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Therapists Spill: When Being a Therapist Was Especially Hard

Therapists Spill: When Being a Therapist Was Especially HardWhen we’re going through something difficult or stressful at home, it often spills into our workplace. This can get especially tricky when your work is being a therapist, an already-demanding job emotionally and mentally.

In this month’s “Therapists Spill” series, we asked clinicians to reveal the times in their lives that made their work difficult, along with the lessons they’ve learned. They also shared how they navigated this time and coping tips for readers.

Sleepless Nights

For psychologist and ADHD expert Ari Tuckman, PsyD, the first year following his son’s birth was a challenging one. His son was a terrible sleeper, which meant that he and his wife were regularly exhausted and sleep-deprived.

“[I]t was difficult to be fully attentive to clients when I was so tired, not to mention feeling generally overwhelmed and unhappy in my life.” He would do his best to focus on his clients, but would crash when he got home.

During that time exercise helped him stay alert and temper the sleep deprivation headaches. He also reminded himself regularly that it’ll get better with time — his son was already sleeping better at six months than three months earlier — and he and his wife would soon have more time together.

Today, Tuckman tries his best to get enough sleep. He also makes sure to discuss sleep with his clients, and delve into what’s preventing them from getting enough sleep.

Concerns Over a Friend

“I have a good friend who lives on lower Manhattan, and was concerned for his well-being for the better part of 9/11,” said John Duffy, Ph.D, a psychologist and parenting expert. In the months after 9/11, these concerns made it tough to work with clients.

What helped was letting himself focus on them in session. “I allowed myself to take those hours to lose myself in their stories, instead of anxiously holding onto my own fears, anxieties and traumas. After giving myself this permission, I found it fairly easy, to be honest, to hold that boundary and focus on the client on the couch in front of me.”

Getting Divorced

Recently, psychotherapist and owner of Urban Balance Joyce Marter, LCPC, made the decision to get divorced. “Although it is an amicable and collaborative situation, and one I trust will bring growth and blessings to all involved, it is a time of enormous life transition and stress. As my identity, home, and daily routine were changing, I was distracted and dropping balls at work left and right.”

For instance, she made a scheduling error and had to send a client home. At the end of a session with another client, she was too exhausted to provide her normal closing summary.

However, these experiences actually taught both client and therapist valuable lessons. The client who went home told Marter in their next session that it was helpful for her to see Marter as human and model how to apologize for making a mistake and moving on.

“Truthfully, I was proud of myself for not self-flagellating about the incident for the rest of the day. I decided to practice what I preach and be self-compassionate and trust that all would be fine,” Marter said.

The second client did the closing summary herself — “better, I might add, than I could have ever done. I was so energized by the experience that I laughed and threw my arms in the air and said: ‘Well, thanks for doing my job for me and for doing it so darned well!’ She laughed too and was clearly very pleased with herself. It was a critical shift in our therapy — one that may not have occurred if I had been operating on a full tank.”

To navigate this time, Marter has sought support from her therapist, friends and family. She’s also focused on her self-care routines and tried to have a sense of humor.

Medical Procedures

“When I first started working as a therapist, I was [undergoing] various medical procedures that had a lot of different hormones floating through my system. This made me overly emotional at times and less so at others,” said Xue Yang, LCSW, who specializes in trauma.

These reactions spilled over into her sessions. “I literally sat on my hands in some situations just to keep from being inappropriate.”

“What I learned was just how uncontrollable emotions can be when there is a chemistry issue. There was nothing I could do other than to have self-compassion and use mindfulness to make it from minute to minute. … In those deeply emotional moments, having the ability to stand back and observe my behaviors without judgment was a relief.”

“This episode in my life taught me that for those clients that are depressed or anxious or both, or for those clients with other chemistry issues, the effects on the brain, on the hormones, etc., are powerful.”

Overload and Overwhelm

Psychologist Ryan Howes, Ph.D, has found that the emotionally exhausting times in his life actually haven’t been an obstacle for him in working with his clients. “I think the emotional times just mean I have a shorter distance to travel when I’m empathizing with and understanding my client’s pain and struggles. I won’t go as far as to say my work improves when I’m in a difficult emotional place, but I don’t think my work was compromised.”

What can become an obstacle is his endless to-do list. Howes has a tendency to overload his schedule, which makes it tougher to stay present with his clients. Practically, he navigates busier times by having a to-do list with little boxes to check. “[I] try to put all my concerns and tasks down on paper. Once it’s written down, I don’t have to think about it.”

“But on a deeper level, I reminded myself that the 50 minutes I spend with a client is their time: They pay for it, they work hard to prepare and show up, they deserve every ounce of my mind and heart I can give them… It takes more planning, but I’m the professional, it’s my job to make sure I can perform the task I’m hired to do.”

Howes has learned that clients appreciate his honesty, whether it’s about a personal loss or an attention problem. For instance, his close friend recently passed away after a brief, aggressive illness. When it seemed helpful and appropriate, he shared the story with his clients. “[T]hey appreciated it and said they could trust me to understand their pain as a result.”

During a session, he’s also said: “Your mention of a party makes me think of something about an event I have coming up. I’m going to write that down really quickly so I’m not dwelling on it for the rest of the session.”

After he does, he gets back to the session and fully engages with his client. “I think most clients understand that I may have my own items that arise, but as long as they don’t monopolize our time they’re willing to roll with it. Even more, they feel like I’m being real as I communicate my real thoughts and feelings, so maybe they can, too.”

Losing a Parent

Seven years ago psychotherapist Jennifer Kogan, MSW, LICSW, lost her father. “It was not unexpected as he was sick for many years, but I had never lost someone so close to me before. I love words and I love to talk, but I didn’t realize at first how much I needed to be quiet at this time.”

Kogan navigated this difficult time by taking care of herself and not pushing herself to do more. She found Reiki to be helpful and connected with friends who’d also lost their parents.

Losing her dad has taught Kogan to slow down and be quieter with her clients, when needed. “Sometimes there just are no words — only time, space and connection.”

Kogan still connects to her father every day. “That’s not to say I only remember the good but I can see where his life touched parts of my own and that is something I will always have.”

Breast Cancer

Ten years ago psychotherapist and relationship expert Christina Steinorth-Powell was diagnosed with breast cancer. “As much as I wanted to be strong and be a role model for keeping it together, I just couldn’t. I was emotionally devastated by my disease and prognosis. At one point it was questionable if I would make it as chemotherapy didn’t work for me. And nine months of chemotherapy left me emotionally and physically in pain and exhausted.”

She ended up referring her clients to a colleague. “I was unable to help anyone — it was all I could do at that point in my life to take care of myself.”

Because of her experience, Steinorth-Powell has become much more effective in working with clients who have a chronic illness and helping their families understand how best to help them.

“The other lesson I learned on a personal level is to never take one day for granted. I tell everyone how I feel about them so there will never be a word left unsaid, and I also live life every day to its fullest. I don’t put things off anymore, because I realize I may not get another tomorrow.”

Navigating Tough Times

Howes encouraged both clients and clinicians to be honest and open about what’s going on in their lives. “You had a tragedy in your life, you are going through a stressful time, or you woke up on the wrong side of the bed, just own it and talk about it, the whole interaction will benefit.”

“Really noticing what you are feeling and honoring the pain or sadness can help you move through it,” Kogan said. “I think we can learn valuable lessons from our toughest and our most joyful experiences.”

Tuckman suggested focusing your attention on the things you can do something about. “Try to not waste too much time and energy being angry about the things that you can’t control.”

Duffy encouraged readers to give themselves permission to feel painful feelings, instead of fighting them. He also stressed the importance of doing something that makes you feel good. “This will help make a tough time resilient to the threat of lasting depression and anxiety, I find.”

Marter suggested readers remind themselves that you’re human, and you can only do your best. “When we make mistakes, we must practice self-compassion and forgiveness and remember our intentions are good.”

Yang also underscored the importance of refraining from judgment. Even when there’s nothing you can do to change the situation, you can try to accept it with compassion, she said.

“Know that it’s OK to ask people to step in to take the reins when you just can’t hold up anymore,” Steinorth-Powell said. “There’s a lot of pressure in society to ‘be strong’ and ‘push through’ things, but sometimes, it’s simply not possible.” This doesn’t make you weak. Instead, it means you’re exercising good judgment, she said.

Therapists Spill: When Being a Therapist Was Especially Hard


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. (2018). Therapists Spill: When Being a Therapist Was Especially Hard. Psych Central. Retrieved on September 14, 2019, from https://psychcentral.com/lib/therapists-spill-when-being-a-therapist-was-especially-hard/
Scientifically Reviewed
Last updated: 8 Oct 2018
Last reviewed: By a member of our scientific advisory board on 8 Oct 2018
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