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A psychiatrist’s couch with a table and small framed picture at the foot of it. Dana Rodriguez for Vox

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The best $160 I ever spent: A session with a Black therapist

I hadn’t realized how important for my mental health it was to talk with someone like me.

Four years ago, during a sticky New York summer, I anxiously sat in the lobby of the clinic waiting to meet my new therapist. Glued to the torn pleather couch in front of the rattling AC (which did nothing to relieve the heat and I was convinced was only there for show), I wondered what this mysterious person would be like. Will they be nice? Will we get along? Will they really listen?

I saw a psychiatrist every week at the clinic, which also required me to attend talk therapy. I didn’t have any say in who was assigned to me. I’d been going there for six years. In that time, I’d been with five therapists. The first therapist I saw for only six months. The last one I visited for a year and a half.

Some therapists had helped a bit. There were others who were just doing a job, biding their time until a better opportunity presented itself. The last person had been okay; I didn’t go deep. I mostly spoke about the everyday surface stuff: I’m overworked. I need to take time for myself. I’m concerned about money. She was more like an acquaintance getting paid to listen to me vent.

The old clock in the waiting room chimed 3 pm. “She’s late,” I thought. “Is this what I have to look forward to? Someone who’s perpetually late?”

Just then a woman appeared at the door, smiling. “Sarah?”

“That’s me,” I said, peeling myself from the couch.

“I’m Malika,” she said. (For her privacy and mine, I’m not using her real name.)

I cocked my head. I hadn’t been expecting this. She was a Black woman, like me. Her 3C curls sat on her shoulders and were at least four inches high on all sides; her hair wasn’t as big as mine, but it was close. Standing there, side by side, we filled the waiting room with Black, natural-hair pride. I took in her brown rimmed glasses with a slight cat-eye and her short, striped summer dress that showed off her toned thighs. Her freshly painted blue toenails peeked out from her strappy sandals. I already felt closer to her than I had to my previous therapist.

“I love your outfit,” I said.

“Thanks. It’s hot. I couldn’t do pants.”

That look was about much more than surviving the heat. It was “I dare you to tell me I look unprofessional” attire.

“Follow me. My office is a bit tricky to get to,” she said.

We left the lobby, crossed past the main desk, and ascended a flight of stairs. Another welcome desk and two narrow hallways later, we arrived.

She opened the door: “After you.”

I found myself in a space that made my bathroom feel like a master suite at the Plaza. Somewhere, someone was very bitter about giving up their supply closet. A large rusted fan was shoved into a corner of the windowless room. There was no desk. Instead, a dented metal file cabinet leaned lazily against the wall. Crammed into the remaining space were two yellow cafeteria-style plastic chairs.

“Take your pick,” Malika said, gesturing to the seats.

I sat in the one the backs of my legs were already touching. Once-white paint was peeling on the opposite wall. The buzzing fluorescent light brought me back to my eighth-grade science class.

“I’m sorry, there’s no air conditioner,” she groaned. “If it gets too hot, we can leave the door cracked.”

“I’m fine,” I said.

It was hotter in here than outside. Yet, I really was fine. She closed the door and sat down across from me, our knees nearly knocking. Our first session was underway.

“How do you feel about having a Black therapist?” Well then. The small talk was over.

“What kind of question is that?” I blurted.

We looked at each other and both laughed.

“Have you been asking that of all your patients?” I wanted to know.

“I have been, yes. People aren’t used to it.”

She was right. It was the first time I’d had a Black therapist and I’d been in therapy more than half my life. I thought about the question again.

“I feel relieved.”

With white therapists, I couldn’t talk about racism without it being a “teaching moment.” Often that “moment” would take up the entire session. It was exhausting. I would feel worse going out than when I came in. What was I supposed to do about that? Go to therapy to deal with my therapist? As it turned out, that’s exactly what I needed.

My partner and I began couples counseling at the same time I started seeing Malika. Our psychologist, who I’ll call Agnes, was nice, experienced, and white. My partner was also white. Once, after attending a party with some of his coworkers, we both came into the appointment with our grievances.

“I feel like Sarah was taking it out on me,” my partner complained.

“That guy told a joke, and the punchline was that all Black people look alike,” I said as the anger once again welled up within me. “When I told him that was racist, he actually said that he had a Black friend.”

I looked at Agnes. Even in her lily-white Long Island world, surely she knew how outrageous this was.

“Couldn’t you have avoided him?” she suggested.

So much for that. I let out a long sigh.

“I didn’t have to. He avoided me,” I said.

“So, what was the problem?” she asked.


“There were no other Black people there. There weren’t even any other POC.”

“I don’t see how that relates to the situation,” she said, looking perplexed.

Had my partner paid her on the side before the session?

“That was the situation,” I explained.

“I’m not following,” Agnes replied.

“How long before someone else made a remark?” I asked rhetorically.

“Did they?”

“No. But they could have. I was on edge. And I had no backup. No one alongside me if they did.”

“I was alongside you,” my partner interjected.

Agnes nodded in agreement with him.

“I mean someone who would understand,” I glared.

Agnes leaned forward. “Why don’t you help us understand?”

Feeling outnumbered, I rolled my eyes, crossed my arms, and sank into the couch.

Two days later, I recalled the ridiculousness to Malika.

“It’s not our job to educate,” Malika said. She was not frustrated for me; she was frustrated with me. “They can try to understand but will never fully get it. They can’t know what it’s like to be Black.” That is what I needed to hear. She got it. It was “our,” not “your,” and “us,” not “you.” I left feeling strong, supported, and seen.

For two years, we congregated in the converted closet. I always felt safe and never judged. Every time police murdered another Black person, Malika already knew what the conversation would be. In those sessions, it wasn’t only me needing her. We needed each other.

As our relationship grew, I learned we had more in common than being Black women. We were both queer in heterosexual relationships. We each had white partners. We shared the same sense of humor, practiced similar self-care, and enjoyed the same bad TV. I often wondered what people thought as they passed her office and heard loud laughter escaping under the narrow door. Wednesdays were my refuge.

One day as I sat down ready to dive into our session, Malika remained standing. She looked anxious, sad, and excited all at once.

“What is it?” I wanted to know.

“I have some news,” she began.

I took a deep breath and held it. My insides knotted. I knew what was coming. I’d been there before. It was the “It’s not you, it’s me” of therapy.

“Noooooooo,” I moaned.

“Yes. I’m leaving. I’m going into private practice.”

Without hesitation, I made the decision. This wasn’t a relationship I was willing to leave.

“I’m coming with you.”

She pressed her lips together and slowly shook her head.

“Unfortunately, I can’t take your insurance. One session is $160.”

“I’ll make it work,” I said, determined.

“Are you sure? I know that’s a lot for you. I could help you find someone here ...”

But she was already smiling, and the anxious energy had dissipated. She didn’t want us to end either.

“If I can follow my hairdresser to an expensive salon, I can follow you into private practice,” I said. “Having someone I trust with my mental health is even more important than finding someone that can do my hair.” If you’re Black, you know what a huge statement that is. Any doubts she might’ve had vanished after that.

Malika was right, $160 is a lot for me. As soon as I decided that I was staying with her, I started thinking about how to cut costs. So long, Aunt Jackie’s $10 conditioner. Hello, 99-cent Suave. My shoes could make it another season. Rather than get a new coat, I sponged down my old one, sewed on new buttons, and replaced the broken buckle. I put a hold on my student loans. I didn’t give up my hairdresser completely (I have my limits). I did, however, extend my cuts from every three months to every six. I now left the salon with drip-dry hair rather than have it styled for an extra $25.

Two weeks later, I sat with her for the last time at the clinic. I signed the discharge papers and said goodbye to the bleach-mopped lobby, the geriatric air conditioner, and the free Metro cards. At the end of our session, Malika and I both stood up. For the first time, we hugged. It was a long, strong, embrace. “See you on the other side,” I said.

The main reason Malika wanted a private practice was so she would be able to work exclusively with Black women. I was one of the chosen ones. Sitting in her new waiting room the following week, I relaxed into a cushioned chair that had yet to be broken in. I leafed through a Psychology Today magazine that not so coincidentally had a Black woman smiling on the cover. My sandals tapped the Pine-Sol polished floor as I walked over to the far wall and checked my makeup in the full-length mirror. I made my way down the hall and fingered through an assortment of herbal teas. Sipping spearmint, with only two minutes to spare, I hurried back to my seat.

Right on time as always, Malika came out and greeted me, “Come on in.”

I followed her a few steps and walked in through the large door. I stood there for a moment taking in the space. Against the far wall there was a large, beige, plush, couch. A lamp stood on one side and an end table complete with coasters on the other. Adjacent to the couch was an oversized stained wood desk. A bookshelf stood alongside. I quickly noted some of the titles: Black Sexual Politics, The New Jim Crow, Post Traumatic Slave Syndrome.

“Oh yeah,” I thought excitedly, “We’re in her office.”

The lights were dimmed and the freshly painted cream-colored wall embraced the calm of the space. A diffuser let out a light mist of frankincense and cloves.

“Have a seat,” Malika said, gesturing to the sizable sofa. I took several strides and eased into the soft center. Malika closed the door and sat down in a large reclining chair. She rolled it forward so there’d be less space between us.

“Let me know if you get too cold. I’ll adjust the air conditioner,” she offered.

“I’m fine,” I said, suddenly aware that sweat wasn’t beading on my forehead. This was nice. I felt like I was in a living room — one much bigger than my own. With that thought in mind I noted my dusty sandals on an intricately woven rug.

“Do you want me to take my shoes off?”

“Go for it,” she said smiling. “I want you to be at home.”

I smiled back. “I am at home.”

Sarah Doneghy is a writer, actor, and activist. She lives in New York City.


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