self help

Is Gifting Therapy to Someone You Love Helpful or Insulting?

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“He is my best friend, a resilient chap – we have known each other since we were in pre-school. The pandemic at first took a toll on his business, next his family – he lost both parents. I called him to check-in on him every-day. That 5 minute check-in turned into 45-60 minutes and before I knew it, I felt overwhelmed. I decided to have a conversation with him and asked him how he felt about therapy. He said he had never tried it before but would be open to it. He also said he didn’t have the bandwidth to look for someone who would “fit” his personality. So, I did my background research and found someone that I thought he might like. I gifted him 5 therapy sessions and last I checked he has continued to go and felt considerable relief from his ongoing stressors. It has also eased my burden and his dependence on me”

Therapy gift-cards have been something of a new trend during the pandemic. Several regular clients of mine (and my colleagues) had a hard time paying for therapy in these years 2020-2021. I offered free services but after 6 months of that realised it would not be sustainable for me to continue free private therapy sessions.  This is when somebody suggested to me offering therapy gift cards that I called “Vent” posing me with an ethical dilemma. How would I feel if someone gifted me a therapy gift-card for a session with a therapist that they liked? The answer is certainly not straightforward.

For starters, it would matter to me who this person was, how well they knew me, if I had expressed to them an openness to see someone, if I was lost and didn’t know how to go about setting a first appointment or if I would actually appreciate any help at all. It would also matter that I did not feel pushed when I was not yet ready for therapy. Furthermore, what if I liked the therapist but I was unable to afford continuing the process by myself due to financial constraints? A gift card can backfire if it makes the person being gifted feel disempowered. If the underlying implication is “you are not okay, go get help”(but I am okay) – it is an outright violation of boundaries. If it is used maliciously to devalue a person it is contemptible and malignant. So the considerations are many. 

But then, the reason why many colleagues, businesses and I added the option of therapy gift cards on my website was our first hand experience in the last two pandemic years. I had employers and colleagues gift therapy gift cards to their workmates who had admitted being under significant stress and requiring therapy but unable to afford it (with no company coverage).  I had friends and family in better financial positions gifting other friends and family therapy sessions because of the significant financial stress that Covid had put everyone under. I preferred that they do it along-with an expressive and handwritten note that said something to the effect of “Dear …, I love you very much and this year has been difficult for all of us. I have been seeking help myself and thought to share with you someone who’s approach has helped me personally. Sometimes venting can just ease a little bit of the stress and strain, and burden of life. With a lot of love,…” There were those who gifted their friends “psychological first-aid” sessions after the loss of someone they loved. These were usually accompanied with handwritten notes such as, “Dear…, I am so sorry for your loss and feel sad that I cannot be with you because of the present restrictions. I cannot imagine the pain of losing (name) … I fondly remember (them/her/him)… I am sharing with you this gift card for (name of therapist) that I know of and believe in, in the hope that it might help ease your burden of grief and suddenness of how things unfolded. With a lot of love…(name).” There were also friends who knew that their friends wanted to see a therapist but just couldn’t afford one at the present pandemic moment. Instead of gifting them Diwali hampers and Christmas treats, they paid for 10 or 15 sessions of therapy. One note that particularly touched me (I took consent before posting it here) said, “Dear…, I don’t think you remember but in fourth standard I could not afford to pay for our class picnic. You paid for me and asked Miss (class teacher) to not take any money from me. I found out later that you had offered to pay for me and that Miss had refused to take the money from you, the whole class kept this secret. From fourth standard to tenth standard not one of you told me that class picnics were not free. This taught me that there is so much goodness in this world. People who don’t know me see me as this intimidating boss and leader; what they don’t know is that I actually belong to Class 4B. Everything that I learned about being humane was from class 4B. Please don’t see this gesture as me returning the favour, but rather, as an emotional investment by me in our relationship. I have no doubt in my mind that you would do the same for me were our roles reversed. Your buddy (name).”

Therapy in a private setting can be a huge financial burden when it is not covered by insurance. French President, Emmanuel Macron announced that the French government would cover the cost of therapy sessions for any citizen aged three and older starting in 2022 in response to the “historic demand” for therapy highlighted by the mental health crisis and increasing suicide rates during the pandemic and its fallout. A large-scale study conducted by them revealed shocking indicators of problems that needed immediate addressing. Thoughts about suicide, sleep problems and use of alcohol to cope with lockdowns were on the increase as a result of this unprecedented isolation, confinement, loss of salaries and grief. 

Recently, India passed the National Mental Health Act (2017) which mentions provisions of health insurance for people with mental illnesses. In it’s attempt to be inclusive it has also adopted mental health coverage In its universal health coverage scheme Ayushman Bharat although private healthcare and therefore most psychotherapy is completely excluded.

The insurance regulatory and development authority of India, in June 2020 encouraged all insurers to “publish on their respective websites the underwriting philosophy and approach with regard to offering insurance coverage for (a) Persons with disabilities and (c) Persons affected with mental illness diseases” with effect from 1 October 2020. HDFCergo, a private insurance company, published their plans online, but sadly excludes OPD (out-patient) costs from their plans, which basically means any conventional therapy provided by therapists like me. This makes it futile for those who come to me, even for short-term therapy of 15 sessions. For the moment and given the present circumstances, gifting someone mental health care could bridge this treatment gap, up until the government or at least private players step up. 

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