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Clinicians on the Couch: 10 Questions with Lena Aburdene Derhally

Lena Aburdene Derhally

Clinicians rarely say much about themselves inside the therapy room. That’s because the focus is always on the client and their concerns. In our monthly interview series, however, we turn the tables and ask therapists to get personal. They reveal everything from the trials and triumphs of being a therapist to how they cope with stress to whether they’d travel the same professional path all over again. They also share the biggest myth about therapy and their best advice for leading a meaningful life — and much, much more.

This month we’re happy to feature Lena Aburdene Derhally, a licensed and Imago certified psychotherapist at the Imago Center in Washington D.C. Derhally specializes in working with individuals and couples. She runs a support group for women called Quarterlife Crisis plus 10. She’s also a writer whose pieces are published in the Washington Post and Huffington Post. In addition, Derhally is the featured Love and Relationships speaker at Bossed Up Bootcamp for women.

1. What’s surprised you the most about being a therapist?

What has surprised me the most is how so many people are hiding their vulnerability. One of the things I hear a lot from the couples I work with is how they think all these other couples around them seem to have everything together, never have conflict, etc. I have learned that no one has it all together, but people do a great job of portraying that everything is OK on the surface.

Part of this has to do with the age of social media — both singles and couples tell me they sometimes feel bad about going on Facebook because they compare themselves to others. And what they are comparing themselves to is a curated, small window into what is actually going on in someone’s life and not the whole picture (which isn’t reality).

Because of my profession, I have friends and acquaintances (and sometimes people I barely know) come to me for advice about all kinds of things. I like to think of myself as a secret keeper because I know things about people that they don’t always share with others, and I always keep everything confidential. (I’m bound to confidentiality with my clients, of course. But with my friends and acquaintances that ask me for help, I take that confidentiality just as seriously.)

What’s continued to blow me away is how skilled people are at pretending everything is OK when it’s not. And if others really knew what was going on, they would be totally shocked in some cases. It’s the famous cliché, “you never know what goes on behind closed doors” and that is probably one of the truest statements I’ve ever heard.

Clinicians on the Couch

All of this makes me sad because I feel we have become so disconnected as a society and it is our vulnerability and honesty that makes us human and bonds us together. I really try to practice being open and authentic about my life (even if I know others aren’t doing the same with me). I think it helps normalize the human experience and it opens the door for deep bonds and real connection with others.

2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?

I really liked the book, Attached. It’s a very interesting look at our romantic relationships based on attachment styles. Since my expertise is relationships and relational issues, I find it is really helpful for clients to understand what they need to feel safe and secure in a relationship and to examine the types of people they are drawn to.

I would also like to give a “shout out” to an oldie but goodie, The Five Love Languages. I make sure every couple I work with reads it. It’s such a great reframe for looking at how we get our needs met in our relationships and how to help our partners feel more loved based on their own individual needs. I think it was a game changer in the world of relational psychology.

3. What’s the biggest myth about therapy?

That it’s hokey or unhelpful. I find we live in the culture where it’s not acceptable to ask for help and it’s seen as a weakness. Although the mental health field has made its strides, I still feel there is a stigma attached to seeking help from a therapist.

I have individual clients who come to therapy and really need couples counseling but their spouse refuses to come in. Sometimes it’s because they had a previous experience in therapy that was really bad and it’s turned them off of therapy. And that is really disheartening for me to hear because I believe therapy can be really transformative.

Many of my clients are some of the most self-aware people I’ve ever met and witnessing them grow, blossom and have a fulfilling life and high quality relationships is one of the most rewarding things I experience in life.

4. What’s the biggest obstacle for clients in therapy?

I think coming to terms with the fact that they may have to do something different that is out of their comfort zone in order to grow. This all makes total sense because we become conditioned and accustomed to operate in the same way for so long that it’s really hard to do something different that isn’t natural or intuitive for us.

It takes real courage to stop and say, “hey, I’ve been doing the same things for so long and it’s not working for me anymore so what can I do differently?” I always like to think there is this period in therapy of growing pains and sitting with a lot of discomfort. Addressing things that are difficult or that we’ve pushed aside for so long isn’t easy and is often painful.

I also think there is an obstacle for many clients of just knowing they are enough. So many people, deep down inside feel they aren’t enough or they don’t deserve to be happy. I think that can be a pretty big obstacle in therapy because that is something that’s long-term work and sometimes lifelong work.

5. What’s the most challenging part of being a therapist?

When you work with someone over a period of time and see them at their most vulnerable, you grow to really care for and respect these people. It can be really hard to see these people in pain and oftentimes, as a therapist you can really only provide a safe and compassionate space to hold their pain.

As a therapist, you have to accept that you can’t solve people’s problems or fix things for them. So sitting with other people’s pain and uncertainty can leave you feeling helpless and really wanting things to work out for the best for your clients.

I also think goodbyes can be hard when the client leaves therapy. Because of the importance of holding strong boundaries in the therapeutic relationship, when clients leave therapy you probably never see them again. That’s always sad because you care about your clients and you learn from them too, so I think it’s always sad to close those doors, even if it’s for the best.

Every so often a client might drop me an email just to update me on how they are doing or to give me a thank-you. I always appreciate hearing from them and know that they are doing well. Other times, they may circle back in to therapy years later—I like to say to my clients that my office is a revolving door for them, and if they ever wish to come back if old things resurface or new things come up, that option is always available.

6. What do you love about being a therapist?

This is my favorite question because I really love my job and consider myself really lucky to have this career. I love that my job gives me faith in humanity. I feel that there are very few situations in life where people are real and authentic with each other. The therapeutic space is such a gift because you get to know who people really are at their core and that’s the most beautiful thing.

What I’ve realized is that most people are so good at the core and incredibly caring, empathetic souls. People are just doing their very best in very complicated circumstances. I often think the world would be a better place if we could all see people for who they really are, know their story and where they come from.

I love that I have a job that gives me so much meaning and fulfillment. One of the major reasons I chose this career path is that I always want to do work that isn’t just about me—that’s about giving back and helping others. Being a therapist has increased my empathy and my acceptance of others. It’s a real gift to be able to help someone else or just be compassionate and non-judgmental to someone who is hurting. I always feel good if someone walks out of my office and at the very least, they feel that someone else cares about them and will listen to them without judgment.

7. What’s the best advice you can offer readers on living a meaningful life?

Hands down being true to yourself and living an authentic life that isn’t dictated by what society, culture or other people tell you. Part of this is being really mindful about the people you surround yourself with—they make all the difference. If we are surrounded by supportive, loving people we feel good but toxic, negative people can drain us of all our energy and happiness.

I also find it’s really helpful to have people you have really deep and meaningful connections with as surface relationships can slowly erode at us and make us feel very disconnected. You can be surrounded by a lot of people and still feel lonely—what makes us feel less alone is the quality of our relationships, not the quantity.

I love all the research coming out lately about the importance of social support and the quality of our relationships. There is a lot of data that is pointing towards loneliness, social isolation and lack of community and connection not only contributing to negative mental health but negative physical health as well. I am a huge believer in helping people feel more connected—to themselves and others.

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?

I would definitely choose this path again. I took somewhat of a risky path because I chose to get my Masters in Pastoral Counseling (which is the integration of spirituality with psychology). This was one of the best decisions I have made because the program was life changing on both a personal and professional level.

However, in my personal experience, a Masters in counseling did not offer as many job opportunities as a doctorate of psychology or a social work degree would have. I wouldn’t change anything, because I have accomplished what I wanted to after many years of accruing hours towards my licensure. I still sometimes go back and forth on getting my PhD but since my focus is on clinical work as opposed to research, I can do the work that I love without any more schooling.

9. If there’s one thing you wished your clients knew about treatment or mental illness, what would it be? 

In many cases with the right treatment you can manage mental illness and live a very rewarding and fulfilling life. I want people with mental illness to know that they are enough and that they deserve the best out of life.

Psychotherapy is also a commitment. It can be a very slow process, often with some regression. This is all normal and the path isn’t linear, so don’t get discouraged if you feel that you’re not progressing as fast as you would like.

10. What personally do you do to cope with stress in your life?

I am a big advocate of self-care! As a working mom with young children, I always say, “if mama ain’t happy, no one is happy!” And I say this not because I am a selfish person but in order to be the best therapist, wife, mother, friend, etc., I have to be well rested, fulfilled and content.
When anyone feels depleted, angry or burned out they become resentful and it manifests in all different areas of life. I tell all my clients to prioritize self-care. What I personally do is I make time for myself every single night.

There are extremely rare circumstances where I will do work after my children go to bed. After my kids are in bed (usually around 7:30/8 p.m.), I take a hot bath, eat some chocolate and hang out with my husband. We get really excited when we can actually make the time to watch a movie in bed these days!

I’m an extrovert so it’s also important for me to be out and with people, although as I’ve become older, I’ve become more introverted in how I like to spend my social time. I try to go out to dinner with either a friend, family member or my husband one, maybe two times a week. I’m a foodie so that allows me to indulge in my love of good restaurants and good company.

I also try to do other things that I enjoy, whether that’s a comedy show, a cultural event, a concert or a massage. I make sure I have a spa day every year on my birthday!

I do have to add that self-care isn’t always easy and the only reason I am able to do what I do is because I have a flexible work schedule; a husband who works from home and is very supportive of my self-care; and family that lives close by and I believe that I deserve it. Everybody deserves self-care—if you can’t enjoy life then what’s the point?

Clinicians on the Couch: 10 Questions with Lena Aburdene Derhally

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Margarita Tartakovsky, M.S.

Margarita Tartakovsky, M.S. is an Associate Editor and regular contributor at Psych Central. Her Master's degree is in clinical psychology from Texas A&M University. In addition to writing about mental disorders, she blogs regularly about body and self-image issues on her Psych Central blog, Weightless.

APA Reference
Tartakovsky, M. (2020). Clinicians on the Couch: 10 Questions with Lena Aburdene Derhally. Psych Central. Retrieved on August 5, 2020, from
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Last updated: 14 Jan 2020 (Originally: 13 Mar 2016)
Last reviewed: By a member of our scientific advisory board on 14 Jan 2020
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