By: Diane Lotto
I was in session with a client this week and we started talking about the lingering effects of the pandemic. I have seen this particular client for a few years—she is one of my faithful “OGs” who has graciously moved with me to three different offices in two towns over the last 4 years. We talked about the impact the ongoing state of the world has had on mental health consumers and providers, as evidenced by multiple stories and op-eds that have become semi-common place in the New York Times, NPR, etc.
At one point, she looked at me and with genuine sincerity said, “Seriously, how do you do it? How do you absorb so much from everyone you see when things are so bad?”
The intensity of the question made me stop and think—what have consumers of mental health services seen from us the past two years? And is this newly-found openness changing how our clients view us? The answer is yes.
And I’m here to reassure you that your therapist is okay. I promise.
Our jobs have always meant we have a front row seat to human suffering. As the pandemic lingers and we have more public discourse around the secondary mental health pandemic—therapists have become more open about the toll it takes on our profession. An article for the Washington Post interviewed several therapists who discussed the impact of increased demand, therapist scarcity, and the difficulty of managing our own mental health. We are in the precarious position of helping others through the pandemic and simultaneously experiencing it ourselves.
This has been an important step for the mental health profession. This field has often been shrouded in stigma and secrecy. We are starting to normalize going to therapy and being consumers of mental health services. By lifting the veil, we are finally able to show the world what every therapist has known this whole time—we have a gift of guiding others towards healing and are able to hold space for suffering, but in the immortal words of Cardi B—”I’m just a regular, degular, shmegular girl.” Imperfect like everyone else.
The part that these articles and op-eds miss out on is that a therapist’s job has ALWAYS required us to be attuned to our own needs and to practice self-care. In fact, self-care is now part of most professional codes of ethics, aka: it is unethical for us to be out here trying to help others if we are not managing our own shit.
Therapist self-care goes beyond candles and yoga. We keep our documentation up to date, so we don’t feel burned out. We are specific about the clients we see depending on our setting, making sure we don’t practice outside of our scope to prevent feeling overwhelmed or “lost in the sauce”. Supervision and consultation is also an ethical obligation, and has always been a cornerstone to our profession. We find that support in other therapists, generally ones who have a bit more experience than we do to help guide us.
And like most other humans, we text our therapist besties when we are feeling unsure to get their opinion (in HIPAA compliant vagueness, of course). We express our own insecurities and doubts to each other about why someone is stuck, we move through the “omg did I just f*ck this up?” panic that every therapist knows so well, and we troubleshoot different interventions that can help us get moving. We also guide other therapists who are newer to the field, providing them the space they need to process, learn and grow.
And of course—we go to our own therapy. Because while we are great at guiding others, that outside perspective is *completely* lost on ourselves.
2022 marks 12 years since I first walked into my first job in the field as a mental health worker in a psych hospital. From there, I worked in inpatient & outpatient, community settings & private practice. So, while I am still not nearly a seasoned vet, I do have some perspective.
Do therapists know that our current system completely overwhelmed by the demand for mental health services? Yes. Are we frustrated by working in a broken system that has a long history of discrimination, disrupted access, and scarcity? F*ck yes. Are there days where I feel discouraged because my caseload is bursting at the seams, but I have a desperate mom on the phone looking for help for her daughter who is struggling, and I know that I can help her? Of course… (and I usually accept them despite my promise to myself to keep my caseload at the current size it is).
But therapists are okay. We go to supervision about it. We cry in therapy about it. We vent to our therapist besties about it. We cuddle up with our dogs/cats/partners/kids, binge The Sopranos, and allow ourselves to disconnect from the intensity. We are used to finding our way through the darkness, holding up just tiny specks of light for people who can’t find it. We are used to having to make something from nothing—a result of underfunded agencies and unpaid internships that most of us have labored through.
So, how did I answer my client the other day? I said, “We look for the small wins. We look for when someone who has been so stuck is able to move just a little bit forward. We see the small changes that improve their day-to-day life. We know that we can’t fix it all, but if we can help make life just a little better—then we are moving in the right direction.”
This comes in the form of our client who had a breakthrough in session, who overcame their fear of COVID and got to the grocery store or spent time with friends, who set a boundary with dysfunctional family, or who broke up with their toxic partner.
We get to walk alongside our clients for the joyous parts of life—getting into a new relationship after dumping that shitty boyfriend, a new job, the birth of a new baby, or finally getting that raise they asked for. We teach self-compassion, we find the joy, and we measure progress from one month to the next—asking, “what would this have looked like 3/6/12 months ago?” Those are the things that keep us going.
So when you have doubts about if we are superhuman, or not able to handle what you’re about to tell us. The answer is: no, we are not superhuman. But, yes, we can handle whatever you throw our way… I promise 