Tuesday, 24 January 2017

Why Therapists in Private Practice Should Have a Therapist

It’s not a new idea. Freud suggested that psychoanalysts should undergo re-analysis every five years. He felt strongly that analysts needed regular support in coping with the accumulated stress of doing clinical work. He also stressed the importance of dealing with ongoing adult development and aging.

Whether you embrace Freud’s work or not, his idea is worth considering. Therapists are no different from anyone else. We are vulnerable to the same life challenges and the same stresses that bring our clients in our door.

In addition, clinicians in private practice have some vulnerabilities that are unique to our work-life and that can be mitigated by intermittent sessions with a trusted therapist. Here are five important reasons to maintain a connection with a therapist and to sign on for a few sessions now and then.

1. Isolation:

While in school or while working in an agency or non-profit organization, there are many opportunities for what I call “fly bys”, i.e., moments in the break room, in the halls, at the mailbox, etc. where we have the opportunity to talk to another person who is not a client.

 The importance of such brief conversations with colleagues should not be underestimated. In those moments, we are not expected to be “fine” all the time; we can get a pat on the back or a little support; we can just feel seen as a person, not as a helper.

In contrast, private practice can be pretty lonely. When seeing clients, one after another all day, there aren’t opportunities to de-stress with a friend or colleague. It’s neither ethical nor appropriate to chat with a client about our day beyond the usual pleasantries. They are with us for their needs for comfort, not ours.

A therapist can empathize in a way that friends can’t about the stress and responsibility of being a therapist. Just as important, therapy can remind us that it’s important to take care of ourselves by making friends and having an active social life.

2. Triggers

It’s not at all unusual for a therapist, no matter how much they have utilized therapy in the past, to be triggered by a client’s issues in the present. Even when we think we’ve resolved an issue, a client’s story can push us back into our own pain.

Intermittent therapy can help us take another step in our own healing. It can also provide support for metabolizing the accumulated stress that comes from seeing people whose issues overlap with our own.

3. Felt Responsibility

Agency therapists get sent home if they look sick or are told to take a day off if they haven’t done so in ages. In contrast, many a solo practitioner has stayed open when sick or put off a vacation because of  the perception that a client was too much in crisis to be without him or her. A therapist who knows us well can help us avoid that narcissistic trap. Therapy can serve to remind us that it isn’t healthy to give clients the impression we are not human. Sometimes we are sick. Sometimes we have personal emergencies. Sometimes we actually need a day off.

Even more important is the reminder that we can’t be responsible for a client’s unwise choices. Our very best work is sometimes not enough. Sometimes we miss a cue that we only see with the clarity of 20-20 hindsight. When a consultation isn’t enough, therapy can give us a place to process any guilt or shame for not anticipating the ensuing crisis.

4. The Stress of Business

Being in private practice means wearing two hats: Clinician and business entrepreneur. Very few graduate programs include courses in business management. We learn (or don’t) on the job. The stress of managing everything from having enough pencils to negotiating with insurance companies has driven many good therapists out of practice.

Therapy can help us clarify if we have the energy, motivation and skills to be in business so we can make good decisions about our own future. A therapist who has known us for a while can call us on it if we aren’t maintaining a healthy worklife/homelife balance.

5. Credibility

If we believe that therapy is helpful for healing and growth; if we believe that it is a good use of a person’s financial and time resources; if we think that self-care is a priority — then it’s important to live out those beliefs by participating in it from the other side of the metaphorical couch. This is not a one and done situation. Our integrity requires that we return to therapy now and then to continue to broaden our self-understanding and to refine our instincts as helpers.

All of these issues can be addressed in a number of ways, of course. Active involvement in professional organizations can reduce isolation.  Regular participation in in-service programs offered locally (not online) can help us connect to private practice colleagues. Creating and maintaining a regular supervision group can provide a forum for problem solving and empathetic support. Once a practice is well-established, it’s often possible to afford an office manager to take care of business details.

But some of our issues are our very personal anxieties, fears or unresolved history that need the very personal and specific attention that only therapy can offer. Whether for continued personal growth or healing, having an ongoing relationship with a therapist who knows us well can keep us honest about our own issues and give us support when we need it.

 

 

 



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