Inevitable Truths Therapists Hate
Ever wondered what your therapist can’t stand? Well, I am going to tell you, and it might not be what you think.
Watching the Clock
In therapy there is something know as the 50-minute hour. This refers to the session time being approximately 50-minutes, followed by ten minutes to complete the session note, prepare for the next session, and if there is time after, use the restroom. That being said, not every session ends at the 50-minute mark. That could be because we are in a place where it is not appropriate to stop yet and we need to use some of the 10-minute cushion. It is not therapeutic to abruptly end session and I try to help close in a gradual way that feels natural. So how do we know when to close? Did we get an implant awarded to us at graduation with an internal egg timer? Unfortunately, we rely on strategically placed clocks. It’s not ideal but it’s necessary. It is our responsibility to our current client and the client we will be seeing in an hour.
Although most therapists hate “clock-watching”, it is not the client’s responsibility to end on time. We don’t look over every minute or when we are deep within conversation and we try to place the clock in such a way that we only need a slight glance to be able to tell if we are on the right track or not. I personally am able to get a feel for when 30-40 minutes have passed so I don’t even bother looking until around then. That gives us enough time to begin reaching a healthy summary and concluding point that helps the conversation end in a hopeful direction with a call to action for what’s to come.
All that being said, we still worry about breaking rapport or potentially looking at the wrong time. I try to normalize time with clients by starting out a therapeutic relationship sharing how long my sessions are as well as the reasoning behind this. I value transparency, and most clients are willing and understanding if I share that this is for their beneficence, as well as my other clients.
So, should you happen to notice that your therapist has two clocks in their room or that they looked off to the side abruptly, it does not mean that we aren’t invested or that we are ready for our session to be done. It means that we want to make sure we have enough time to really dedicate to this subject or that we are running out of time and do not want to leave you abruptly feeling activated. We truly do care and we really are here for you, and time is a constraint we all are subject to.
Getting Paid
What is another thing that therapists struggle with that all humans are subject to? Money and our need to eat to survive. Once my sister and I were in another state and I told her that I knew this place close by we could eat. Turns out, I was way off course and took her on a wild goose chase that ultimately did not end in finding food. I told her that I was very sorry and that I thought I had a good feeling I knew where it was. She eloquently said, “I can’t eat good feelings Bryce.” Circling back, clinicians come into this field to help people, not to get a paycheck. That being said, we also have to be able to take care of ourselves, our loved ones, and our pet chinchilla Mikey (I don’t really have a pet chinchilla… I’m not sure why I say the things I do sometimes… I do however stand by my responsibilities to the hypothetical “luxury indoor squirrel”)
Being that payment is necessary, how do we handle it? The answer is, as little as possible! I always struggle with conversations when it comes to getting reimbursed for the work that I do, and I know that I am not alone. We care so deeply about what we do that it is hard to hear comments like, “you’re just hear because it’s your job.” or “do you really care about me?” Luckily, I have gotten few of those and I try to make very clear to my clients that although I am compensated for the work that I do, I am fully invested in the people I serve. Clients unfortunately face some of the same stigma as well. Hearing, “Oh, so you have to pay someone to listen to you?” Luckily this stigma and judgement is on the decline and people are more universally seeing the benefit in connecting with someone.
Therapy is an investment. Of your time, your energy, and yes, finances.” You are deserving of investing in yourself and of having a therapist that fully invests in you and appreciates what it takes for you to make that first call and to show up for following sessions. I have worked with clients who are able to pay my full rate, clients who paid their co-pay through insurance, and clients with low-or-no income with no compensation. I show up to each of these sessions fully and the people we serve deserve nothing less.
When your therapist has a card on file, accepts a check, or you see a transaction on your account following a session, the reason is not greed. The reason is that the person you work with has dedicated themselves to this field and to you and subsequently needs to make a living just like we all do.
Imposter Syndrome
One of the things that every clinician experiences at some point is the much dreaded, “Imposter Syndrome”. We all feel it to some extent but therapy is a unique field where there is so much grey, so much variation, and every single interaction takes on a new shape depending on the client, topic, and clinician. Imposter syndrome is often not something that magically disappears either, regardless of experience, training, and ongoing education. In some ways, it is a good thing that clinicians worry if they are enough. It drives us to work harder, continue evaluating and growing, and to be the best that we can be for each client.
To any new or even tenured clinician: There will always be firsts, you have never seen it all, and use your mistakes as opportunities to grow. The people we serve are remarkably resilient, kind, and forgiving. We are human and to err is human. So long as you have shown up congruently and provided care, you will be ok.
Watching Remarkable People Get Hurt
Therapy relies on building a strong therapeutic relationship with the people we serve and getting to know them in a way they might not let others know them. One of the most challenging things about this role is getting to know someone deeply and then watch them get hurt. Whether this is learning about a past trauma, an ongoing painful situation, or an event that is approaching. It is often in these times that we feel as though we can’t possibly do enough or wish we could do things to intervene and support that are outside of our ability as a therapist. We know that these are often the topics that will walk through the door but it never gets easier to watch people hurt and suffer that are deserving of love and care.
Vicarious trauma is often one of the factors leading to burnout in this profession, and if clinicians are not careful, it can easily be consuming. It can also remind us even more of why we are here. It is due to some of the lowest points in my life that I knew I wanted to try and help others in theirs. No matter the topic, the pain, or the impact, it is a privilege to be trusted to show up and support the people we serve how we are able.
Conclusion
Despite a few things that aren’t the easiest to navigate, being a therapist is a remarkably rewarding profession. I am sincerely grateful to make a living doing what I love and being of service to others. I feel deeply honored.