The process is daunting, and the mental healthcare system is deserving of extensive complaint. I have had my own “bad dates”. My fav: I was suffering extreme burnout and had just had my car stolen, among other things. I found a therapist. On our initial appointment, he bloviated about his academic pedigree and how it “wasn’t his first rodeo”, then dismissed my problems as not knowing what I wanted out of life (I was getting an MS in math while working full-time). Cost? $400.

Not long after that I (spoiler alert) needed a psychiatrist. It took me 30 calls to find someone with availability. I punched a hole in my wall around call #20.

As recently as last Fall, I was still spinning my wheels, delaying the unpleasant search process for a therapist. I was so frustrated with “the system” that it short-circuited any desire to make the effort. There were at least four major barriers:

1) communication anxiety — worried about explaining myself and my problems to a prospective therapist. [addressed in my previous comment—keep any introduction email/call extremely simple.]

2) financial anxiety — as with all healthcare in the US, the amount you pay is a random variable. Maybe it will be a waste? Maybe I will go bankrupt? [if you have insurance, find someone on your plan using the Psychology Today search filters—they also often list the cost. if not, there are other free or low-cost resources available, but it’s context/location dependent. some potential options include the VA, school/college therapy, counseling programs @ your employer, therapists in-training, various community/nonprofit organizations. ask a trusted friend to help you search, it can alleviate some of the frustration. you can ask me.]

3) avoidance anxiety — embarrassment around explaining my life story. Why and how should I explain the fact that I smoke weed 10x a day (a true 10x developer over here) to cope with my issues, when I could simply roll another joint? [one role of the therapist is to be a non-judgmental sounding board and co-strategizer—they aren’t your coworker, parent, partner, etc. this is a hard mindset to learn, even for me to this day. I find myself saying things I think my therapist wants to hear. as a corollary: ER docs have seen the full Cartesian product of injuries from {objects} x {orifices}. whatever you come in with is not as unique or embarrassing as you think. they do this all day long.]

4) perfectionism — “Yeah I’m sure this therapist can help someone get over a breakup or their dead cat, but I’m a special brand of fucked up and they won’t get it. I need to find a someone that is perfectly specialized in my personality/problems, or it will be a waste. Also they need to have a PhD from a good school, female, not too young or too old, not ...”. [just a reminder that this is not a search for your soulmate. a student therapist or MSW may be more effective for you than a famous professor with books and accolades (see above). anecdata: the two therapists that I hand-selected didn’t pan out for me at all. the two that were chosen for me at random were a wonderful fit.]

Finally, I would push back on the idea that remote therapy is ineffective. Telehealth in general is proving to be pretty effective, and with therapy they don’t need to interact with any physical structures. The only thing that is slightly diminished is nonverbal cues, but that’s not insurmountable. There are a lot of advantages: significantly more options (no location constraints), easy to schedule and keep appointments, can be more comfortable to not be physically present, and no stressful driving. I recently did a therapy appointment call from the Appalachian Trail!