The career of a therapist comes with its fair share of highs and lows. In the highlights, you have the pleasure of knowing that you can help make a difference, provide critical care in the ongoing mental health crisis and that due to said health crisis, you will always have job security. Then, in the lowlights, there are the crisis calls, the overwhelming caseloads, and the minor existential dread that you’re not making the slightest difference in anyone’s life. Then there’s the stress.
The Stress of Being a Therapist
In the summer of 2023, I started to lose my hair. In massive clumps, my dark brown locks circled my shower drain. The rest of my morning and hour-long commute was spent in a panic-induced haze as I wondered how much of my hair had fallen out and whether or not I was experiencing the early signs of some deadly but unknown disease. I saw my doctor. I was cleared medically. There was nothing physically wrong with me. I would spend the rest of the summer and most of the fall with my hair up and downing vitamins like my life depended on it. Eventually, I was able to see a curly hair stylist by the name of Claudia. When I asked her what I could do to stop my hair from falling out, Claudia stared at me and asked me point blank “Are you stressed?”
I would have sworn up and down on a stack of DSM5s that I wasn’t. But then, Claudia asked me another question “What do you do for a living?”
“I’m a therapist.”
She looked at me with pity. In the cozy atmosphere of Claudia’s salon, I tried to remember when exactly my shoulders had started hurting, why I shifted from being anxious to irritable all the time, and why I was beginning to dread setting foot in my office. It dawned on me as Claudia did her best to manage my mess of a mane: I was burned out and sliding hard and fast into depression. I loved my work, but my work did not love me back.
Therapy Burnout
I was burning out faster than a dying star. My Master’s program in Clinical Mental Health prepared me for many things: theories, modalities, and diagnosing. I was not prepared for burnout or depression on myself. There is a heavy emotional burden to working in clinical mental health that can and will bleed into the counselor. “Self-care” is a word that is often thrown around for counselors both new and experienced. The harsh reality is that unless you are very much intuned with yourself or have experienced burnout, you won’t recognize the symptoms until it’s too late. The caseload can get to you, the notes and treatment plans will aggravate you, and filing CPS cases due to ongoing sexual/physical/emotional abuse and neglect will take its toll.
The Trauma
People are capable of extreme acts of kindness and generosity. In the same vein, they are also capable of extreme acts of violence and hate. In this line of work, you will wonder “How could someone do that to another person?’. Children being used as their parents’ personal punching bags, spouses use each other’s greatest insecurities to inflict mental anguish, and people trying to manage their intrusive thoughts. You will leave work wondering how anyone gets through it. Sometimes, the acts of violence committed against others will live in your head.
Your Issues
That brings us to your own issues and trauma. Everyone carries their own issues. Sometimes, the issues we carry and their causes are very obvious and can be managed accordingly. Then, I have found that very few people who are counselors have “good” coping skills. Developing coping skills and engaging in self-reflection of your own issues and baggage is neither fun nor pleasant but ultimately beneficial.
Carrying Work With You
Working on your own mental health will require time and energy. Your brain will stay on for the first few months/years. You’ll be reminded of things that your clients told you in session. Seeing ramen at the store will remind you of how your client is struggling financially, physically, etc. You’ll learn all of your client’s activations and carry their trauma with you. This means you’ll need your own therapist.
Finding Your Therapist
Who is the therapist’s therapist? Everyone needs someone to talk to process their own mental health struggles. I fully recommend that every therapist both new and experienced has a trusted and reliable therapist to talk to…providing that they can find one to begin with. As it stands, the United States and much of the rest of the world are embroiled in one of the worst mental health crises ever, finding a therapist that fits your schedule is hard. Waitlists are a mile long. Then, there is the issue of finding a therapist that you click with. A good connection is hard to find. People will often go through multiple find therapists to find one that fits their needs.
The Finances
The financial cost that goes into becoming a counselor is steep. Paying for a good master’s program, books, conferences, and then there is the matter of practicum and internship – it all adds up. Students within a counseling program will need to accrue hours by providing indirect and direct services. The first six months of my practicum and internship were completely unpaid. This is, regrettably, an industry standard. If you can find a paid internship, all the better for you.
However, a majority of people will not find paid internships. They will provide vital mental services for free to an at-need population. This places an undue burden on all future therapists to get their financials to survive until they can gain partial licensure and find employment. After that, then it’s paying for supervision and accruing more hours to become fully licensed. Let me be very clear about this: I do not believe that supervision should be paid for. It creates an unfair balance between supervisor and supervisee. Some good supervisors are without a doubt worth their weight, time, and experience in gold. Then some are not. This goes double for sites that engage in predatory behavior. They treat their clinical interns as full-time staff but can withhold signing off on hours – hours that are needed for licensure.
Boundaries – In and Out of Counseling
Having a social life while attending grad school is hard but not impossible. There can be issues in maintaining healthy relationships with others. People, mainly family and friends, upon finding out that you are a therapist, may be tempted to use your services free of charge. Despite your pleas of ‘It would be unethical’, it never seems to work. Developing good boundaries is a must to maintain relationships both in and out of therapy. This counts even more should you and your client/patient engage in similar social circles. I am an unabashed fan of anime and manga. I’ve cosplayed too. That’s why when I find myself counseling someone who shares a similar fandom and attends similar events, we discuss what will happen should they catch me cosplaying as TenTen from Naruto. Nodding in acknowledgment is fine, but we will not take photos or discuss therapy outside of the office.
Letting Go
Eventually coming to terms that you will not be able to help everyone. There will be people that you will not mesh well with, that need to be referred out to, and that sooner or later, you will be fired by clients. It’ll sting. You’ll want to do everything you possibly can to help, but it’s not possible. You’re not meant to work with everyone. There will be populations that you will not want to work with and that’s okay. Everyone has their specialties. Everyone has a population that they do not work with. We’re not meant to be a one-size-fits-all for every client. We’re meant to work with the people that we can do our best with and to help find a good therapist for those who aren’t a good match.
Knowing vs. Doing
Every therapist worth their salt knows that maintaining a routine, engaging in self-care, and working out are vital to preserving their mental health. Then, there are days when the idea of getting out of bed, brushing their teeth, and getting some fresh air feels like an impossible task. These tasks alone are not enough to stave off depression or the general wear and tear of the counseling profession, but there is a pain in knowing that engaging in these actions would help. Some days, you will feel bad. You’ll know what needs to be done to help make yourself feel better.
In the end, like all occupations, being a therapist is hard. There are ups and downs, but overall, if you can process your own mental health, the strain of finances, and manage an ever-mounting caseload as the mental health crisis continues to grow, your own path as a therapist will become easier to forge as time goes on.
As always, if you or a loved one are struggling is in crisis, experiencing severe emotional distress, or in need of immediate assistance, please do not solely rely on the information provided on this blog. Instead, we strongly encourage you to seek help from qualified mental health professionals or utilize the hotlines here. If you are seeking therapeutic services and do not know where to begin, please consider Psychology Today.
