In this guide you’ll find some useful links, some names of clinics, and tips on interviewing therapists, psychiatrists and other forms of mental health providers. This guide is a hair long, but I tried to touch on most of the main hurdles and misconceptions to getting effective treatment or support. And besides…don’t we all need this? I mean, who hasn’t experienced 2020 as a dumpster fire of unrelenting fear, loss, heartbreak and disappointment? Who isn’t functionally depressed and worse off for it these days? Really, it’s self preservation for most of us at this point, not a luxury.
Due to social distancing, 98% of mental health services are entirely remote. That means you can choose from anyone in your entire state! A few benefits being— proximity not a factor in seeking the best fit with someone (more on this below); service prices for private practices outside big cities drop dramatically.
Things to consider including in your introductory email to providers:
-Preferred name and preferred pronouns
-1 to 3 sentences about what is bringing you to therapy at this time
-1 to 2 sentences on anything else you would like support around
-Price range that you can comfortably afford for minimum 1 session/week
-Whether or not you hope to bill through insurance or have out-of-network benefits
-Anything that needs to be considered with scheduling and availability
Some popular sites for private practicioners (likely your most expensive option):
www.psychologytoday.com – has lots of check boxes to narrow your search results; most popular advertizing website in North America
www.ManhattanAlternative.com – Affirming health providers for people with non-heteronormative, non-vanilla, and/or non-monogamous identities
Some NY community clinics and institutes – MUCH cheaper, still excellent services – (names may be a little different than what’s written here but that won’t stop Google from finding it for you).
-Pride Healing Center
-The William Allenson White Institute
-The Psychoanalytic Association of New York (PANY)
-NYU PostDoc Center for Psychoanalysis
-Institute for Contemporary Psychotherapy
-Columbia Institute for something like Psychodynamic/Psychoanalytic & Research – all very highly trained medical doctors+mental health providers = very tailored care at under $40.
-NYC Covid Care- free emotional/mental/spiritual services for essential workers AND/OR their family members
No doubt there are more clinics in major cities and most state who will provide low and/or entirely free services because it isn’t a financial burden for them to do so. They’re subsidized and salaried and have that capability built into their business model. Outside the city they probably have much lower demand for their services and current openings so you could be less likely to have to wait on a list. Could be worth exploring. You know best what you can reasonably and sustainably do right now, but good therapy doesn’t have to be a financial burden.
What is therapy in the 21st century?
It is an hour (or more, if needed) a week where it’s all about you and your needs. Whether emotional support is needed, a place to vent, or someone to problem solve with, therapy can be any and all of those things, consistently, with someone completely invested in you living your best life.
What is so special about that? I have friends or family for that.
Great! Love that! Therapy is very much a relationship with someone who genuinely cares about what is in your best interest (like a dear one would); but with whom you don’t have to protect their feelings, hold space to hear about their life or problems, or censor yourself in order to preserve the relationship. It is no longer just a place for people with severe disturbances, or who feel broken inside and cannot cope with life’s challenges. For 50 years, therapists have been diligently researching and applying what works for people to help them live their best life (the psychology of a happy, well adjusted life) and is no longer entirely focused on pathology. Now, it’s really for everyone, because who couldn’t use an hour a week where it’s all about them and their needs?
What is different about seeing a therapist vs other types of doctors?
1) YOU are the expert on your mind, your body, and your needs.
2) You can set boundaries like—”I don’t want to talk about X,Y,orZ right now.”
3) You can tell your therapist what is feeling helpful in your work together and what you don’t love, and they will listen compassionately and do their best to adapt the sessions to work well for both of you, but especially for you.
4) Your therapist is not afraid of your emotions, and won’t turn away from your emotional pain and suffering.
5) Therapists understand that working with someone is a lot like dating—in that, even if everything sounds perfect on paper, personal chemistry can only be tested by doing some work together, and it’s no one’s fault if it isn’t (and you probably shouldn’t stay with them if it’s not there and can’t be resolved ala #3). Chemistry here means that you feel safe with and want to tell them everything without holding back or censoring yourself because you know they won’t judge you– just feel compassion and empathy for you regardless of the content of your work together.
6) Therapists are entirely comfortable with being or hearing a “broken record”.
We don’t get annoyed when the same things keep coming up (let’s be real, your BFF has gotten fed up at times). That’s expected and natural in this work.
7) You set the pace of the work. You set the main agenda each week.
8) No bullying or threats to get you to change to meet their needs/expectations at their pace.
9) Every therapist uses different techniques, and has their own style and personality they bring to the work, so no two experiences will ever be the same no matter what. If you had a less than stellar experience in the past it was probably a bad fit with no chemistry. Keep looking!
10) You can do great work with a therapist, feel it get stuck, and work with someone new on different things you need support with. Totally normal! No therapist expects to keep a client on forever! In fact, a core goal of ours is to give you the support and tools and new coping skills you need to fire us! It’s ok if you want to come back to it in the future, too. None of us believe we are the end-all-be-all for our clients.
And if you do happen to recognize that you’re experiencing symptoms of depression that are disruptive to your life, I’d wager they’re like their own voice in your head— talking you out of taking action to treat it. That’s exactly how it do. It will never easily and willfully let go once it sets in. It literally rewires your brain and preserves its own persistence. An estimated 19 million Americans are experiencing symptoms of depression at any given time. But no one needs to live that, and that doesn’t have to be “just who you are” for the rest of your life. Effective and diverse treatments are available, and accessible–and doesn’t every little bit help? That pearl of wisdom works for way more than just fundraising.
Below are a few of my favorite worksheets for self-care and de-stressing. For more mindfulness and meditation exercises, check out my dedicated YouTube playlist here.
Good luck! You deserve this!
Tex Gibson, LMSW
Please feel free to share this information far and wide with anyone whom you think could be helped by it, whether or not they live in New York.
Earlier this week I was asked by a journalist at New York Magazine’s The Cut to provide comments on some questions about masturbation, fantasies we have during masturbation, and shame. As my clients know, this is a topic I have a LOT to say about! The article itself is a wonderful (and brief) sex-positive and pro-masturbation piece, and you can read it here, but I decided I wanted to share my full answers in case it could help anyone who finds themselves on the internet questioning if what they think about when they masturbate is normal, ok, or healthy.
-Why do we fantasize about what we fantasize about? How and when do we develop these fantasies?
Because it’s how we are wired! Humans are at once physical, emotional, and cognitive creatures. Something we have understood through observation of ourselves and others, and more recently had validated with the dawn of human behavioral sciences—is that human beings are pleasure seeking animals.
Thanks to 3D ultrasound video technology, we can confidently assert that humans enjoy and seek out pleasurable experiences in its myriad forms from the womb to the grave. Our earliest experiences are predominantly sensory and emotionally oriented, and as we mature and become more able bodied, more cognizant, more imaginative, what that looks like for humans becomes more complex and varied. Whether that is through consumption and excretion, snuggles, thumb sucking, or intentional explorations of the many highly sensitive parts of our bodies; whether it’s sexually or erotically driven or not, the simple truth is is that we all like and seek out things that feel good, engaging, and (comfortably) exciting/stimulating.
As such complex creatures it makes sense that we would use our brains and imaginations to recall or create physically and emotionally arousing fantasies to conjure and heighten our physical and emotional responses during a sexual experience. We grow and shift in our fantasies organically as we mature towards sexually explicit gratification seeking behaviors, but it’s an easy thing to do because we’ve literally been doing it our whole lives. We’re hard wired from the start to seek out pleasurable, arousing, and gratifying experiences in all the ways we can possibly enjoy. What a wonderful gift we can give to ourselves with our fantasy lives! And we can do it for free!!!
-How do they change over the course of our lives?
They change as we gain experience points in life and grow our own personal library of exciting and arousing ideas, experiences and feelings. Some of them may seem relatively unchanged over the course of our lives. Some of them may become noticeably more graphic, more “intense”, more elaborate (or more confusing) in their evolution. Both are normal and healthy experiences, and neither is inherently better than the other. Having a good ol’ go-to fantasy when we’re not feeling particularly creative or we’re crunched for time is fantastic! Having an opportunity to let our imaginations run wild is also fantastic! It’s just plain old fantastic that we have the capacity to help ourselves achieve physical bliss for a moment in this life—regardless of whether or not it’s possible to enact these things safely, pleasurably, or ethically with others.
-If people don’t like what they fantasize about (it’s illegal/not aligned with their values/something they wish they didn’t think about) is it possible to change their fantasies, or somehow train ourselves out of them?
Often that discomfort and desire to distance ourselves from arousing fantasies is informed by internalized sex/body-negative stories we’ve been told or had modeled to us by others throughout our lives. If the stories we tell ourselves about desire/arousal/gratification/experiences we’ve had are inherently bad or harmful to ourselves or others, we’re going to have a hard time embodying our sexual selves, achieving our sexual potential for our own let alone our partners sakes, to say nothing of the generally socially acceptable self-actualization (which I would argue cannot be accomplished if we are sexually repressing ourselves).
It’s very common for anybody and everybody, at some point, to walk away from a sexual experience—alone or with others—feeling confused or upset with where their mind and fantasies went. Brains are curious! They think curious things. They make curious associations. They have curious responses. And that is NOT limited to the sexual realm! Not by a long shot. It’s normal—and healthy—even when it is curious/strange/surprising/upsetting.
If you’re not familiar with the psychological phenomenon of “The Call of The Void” it’s basically the same thing in a different situation. Many non-depressed/non-suicidal people have experienced an alarmingly powerful impulsive desire to fall/leap/veer into a situation that would likely be catastrophic if not fatal for ourselves or others. As we pull ourselves away from that edge and try to process and understand why we felt that and what it means about us, we often forget—in that alarmed state— that brains are curious and noisy things that sometimes just think of something or desire something or find something arousing that “normally” we would not willingly engage with (at that time, if ever). Did you really want to find yourself singing the Empire Carpet jingle all week? I didn’t think so.
Thought policing ourselves just doesn’t work. We’re not wired that way. When we try not to think about things we usually cannot help ourselves but to think about them! It’s why meditation and mindfulness is so inherently challenging without regular practice. What we can do is give ourselves the benefit of the doubt that we are not secretly wicked sex fiends or sexual predators, or that we really wish to be the victims of such persons in real life. Hold onto the undeniable fact that things that are most certainly not sexy in life can be and are very sexy in role play and fantasy. The fervently ethical and consensual BDSM communities around the world have taught us this very explicitly.
-How can people work to broaden their sexual fantasies?
By letting ourselves! Let yourself explore sensuality, identity, behaviors and expressions with curiosity in place of judgement. Let yourself find things interesting or engaging without judgement of good or bad, healthy or unhealthy. Let go of any shame you have about being a complex and unique sexual being.
Is something we’re observing or experiencing interesting or arousing? Be curious and let yourself enjoy exploring what or how it is that is appealing to you about it. You don’t have to take it at face value. Everything enjoyed in sex can be done and experienced innumerable ways.
Remember that none of us are under any obligation to act out our fantasies in whole or in part. Accept that some are best kept entirely as fantasy and keep them in your mind-palace/spank-bank for when you want them. Know and accept that some can be enacted in satisfying and consensual ways—if you want them to be.
I feel that one of the best ways to broaden our sexual fantasies is to explore and seek to understand what other people find arousing and satisfying. You can take it, leave it, or adapt it as you see fit. They’re all just suggestions and you get to build your own sexual menu of starters, dishes for one, and dishes to share. And you can update that menu whenever you want. Put on your sensual lens and take a long look at the world and people around you. I promise you you’ll broaden your horizons real fast if you let yourself engage with a curious, non-judge mental mindset.
-How do we reconcile our personal fantasies during masturbation with our partnered sex lives? In other words, what if our personal fantasies are not something we necessarily want to share with a partner?
By giving ourselves permission and opportunity to keep to ourselves, share, or seek to enact at our pleasure (pun intended!). Secret implies shame; private implies “yeah and it’s none of your business. Just because we don’t want to do something now (or ever) doesn’t mean that we cannot share it with our partners or besties. That’s potential fuel for the sexy-time fire! However you (both) choose to burn that fire.
I think most people instinctually feel and morally know that pressuring or being pressured to do something they/we don’t find arousing doesn’t feel good or satisfying—for anyone involved. And nobody likes to be rejected because they have a normal, healthy, and curious brain— aka “kink shaming” or “thought policing”.
We all deserve to have our non-harmful sexual fantasies and behaviors respected and accepted with the same deference people give each other for our preferences in food, entertainment, hobbies, careers, recreation, social habits, etc. What works for me doesn’t have to work for you and that’s ok!
Fantasies don’t harm to anyone. They’re not some secret insight into your true wicked nature. Sharing and engaging with our fantasies can be negotiated at any and all levels with our partners in mutually arousing fashions. Pillow talk, harmless flirtations/sexy “threats” to do “it”, or finding the risk aware, safe, and consensual way to enact it are all perfectly healthy, normal, desirable sexual behaviors.
We are pleasure seeking animals, after all, and thankfully there’s no one way to find that—even if we’re typically (not exclusively) inclined towards a particular…vibe (thrills and chills vs swooning and snuggles). We’re all entitled to want what we want how we want it, whether or not it’s possible to gratify in a way that aligns with our core values and beliefs.
If, after reading all of this, you still find that you’re deeply concerned, or having trouble letting go of the (unsexy) shame or recrimination of your sexual fantasy life; or you are struggling to share the fantasies with your partner that you do want to, there are many wonderful providers and communities who would absolutely love, LOVE! to support you. It is possible for you to have a better relationship with your fantasy life and successful sexy experiences of your fantasy role plays with your enthusiastically consenting partners. Seek, and you shall find.
Take gentle care,