I began my first therapy session at 7:41 in the middle of a crowd near Manhattan’s bustling Union Square Park.
I was on my way to the subway when my phone buzzed with a new text.
“Hi Erin, it’s nice to meet you,” it read. “Can you tell me a little bit more about yourself? I’m glad you are here.”
I was glad too, even though I wasn’t sure why.
Not wanting to interrupt things when I went underground, I copy-pasted the message — which I’d gotten after subscribing to a new text-message-based therapy app called Talkspace — into the Notes app on my iPhone. That way, I could type out a response while I rode the train home.
Getting matched with a therapist
By the time I arrived at my stop, I had three new messages from the therapist, who introduced herself as Holli Fiscus-Connon. Holli said she’d explain how the app works and pair me up with a “primary therapist” who could meet my specific needs. Then she asked me some questions — from my history with therapy to my reasons for coming to TalkSpace. As soon as I started responding, she began messaging back.
We were having a conversation in real time.
As I climbed the stairs to my apartment, the rapid-fire texting slowed a bit. Holli texted me a “form” to fill out with a series of standard questions, not too different from the intake paperwork I’d have filled out at a traditional therapist’s office.
The main difference was that instead of finding the therapist myself, Holli would be doing it for me.
To make sure she picked someone who’d be a good fit, she asked if there were any specific things I wanted her to consider. I mentioned that I’d been having panic attacks occasionally ever since I was a kid.
While that was appealing to me (spending hours scouring the internet for doctors that take my insurance and seem like a good fit based on their photo and one-line bio isn’t my idea of a relaxing evening) it might not be to some.
Cost is also a factor. In comparison to traditional therapy, which is sometimes covered by insurance and can range anywhere from $US20 to $US250 per session (sessions are usually once a week and last about 45 minutes), Talkspace costs $US25 per week.
Other text-based therapy services exist too, including BetterHelp ($US40/week for unlimited texting with a licensed mental health professional) and 7 Cups of Tea (free anonymous online chatting with “trained listeners” who don’t necessarily have a degree or licence in mental health or social work).
The next morning, I awoke to half a dozen texts. A few of them were from someone at Talkspace.
Opening the app, I saw I’d been introduced to my primary therapist, Nicole Amesbury, MS, LMHC.
A little Googling told me what these letters meant. Nicole is a Licensed Mental Health Counselor, which (at least in New York state) means she has a Master’s degree, spent at least 1,500 hours of working with patients, and passed the licensing exam, at minimum. (Nicole is also listed on the blog and therapist database Psychology Today, along with one other Talkspace therapist).
Nicole and I spent the next week texting daily — both on the iPhone app and on my computer (conversations on either platform sync seamlessly).
Sometimes when I’d send her a message, she’d get back to me immediately and then we’d text back-and-forth for anywhere from a few minutes to half an hour. Other times, we’d respond to each others’ messages in a few hours.
Occasionally while I was writing, I would feel myself getting worried about what Nicole would think when she read my message. I’d had the same feelings in traditional therapy — Did I say the right thing? Was that TMI? Will she think I’m totally off my rocker?
Since we were texting and not sitting in a room together, I couldn’t look into her eyes for reassurance. Instead, I’d have to sit with my text and wait.
A fresh perspective
Typically, by the time I was halfway through re-reading what I’d written, I’d get a message — or several — from Nicole. Her responses were thoughtful, detailed, and insightful. She was really listening, I’d find myself thinking.
Here’s an example.
Once, after I’d said I was feeling frustrated with my emotions (I told her I felt like I’d been feeling either really happy, really sad but rarely in between), she mentioned something that I found incredibly helpful.
She said feelings were like the symbols that light up on the dash of a car when something needs your attention. “Some of the lights you don’t mind seeing, they give you comfort — hooray full take of gas!” she said. “But some feel like they will put you over the edge — engine light?! What in the…?!”
No matter how uncomfortable those feelings may be, Nicole reminded me, they’re there for good reasons.
We need feelings to live. They tell us when something is happening that needs our attention, whether it’s taking place somewhere around us or internally.
I’ve thought about Nicole’s advice in that moment over and over again, and I continue to remember it whenever I catch myself being too hard on myself or feeling like I’m trapped in a feeling and just want to get out of it.
I still have Talkspace on my phone, but I haven’t stopped seeing my traditional therapist either. Sometimes, I still feel like I need to sit with someone and look into their eyes. Other times, a text will do the trick just fine.