Why Don’t You Take Insurance? I Don’t Want To Diagnose / Pathologize Your Coping Skills

Insurance companies will not pay for your therapy without a diagnosis

I get a lot of questions about why I don’t take insurance and wanted to write this post to help people understand. The short of it is this: I’m not taking insurance because I don’t want to diagnose people with arbitrary ‘disorders’ that will affect the way they view themselves and the way they move forward in life. The long of it?

The term abnormal is arbitrary

We label something abnormal based on the cultural norms and context it’s within. What’s abnormal in one culture, point in time, or context is normal in another. In the context of religion, hearing a voice could be a message from God; outside the church it’s schizophrenia. In a culture where food is scarce, eating uncontrollably when you have the opportunity to do so is seen as a survival skill; when food is plentiful, it could be considered binge-eating disorder. In one point in time, being gay was considered a disorder of pathology. Diagnosing is just a way of categorizing behavior outside the norm as disordered.

We often learn ‘disordered’ behaviors in response to trauma

Most ‘abnormal behavior’ is an adaptation to fucked up shit. It’s a way of coping with brokenness and pain. You may turn to an addiction as a way of escaping painful memories of past abuse. You may disassociate from your body during and after a trauma in order to protect yourself from fully experiencing the trauma. You may experience extreme anxiety as a response to constantly being in situations where your life was at risk or threatened. You may experience crippling depression because you learned in your childhood that nothing you do can get you out of the shitty situation you’re in so you might as well stop trying.

Our bodies try to protect us from further trauma by sending us messages

Anxiety and depression are messages, not disorders. Anxiety is a normal reaction to a fearful situation. Depression is a normal reaction to an upsetting situation. If you are constantly being put in or putting yourself in fearful situations, you will feel more anxiety. If you are constantly being put in or putting yourself in upsetting situations, you will feel more depression. This is not disordered, this is your body sending you a message to get out of that situation!

I want to honor your capacity for survival

If I give you a diagnosis of pathology for the behavior you’re engaging in that’s helped you cope with your trauma or pain, then I don't feel I’m truly honoring your amazing capacity for survival. If I say that your extreme feeling of anxiety or depression are disordered, I feel like I’m discounting the wisdom of your body. Your ‘disordered’ or ‘abnormal’ behavior has come about as a means of survival. I don’t want to pathologize it. If I pathologize your behaviors or bodily sensations, you are likely to pathologize them as well. You’re likely to say that the way you act or feel is wrong or bad, which may make you feel like you are wrong or bad. This will make it hard for you to see the amazing ways these behaviors and/or sensations were trying to serve you. And if you can’t see the amazing capacity you have for survival, you may never address the underlying reasons for why you adapted these survival mechanisms in the first place. You may just stay stuck in thinking you’re wrong or bad for the way you’re getting through life.

Your coping skills are not disordered

I don’t think people are wrong or bad for their survival mechanisms. I don’t want to call coping skills disordered. I don’t want to put you in a box based on an arbitrary diagnosis. Also, insurance is super corrupt and I really just don’t want to be a part of that whole system. So that’s why I don’t take insurance; I hope you understand. There are a lot of wonderful therapists out there who do and I am so thrilled that they are providing people access to care who wouldn’t be able to afford it otherwise. I just know that it doesn’t feel right in my soul to diagnose and I’m determined to conduct my work in a way that feels right in my soul.

Any more questions? Contact me and I’d be more than happy to answer them!