension of the age at which young people could be on their parents’ insurance. Now more than at any time, therapy is accessible to people who didn’t think they could afford it.
And it’s worth the money. It can literally save your life.
These days, rates of mental health issues, including depression and anxiety, are vastly higher than they have ever been. The pandemic is not just a pandemic of COVID-19, it’s a pandemic of all the isolation, helplessness, uncertainty, and frustration that result from our efforts to cope with COVID-19. This distress also brings with it relationship difficulties, including an ongoing rise in divorce and slowed rates of marriage. People need help! Therapy is help! It’s good to get help!
Who doesn’t need therapy? Dr. Oriowo says, “If you feel goooood about what you’re doing and you don’t feel guilty for feeling good, you’re exactly where you need to be.” But it’s so much rarer an experience than it should be. Says Dr. Oriowo, “Women and people of color have been taught that they have to suffer. Black people that they have to work twice as hard for half as much.”
Should you try therapy? If you’re asking yourself whether therapy might be for you, it’s probably worth a try.
And if you’re worried about other people having opinions about you getting therapy, or you’re worried about people thinking you should be making different choices in your life, here’s one last word of wisdom from Dr. Oriowo:
Stay safe and see you next time.