The 9 Most Difficult Things About Being a Therapist

The therapy profession is designed to be all about the client. We’ve become experts at doing everything we can to center the client and ensure they have a positive experience. While I support this, I think we also need to look at the needs of the therapist.

In my essay, I’d Like Some Real Talk About Therapy, I shared why it is so important that we begin openly talking about the challenges that come with being a therapist.

In that effort, I am sharing the nine most difficult things about being a therapist for me. My intention in sharing this list is to

1. Normalize the difficulties that therapists face

2. Name the challenges we face so that we can brainstorm improvements that can be made on a systemic level

3. Encourage other therapists to begin naming the difficulties they are trying to navigate

With that, here are my 9.

1. The Weight of Another’s Entire Well-Being Placed on Me

We cannot control other people. And yet, when someone becomes our therapy client, we are treated as if their entire well-being is our responsibility. That is impossible when we are only with clients for a limited amount of time a week. And yet, if a client were to die by suicide, everyone would question the therapist. It’s a confusing mix to be held responsible and yet have no control.

2. Hearing Unexpected Disturbing Topics

I understand that it is part of the profession that we will hear the darkest side of humanity. And yet, I still find it difficult when a client unexpectedly shares a devastating thing. It impacts me. There’s no way it couldn’t - I am a human. I don’t want to reach the level where I’m unphased by hearing about abuse, assault, murder, and other atrocities, but it’s still difficult.

Collage by Jackie Schuld

3. Watching a Client Make Destructive Decisions

Again, we cannot control our clients. It is very difficult to watch clients make destructive decisions that I know will harm their present and have lasting negative impacts into the future. I work very hard to ask insightful questions and help them reflect on their behavior, but I still have no control.

4. When Clients Displace Anger by Directing it at Me

Sometimes clients go through experiences that leave them incredibly angry. They show up to therapy angry. They’re not angry with me, but that anger is sometimes directed at me. They make snide comments. They respond rudely or sarcastically to my questions. They shut down at almost anything I say. While I understand the psychology of what is happening and that it is not about me, it still impacts me. It still does not feel good to hold.

5. Holding My Opinion In

Therapy is far more effective when clients come to their own conclusions. This means that it is not always helpful for me to blurt out my opinion or advice. Sometimes it is difficult for me to patiently hold it in and let the client take their own journey.

6. Never Knowing What I Will Show up to in a Meeting

In therapy we set treatment goals and work our way toward them over time. At the end of each meeting, I write out a synopsis and a rough plan for our next meeting. However, I have NO IDEA what will happen in my client’s life between now and our next meeting. Furthermore, I have no idea what kind of mood or mental state they will be in when they show up to our meeting. I get that therapy is supposed to be a safe space for our clients to show up any way that they are. I want that. AND, it is still difficult for me to not know what I am showing up to.

7. Existing in a Profession that Ignores The Needs of its Professionals

The therapy profession is centered around the clients. We’ve developed the toxic cultural norm of centering clients’ needs and forgetting about our own. I’ve written extensively about this, such as the Invisible Therapist Myth and the Martyred Therapist Mentality.

8. Being Judged or Shamed for My Fees

I set my therapy fees at a rate that meets my financial, emotional, and mental needs (you can read more about that here). My rate is above the norm for therapists where I live. As a result, I am sometimes judged or shamed by others for my rate. This is a direct result of being in a profession that ignores the needs of its professionals. It is now the norm for therapists to work exhausting hours with inadequate compensation. When I operate outside of this norm, I am attacked instead of the systems that created and benefit from this mess (such as insurance companies and our health care system).

9. Operating in a Highly Regulated and Policed Profession

Therapists must adhere to strict rules and ethics. We are overseen by a governing body that has the right to remove our ability to practice. Given the immense amount of power we have as therapists, it is necessary that we have standards of practice. AND, it is still difficult to operate within that system. It breeds a culture of self-judgment and self-policing that quickly becomes toxic. I write about it in my essays on Therapists who Police Other Therapists and Shifting Away from a Fault-Proof Mindset.

Where Do We Go From Here

Before you rush to add a comment telling me what I can personally do better in relation to these nine topics, please keep in mind that the number one thing that keeps therapists from speaking up about their challenges is fear of judgment from other therapists. Fear that other therapists will say, “Here is what is wrong with YOU and here is what YOU need to fix or what YOU should do better.”

The challenges of being therapists are not individual problems to be fixed. They are collective and systemic norms within our profession that need to be collectively addressed.

To blame it on the individual is to gaslight them.

So if you choose to leave a comment, please speak on a collective level. Name the collective norms and what we can be doing as a profession.

I want to encourage others to share their own challenges of being therapists, and that can only happen if we stop targeting the individuals that name them. We need to focus our energy on targeting the systems, cultures, and norms that collectively harm us.

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