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Can You Afford to Be in Therapy? Can You Afford Not To?

coins photoAfter being in private practice and specializing in therapy and coaching for gay men for over 21 years, I have sometimes seen clients start therapy, and then decide they “can’t afford it” – yet they pay their drug dealer weekly full-price for crystal meth.  Or they still pay $15 for a cocktail at the Abbey – many, many times in a week.  Or they lose money at the casinos on weekend trips to Vegas.


Can you afford to be in therapy?  Not if you make it your last financial priority.  Sure, some people can’t afford therapy and still pay the rent on a modest apartment and driving an 8-year-old conservative car.  And for those folks, I can make referrals to places where counseling and therapy are delivered by less-experienced clinicians or in less-convenient locations.  But what is really “affording” therapy?  How do we define that?


It means thinking about what is important to you in your life, for the short term and the long term.  If you are willing to spend the money to upgrade from coach to first class on a vacation with your partner, but you’re fighting the whole time, perhaps coach could be OK and then you come to couples counseling to address the real issues once you get home.  If you are willing to spend lots of money on clothes to go to a job that you hate, maybe you could buy clothes that are still appropriate for work, but more practical, so that you can learn the skills in therapy that are about career coaching and building your self-confidence to go after the job you really want.  If you’re willing to pay your dealer lots of cash for a fresh supply of drugs, perhaps some of that should be allocated to figuring out why you’re self-medicating so much in the first place, and resolving the issues that are taking the “party” out of partying.  Or if you can’t afford to have both a therapist and a personal trainer, are you working from the outside-in, or from the inside-out?


Someone said to me recently, “gay men don’t like to be uncomfortable.”  I thought this was very funny and very astute, because as a group, he’s right; we don’t.  We endure so much crap from anti-gay political rhetoric in the United States and from depressing world news (Russia, Nigeria, Jamaica, and Senegal, just this week) that we tend to luxuriate any way we can manage to do it.  We seek a certain selective, compensatory hedonism in where we live, what we do outside of work for fun, what we wear, what we drive, what we eat, or how we look.  The downside is, under this kind of relentless pressure, culturally and even globally, the balance between short-term and long-term gains can get of whack; the balance between internal/enduring and external/transient pleasures can get a little “off”, especially living in LA, West Hollywood, or any gay American “Mecca”.


For many, the question shouldn’t be, “Can I afford therapy?”, but, “What would be the value of what my life would feel like, every day, if I invested in getting the help I need to take my life (relationship, career, health, finances, social life, sex life, dating, etc.) to the next level?”  What is worth giving up in the short term, in order to have something more enduring for the long term?  What represents real life change, in terms of my thinking, feeling, and behaving, versus what is a Band-Aid that’s a temporary anesthetic without any real progress toward improving my quality of life?


In my book, “Self-Empowerment: Have the Life You Want!”, one of the chapters is on Finances.  In it, I give the “Seven Ways to Take Care of Your Financial Self”, and these include what I call financial self-empowerment, which is spending your money (and other resources, such as time, energy, and attention), according to your values, priorities, and goals.  As someone who is now middle-aged, one of the mistakes that I see younger gay men make (often!) is spending in the short-term for immediate gains, rather than budgeting and spending strategically, over the long term, to set themselves up for success at every phase of life.  This is a skill most parents and teachers don’t teach anybody, so younger gay men (like many of my clients), get coached on these “life skills” by older gay men (like me).


They say “youth is wasted on the young.”  Older gay men have “been there, done that”; we know what we would do the same with our lives, if we had our youth to do all over again (such as getting laid a lot), and what we would do differently (such as investing earlier, or using our young looks more to our own advantage).  I like sharing the secrets of what I, and friends my age, did then that put us in a good position today, and what we would have done differently, that would have made it even better.  Since I don’t have kids of my own, I treasure the opportunity to coach and mentor younger gay men to see how their long-term goals can come to fruition – with patience, planning, and persistence.  With clients my age and older, it’s never too late to learn to love and appreciate yourself, and put your best foot forward.


Sure, it’s easy to say that touting the virtues of investing in therapy is self-serving of me.  “That’s great, Ken, spend less money on me having fun, so I can pay more for you to have fun!”  I realize that can sound hypocritical, and I admit that when people spend more money on therapy, we therapists earn more.  But what might the value of therapy be to you?  What could you accomplish with my collaboration, concern, support, and skills that I bring to you in our working relationship?  How can our interactions bring you self-awareness, a different point of view on an issue, or a perspective on how you might be holding yourself back?


In addition to my practice at the West Hollywood office, I teach a course in advanced psychotherapy techniques in the graduate MSW (Master of Social Work) program at USC.  There is a lot (a lot!) of clinical research in academia about how various models of psychotherapy help people solve all kinds of problems and achieve a new-found peace of mind.  It’s my job to know that material; that’s what you’re paying for, in addition to my time, as a consultant.  I continuously study it, so you don’t have to.  It’s my job to apply it to you, customized to your individual circumstances.  But I am by no means arguing against enjoying your life; I am, perhaps, advocating for you to balance it, between what feels right, for right now, and what is right for you in the long term, at your utmost potential.


The skills that are developed and the changes that are accomplished over time in therapy aren’t  just “common sense” or “second nature”; they are skills that need to be discussed, planned out, even argued at times – or at least evaluated from different points of view.  Your values, priorities, and goals need to be both clarified and acted upon if you expect to achieve what you want from your future.  There have to be answers to questions like “Where do I go from here?”, “What can I do now, to set myself up for success later?”, “How can I have fun now, and enjoy my life, yet still position myself for growing my career, relationship skills, mental and physical health over the long term?”


When you start to ask yourself these questions, the student is ready.  And when the student is ready, the teacher will appear.  In my office, on the phone, or via Skype – starting at, or 310-330-5778.


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