[TRIGGER WARNING: This post discusses suicide]

Let’s #TalkTherapy.

The Two Chairs team is excited to launch a series of reflections about the unique lived mental health backgrounds of people in our community. With therapy at the core of every conversation, this series will embrace diversity in experience and varied interpretations of therapy: for some it looks like 1:1 talk therapy, for others it could be a creative outlet or self-care. Each person’s story is a chance to give a face and voice to therapy — a topic that is often faceless, and rarely talked about in social settings.

We kicked off the series last week with local master printmaker James Tucker, whose work we feature in all of our clinics.

Our growing team at Two Chairs consists of people from all walks of life who are advocates of mental health and the benefits of therapy. From clinicians who practice therapy daily, to operations staff who have had significant touchpoints with mental health — either personally or through loved ones — our team members are drawn to the mission of building a world where everyone has access to exceptional mental health care.

This rings true for Rachel Seeman, Operations Lead here at Two Chairs. She joined the company as the third employee after she was introduced to our founder, Alex Katz, and deeply connected with his vision. She played an instrumental role in opening our first four clinics in the Bay Area. As Operations Lead, Rachel now manages the Care Coordination team — the dedicated foursome that helps our clients start care and navigate insurance.

Rachel hails from Portland, Oregon but has since made the Bay Area her home. Considering her love for the outdoors and running (she completed the LA Marathon last month!), it’s no surprise that she has fallen in love with her adopted home; San Francisco offers a bounty of public outdoor spaces where Rachel can run and clear her mind. Mental wellness has become an increasing priority for Rachel over the last few years, so after beginning her career in healthcare at Mercer Consulting, she seized the opportunity to work in the field of mental health at a dynamic, mission-oriented startup.

A few weeks ago I had the opportunity to #TalkTherapy with Rachel. We discussed the ups and downs of her relationship with therapy, from an underwhelming first experience to now, where it functions as an invaluable and empowering form of self-care. The two of us met before an event at Stanford University, her Alma Mater and the backdrop for a handful of stories she shared throughout our interview. We found a pair of adirondack chairs secluded under an expansive, welcoming tree in the heart of campus and settled in.

Asking for help

Every individual’s introduction to clinical therapy is different. Due to her mother’s familiarity with the notion of therapy, Rachel was exposed to it during her formative years in high school. “I was having difficulty with some life changes — balancing demanding extracurricular activities with the regular challenges of high school — and questioning broader life path decisions around where to attend and how to pay for college. Once I realized that the guidance I needed was better provided by a trained professional than my mother, I asked for help. My mom and I made a joint decision that I should give therapy a try.”

Rachel and her mom didn’t quite know where to start, but were eventually able to find an in-network therapist with availability. Unfortunately, to Rachel, this first therapy experience was underwhelming; impersonal and routine rather than transformational. The discomfort of the physical space was the most notable aspect of this course of therapy for her. “I distinctly remember the stairs on the way up to the old lady’s house, they were super creaky. She lived in a dilapidated building that echoed as I moved through it. Our chairs were seated far from one another, almost like a physical manifestation of our lack of connection.”

“It just wasn’t a great experience but I didn’t know what I needed at the time or what to expect, which is the case for most people going to therapy. The system is such a blackbox, and so stigmatized — the taboo activity that is mental health.” Rachel attended a few sessions before ending her treatment, left with a sense of disillusionment.

Given her pessimistic mindset that was developing around the effectiveness of therapy, Rachel didn’t feel the need to continue care when she moved down the west coast for college. “I felt happy for four years. In retrospect I was probably choosing not to feel certain things, but I have so many positive memories from Stanford. I looked into the on-campus counseling services briefly, but since the wait times were long, I only ended up going to one appointment and it wasn’t impactful.”

A difficult year

[TRIGGER WARNING: Suicide]

While her overall experience was positive, Rachel’s senior year was emotionally straining. When she was visiting home for Thanksgiving, she was blindsided by the horrible news that her neighbor had taken his own life. “My mom and I were the second people to learn about it. His girlfriend came knocking on our door in hysterics. From that experience I learned what it’s like to have the cops come for an investigation. It was a very chaotic experience and we had no idea that he was depressed or suicidal, for that matter. We didn’t really talk about it at home, didn’t process it together — he died, the next day was Thanksgiving, and life went on.”

After observing the worse-case-scenario for undealt with mental health issues, Rachel began questioning the stigma surrounding mental health care access and mental illness. It was impossible to wrap her head around the social barriers and systemic flaws that people encounter when addressing their mental wellness, just as she had a few years earlier.

Without having fully processed the gravity of the event at home in Portland, she found herself confronted by another piece of distressing news on graduation day, only seven months later. “I was the resident assistant at the house called Xanadu. I was about to take photos with my family after my graduation ceremony when I saw five missed calls from one of my residents. When I finally answered, he said ‘Rachel, there are cops surrounding the house, you gotta come home.’ I called the residence dean and she wouldn’t tell me what happened. When I insisted, she said, ‘One of your resident’s passed away.’ It turns out he had committed suicide the night before.

“He was going to be a first generation college graduate, but his sister found him when he didn’t show up to the ceremony. The whole thing was an absolute nightmare. It was this incredible contrast of the happiest day on earth, at the happiest place on earth, alongside this incomprehensible loss for a family that had invested everything in their child.”

To add a layer of complication to an already-difficult situation, all of the students had to move out of their campus housing that day. Rachel lamented, “We were never able to come together as a community to honor his life and process what happened. I felt stripped of not only a community member, but also of the opportunity for closure.”

Without guidance on how to make sense of her grief and after such jarring final semesters of school, Rachel describes feeling “spit out in the real world…feeling confused, frustrated, angry and sad, without a support network or a way of knowing how to process all of it.” That’s when she decided to pursue therapy again, this time on her own. Unfortunately, the therapist she was referred to was not a good match. She shared, “I always felt judged by her.”

Overwhelmed by insurance

Like most entering our complicated mental health care system for the first time, she had little knowledge about how the payment for these sessions would work with her insurance coverage. “[My therapist] continually told me that she would provide me a sliding scale rate, but remained unspecific about the exact price per session that she’d charge me. Being an under-educated healthcare consumer I thought I’d be able to afford it. We had a few sessions and she said that I owed her $700-$800. I asked her if she could help me with insurance submission, and she said no. I felt like I was being abandoned.”

Despite her proactiveness and attempt to do what was best for her mental health, Rachel said, “The insurance piece was completely overwhelming. I felt betrayed, and since I couldn’t afford to see her again that was it. She wasn’t particularly sympathetic. To her, it was just a transaction. I was left feeling like I didn’t have the resources I needed for healing even though I had tried so hard.”

“The combination of realizing how difficult an experience my resident at Stanford must’ve had — how alone he must’ve felt, combined with the firsthand experience of not being able to find care as an educated, resourced person led me to Two Chairs.”

Now, working directly with our clients and alongside the rest of the Care Coordination team, Rachel facilitates a more streamlined and thoughtful insurance navigation process so our clients don’t face the same frustrations throughout their care that she did.

Despite her less-than-satisfactory client-therapist connections thus far, she gave therapy another shot after starting work at Two Chairs. One of our Clinical Directors referred her to a clinician, and Rachel has been seeing her on and off for the past year and a half, working in a combination of both Cognitive Behavioral and Psychodynamic modalities and using the time to create extra space for reflection in her life. “I’ve built a relatively healthy relationship with my therapist and one that I’m really thankful for. She provides structure when needed, but incorporates psychodynamic work so we can explore different thought patterns that I have. I find that my time between sessions is equally as valuable as my time in session.”

Like any relationship, though, it requires attention and effort. She added, “I’ve seen how [therapy] can benefit me, but it certainly takes work — being vulnerable and discussing repressed feelings or things you’ve never thought about before is exhausting. If you’re not willing to put in the work, you’re probably not going to see the outcome either.”

Give therapy a try

Near the end of our conversation I was curious to hear what Rachel would tell friends or loved ones struggling with mental health issues and weary of therapy, especially since she was introduced to it at a relatively young age. She urged, “Give therapy a try. It can be an intimidating and daunting experience for anyone, so it’s best to lay the foundation of trust with a therapist when you are in a healthy state. That way, when you do inevitably experience a crisis, you already have rapport and a strong foundation with someone.”

We closed our time together talking about the universality of mental health. “You are not alone. Pain, loneliness, self-doubt and sadness are natural parts of the human condition. Often in urban, transnational settings like the Bay, we forget that we all have shared common experiences that make us human.” Though she’s still figuring out the function therapy will have in her life long term, she sees its inherent value. “Therapy serves as a resource and tool to help people process and work through these natural parts of life. I’m a huge believer that the body is a vehicle for the soul to carry throughout our lifetimes; in order to keep the body going in the right direction, keeping the soul healthy is number one — and therapy serves as the root of that.”

I want to thank Rachel for being open throughout our interview — at Two Chairs, we believe that this kind of vulnerability can serve as a meaningful step toward healing on an individual and larger community level. In the words of our founder, “every act that acknowledges the importance of mental health moves us forward,” whether it’s sharing your story or simply engaging with someone else’s.

If you would like to share, I’d love to #TalkTherapy with you. If you’re interested, you can email me at [email protected].

If you or someone you know is experiencing an emergency or crisis and needs immediate help, call 911 or go to the nearest emergency room. Additional resources can be found here.