I don’t even remember when Licensed Psychological Examiner with Independent Status Amy Flaherty and I first crossed paths. It seems like it must have been years ago.
Then, within the last couple of years, we’ve had opportunities to chat, collaborate, and network with each other online.
Just a few months ago, we were both involved in a conversation on Facebook talking about the need for therapists’ self-care.
When she shared a conversation that she had had with her husband, I knew I wanted her to share it – and her response to that conversation – with you.
I am delighted today to say that Amy hails from Northeast Arkansas, has been in the field of mental health for almost a decade and has spent more than half of that time in her own private practice.
So, when she accepted my invitation to guest post on this topic, I knew she would be sharing her personal experience and wisdom. Please join me in welcoming Amy to her first guest post here at Private Practice from the Inside Out!
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A Guest Post by Amy E. Flaherty, LPE-I, RPT
The Conversation Every Therapist Has
I’ve been married 10 years and have been doing therapy for almost that long.
Over the past decade, this conversation has happened in my house more times than I care to count.
See if you can relate.
Me: I’m so tired. I mean I don’t want to do anything or talk to anyone.
Husband: Why? I mean you only worked 6 hours today?
Try 10 like me.
Me: Well, my type of work is a different kind of hard than yours.
It’s emotionally exhausting.
Husband: I don’t get it. I mean you just literally sit in a chair all day and listen to people.
What is so hard about that?
Me: It just is- it’s hard to explain unless you do it.
And it’s not “just listening to people.”
Husband: On TV that’s what it seems like.
It’s just asking questions like “How does that make you feel?”
How hard can that be?
Come to my work and then we’ll talk about hard!
Me: Whatever.
You just don’t get it.
It’s exhausting.
Husband: What’s there to get?
Me: (I leave the room in a huff to call one of my therapist friends who gets it.)
Sound familiar at all?
Unless you are married to another therapist or someone who is very understanding (or is a boyfriend in a romance novel), I’ll bet something like this has happened to you, maybe not with your husband but definitely with family or friends.
The Work of Being a Psychotherapist
My guess is that you already know therapy is different than other jobs but you may find it difficult to articulate the reason you feel so drained at the end of the day.
It’s like soul-crushing, bone-weary, don’t-talk-to-me-or-I-will-cut-you exhausted.
I’m here to help you understand some real reasons why being a therapist is so exhausting.
Yes, as therapists, we may just look like we aren’t doing much, but in reality, it’s hard work, mentally and emotionally.
Let’s get to it.
Here are 6 reasons that providing therapy is hard work.
You may want to print this out to refer to it when you get to wondering why you need a massage when you just had one last week.
6 Reasons Why Providing Therapy is HARD
Reason #1 – The Stakes are High
I’ve had several jobs in my life. Some I’ve loved, others I’ve loathed.
Now, I’m happy to say I love my job on most days.
However, I sometimes wish that if I messed up, it would not be a big deal.
Like if I filed something wrong or dialed the wrong number, no biggie.
Most days in our profession, we don’t get this luxury.
A recent study found that being a mental health professional is the 2nd most stressful job in America right behind a police officer.
That’s it guys – #2!
The study also noted that the decisions most of us make on an everyday basis can have major impacts on lives.
Here are just some of the questions many of us face on a fairly regular basis.
- How do we tell the parents that we are going to have to make a hotline call?
- What do we say when a couple is fighting and look at you for answers to save their marriage?
- When a client doesn’t come back, we worry- is it us?
- What is the right time to break it to a client’s family that their loved one has a major psychological illness that will likely be lifelong?
It’s not just shuffling papers or flipping burgers for six hours.
It’s being on the spot with many big decisions every day that affect people’s lives.
Reason #2 – It’s Not “Just Listening”
We are processing information all the time.
I recently heard a Ted talk about sounds and communication.
According to this Ted talk by Julian Treasure, we can only process 1.6 conversations at a time.
Think about that.
That’s just enough for one person and a little bit of your own inner voice.
As you likely know, we as therapists don’t just listen.
We are constantly taking information in, processing this, thinking of what we should say in the that moment, and how everything relates to help move our clients towards health.
This is more than “just listening.”
Just listening and conversing in everyday situations is actually just trading microphones.
We do more than just that in therapy.
Our brain is trying to process more than just its 1.6 conversations at a time, multiple times a day with completely different issues.
No wonder we are exhausted.
Reason # 3 – An Hour of Therapy is An Hour of Work
Most people who are at their jobs for 8 hours a day only ACTUALLY do about 6 hours of real work .
If I have 6 hours of therapy from 12-6 (my schedule yesterday), I’m actually working all 6 hours.
And, if you are like me, it’s not like when those 6 hours are up, I’m clicking my heels together to sail home.
I have lots more stuff to do before and after those appointments.
I have notes to write, an office to clean, calls to make to ensure continuity of care- and that’s not even counting the B word – billing!
So, think about it in these terms – if you are working doing 6 hours of therapy, that’s equivalent to everyone else’s 8 – 10-hour shifts.
No one ever asks people who work 10-hour shifts why they are so tired – do they?
Nope!
They don’t!
Reason #4 – The Crunch
Whether you are working for yourself or for an agency, you have to keep your hours up and billable time up to keep your job and your doors open.
You don’t have the luxury of not doing work or just goofing off and still getting paid.
If you are like me, when I’m not billing, I’m not making money.
However, things still need to get done.
I still have to market, update my website and make sure my billing is in on time.
And that’s just when the days run smoothly.
What happens when your kid gets sick?
Or your office floods and you can’t see clients until the carpets have been dried out?
You just have to figure it out – there’s no vacation time and no sick time when you are working for yourself or are given a quota.
So in the middle of trying to be like Carl Rogers and provide unconditional positive regard, you have to worry if you are doing a good job and if your clients will come back.
And then what happens when your clients get better and don’t need you?
You still have to pay your bills.
I’m getting stressed out just typing this!
Reason #5 – The Extras
I’ll give you a snapshot of a typical day for me.
I may start at 10 am and plan to leave at 6 pm.
I see 6 clients during the day.
One of them goes into crisis and I have to reschedule another client for a different day because I am on the phone making calls to ensure my teenage client is safe.
I may or may not get paid for this extra time but I do it because I care and because it’s ethical.
That crisis stresses me out and I realize that I have to figure out how to bill that and how to ensure that I have an open spot for the person I had to bump.
And, by the way, I hope they don’t leave.
I understand they are important as well.
I get finished finally at 7 pm and plan to head home but realize I need to take out the trash and get some notes written before I leave.
Now it’s 7:30 pm.
I then think about who I have coming in tomorrow and realize I have a few treatment plans I need to finish before the parent comes in tomorrow to get the paperwork signed and I can keep getting paid for doing my job.
Oh – and my assistant?
Her mother is ill and so I need to also figure out how to bill stuff myself so my rent can get paid.
Yes, it is true that I worked 9 hours with no lunch break.
I “only” did 6 hours of therapy but I’m exhausted . . . from the stress of the crisis, from trying to keep my office clean, from doing the billing, and from worrying that I’m doing the best job possible for my clients.
One (of many) studies point out that this type of multitasking (What else could you call it?) is not only not efficient but it is bad for our brains.
It’s like riding on a rough road for many miles at high speeds.
You can only do it for so long until something has to give.
So, even if doing rote tasks, like entering numbers for a long period of time, it is still less exhausting than juggling the many tasks that we therapists do each day.
Reason #6 – Mirror Neurons
Mirror neurons exist in several parts of our brain but were first discovered when scientists were examining motor neurons in monkeys.
Mirror neurons are the neurons responsible for helping us understand the pain of others.
We now know that when we see something happen to others, this part of the brain is activated as if it were actually happening to us.
In therapy, we deal with the underbelly of life.
We usually don’t get to see people on their best days and we have to work through some tough problems.
Every time we see someone break down in our office or scream at a spouse, our brain is processing it as if it is actually happening to us.
Think about the last time you had a knock-down, drag-out fight with your spouse or family member.
It was exhausting, right?
Well, that’s what your brain is experiencing all day when you have clients in your office suffering.
You don’t just feel them in an “I feel your pain” metaphorical way.
You actually feel their pain.
When you experience that kind of stress and pain all day, you are going to be more tired than sitting and filing paperwork in an insurance office somewhere.
As I mentioned above, you may want to print this out somewhere to remind yourself when you start feeling bad about seeing only 6 clients in a day. It’s hard stuff.
Which parts of this ring true for you? How you have explained the difficulty of your job to other people?
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About the Author: Amy Flaherty, LPE-I is a Registered Play Therapist
in Northeast Arkansas. She provides personalized training in sandtray therapy for all therapists (not just those who work with kids) through her business – the Southern Sandtray Institute. Here is where you can sign up for her free webinar and learn more about her training that leads to certification as a Registered Integrative Sandtray Therapist (RIST).
We’ve got the double whammy going on in my house! I’ve been in private practice 20+ years, and my husband of 37 years is a physician who specializes in end-of-life / palliative care / Hospice interactions. I won’t get much “sympathy” from him either! Things can get heavy, particularly if the emotional intensity of the work eclipses the lighter side of life. We have committed to an active campaign of regularly scheduled “fun that is funny” (to quote Dr. Seuss.) While it feels helpful to “decompress” at the end of the day with someone, we have had to ban “work talk” from the dining table. You mention mirror neurons. My husband and I are both empaths. For empaths, the body can mightily affected by the emotional fields we are surrounded with. I don’t recall the empathic reality being mentioned even once in my training! We have learned that physical exercise is a MUST to maintain ourselves. We have also found the techniques from the world of Energy Psychology to be extremely helpful.
Oh, my goodness, Mary! That so explains why so many of your interactions online are so self-care focused! I appreciate you joining this conversation this morning specifically to address how much more complicated this can when your spouse is also empathic and working in an emotionally intense field as well!
Like you, there was never a mention in my graduate program about how our clinical work would / could impact our personal lives, either. I would like to think that those who have graduated more recently in the field are entering with their eyes open wider to these issues and how to handle them, too. Perhaps some of them will chime in here to share . . . .
Tamara, to answer your question, I would love to say that we covered this in my graduate program; however, coming from a professional who finished her graduate studies in June of 2014 at a highly reputable social work program, I can’t say we were formally prepared to navigate our personal relationships and the effects our work may have on them. That’s not to say student-to-student we didn’t notice or discuss the obvious effects on our relationships, but as a program, this portion of self-care was not explored sufficiently in ways that more objective aspects of self-care were addressed. Moving across the country to pursue a job as the only clinician in the office and building a new social community without a single mental health professional has definitely made me even more appreciative of the value of my friends, colleagues, and mentors in the helping profession. There definitely is something to be said about surrounding ourselves with people who understand our work. Thanks for the insight and validation in your article Amy, and thank you for sharing Tamara!
Hi, Kristin! Welcome to Private Practice from the Inside Out and thank you for taking time to drop in to address this issue! It’s so helpful to those of us here who provide clinical supervision and professional education in mental health to know where the knowledge gaps remain.
I’m curious, Kristin . . . . In your graduate program, were you and your cohorts required to go through any counseling as part of your degree requirements?
That was a requirement in my graduate training.
It’s comical now for me to look back to that period and remember how I didn’t “have a clue what to talk about” in those sessions.
In hindsight, of course, I don’t think that there are enough hours in the day to shut me up.
I’ve got plenty to work on still!
But, the reason I ask is that it occurs to me that those required counseling hours in grad school could be one place to start to introduce these conversations that get missed during actual class time.
You mentioned that you relocated and found yourself without a professional community.
That was true for me, too, when I relocated to Colorado 12 years ago.
Like you I made and found communities of support but it definitely took time and considerable effort.
I look at the vibrant community of mental health providers that exists here now and take pride in knowing that I helped to create it.
But, I also know that there are too many other therapists around the world who do not have the benefit of having that collegial support and desperately desire it.
Often, online communities such as this are the only places that isolated therapists can ask questions, find answers, look for mentors and resources.
Every single voice here matters.
Kristin, I hope you’ll drop in often to join the conversation here.
Your fresh eyes and clear voice are needed here, too!
Hi Tamara! Thank you for the sweet welcome and your response. In my program, seeking out personal counseling was not a mandatory requirement. It was encouraged by several professors, but mostly on an as needed basis (encouraging additional exploration and support if something triggered a student in a class for example). I made a conscious decision right before grad school started to pursue personal therapy to delve into my own stuff at a deeper level so that I could better understand myself and be more present and effective with clients. I strongly believe all mental health inclusive graduate program students could benefit from seeking out their own therapy, even if they initially struggle with coming up with things to discuss (as you pointed out, there are always areas we have to grow). I also believe there are always aspects of personal lives to explore further to gain better understandings of ourselves and how we show up in this work. At minimum it’s good to experience being on the other side of the chair and being in a position where you have to ask for support (something most mental health professionals are not great at in my experience…we’ll be the first to offer to support others, but we don’t need anything ourselves…or that’s at least what we often try to tell ourselves). Seeking our own therapy gives us a greater appreciation for the courage it takes for our clients to show up, choose to share intimate parts of their life journeys, and ask for support in navigating what they are experiencing.
I definitely think mandatory therapy could be a great way to explore some of the effects of this work on personal life further. Within that, having identified, dedicated therapists who are willing and able to engage with another helping professional/fellow therapist is an additional challenge. In the words of Brene Brown, we need to identify therapists who see other therapists, as their BS meters are better. Haha. If I can anticipate my therapist’s next move, it takes a lot of the impact out of the experience, so I personally need someone who is not going to be intimidated by my experience and is willing and able to challenge me.
Clinical supervision with graduate students also provides a great opportunity to discuss these relationship dynamics in relation to one’s work. Students are dedicated learners, so internships may offer a great, practical, timely opportunity to discuss the potential challenges this work may present in relation to personal relationships, peer support, and self care. For many grad students, internship may be the first time that they are experiencing the different facets of this work, so addressing these dynamics right out of the gate may prevent some frustrations and struggles down the line. As an intern, there is an expectation that you are there to learn, so it may feel safer to ask questions and provide guidance as a supervisor at that time as well.
There are many ways this could be addressed, and I am thankful this community of mental health professionals is engaging in this conversation to explore effective ways to further support our current and future colleagues, which in turn will also benefit our loved ones and clients.
Warmest regards,
Kristin
Thanks, Kristin, for continuing this conversation! I keep meaning to tell you that you can get a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
And, where are you and what is it you are doing right now?
I now live in Massachusetts and coordinate the clinical aspects and intake processes for a national bereavement camp, serving in different locations around the U.S.
WOW! What a cool job, Kristin! How does that mean you spend your day and do you do all of that from Massachusetts or do you end up traveling for some of that work?
We serve children and families who have experienced the death of a parent, guardian and/or sibling, so my job is to coordinate the clinical portions of our camps, complete assessments with families, collaborate with community service providers, and serve on site at camp programs to respond to all clinical-related issues and other crises that may arise during a camp program.
So to answer your question, yes, my job includes quite a bit of travel. I love it! 🙂
🙂 I hope when you are in Colorado that we can connect!
I would love that! The next time I’m planning a trip to Colorado, I’ll definitely reach out! 🙂
Mary,
I LOVE energy work! I find that it is just as necessary as physical care for sure. I love the idea of “fun that is funny” what does that look like for you guys? Sometimes it’s hard to come up with “fun that is funny’ when you just want to veg (or at least it is for me).
Amy, I think that “fun that is funny” means anything that is restorative for us that has ABSOLUTELY NOTHING to do with death, dysfunction, or emotional caretaking of others. That varies for us.
Kevin plays the Bodhran (drum) in a local Irish music group once a month. I’ve taken up printmaking. Kevin makes sure there is a lunch or breakfast scheduled regularly with a friend. I have my never-to-be-missed monthly creativity club. Kevin took up golf to get himself outside in fresh air and as a way to spend some solitary time. I’ve gone on silent retreats (blessed silence!). We attend an Italian language MeetUp twice a month. Kevin loves mystery & detective novels, I’ve just learned I need to return to fiction after I realized I was always reading work related material.
It is very easy to let the “therapist” identity become a limiting straightjacket….even something to hide behind. Mirror neurons work both ways! By consciously embodying the sort of presence & energy you would hope your clients might aspire to, there is a chance they will begin to resonate toward that.
I consider this part of my role as a therapeutic presence. A lot of the work is about maintaining your tool….which is you!
Mary, you obviously practice what you preach! I love that you can rattle off the many interests, the many practices that you have – with and without your husband. I think that our graduate programs for mental health professionals ought to focus more on the risks for therapists and clients alike when we don’t have these healthy practices in place.
Love your statement “I consider this part ofmy role as a therapeutic presence. A lot of the work is about maintaining your tool . . . which is you!”
Thank you, Mary, for being part of our online community here at Private Practice from the Inside Out!
Well said. I am at the airport for a week off in AZ. and oops – looking at a work related email/blog. But glad I did. Over the past couple years I have “enforced” out of office time for myself. I am fortunate to have a spouse who is supportive of my stress vacations. My practice began in mid-life and now am reaching my 18th year of professional work. I have 2 offices, no assistant, have begun the 3rd year of my own billing (data entry is just as hard to send to a biller as it is for me to pop it into my billing program). I have the ongoing what if worries you speak of; the heart break of hearing of horrific tragedies, mending small children and every other age person; Just yesterday!!!! And you are so right about the processing all the time. Problem solving on steroids. Ongoing always needed consultation is a must and “enforced” vacations! be it a day or a long weekend or wow! a week. I have a sis-in-law and brother in AZ who have an open door policy for me. They are a lifeline of laughter, new adventures, and my sis-in-law is a retired certified ER nurse, so she so gets my work.
Mary,
Sounds like you have figured out what works best for you and you are forunate to be able to have a safe, happy space to decompress. Wow- 2 offices and you do everything yourself! I can’t imagine but it sounds like you have a system that works. Thanks for checking in 🙂
Good morning, Mary! Welcome back!
I remember in the first few years of being in the mental health field that I couldn’t seem to get enough of the high stakes that Amy refers to and the drama.
Back then I craved that stuff and, in hindsight if I am being truthful, that was all about me donning my imaginary white cape to “save the world.”
I can see now that my language back then about the work that I do, was couched in the terms of a martyr and self-sacrifice and I was somewhat clueless about the realities of what was needed for effectiveness and longevity in the field.
30 years later, the last 20 in private practice, the “enforced” down time that you speak of is a no-brainer for me.
I learned along the way to schedule the down time and step away from the heady highs and the heart-breaking lows whether I “want” to or not.
It occurs to me that the way we initiate new professionals into the field – with little exposure in grad school to understanding how our work impacts our personal lives – and then ushering them in to agency jobs where they are underpaid, overextended, and working with the neediest of clients – our newest colleagues are set up from the start to struggle with work / life balances, boundary issues, and how to get their own needs met.
Perhaps now is a good time to put in a plug for clinical supervision, life-long professional consultation, and the benefits of having a good therapist to speak with as needed!. Much of my clinical work these days is focused on these things. At least half my practice is made up of therapists. Some come on a regular basis but many just need the structure and safety of a confidential space to openly process, vent, and regroup so that when they do go home . . . it actually feels like home.
Thanks, Mary, for talking about “enforced” time off just for you. It’s a concept that we (and our clients) can certainly benefit from!
Over time, I learned that whether I “wanted” it or not, I needed to
Ahhh, Tamara. Me too. Thank you for putting into language what I couldn’t quite articulate.
I love Amy’s piece as well. (Brava, Amy!) It’s not just the spouse though, it’s Insidious Smallness too, whispering in your ear that “what you do isn’t hard or worth it.” This piece speaks to that beautifully.
Jeanie, it’s so great to have your voice here! And, I love “insidious smallness!” YES! That little whisper can be amazingly LOUD and DISORIENTING!
The truth is that our work matters! It touches lives. We change the world – our own worlds and that of our clients’ too.
Thank you for doing what you do – what each of you does – and thank you, Jeanie, for giving us the phrase “insidious smallness!.”
By the way, I’m looking forward to your new website – when is it up?
I hope you will drop back in often to join the conversations here at Private Practice from the Inside Out!
(And, here’s how you can set up your own little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Mary and Jeanie, I forgot to mention that you don’t have a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
What a great article. Oh how true this is. (mental fatigue)
As always, Thank you Tamara G. Suttle and to Amy Flaherty, I really enjoyed reading this mental reminder. For the newbies, mental fatigue is a common condition, especially for those who work in careers requiring a lot of mental exertion, such as scientists, writers and business professionals.
Neal,
Thanks for our kind words! And yes mental fatigue is common among young professionals but it can also afflict those who have been doing it a while. Mental exertion is real too! 🙂
Good morning, Neal! Welcome back!
I appreciate you actually extending this conversation to include the mental fatigue that is also experienced in other fields.
It’s true! And, sometimes, I find that I have clients in those fields (or my colleagues and I have spouses in those fields) that may be sensitive to their own fatigue but not have the language or understanding of the emotional fatigue that mental health professionals likely experience.
Talking about others’ mental fatigue can be a great starting point to discussing our own emotional fatigue . . . and vice versa.
I think about the areas that I am most challenged in . . . . Linear thinking, in general, and numbers , in particular, wear me out and stress me out very quickly.
My partner, on the other hand, is really much more challenged by high emotions.
(Can you say “Opposites attact?”)
I know that she is as easily exhausted by emotional intensity as I am by thinking in straight lines and that means conscious conversations are required.
Thanks for the reminder, Neal!
Tamara, I was planning on reading through all of the comments before I commented at the bottom, but what you say here reminds me of something I learned long ago – it’s important to know who in my life really wants to know about my work (as far as advocacy or maybe wishing there was a different type of treatment to help a certain symptom, for example) as compared to those who really don’t care in the way that it is beneficial to me to discuss these things with them. The same goes for the self-care aspect in that some people in my life really get it and care to get it and others react similar to the way Amy expressed in this post.
I also find it interesting that the place where most people seem to fall on discussions on self-care really doesn’t change over the course of time – unless they have an event in their lives where they are involved with a counselor or some other similar profession and they have a change in outlook.
Great post!
Oh, Lauren! I’m so glad you’re in this discussion!
You are making some really interesting points.
So . . . why is it important to you to know who wants to know about your work and who doesn’t. How does that effect what you do and say?
And, I don’t think I’ve ever thought about how I discuss and think about my own self-care and whether or not that practice (and point of failure to practice?) changes over time!
Thank you for offering a point of self-reflection for me to engage in!
Is that true for you, too?
Well, as far as how it affects what I say, I try only to discuss (with regard to my work as a counselor) what the other person actually wants to hear. For example, if I’m frustrated because a school district is not following through with the accommodations on an IEP, I have a friend who is involved in the educational system and she can totally empathize with the frustration of dealing with a school district. As what is probably a better example, if I want to complain about how much paperwork there is with agency work, I have some friends who will just listen and say that that’s really crazy or something like that, as compared to some others who will say “who cares, you chose to do that work.” After hearing the latter response enough, I’ve learned not to do that with certain people. That certainly takes away from the idea of having a mutual discussion.
I must also be clear that a large part of my self-care is talking to my closest friends. I don’t mean that we are always talking about counseling-related stuff by any means, but it is still nice to have a friend to whom I can say “hey, I just read a really cool blog post.” It certainly makes the world of being a counselor not feel quite as – I guess the best word I can find right now is lonely – when I have a few people who really understand how much the world of professional counseling means to me. I certainly love my work. For people who choose not to recognize anything about it beyond the fact that I “work,” they are missing a large part of what makes me who I am.
Because I know there are a lot of people reading this, I also wanted to mention that when I say that I have spoken about an IEP, for example, I’m talking about saying something like “Why is it that it takes almost a full school year to have an IEP evaluation and then when it is finally completed, it doesn’t even begin to cover any of the accommodations that the kids might need” or “what is the point of having an IEP in place if there are always reasons why the teachers don’t need to follow it?” It’s very easy to talk about those kind of rather systemic concerns in such a general way that there is no concern about privacy.
Thanks, Lauren, for giving these examples.
I think there’s a lot of counselors out here who can relate to the frustrations of working in or collaborating with systems that fail to meet individual’s needs.
When I was new in the field – working first in mental health agencies, then working in the criminal justice system, and eventually working in a for-profit psych hospital – it was extremely frustrating to me to keep running into those and other “failures” of the systems I was working in.
Those are my words, Lauren, not yours, I know – but that’s how I thought of them back then.
Eventually, I started to shift my thinking (but not my frustration) and language about these gaps.
Today, I think that systems such as the ones you and I are talking about right here . . . are human i.e.imperfect attempts to (impossibly) meet the needs of individuals and families who have most often been the least resourced, most traumatized, and least valued among our citizens and immigrants in our country.
As such, I was ill-prepared to understand that those systems are underfunded, over-extended, and were never going to successfully meet the needs of those individuals seeking services.
People meet people’s needs.
Systems are only as good as those weakest links.
And, you and other professionals who are working within those least glamorous of setting committed to doing the best you can with what you have couldn’t help but be frustrated and even angry at times.
You, Lauren, are doing the really difficult work, the real heart-work in the trenches.
I’m glad you have support around you and are discerning enough to recognize when it is and isn’t there for you.
Thanks for being part of this community and being willing to share your experiences so generously with us!
You make a difference . . . in your work setting and also here.
Thanks. Now that I am working in both community mental health and a group private practice, it’s interesting to see the very noticeable differences in a lot (I would say more than 60%) of the way that the clients approach counseling. I certainly think that some of this is related to the fact that a lot of the people in the group private practice don’t need so much advocating for their basic needs. For example, I may just that they contact a doctor or a school or something, but I don’t actually have to model how to go about it. I know that the “systems,” as you put it, affect all of us in different ways, but I honestly believe that the coping skills that we have affect the way that we interact with the system. Maslow’s Hierarchy of Needs comes to mind here, in a way, but on a much larger scale. It’s almost like if we have a solid foundation of good communication skills and knowing how to ask what we need or want in a way that takes into account the system’s abilities and our own needs and desires, it seems to be akin to Maslow’s basic foundation needs, from which we can then build.
I love being a part of this community and there is certainly a sense of belongingness here.
This is just a thought, but perhaps you could put a sentence or two about the Gravatar in the form that we use to comment? That way, everyone would have a consistent reminder.
This is so wierd that a lot of my comments have disappeared – including my reply to yours here, Lauren. Hope that’s not happening to others!
You’re right, of course.
I kow that 100% of my thoughts, my feelings, and my behaviors are always about me and my history.
“Knowing how to ask for what we need or want” absolutely affected the way I felt in those systems and agencies as did everyone else’s.
We all have a responsibility for making the choices to improve or obstruct the places in which we work.
And, clearly in my 20’s had still had much to learn . . . about organizations and about myself, too.
When we learn better, we do better, right?
I love that you are so at home in your work settings, Lauren!
And, I know that’s not about the systems at all – but is, instead, all about the people that work there, their own histories, and the choices that make every day.
Thank you for the suggestion about the Gravatar! I’m in the midst of having my website redone. (I hope you’ll see that in the next month!)
I’ll definitely ask my favorite geek Michelle Panulla to see if that’s possible!
Thanks for the great suggestion!
Love the conversations and the article. I’m very fortunate that my spouses have been and are in fields that relate. My first was an ER nurse and then a jail nurse. My second was a hospice nurse. (I’ve been widowed twice). My current (and hopefully last) spouse is a funeral director and has extensive grief work training and is on a national disaster team that responds to mass disasters as a mortician. They get the downtime, and my current wife has a semi firm rule that work stays at work but support is always needed- for both of us. My recently adult kids have had trouble getting the work stress, but as they’ve faced close friends having serious crises they’ve become much more understanding- and in fact are calling me for the rapist referrals and psych referrals for med evals. Suddenly I’m doing hard work with real skills!
Hi, Jill! Welcome to Private Practice from the Inside Out!
Thanks so much for dropping in today to share your thoughts.
I, too, was widowed when my first partner died unexpectedly.
Thank you for sharing a bit of your story here.
It occurs to me that a different angle on this whole conversation could just as easily be how stress from our home lives and personal relationships also impact our clinical work on a daily basis.
Again, with a nod to the need for ongoing supervision / consultation and even therapy to keep our heads (at work and at home) where they need to be.
You do seem to have a lot on your plate!
Hoping you are taking the time to implement your own self-care plan along the way!
Already done and in place. And very fortunately my practice is shared with my best friend of decades, and now includes several others.
Sweet! So happy to hear of your success, Jill!
I hope you will be back here often to join the conversations, find support on your journey, and share what you know, too!
Oh, I meant to add, Jill, that I just noticed that you don’t have a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
I totally agree — I spend last week simply reading, watching TV, cooking soup; did not have much motivation to do anything. I was beating myself up for not “using” my time off well. After yesterday, I realize that i must have needed to just sit and be — because it felt good to be back in to office i feel ready to do this work again.
Kathy
My wife is a full time Therapist and group practice owner. She forwarded this article to me with a parenthetical “I think you “get” most of this.” , and indeed I do.
When we met almost 24 years ago I was an Executive Chef in Manhattan’s SoHo district. Our 3 year courtship certainly had its bumps. I believe we broke up 3 times as a matter of fact. I was consuming a steady diet of what it was like for a therapist in the trenches of addiction therapy (matrix model? If I’m getting that wrong I’ll know soon) In a nutshell, even then she needed to explain to me how it wasn’t just a job from which one could detach immediately at quitting time. She was good at explaining that to me and the more I knew the more I loved her.
As her career progressed and we adjusted to married life her daily stresses became compounded by the politics of Non-profits and Corporate structures. her days became difficult and exhausting. Did she take a break from any of it? LOL no. She decided she needed her doctorate and while maintaining a full time position as a clinical director she became a full-time student. When the dissertation process started I was warned about her absenteeism from the marriage (figuratively) until she got it presented.
I had my moments of resentment. I worked extremely hard during those years as a chef and really couldn’t equate her mental exhaustion with my physical labors AND mental exhaustion. I mean decisions I made everyday effected people’s lives and health. I was in a position where I could possibly KILL someone if I made a mistake for kriminey’s sake! However….
I had NO problem disengaging when my day/night was over. Heck I could have a couple of cocktails and play a video game or play an instrument or any number of hobbies and interests I’ve had over the years. When the check was paid, good or bad, it was over.
I have no vested interest in knowing if that wedding reception I catered was for a couple enjoying a blissful marriage to this day. Heck they could be divorced – what do I care?
Now that my wife is a Doctor of Psychology it all gels for me. She is as much of a healer as any physician. And since she is dealing with mental illnesses and concerns, her brain is not only multi-tasking but editing, classifying, buffering, working in tandem with her own emotional growth and development , formulating and quite frankly at times, praying…all in the same hour.
My conclusion, every therapist with a full practice needs a housewife, a cook, a maid, a listener and a friend. I fail miserably in trying to be all of them but she loves me for trying. I now know without any doubt how important her work is and how important it is TO HER. To this day (thanks to facebook) she receives the occasional note from a former patients usually accompanied by photographs of smiling people with kids. Each and every time it means the world to her, it’s like just that much more weight has been removed from her secret bag of doubts. She is truly my hero.
We have a code-phrase for the days full of those hours. “My ears are full.” is all she has to say. And in the ensuing silence we couldn’t be closer.
Love this! Thanks for contributing Michael. (By the way, you could be a writer in your second career!)
Michael! Welcome to Private Practice from the Inside Out and thank you, thank you for taking time to share the other side of this discussion! I had hoped that spouses might show up here!
As mental health professionals, it can be easy to hang out right here among our “own” kind and wallow and weep over the ins and outs of running a private practice. However, it’s when we get those dissenting voices, client voices, and yes, even spouses’ and partners’ voices at the table that we can best see ourselves in context.
I laughed when you talked about your own responsibilities as an Executive Chef because I can’t think of anything more anxiety-producing than trying to get a meal on the table all at once – that had to be edible! Give me a suicidal teen or a grief-ridden mom any day over that!
Still, I get what you mean and appreciate you noting that it has taken work – real work to build a solid relationship based on mutual respect and full hearts. Yours is a story that doesn’t get told to mental health professionals in training . . . and one that’s not heard often enough by more seasoned professionals, too. And, when those stories don’t get told and repeated . . . couples struggle and therapists fail.
Thank you for your generosity in sharing today! I hope you’ll be back to chat again!
Oh! And, I almost forgot . . . You don’t have a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Wow Michael- I think I’m going to forward YOUR comment to MY husband 😉 I love how empathetic you are for her journey and you can tell that you really respect what she does but it sounds like it took a big of struggle to really see it. I agree 200% about the writer bit and it sounds like you would have the life journey to flesh out your writing as well but that is just my 2 cents:)
Hi, Amy! Thank you so much for guest posting today and for staying so engaged with our community here! I so appreciate your commitment and follow through to this.
And, I wish I had little “like” buttons by each comment because I am loving this one –> “I think I’m going to forward YOUR comment to MY husband ;)”
Have a great week!
Thanks for sharing your thoughts, Michael. I’m definitely going to share your response with a few friends of mine. I think it’s great that you’ve taken the effort to understand the professional counseling that is so incredibly important to your wife. It really seems like you’ve given a gift to each other in becoming that much closer. Also, I love the phrase that you use about her ears being full.
Hi, Kathy! And, welcome to Private Practice from the Inside Out!
Good for you for allowing yourself the down time to recuperate and that you get, in hindsight, that you actually needed that vegging time to get ready to do the hard work of providing therapy again!
Just took a quick peek at your website to find that you are in Greensboro, North Carolina!
I so miss living in Avery / Watauga Counties there and have my favorite old college roommate and her husband moving to Greensboro as we speak. Lucky you!
I’m hoping to make my way back to North Carolina later this year to provide some consulting and training for local therapists.
I hope you’ll stay in touch! Maybe we can meet when I get back there!
Kathy,
I love that you said openly that you did NOTHING- sometimes I feel bad for not doing anything- like even in my time off I feel like I SHOULD (that nasty word) be doing something more “self-carey” like yoga or meditation or something that everyone talks about is so important but then end vegging out to netflix. I bet your clients get better care when you feel better too- how often do you take these little mini vacations?
Hey, Amy, just for the record, I am not borrowing “self-carey.” You’re cracking me up!
And, I’m a huge advocate for binging-for-self-care – on soap operas, sitcoms, movies, or whatever! It’s called escapism and sometimes it’s wonderful to see other folks struggle and know that it’s not my job! After all, where else in the whole world can therapists really say that?!
It makes me sad that Amy’s husband says these things to her. It must be hard to deal with such a blatant lack of support from the one person who should know–or at least attempt to figure out–how she’s feeling. Even if he can’t empathize because he hasn’t been there, shouldn’t he make an effort to find out *why* she’s feeling so depleted? I appreciated Amy speaking out for therapists in this post. But there seems to be a defensiveness in her words (saying how much harder a therapist works than someone who flips burgers or answers phones or does data entry, for instance), and I wonder if she might be able to resolve some of that if she and her husband had a sincere heart to heart.
Hi, SG! Thanks so much for dropping in to chat today.
It’s funny, I think, how easily it is to be misunderstood when communicating through text rather than through video, face to face, or even by phone.
We just lose so many of those nonverbal cues, don’t we?
I don’t know who’s right here but I will say that I didn’t read her post quite the way you did.
I didn’t hear a “blatant lack of support” or even “a lack of effort” to understand her as much as I heard she’s married to a guy who doesn’t do emotionally intense work.
In my mind, it’s like . . . a language barrier more than a lack of interest.
Ha – of course, I could easily be projecting my stuff on to Amy’s household because there’s definitely a language gap that has to be worked around at my house!:)
I know I am most comfortable speaking my “touchy-feely” language about “emotional fatigue” and that certainly some others feel more comfortable talking about their “physically exhausting” day of doing manual labor or answering the phone, as you suggested.
I so appreciate you taking time to share your own observations here and note that whatever Amy is experiencing and choosing to share here, I’m sure there are certainly many homes of many therapists in which spouses do fail to empathize, do make no effort to understand “why,” and do struggle to stay connected when so much of a therapist’s energy is directed toward others.
Perhaps Amy and others can share some of the third, fourth, and fifth ways of having understood Amy’s post.
All of your words speak to me and for me! I have a private practice that treats individuals and families. But I also see over a hundred convicted sex offenders in groups. I do the billing and cleaning and pastor a United Methodist church. On Sunday afternoon I succumb to the Holy Nap! I love my work, but, yes am exhausted!
Marilyn!!!!!!! “The Holy Nap!” Oh, my goodness, I love that language and I love that concept!
Welcome to Private Practice from the Inside Out and thank you thank you for joining this conversation!
Pastors and and others who work within the context of meeting the needs of resource-challenged individuals and the emotional intensity that is required can definitely identify with Amy’s words.
Unlike many of us, you have even additional layers of high stakes to attend to.
I hope and pray that you have created and are attending to your own solid plan for self-care.
And, yes, I say that fully knowing that I’ve never met a pastor (or even a pastor’s wife) who routinely carved out time and space guilt-free to take care of their own needs.
(So should you be really good at this already and be looking for a niche . . . .)
Marilyn, I hope you will drop back in often to join the conversations here.
Your voice and your perspective are always welcome!
OK, Marilyn, I know people are going to think I’m a bit obsessive about this but . . . our community here at Private Practice from the Inside Out is growing so quickly that having those little photos by our comments really does help us to get to know each other easier so . . . .
If you want one of those little photos of you that shows up with your comments here (and on other blogs, too). . . . They are called “gravatars.”
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Wow! Wonderful. Thank you for writing this. Brought a tear of recognition to my eye. Blessed to have an understanding husband.
Thank you, Marc, for taking time to so generously share this post on Facebook with your tribe! I so appreciate it! Please let me know if I can reciprocate at some point!
Hey, Marc! I almost forgot!
Where is your gravatar?! I just noticed that you don’t have a little photo of you that shows up with your comments here (and on other blogs, too). Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Thank you Marc for sharing this article on Face Book. This article so confirms and validates my experience as a solo practitioner. During the recent holiday I took December 24th thru January 5th off from work. I excused myself from visiting my significant other’s family for Christmas and stayed home with my two lovely pets (Sigmund the cat and Diego the dog). It was such a lovely time of solitude and self-care. I sensed that some friends and family felt badly for me that I was alone. I don’t think they understood how refreshing it was to just BE for a moment. No phone calls to return, no appointments, nothing to reflect back to anyone other than the sweetness of my furry kids. It was my own personal retreat. AND I managed to sidestep the insanity of the holidays. I think I’ll do it again next year (maybe sooner).
The one thing I will add to what makes this work exhausting is that we as therapists also have the added responsibility to keep learning. It is not stagnant work. Through my 16 years as a therapist with 11 of those in private practice, I (as most of us do) continue to read, study, and train. As I move my practice into deeper work, I find myself more challenged to bring to the consulting room and to each client what I am learning towards a deeper experience of the Self. That means my own personal therapy has to deepen as well. We are (hopefully) always working on ourselves!
Thank you very much for this article and for the conversation that followed. I agree, exercise and fun have become important parts of my weekly routine. So necessary to maintain the balance. I am so fortunate to have a partner that doesn’t question when I say I am tired, listens to me ramble on about Jungian writing, and is always ready to have fun with me. Thank you for letting me share my thoughts.
Meg, welcome to Private Practice from the Inside Out! I’m so happy to have your thoughtful comments here!
You’re right, of course, ongoing work on ourselves – both emotionally and mentally – is a double-edged sword.
It’s invigorating to continue dis-covering, unearthing, and cleaning up throughout our professional lives; it’s also an addition commitment of time, money, energy, and resources – and all of that means additional burdens and pressures.
I would say ‘lucky you!” for having such a supportive partner but . . . I don’t believe in luck!
Nevertheless, so happy to meet you and happy to hear that you and your partner have made some great choices to support you on your journey!
I hope you’ll drop back in often, Meg, to join the conversations here!
Meg, just dropping back in to let you know that you can get a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Amy and I are great friends as well as colleagues. And I am fortunate to get her good feedback and wisdom often. Amy your blog is spot on and super helpful. My New Year’s resolution is to have more of a life outside the office _ to hobbies and tasks at home that I look forward to going home to. That way, I can insure more time for myself, me-time, to focus on something other than the challenging stories I have heard all day. Thanks again for your words. Love your article AND the conversation! I can’t wait to hear more.
Hi, Rebecca! Thanks so much for taking time to drop in and chat! What is it you do and where are you?
Here’s how you and others can get a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Rebecca,
Thanks for the positive feedback and everlasting support. Your practice is awesome and I’m so happy you are my friend!
Now, like Tamara said you need to set up your gravtar so we can see your pretty face 🙂 (Don’t roll your eyes) 🙂
hi Amy and Tamara
Amy you did such a great job explaining this! I thought talking about the mirror neurons was an especially effective way to illustrate what is exhausting about the work.
Great job on a great post.
Amy
Amy Maricle! Welcome back!
And, where is your gravatar?!
Surely you have one 🙂 !!
Thanks for taking time to drop in and let us know we’re on the right track!
Amy,
Thanks for the nice comments. Glad you liked the mirror neuron stuff, I often think about my mirror neurons after a long day of hearing yucky stuff.
Do you find that your art therapy stuff helps “clean off” your mirror neurons a bit? I find that sandtray does that for me and I bet art is the same way.
Hey, Amy – Martha Crawford, LCSW (blogging at What a Shrink Thinks) was tweeting yesterday in response to your guest post and stated the following . . . . “Some really nice points but no evidence links therapist work fatigue to mirror neurons . . .” and then links to this post http://www.wired.com/2013/12/a-calm-look-at-the-most-hyped-concept-in-neuroscience-mirror-neurons/> .
I wanted to offer you an opportunity to respond right here.
Well . . . It looks like Amy has gotten a little busy with her new training gig and Martha followed up on this by saying the “only thing that has been established is they mirror the motor cells in the monkey brain” and offers a second source of info here: https://www.psychologytoday.com/blog/brain-myths/201212/mirror-neurons-the-most-hyped-concept-in-neuroscience .”
Tamara,
Thanks for bringing up this point and I will clarify- as I did with Martha- I’m by no means saying I’m an expert in all things mirror neurons nor do I claim that this article is an end-all answers to why we get so tired. What I do posit though is that there is some research that backs up the motor neuron/mirror neuron posit that what we see feels like it is happening to us- especially with an emotional connection or past experience- which the article Martha referenced does indicate. Mirror neurons have been referenced in many national talks I have witnessed, such as at Association for Play Therapy national conference and is made referenced to in several trainings and books, including those by several leading neurosciencists. I think to dismiss the idea that mirror neurons play a role in what is happening in the therapy session just because some scientists don’t agree on their role is liken to throwing the baby out with the bathwater.
Hey, thanks, Amy, for dropping back in to address this! This is not my area of expertise but, like you, I, too, have attended workshops where mirror neurons are discussed in this manner.
Dr. Bessel van der Kolk’s work comes to mind as one place that I have seen this addressed.
Wondering if there are other readers who can reference specific sources that discuss the role of mirror neurons in this context . . . .
If so, feel free to share below!
That was an excellent post! First of all, my husband will definitely be reading this! I have a hard time “shutting down” at night. If I finished one thing, I am still thinking about the countless other things that need to be accomplished. My husband always tells me, “shouldn’t you go to bed now? It’s late, go to sleep.” He doesn’t understand that if I don’t do it, no one else is there to do it for me. Did I mention I am narcoleptic. I don’t fall asleep on anyone. I just suffer from EXCESSIVE day time sleepiness and can’t fall asleep at night. It is total mood altering madness. As I continue to grow my practice, I am learning the importance of self-care that I have lacked oh so much in the past. I feel like I am constantly on edge and the narcolepsy is gasoline to the fire. However, I have been working on getting back to my hobbies (painting, photography, reading) and IT IS OK! It is more than ok, it is crucial! I am thankful I am learning to take care of myself early in my career. Again, great article!! It provided me with the much needed validation!
Tamara, I know you are going to tell me to put a picture up…please tell me how to do so 🙂
You did it, Cindy!! That’s great!
HEEEEYYYY, Cindy! It’s so great to find your voice here!
You know . . . I hope you give some serious thought to specializing in sleep disorders at some point in your career!
Most therapists have clients that struggle with this but have very little in depth knowledge (including me) about how to work with long term sleeping disorders.
There’s a HUGE niche there waiting to be
exploiteduhmmmm . . . errrh . . . I mean “filled.”You just might be the gal to do it!
Thanks for dropping in tonight to chat!
Hope you’ll be back often to join the conversations!
Hi Amy and Tamara!
Great post and I couldn’t agree with this more!
There’s so much more to being in private practice than just clinical work! With so much to do, it is impossible to get it all right all the time — especially when we’re exhausted and overwhelmed — and sometimes we have to make the difficult choice to let some things slide. Too often, however, those things end up being the very things that can land us in a lot of hot water — not correcting billing mistakes, missing paperwork deadlines, the list goes on and on! These are the very things that result in audits, lawsuits, licensing board complaints, etc.
With both of your permission, I’d like to include/link to this article in an upcoming post focusing on self-care on my own blog (The Synergist, http://www.SynergyConsultingSvc.com). May I?
Theresa,
I’m glad you found that the information rings true for you. I know all of those little “details” often cause HUGE amount of stress for me. Only recently have I allowed myself to hire out as many of the details stuff as possible and my business and my personal life is so much better for it.
I don’t mind you reposting the blog but Tamara would be the final say about this since the blog post in on her site.
Best of luck:)
Theresa, this is soooo WIERD! I responded to this last night but can’t find any evidence that it ever got posted so . . . trying again!
I’m so glad you dropped in to chat because, of course, we can’t do everything all at once and we certainly can’t do it “perfectly!” And, you’re right that when we make those judgement calls (or refuse to make those judgement calls) and drop the ball, those are the places that we are most vulnerable to doing damage, being the subject of complaints, or even legal allegations!
You are welcome to include a link back to this article – thank you, thank you – but you do NOT have permission to repost this article in part or whole anywhere else. I love that you want to share the content with your readers – and please do by linking back here. If you copy and past even a portion of this article (beyond a few words), Google will severely penalize you and me.
In blogging, the proper thing to do is to reference the post, the author, and the blog it resides on and then link directly back to it. Thanks for asking! Here’s the permalink that will take your readers right back to the actual post rather than having to plow through my entire blog to find it: http://www.allthingsprivatepractice.com/1-post-every-psychotherapists-spouse-must-read/. If you let me know when you reference it, I’ll be happy to drop in to chat over there, too!
Amy and Tamara — thanks for letting me share this – and thanks for giving the info to do it so the both of you get proper credit! There’s nothing I hate more than someone “swiping” someone else’s stuff!
🙂
Thanks for this insightful and validating article. My husband, a physicist and therefore a numbers, hard-science guy, used to question why I wasn’t willing to work a 40 hour week. I think he now understands that listening intensively for 50 minutes straight times six or seven, not having the freedom to get up and move around, experiencing the emotional intensity of trauma survivors, and then dealing with the vagaries of office staff and insurance issues is consuming and draining. Does anyone else experience listening fatigue? At times after a full day of concentated listening I can barely stand to listen to anything other than trivialities when I get home. I now realize that most therapists book about 20-25 patients weekly, about what I do, and so I have banished the notion of the 40 hour work week from my mind. Seeing 25 patients equates to more than the face-to-face time.
Lisa,
YES about listening fatigue! It’s like I can’t hear another person’s stuff but then I know I have to keep going to do more stuff for my business and my clients.
So you have about 20-25 clients a week? That sounds about right. Do you have a waiting list or struggle with keeping your schedule right where you want to be? I’m always going back and forth with that.
So glad your husband now understands about why it’s hard. I know that when I take days “off” to work on marketing and such I’m not NEAR as tired after workng on that stuff for 6 or 7 hours.
“Listening fatigue!” Oh, my, YES!!
But, Lisa – it affects me differently . . . .
Yes, I’m tired of listening BUT what drives me batty is the trivial and incessant chatter that can go on after I’m done with work!
Like you, much of my work is trauma-focused and filled with intense emotions and high-stakes stories every day.
I sometimes struggle then with having to listen after hours to normal chit chat about football games, pop news, and fashion.
What I know now that I didn’t know 20 years ago is that your reaction and mine are both normal and even predictable.
Right on, sister!
YES!!!!!!!!
I just opened my practice in May of 2014 and find that I love what I do, however, I do find myself lost in thought when not at work, lately, thinking about my clients. I have been a clinician for a long time and thought I was pretty good at letting it go but for some reason I didn’t realize the additional pressure I had put on myself now that I am not in an agency. My husband just asked me the other day why I was still thinking about a particular client that had finished therapy. “Your client is back in school so your work is done with them”. Little did he realize that my mind was at school with them!!!!!! Thanks for the great article. I needed this little reminder that even though I love what I do, it still is stressful.
Hi, Krista! Thank you so much for showing up in this conversation to point out this pattern!
I’ve heard therapists describe this as “obsessing,” “ruminating,” and “daydreaming” about clients.
What I know now that I didn’t know 25 years ago is that this type of behavior is most often a sign of boundary issues and counter-transference.
It makes sense, right, when someone else names it?!
I don’t know why we can’t see that for ourselves . . . Oh, yeah, it counter-transference! 🙂
I used to fantasize about taking care of my clients for days after I saw them.
The only thing missing was my white cape!
I don’t know why counter-transference is not more aggressively discussed in graduate school.
These days, the term is almost relegated to being some archaic reference to Sigmund Freud.
However, what I know is that when it shows up – as it inevitable does (albeit less often now than in the early years), I get my butt into consultation to figure out what’s really going on and to clean it up!
I don’t know if any of that resonates with you, Krista, but I’m certainly happy to have your voice in the mix today and to have an opportunity to say “Therapist beware!”
I wish someone had clued me in much earlier in my professional work so that my time away from work was truly my time for me and my family!
Hi Amy and Tamara,
Thank you so much for this post. I found it so useful. I have opened my practice in Jan. of 2014, and I cannot believe how much additional stress I have been experiencing. Often people say: “But you are your own boss now….enjoy!” They are right, but what they don’t know is that I can be the most demanding and critical boss of myself:) Amy, your post reminded me (not even my husband) that doing therapy is hard!! I love the part about mirror neurons. I am an Emotionally Focused Therapist, so I do work hard on heightening people’s softer emotions–usually pain and fear. No wonder I come home exhausted:)
Maybe I should treat myself to a massage at the end of his week!
Best wishes,
Marta Kem
Hi, Marta! It’s great to have your voice back here! Your comment makes me laugh because we actually had one colleague who reached out in Facebook to say that she “scanned” the article and decided not to read it precisely because it reminded her, too, of how hard our work is! Ha!
I’m highly recommending that massage. In fact, you’re reminding me that I’m overdue for one, too!
Marta,
I love EFT and yes heightening those emotions can be wearing. You deserve a treat for sure, I’d get the massage. Take a break- you have to work for something right? 🙂
Hi Amy and Tamara,
I would like to post your information/blogs to my supervision site. What is the correct way to credit another blog or specific site where information came from?
Hi, Athena! You’re hailing from one of my most favorite states – Washington! I’m always looking for opportunities to head back there!
Welcome to Private Practice from the Inside Out and thanks for dropping in to ask about the proper way to share info from another site on your own website. Your question speaks volumes about your integrity.
The proper way to share information found online is the same as it is for print material. You can simply summarize the content or even quote a sentence or two and then link the actual post where the information was shared. For this particular post, you would like back to this permalink: http://www.allthingsprivatepractice.com/1-post-every-psychotherapists-spouse-must-read/ .
Thanks for reading my blog! I hope you’ll drop back in often to join the conversations!
Our own personal wellness and self-care is vital. I remind the practitioners in my office of this all the time. I am fortunate that in my practice we have 2 massage therapists. One would think the counselors would make time and take care of themselves. Unfortunately, I do not see this happening as often as I would like to see. I am diligent about it. I am on that table every 7-10 days. It is in my schedule just like my clients. I also schedule in my weekly pilates class, my meditation group energy work/Reiki and so on.
Having lived with MS most of my adult life, I realize the importance of self-care. If I do not put that first, then I would never be able to do my work. I also feel that for me to be authentic with my clients when I speak about self-care, I need to be also be taking care of me.
I do remember this being discussed in my masters and doctoral program but the message does seem to go over our heads. I think for many we do not realize how many layers there are to the work we are doing. Amy did an amazing job of laying that out for us all to see.
What do you do when you are so emotionally exhausted? How do you take ownership of your positive thinking and avoid falling into the trappings of depression or feeling overwhelmed?
I’m told “being generous and kind are the ultimate mood boosters” by blogs like: http://thepowerofpositivehabits.com/seven-tips-to-improve-your-health-immediately/ but what do you do when you’re feeling all your generosity and empathy is tapped out for the day? How do you avoid that burn out, or is it just something that needs to naturally recharge? Do you just simply choose to celebrate the little victories?
Jaclyn,
I think almost every mental health professional has things to do when feeling overwhelmed. Because of the subject of this post, I’m assuming you mean when you get home from a day in the office rather than when you are in the office.
In addition to things like watching TV, scuba diving (when I can), and leisure reading, I find a lot of help through being involved in communities like this one. Most most of the people here will have empathy for your questions of what to do when you have any more empathy at that particular moment.
Do you have anyone in your life who just recognizes when you need to be who you are and can provide that support for you to just allow you to “be”?
And yes, I do most certainly celebrate the small victories.
Hi, Lauren! Thanks so much for dropping in to share what you do to help reduce the onset of burnout and to ask about Jaclyn’s access to support! That is key to long-term survival as a mental health professional, isn’t it?
(Hey, your business cards arrived today! Thank you!!!!)
Hi, Jaclyn! Thanks for dropping into chat! You bring up such a good question here. I tire easily of simplistic answer to these questions because as mental health professionals, we are actually mandated to engage in both self-reflection and self-care. Overly simple “solutions” like “just think happy thoughts” aren’t useful at all and can be demoralizing to professionals who typically invest their own money, time, and energy to help others feel better. Burnout is a very real risk for mental health professionals (and other helping professionals, too). And, “celebrating the little victories” is certainly one piece of that puzzle. However, proactive as well as reactive steps need to be taking on a regular and habitual basis to reduce the likelihood of falling into overwhelm as you so aptly imply.
I am in the middle of my second year of graduate school; I will commence practicum this summer. I was scared before, and now this article terrifies me. This is my passion, but I am so scared to go forward with it. There are so many things that can go wrong, not to mention that I am already a very stressed person. I don’t know how much more I can handle of that. It might break me. (Stress-induced heart attack anyone?) How much self-sacrifice is appropriate? I understand how important self-care is, but where the hell do you find time for it??? I wonder.
Hi, Bethany! I’m so glad you took time to write today . . . and so very sorry that this has scared you.
I do know that graduate training is / was stressful – really stressful – for many of us and that’s before life happens to us while we’re in graduate school.
My mom died while I was in graduate school; I had friends who got pregnant and had babies; others went through divorces and job changes.
So, I totally get wondering how much any of us can handle and it’s a fair and necessary qustion.
I chose to drop out the semester my mom died (because I couldn’t fathom catching up) and then returned to classes.
That break served me well.
What I do know is that I tell every therapist that it’s critical (especially during periods of high stress) to carve out time for self-care FIRST.
If you aren’t yet good at that, then nothing – including your graduate training – is more important than that.
If that means time off from your graduate program, the so be it.
Self-sacrifice does not serve anyone well.
It’s not useful; it’s not healthy; it’s not necessary or needed to do a good job in mental health.
If reading any of this feels like a breath of fresh air or permission to breathe, then consider where you are going to find your support.
Consider working with a therapist; after all, we all need support.
If reading any of this makes you feel even more stressed and panicky, consider again where you find your support.
My graduate program required 6-10 weeks of therapy.
I hope yours does, too.
Although I didn’t “see a need” at the time, it was the best thing I ever did for myself for so many reasons.
Even if all you do for yourself for 6-10 sessions is focus on self-care, you will be a better therapist because of it.
Bethany,
I’m glad you chose to write as well. As Tamara mentioned, self-care is very important. I wonder if right now the prospect of adding one more thing (in this case the “thing” being self-care) is overwhelming in itself. I would encourage you to consider something like this: I wonder what you can do for 5-10 minutes each day for yourself. I wonder what you could do for an hour on a weekend or non-working day.
Self-care is something that changes pending on what you need or want at the time.
I have friends who consider that I do too much work on the weekends. The thing is, to me, the online course that I’m involved in is something that I really enjoy and while it is work related, it’s also something that is personally empowering. To me, 95% of the work I’m doing for the online continuing education course is not really work, but something I really enjoy. Also, like the community here, the community there is really supportive, so it’s actually an environment from where I get to learn from people who share some of my values.
My point is that self-care varies considerably. For me, it involves talking with one or both of my closest friends on a daily or nearly daily basis. I also use imagery. In addition to that, I enjoy watching some TV. I follow several different shows and make sure that throughout the weekend I catch up on the shows during the week that I might have missed. This could amount to anywhere from 2 to 6 hours of TV depending on how many shows are running in that particular time frame.
This is what works for me.
Do you have any thoughts as to what might work for you?
I also encourage everyone to have what I call a “reset button.” This is an image that you can have in your mind – whether it is related to someone you care about, a place you have been that brings you joy, or any number of other things – on which you can focus for just 30 seconds or so as a way to quickly “reset” in between sessions or during some other very short break.
Lauren, just dropping in to say I so love that you stay engaged with the therapists in this community! Thank you for offering such concrete examples of how you engage in self-care. I remember you saying years ago that you use this “reset” button and I’ve used it on many occasions for myself and taught it to my clients as well! Hope you’re having a lovely week!
Thank you! This is all so true. I even had a good laugh when you talked about “your office gets flooded”. It happened to me just over a year ago and of course I was out of town on one of those short vacations that really only add stress because you know you’ll be returning to more work than you had when you left! Love and light to you and all my other fellow helpers in the world!
🙂 Hi, Alanna! Hope you’ll be dropping in often with your own stories – but no more flooding, please!
Hello, My wife has her own private practice. She works 10-12 hour days 5-6 days a week. I also have my own business and work the same amount of hours. My question to you is, how can I help my wife with relaxing, and help to make her life easier so she can unwind faster. I know her job is really exhausting. My Work can be also but not everyday like hers. I love my wife and I would like to be able to talk to her more, but when she gets home she does not want to talk or do anything. And I completely get it. Im just looking for some ways and things to do to make her life easier and better, and supporting her and her business the best I can. Any suggestions would be great! Thanks!
Hi, Thomas! Thanks for dropping in!
Your wife is lucky to have a husband concerned about helping her relax.
I could offer you simplistic suggestions that would likely change nothing.
Instead, I would encourage you to go with her for a “tune up” to a couples therapists to help you both reconnect.
It can be a fun and energizing way to look at your individual needs, interests and resources and reassess how you want to take care of those.
My wife is a therapist. What can I ask to show interest? What topics DO therapists want to be asked about their day? I’m sure bringing light to information that may have been difficult can be hard. I want to be able to hold space for her to feel heard and appreciated when she comes home. How can I better show that?
Nicole Hoopingarner
Hi, Nicole! Welcome to Private Practice from the Inside Out!
How lovely to hear from a mental health professional’s spouse.
It’s a great question!
I think you can ask what you would ask anyone else . . . “How was your day?”
And, “what can I do to support you?” sound like good beginnings.
While your wife cannot discuss clients and their work with you, she can definitely discuss her feelings and her work with you.
And, most of us welcome someone who is interested in knowing how our day went, what the high and low points were, and how we are / are not coping with those feelings.
If you are into books and haven’t read The 5 Love Languages by Gary Chapman, you might find it to be a quick and helpful read, too!
Thanks for dropping in!