In the Therapist’s Chair and at the Kitchen Table: Juggling Personal and Professional Struggles

• Relationship with Myself
• Relationship with Others
• Relationship with Work

Imagine a therapist, trained to help others navigate the darkest moments of their lives, who, despite years of expertise, finds herself unable to ease her family’s suffering regarding the mental health challenges of one family member.

Most of us know someone whose family is touched by mental illness or addiction; it’s a sad reality of modern life. When a therapist has a family member with mental illness, people might find it interesting, but most understand that no one is immune. But when a seasoned psychotherapist—armed with knowledge and resources—cannot help their child, that’s an eyebrow raiser.

That therapist is me!   

Therapists are expected to have answers, engage in stable relationships, make good decisions, and be overall healthy people. With all the education, training, supervision, and consultation, others often assume that we are equipped to pinpoint problems when they arise and have solutions. I remember how shocked I was to see my gynecologist, who delivered each of my children, walk out of a convenience store with beer and cigarettes. It’s normal to hold healthcare workers to a higher standard.

Nobody cautions us that training and education do not prepare us for the jerky rollercoaster ride of living with a child with mental health challenges. We do not get a map to navigate the bumpy roads of fear, anxiety, worry, and sometimes, shame. And we cannot be therapists to our children—emotion, protectiveness, and maternal instinct muddy the waters.

Being a therapist while also having significant personal problems at home is an isolating experience. A decade ago, shortly after achieving my goal of private-practice ownership, conflict drastically arose at home; I did not understand the severity of one of my children’s mental health challenges. I had difficulty responding to her behaviors, identifying effective resources, and taking care of myself. My self-talk was bleak. Am I hearty enough to handle all this?   

Anxiety invaded my family exponentially throughout this unpredictable period. It inflicted headaches, stomachaches, heart palpitations, and insomnia. I was dominated by fear and agony about how my problems affected my work with clients, even though the feedback I received from clients was positive, and they were unaware of my problems. I considered exiting the profession completely. I daydreamed about a far simpler job to make work life easier.

I was unaware of any other therapists going through the same thing. I kept my despair to myself. During consultation groups or supervision, I politely discussed cases with colleagues, and occasionally mentioned something trivial from my personal life, but nothing that risked judgment from other professionals. I felt alone.   

Shame was present in both roles: as a mother who failed to help her child, and as a therapist whose guidance for others did not work for herself. My heart ached with sadness. Intellectually, I made sense of my shame, but social stigma around mental health and self-imposed pressure to live up to a parenting and professional standard kept me quiet.

On one occasion, I was around other mothers of peers in my child’s grade who were celebrating their children's college acceptances and decisions. Shame and sadness flooded my body when they talked about their child’s exciting plans. Was my child’s inability to achieve these milestones a reflection on me? Was her condition an indicator that I had failed as a parent and therefore could not possibly be successful as a therapist?  

Sometimes on social media, I saw posts by therapists who showcased pictures of their happy families and children with smiles on their faces. Sadly, I thought, Not my family. You might be wondering, What did you do?

Perhaps it was the years of effort to establish my dream-come-true therapy practice, recalling the original reasons for choosing this work, or the long-standing student loan debt—I decided to learn to cope, for my sake and that of my family, and to continue delivering quality care to clients. You ask, How did you do that?  

My answer: Focusing on three core areas—my relationship with myself, others, and work—helped me cope most effectively. Little by little, prioritizing these foundations built my confidence, strengthened my judgment as both a mother and a therapist, and guided me through difficult times. This is how I made it. 

Relationship with Myself

Finding a Therapist, or Two or Three

Therapy became my cornerstone for coping. I have engaged in psychotherapy throughout adulthood—not only in crisis but as steady support for daily life. For therapists, therapy isn’t just wise; it’s essential, especially when personal struggles feel overwhelming. I relied on my therapist’s insight, warmth, and the comfort of her office. She helped pull me out of the trap of relentless self-blame and anger. What did I do wrong? I’ve done everything I can to help my child; why isn’t she better?  

My therapist, a seasoned clinician of many years, has told me more than a handful of times that she has not known a mother to seek out and identify as many resources as I have. She helped smooth my tumultuous feelings and showed me that my efforts as a mother matter. The therapy process served as a continual resource for me. Over time, it helped me cultivate a belief that I was capable and resilient.

Throughout this journey, I addressed traumatic experiences during family conflict, so I started seeing an Eye Movement Desensitization and Reprocessing (EMDR)-trained therapist. Those sessions freed me from negative patterns and boosted my confidence as a mother. I sought out an EMDR certified therapist who identified as a parent in her profile on her website. It was important to me to work with someone who I thought might understand that aspect of my turmoil.

I consulted a Bowenian family systems coach and immersed myself in seminars to understand my role in family dynamics. The work helped me focus on my influence—how changing my actions or words impacted my entire family system. Studying my family diagram deepened my understanding of generational patterns. Learning about triangles in my family made me more focused on my behaviors and thoughts.

I began to see the role of chronic anxiety and started to change the way I contributed to it. As an added benefit, my new understanding of Bowen theory directly informed my clinical work, allowing me to help clients break free from unwanted patterns. Sharing aspects of my Bowenian family systems journey with clients created a sense of common humanity and made me a more relational therapist.

Getting a Hold of Myself

At the peak of my anxiety, I joined a 10-month fellowship cohort to learn a specialized bottom-up modality, called Acceptance and Integration Training (AAIT), developed by Melanie McGhee. At first, the learning was personal. The experience was transformative—using sequenced protocols that addressed thoughts, images, emotions, and body sensations brought real relief. Taking responsibility for my inner state became the priority, with becoming a skilled therapist as a welcome side effect. The cohort and the program restored my confidence. I practiced daily: on my walk to the office, between clients, and before bed. When self-doubt or fear hit, I had tools to find relief. Calming my body cleared my mind, leading to better decisions for myself, my family, and my work. Once proficient, my clinical skills were sharper, and I utilized the approach with clients.

Seek Purpose, Find Perspective

Tunnel vision blinded me. Worries crowded my head, leaving little room for anything else. I lost a sense of purpose. Is this what my life amounts to? There were infinite ways to engage with life beyond the problems in front of me. I gave time to volunteering through my church to missions that reminded me of what existed beyond my small orbit of issues and privilege. I chaperoned a service trip with my youngest child. These experiences were doses of humility that filled me with a refreshing view of all the things that are important in this world. Perspective helped ease the self-imposed urgency to be a good mother and a successful therapist. 

Relationship with Others

Boundaries and Discernment

Personal, family, and professional boundaries begged my attention. They needed a reset. Stress often caused me to mask my feelings or censor content, leaving me uneasy with my dishonesty. When I did speak up—commonly out of anxiety—I’d instantly regret it. The unpredictability of others’ reactions left me powerless. Many people think they have a solution for you, even though they have not experienced the same thing, and the consequence for me was believing I was a bad parent.  

I learned how to discern between what I felt comfortable sharing and what to keep to myself. My usual discernment process did not apply. For example, I would typically tell my closest friends everything. Yet, I found that I needed to be more conservative about what I shared for two reasons. First, some friends lacked the capacity or interest to listen to chronic problems. As much as they cared about me, some could not tolerate the negativity. Second, nobody wanted to talk about the same conflict over and over. My “fixer” friends and protective friends seemed to find this difficult. To mitigate frustration, I said less.

I also needed to be cautious about what I told family members. I learned that some family members did not keep private information to themselves. Some family members spewed “you should just” while not understanding that those solutions had been tried and failed. Sometimes, telling family members reinforced the reality that while many people understand the difficulty of having a family member with mental health issues, most do not.

The boundary work of Julianne Taylor-Shore revamped my relationships so that I wasn’t as reactive or affected by others’ opinions. Taylor-Shore wrote about different types of boundaries. Her concept of the psychological boundary is the one that helped me the most. It is an invisible boundary that separates your thoughts and feelings from others. It’s a process by which I respect and allow others to have their thoughts and opinions while I have mine. The psychological boundary says that it’s okay for us to think differently about something, and when we do this, we reduce the risk of feeling offended or hurt by others’ words. We also develop more compassion for ourselves and others when we practice this boundary.   
  
When I communicated with a professional or teacher about my child, I tried to be factual and general. If I made mistakes in oversharing, the result was feeling ashamed and guilty for not protecting my child’s dignity and privacy. Learning how to be more discerning eliminated this risk.

After a few discouraging family trips, I realized things needed to change. One solution was to stop traveling as a family of five. My family and friends were confused. They said, “That's sad that you are not all going together.” It’s sometimes hard for others to understand how setting personal boundaries, protecting my time and space for the sake of sanity, is non-negotiable. Once I practiced my psychological boundary, I understood that they had their opinion based on their own experiences, and I had mine. And that is okay. Instead of ending the conversation annoyed, I could say, “It's complicated, but what works best for us.” The “it’s complicated” remark validated their question or confusion about not vacationing as a whole family, and the latter declared that my family values were not up for scrutiny.   

Support Groups

Parent support groups were trying for me. I was ashamed as a therapist who couldn’t “fix” my life, and I was frustrated by weak group facilitation, whether it was a professional or a volunteer. The solution came unexpectedly: I reached out to three colleagues who had mentioned having family struggles. I proposed we started a private, self-led support group to share our challenges. They all agreed without reservation. Now, we meet monthly, deepening our connection and trust with one another.

I joined a second support group with some hesitation—this one led by Judith Smith, author of Difficult: Mothering Challenging Adult Children through Conflict and Change. Dr. Smith’s serious, supportive style fostered a safe space. For the first time, I was among mothers who understood the pain of struggling with an adult child's challenges, and I was moved to tears in our first session. After the formal group ended, a small group of us continued meeting every other week. We remain the only women in each other’s lives who truly get what it means to face these struggles.

Being in support groups eliminated frightening feelings of isolation. With two groups of compassionate and understanding women, the crazy-making thoughts of wondering if what I said or did was right or wrong do not exist. I talk about it with my understanding group members, who give honest and caring feedback.

Focusing on Other Relationships

Parenting stress strained my marriage, so my husband and I started therapy to improve our communication and work better together as parents. When I met my husband, I was ecstatic to be a mother. I wanted my kids to feel important, so I prioritized them over everything else. Our child’s mental health and the way it affected our family system often became a divisive topic, and our marriage needed attention. Having a therapist guide us through those rough conversations made all the difference.

Attuning to my other two children was also an intentional tactic to focus on the joy that was right there in front of me. I celebrated their milestones and made space for enjoyment with them. It was difficult at times when my head was fuzzy with fret and tension. Making myself available to them despite the family problems laid the foundation to open communication as they got older.

After my father passed away, I responded to my longing for connection with my cousins and relatives on his side of the family and initiated spending more time with them. Our visits filled me with love and laughter. Even though they only knew small portions of the challenges in my personal life, and despite differences in lifestyles, connecting with my family roots was grounding and important to me.   

Relationship with Work

Spotlighting Blind Spots

With so much stress related to my problems at home, my skills as a therapist dulled. Some days, I sat in my therapist chair, mind foggy from overthinking, and an undercurrent of anxiety coursing through me. I was listening, but not with curiosity. I was compassionate, but my capacity was too weak. Under those circumstances, I did not realize how susceptible I was to countertransference and vicarious trauma.

Countertransference is the therapist’s unconscious reactions, feelings, and attitudes that stem from personal experiences and unresolved issues. It is ubiquitous in therapy and might erode our well-being if ignored. It is a common topic in clinical training, supervision, and consultation groups. Certain clients evoked strong responses in me, such as disgust, anger, or anxiety. Raising my awareness of this dynamic and addressing it was crucial to the integrity of my work as a therapist. I processed countertransference in individual therapy, supervision, peer consultation, and in my small therapist support group.   

Vicarious trauma is the negative impact on us when we are exposed to other people's suffering. For several months, I worked with a client who had a trauma history. I began experiencing bad dreams, difficulty falling and staying asleep, and intrusive images in my mind. I dreaded sessions with this client. I discovered that my empathy and imagination were overloaded, and I was absorbing too much of the client's story.

A colleague referred me to an experienced psychologist who works with therapists. The therapist created a supportive space and listened to all of my symptoms. He helped me tune into my reactions and develop a plan to have more psychological boundaries in sessions with clients. My work with the psychologist liberated my mental and emotional space, so I was more available for my family instead of being consumed by someone else's trauma.

Taylor-Shore's boundary work also strengthened my ability to separate from clients' stories. Taylor-Shore suggests creating an imaginary boundary (she calls hers a Jell-O wall) between yourself and the other person to filter what comes in and what stays out. The visual image of a slightly porous wall helped slow the intake of information, both content and emotion.

Somatic work from Acceptance and Integration training helped me identify my bodily responses to various feelings. Practicing mindfulness and breathwork signaled my nervous system to stay calm.

Reworking Work

I adjusted my work schedule—specific days and hours—to accommodate my family’s needs, prioritize my family, and continue working. Scheduling consistent days and hours for business-oriented tasks helped minimize anxiety about the business. I moved my office to be closer to home so I could get there quicker if a crisis arose.

Deciding who I want to work with and whom to refer out was a practice I developed over time. I eventually proved to myself that I had a choice. I learned to say no to some referrals. All therapists probably have a list of issues or populations that they would rather not work with. I clarified my list and stuck with it. Having a long list of reputable therapists to refer to was key to my confidence in saying, “No, I believe I am not the best fit for you, but I have trusted referrals for you, and I will be happy to connect you.”   

At last, I needed a major change. After reflection and discussion with trusted colleagues and family, I closed my private practice. Freed from business ownership, I sought employment with an established group practice. It was hard to say goodbye after fulfilling my dream of running my practice. That decision ultimately alleviated stress, added financial predictability, and brought greater stability to my life. I found that I thrive in a group among other clinicians. It is comforting to know others are around to consult with or say a friendly hello to. Being in a group practice affords me more time to take care of myself and my family.

Summing Up

Years of stress from raising a child with mental health challenges permeated every area of my life, including my professional work. Missteps and a lack of self-awareness about how this conflict affected me became a turning point, prompting me to seek change. When self-doubt and exhaustion overwhelmed me, I reached out for support, accessed helpful resources, and leaned on trusted individuals until balance was restored. This process enabled me to approach my clients with clarity and my family with openness. By strengthening my skills and understanding within each relationship, I became better equipped to continue practicing as a therapist and to be a more relaxed, present, and supportive mother for my family.  



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