When the Clinician Becomes a Client By Elise Howard, MA on 5/28/19 - 2:53 PM

After my husband and I moved to our new home state, I found myself coping poorly, to put it mildly. Hundreds of miles from our friends and family, unable to find work and struggling to start a family, I found myself spending entire afternoons lying on the floor of our would-be nursery. I had no appetite, snapped at my husband over every minor annoyance, and was consumed by utter hopelessness.

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But when my husband gently suggested that I seek professional help, my defensive glare could have sliced him in half. Me go to counseling? Had he forgotten that I was the therapist here? I knew what to do; I didn’t need anyone’s help.

But after another month of being impossible to live with, I conceded. I found a clinician who shared my therapeutic approach, swallowed my pride, and stepped into her office feeling completely powerless.

I quickly discovered that my therapist had no idea what to do with me. She also believed that I already knew everything I needed to know to cure my own symptoms, and spent most sessions starting psychoeducational sentences, then cutting herself off.

“Here is a sheet with some common types of cognitive distortions—although I’m sure you already know them…Let’s try keeping a thought record. In the first column—well, you don’t need me to explain that.”

To make matters worse, I was a horrible client. I had intentionally chosen a clinician with more education and experience than me, but the result was that every session felt like supervision with one of my old bosses. I felt the need to impress her, and struggled to discuss my symptoms honestly. When I didn’t offer her anything to work with, my therapist ended up talking shop with me, making me feel more than ever that I was in a work setting where my symptoms would be unacceptable signs of weakness.

After a few months, I stopped booking appointments. The feeling of discomfort must have been mutual, because my therapist never reached out to ask why I had stopped coming. I wondered to myself if this was a common experience, if those of us who are the most steadfast proponents of therapy and bear the emotional burdens of 20 to 30 people at a time, end up having the most difficulty accessing (or contributing to) quality treatment.

A Washington, D.C. area clinician I asked about this noted that she had long avoided counseling for the same reasons I had. “I am certain that working in this field has prevented me from seeking out treatment in times where I could have greatly used it,” she said. “I believe I didn’t seek treatment because of my own belief that I could ‘treat’ myself because ‘I know what I should do and not do.’” Another clinician, based in Massachusetts, confided that when she did seek out mental health treatment, differences in therapeutic approach between her and her therapist made her experience unsatisfying.

“[My therapist] was very approachable, patient and validating,” she recalled. “[But] what I found disappointing was that, in my work with my clients, I generally had items prepared as tools we could use to address challenges or present new perspectives and techniques, and that was not my experience in my own sessions. It had more of your stereotypical air about it where you sit on a couch and talk about your feelings, no preparation, just whatever the client brings. And my work being different, I had a harder time appreciating that and eventually discontinued my work with her.”

I only found one person who felt that being a clinician had improved her experience as a client. Mia DeCristofaro, a Florida-based LMHC, recalled seeking counseling early in her career, when concern for her clients escalated into unmanageable anxiety. “My fear of not doing a good enough job or someone getting hurt on my watch was really hard for me to manage at first,” she recounted. “But being in the field also made it easier to be a client, I think, because I knew what I expected for my own treatment, what I believed about treatment, and I knew how motivated I had to be for it to be effective.”

Perhaps if more therapists who have received mental health treatment were open about their experiences, other clinicians would not feel like professional failures for seeking counseling. Although it may be awkward to discuss, who knows how many clinicians—and their clients—could benefit from this transparency. “We take on a lot of pain in this field and, diagnosable or not, I think we need somewhere to safely manage our own feelings,” DeCristofaro said. “Even if a problem we’re going through isn’t related to our work, we should manage it so that it doesn’t impact our work.”

Maybe this shift in focus from reducing our own symptoms to better serving our clients is the cognitive key to getting more mental health professionals through a therapist’s door. But whatever your reason for going, be the brave one at work and start the conversation about your experiences; you may be surprised to find you’re in good company.

File under: The Art of Psychotherapy, Musings and Reflections