Therapists in the Real Word: We’re Struggling Too

By Ryan Cocron, LMFT and Kat Glick, LPC, LCADC, ACS, SAP

Disclaimer: this is based on our own experiences and the experience of therapists we know. We recognize that each therapist’s interaction with the work is different and unique, as is the impact of the job on each individual therapist. It is our hope with this blog that other therapists who are having a hard time may feel seen and validated through what we share here. 

The Pandemic

Therapists are struggling right now, even more than before.  When the pandemic started, therapists shifted from seeing people in person to seeing people virtually. During that time the world slowly began to fall apart and more people were seeking out therapy to process the collective traumas that were occurring in our world.  Much like doctors and nurses, therapists were dealing with a massive influx of people needing help at the same time that social acceptance of mental health and therapy was rising. 

Instead, the stigma of mental health has weakened as the paradigms have shifted to see mental health services as important health services. At the same time, we saw significant increases in access to therapy services as the world went remote.  

These large-scale shifts changed the face of therapy, almost overnight.  Many therapists had to learn a new way of providing therapy. Video chat and other technology-based telehealth services included a demand for immediate training and education about how to “do” therapy through a screen. (Most therapists we knew prior to the pandemic had been adamant that therapy could not be done if not in person! Imagine the attitude shift necessary to adapt to a new way of having to show up as a therapist- on a screen, but still as a human that can connect with multiple clients in a week.) 

Being a Therapist

Being a therapist is a weird job. It requires you to know yourself really well, sit with unimaginable pain and despair, be a guiding light, and so much more. Being a therapist is not just sitting and listening and telling people how to fix their lives. It’s sitting with the darkest, deepest, rawest parts of our clients. It’s going there, to those dark places, with them.

It takes tremendous self-awareness and regulation skills to sit with peoples’ emotions without letting those emotions overwhelm you or trigger your own “stuff.” With each client that we see, we have to not only be tuned in and connected to that person (which takes finesse since each person is different in how they connect), but we also have to guide the session in a way that is therapeutically relevant WHILE being super aware and regulated with our stuff as it comes up.  Hour after hour, on zoom (and/or in person), week after week.  

To that end, each therapy session we provide is almost like a therapy session WE are going through, in that moment to be super self-aware, and then later after work when we should take the time to be with and process what came up in us that day. Some therapists don’t take the time to sift through their own stuff that comes up in sessions- these are folks that sometimes inadvertently cause harm to clients when that stuff inevitably comes out in the therapeutic relationship. It sometimes happens to the best of us despite best intentions– another reason why therapists need REALLY good self-awareness in order to do the job well.   

Struggles

In therapist circles many of the conversations are about how burned out we are. Many therapists have dialed back their hours or even quit to pursue less demanding jobs. Nevertheless, the rest of us continue on because we got into this work to help people. We care and want to make a difference in the lives of the people we see. 

We also have to make a living. For those of us in private/group practice, the financial model is often what is called “fee for service”.  Simply put- you get paid only if you work. The pay you earn is directly related to how many clinical hours you complete- i.e.  each hour of emotional labor = $X dollar amount. 

For those of us who rely on our clinical work for financial stability, this means that there is an ever-burning recognition that if we did more therapy hours, we would make more money. But also- the more people we see, the quicker we burn out (and the less able, over time, we are able to give a high percentage of ourselves into our work. What this means- the quality of our work is impacted). 

At the same time- if we don’t work, we don’t get paid. For some therapists, having a couple clients cancel last-minute could mean the difference between that therapist having the funds to pay for rent or childcare that month. And don’t even get us started on how expensive it is to be a therapist in terms of fees and taxes- that will be another blog for another day. 

Health vs. finances

We often have to choose between our own health and need for rest and 1. Our commitments to clients and 2. Our financial survival needs.  I (Kat) share this truth as I am currently dealing with a daily experience of significant pain and lack of mobility- having to get back to work after only being able to take a few days off after foot surgery.

Each day I have to figure out how to work with my body being in pain and fatigued, to show up and provide the best therapy I can for my clients.   If I don’t, I leave them out to dry, and I bring on additional financial stress because I need those sessions to pay my bills. This is the same for all therapists especially in private practice. You only get so much rest before you HAVE to get back to this very emotional work.    

Thank You

Our hearts go out to therapists who struggle with chronic and daily pain/disability/illness who have chosen to provide therapy as a career/life calling. Our work is challenging in some many ways- and showing up for others while struggling with health conditions is really quite amazing.  <3  

The purpose of this blog is to hopefully give some validation and acknowledgement to other therapists who may be struggling.  We wanted to name something that many of us are dealing with on a day to day basis. This job is hard, and we are happy to be doing it.   

We will also be offering a seminar on challenging internalized ableism and incorporating accessibility into our work.  The content is geared for therapists in practice, but everyone can benefit from the material and are welcome to join. Check out our eventbrite page for more details soon.