Therapists are People, Too
This week, I came across several statements in the professional counseling literature that said, in the simplest terms, that therapists should be free of psychological distress and not let our own issues or struggles come into our work with clients.
On one level, these guidelines make perfect sense. Clients don’t come to therapy to hear our stories, carry our pain. They need that service from us, and to provide it, counselors must be emotionally and intellectually available. There may indeed be times when we aren’t able to adequately care for others and need to step back until we’re ready again.
But here’s the thing — therapists are people, too. Just like everyone else, we go through all kinds of hard stuff, some of it quite psychologically distressing. Taking off work every time we experience psychological distress just isn’t an option. Not to mention that I’ve often done my best, most connected therapy with clients when I myself was going through a hard time; my heart was more open, and I was more empathic.
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Unfortunately, ethical codes, scholarly opinions, prescriptive diagnostic categories, and licensure requirements that were originally intended to protect consumers and guide effective practice have been increasingly interpreted as prohibitions against basic, universal suffering. Contemporary mental health culture has drawn such a huge circle around all manner of human distress and labeled it “mental illness” that we have practically written ourselves out of our right to acknowledge when we experience life’s hardships.
The important thing is not that therapists are free of psychological distress — which comes with living — but that we learn to be self-aware enough to step back if our pain becomes so overwhelming that we can no longer engage in valuable ways with the pain of others. Of course, for this to work, we must first acknowledge that we do in fact experience pain, and second, stop damning ourselves for it.
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Consider this. I recently had a miscarriage. The first client I saw after the miscarriage did not know I’d been pregnant, but knew I’d been out of the office for a medical procedure. As we rode the elevator, she looked in my eyes and asked me how I was doing and if everything was okay — as if she really wanted to know. I told her I was fine now, thank you, and she raised her eyebrows, perhaps indicating curiosity or disbelief. So I told her I’d miscarried, that it was sad but my partner and I were well-supported and hopeful we’d conceive again. I told her the truth, and my eyes teared up a little. I didn’t want her to hide her realness from me, so why hide my realness from her?
Her response was lovely, filled with compassion, which was nice. Then, we spent the next 90 minutes talking about her, which was meaningful and generally how it’s supposed to go. Although my training would say otherwise, my disclosure was not an overshare, and although my loss was still fresh, this was not my own “issues” spilling over into my client’s time. This was genuine relating. This is what we do best.
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I’m close to several of my colleagues, but I still haven’t told them about the miscarriage. I’m not ashamed to talk about it, and I know they’d be supportive, but I still sometimes feel sheepish letting my work mates know when I’m going through a rough time. Although I’m an open person, I’m also working in a larger national mental health culture that constantly tells its professionals to tuck themselves in.
When counselors apply for licensure to practice, we’re asked if we’ve received counseling for a mental health condition in the past several years. If we say yes, we must submit documentation from a therapist that testifies we are fit to practice. Maybe we saw someone to work through a bad break-up or a childhood trauma — no matter, we probably got diagnosed with a “mental illness” so our therapist could be reimbursed by insurance. In another example, counseling students who express painful emotions may be unpopular or shunned by their peers for oversharing. As my family counseling professor bluntly told class on the first day, “We aren’t here to understand your dysfunctional family dynamics, we’re here to help clients with theirs.”
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I’ve recently been recording a series of interviews for my Counselor as a Person podcast, in which I talk with counselors about who they are as people. People tell me they are anxious and scared about coming on the podcast. Some have, for this reason, outright refused to participate. What if they reveal themselves as uncertain, as lost, as grappling with their own difficult territory? (To which I respond, “Come on! That’s exactly what I want to talk about!”). When therapists do agree to be recorded, we invariably wind up talking about this conflict between being real people going through real things, and fearing that to the extent we reveal ourselves to others, we are taking not only a personal but a professional risk.
Some counselors are just plain private, but others are afraid. We fear a backlash, perhaps less from our clients than our own profession. In response to my article, So What Can Therapists Write About?, I received an email from a counselor who said that after years of keeping his own trauma history hidden from colleagues, he’d finally gotten up the courage to start writing about himself. Anonymously. Another woman wrote to say she’s started a support group for therapists who want to write about themselves but don’t know how to even begin breaking the professional taboo.
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Just because our clients don’t come to therapy to take care of us doesn’t mean they expect us to be above the threshold of human experience. As my mentor recently said, “I need my therapist to understand and validate me, but I don’t need him to be better person than me.” In fact, I don’t want a therapist who positions him or herself above the mess of everyday living — how could such a person possibly understand me? Nor do I believe that our clients necessarily want us to take great measures to hide from them; how uncomfortable if they should be the only ones exposed and vulnerable in the relationship.
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I used to have a private practice in which I almost exclusively did therapy with counselors, many of whom were quite skilled. So I can tell you, they’re just like the rest of us. Ups and downs. Sometimes more downs than ups.
Therapists don’t get a pass on pain, and since we’re the ones who perpetuate such a stifling system, we’re also the ones who can begin to free ourselves. The benefits of freeing ourselves are likely to be many — less compartmentalization, renewed energy, closer relationships with colleagues, just to name a few. But the price is that we must also renegotiate what we’ve been led to believe about human distress and our role in “treating” it. We must question the big circle of “psychopathology” and ask why we are placing more and more people somewhere we ourselves don’t want to land. We must also re-conceptualize what it is we offer our clients — for if we don’t have a leg up on the human condition, then our gift, our service, is not about our expertise but rather our willingness to engage fully in the face of inevitable uncertainty, anguish, and loss.
Because we too divorce and cheat and drink too much and fall in love with the wrong people and avoid the gym and overeat and experience trauma and crisis and depression and discrimination. Perhaps to the extent that we are good at what we do, it is not because we have mastered suffering, but because we are so intimately familiar with it.
