Confessions of a Therapist - Part 1

I think we likely all agree the tendency to compare ourselves to others is just a normal part of being human. Of course, it’s not particularly helpful when it involves making assumptions about others and judging ourselves to be inadequate or inferior in comparison. Because therapists are humans too (yep, that’s right!), we are equally prone to falling into this trap.

Over the past year or so, I’ve been trying to make a more conscious effort at evaluating some of these assumptions by actually sharing some of my perceived therapist shortcomings with trusted colleagues. It’s been an eye-opening experience for me as I’ve come to realize I am not alone and, in fact, I may be more like other therapists that I realized! So, I’ve decided it’s time for me to start having these conversations at a broader level in hopes that other therapists reading this may also feel less alone in their perceived inadequacies.

Ready? (Deep breath in) – My name is Karen and I’m a four clients per day therapist. There, I’ve said it.

Before moving into private practice, I worked in a setting that enabled me to engage in a range of activities that involved client contact (therapy and psychometric assessments) but also administrative responsibilities, consultation with other mental health clinicians, and supervision of residents. In many ways that was a perfect job for me and I loved it! I made the decision to move into private practice as a way of reducing my work hours and I knew the shift would be difficult because this change also meant me leaving a job I loved. In some respects, the challenges I experienced weren’t particularly surprising (I knew the exchange of money for services would be uncomfortable for me, but I’ll leave that confession for another time).

What became apparent for me is that my “sweet spot” is about four therapy clients per day. I’m not going to lie, there have been times when I’ve thought that says something negative about me as a therapist and that maybe I’m not well-suited for this type of work. The reality is, providing therapy takes a lot of energy for me. Of course, that’s not to say it isn’t also energizing (there’s nothing better than feeling like you’ve helped facilitate some positive change for another person) but the reality is, at least for me, it takes a lot of energy to remain totally present with clients and to connect with them in a way that facilitates positive change.

In speaking with colleagues (like my co-founder of Intentional Therapist), I’ve learned I’m definitely not alone with this experience and that others have also had moments of feeling inadequate because of this. So, if you too are a “four clients per day therapist”, I have some reassuring words to share with you. The authors of Leaving it at the Office begin their chapter on workplace hazards (p. 38) with the following quote from Jonathan Kellerman (When the Bough Breaks, 1985, p. 15):

“Don’t let anyone tell you different: Psychotherapy is one of the most taxing endeavours known to mankind (let’s just say “humankind”) …there’s nothing that compares to confronting human misery, hour after hour, and bearing the responsibility for easing that misery using only one’s mind and mouth.”

With those words of wisdom, we encourage us all to ask ourselves: What is my “sweet spot” when it comes to clients? (perhaps it’s a number, a certain presentation, or other factors that influence your unique “sweet spot”) Is there a way I can work towards having more days in that range than not? For those in salaried positions: Is there an opportunity to diversify my role so that I can work within that sweet spot? For those in private practice: Are there other opportunities for billable hours that are less draining on me?

Hopefully these reflections will point your feet in the direction of a work situation that’s best suited to you. No apologies needed.