The Curse of Being a Therapist

Most of us join this profession because we truly want to help.  To be present with another's suffering and healing is such a powerful experience.  There is so much meaning and purpose in what we do! But with all this meaning comes the other side of our job, the curse some might say, the intense internal stress of being a therapist for hours day after day.

It's important to be honest about its effects, identify the stressors, and find solutions to cope effectively.  Through the proper support we all can thrive in such a unique environment or else live our lives cursed by helping.   

Stressors of Being a Therapist

1. Alone in room with clients so no direct support for the job.  

This one factor has a way of isolating us from others, forcing our own emotional baggage to the surface, and leading to burn out.  

2. Dealing with severe mental health issues can be very OVERWHELMING, especially if not ADEQUATELY trained.  

Without the proper training we can feel like we are suffering with our clients by feeling helpless and overwhelmed.  Now repeat that times 5 days a week 52 weeks out of the year.  

3. Dealing with high intensity emotions daily.

If we have not done our own work, our own countertransference can create poor internal and external boundaries, leading to poor self care, and feeling like we are constantly in fight, flight, freeze, or fawn. 

4. Trained to do no harm - can be misinterpreted when in practice in the therapy room.

We know the do no harm ethical dilemma, we hear it repeatedly in school. Therapists as a whole are rule followers so this suggestion become a barrier to proper treatment.  Imagine being in a therapy room, in front of you is a highly depressed client unable to get out of bed.  So we warmly understand their plight and unknowingly support their choice to stay in bed.  Do no harm right?  Versus exploring the consequences of staying in bed, and being honest about how that behavior affects their daily functioning and increases their depression.  

5. When EMPATHIZING at such a high level with high intensity emotions, It can be difficult to hold your boundaries.  

I do not allow myself to ruminate over clients when I leave the office.  It is a job I do, a role I play, and when I am home I focus on my life outside of work. If this is hard it may be a sign of countertransference.

More Contributors to burnout

1. Overworking

Make sure your caseload is sustainable.  This is a marathon not a sprint.  I hear so many stories of therapists in agencies with a large caseload that contributes to their stress and ultimately burnout.  

2. Alcohol/Drugs/other Addictions

Many humans use alcohol, drugs, excessive shopping, overworking, or gambling to cope with their inner stress.  Addictive or compulsive behavior patterns provide temporary relief but create consequences that contribute to burnout.

3. Increased emotional DYSREGULATION

Therapists report arguing with family members and isolating after long work days. Now repeat this for 52 weeks out of the year.  

4. Problems sleeping

Problems sleeping can be biological or indicators of stress and contribute to burnout.

5. Decrease in Self care 

Therapists report not having energy or time to do the proper self care to rebound from the day.  Self care is like an elixir that helps us bounce back from the stress of our job.

6. RUMINATING over work

This one can be an indicator of countertransference, or overworking, or a need to consult with therapists with more training than ourselves.  

7. Poor boundaries with clients

Poor boundaries with client's emotional needs, with their scheduling requests, and responding to texts and calls frequently contribute to therapist's burnout.

8. Poor internal boundaries

Taking their problems within you is poison.  Our clients are responsible for their own work and if we are carrying them emotionally it may be time for a referral or more training.  

Coping effectively with The helping profession

 1. Exercise

This one is a personal favorite, being outside and feeling those endorphins helps release the day's stress.  

2. Time boundaries with work

For me this looks like setting times when I stop answering texts and calls.  This one is essential. Setting boundaries with our clients creates safety in the therapeutic relationship.  It does not make us a good therapist to never say no.  Effective relationships have boundaries and I am empowering you to set and hold your own.

3. Seeing clients in scope

Only seeing clients you are trained to see! This one may feel daunting in the beginning so it helps to consult to stay in your training lane.  It is a gift to yourself and your clients.  We are a community of helpers and referring reinforces that reciprocal community.  

4. REFERRING COUNTERTRANSFERENCE clients

Countertransference means you have your own work to do, so referring these individuals is essential.  It is not a deficit to refer clients that contribute to your anxiety, poor boundaries, or similar histories.  When my father died I could not see clients struggling with death.  I referred these clients until I did my work and had time to grieve.  

5. Hobbies

Creating our own joy, contentment, and novelty is important daily.

6. Sleep

Sleep may be one of the most important things you do.  It is where we process the day and our body repairs itself.  

7. Consultation groups

I am in 3 consult groups.  Support for difficult cases keeps me in scope and certain about how to treat my clients. Certainty leads to more presence in session and less emotional consequences afterwords.

8. Continuing education

I am always learning, because knowing creates confidence when I am alone in that therapy room.

9. Seeing your own therapist

Our work is never done.  Seeing a therapist heals my own countertransference.

10. Support- the 'right' support

Having relationships provides untold resources.  I am never truly alone, when I struggle I reach out. Make sure your support reinforces healthy boundaries and not poor internal boundaries.

11. Holding internal boundaries

This one is probably the most important for any therapist.  We can cannot carry our clients and still be present, you must release them.  We cannot waste hours ruminating at night when we should be present with our loved ones and with ourselves.  

By honoring this truth within each of us, through blogs and continuing education, you will find the quickest route to coping effectively.   The end result will be ease with this occupation.  When I started in private practice, I did not have adequate support. Learning this has taken years.  I offer this knowledge to improve you, our helpers, which improves our clients, and improves the outcomes in therapy.  Take this educational ride with KDH Collective.  

Support is one of the most powerful tools humanity has. We must RECEIVE it, to give it.