I hesitated for a long time to share any of my thoughts or essays about the mental health field or my life as a private practice therapist.
As a therapist, I am part of a profession that is highly regulated.
We are taught to carefully monitor ourselves and hold ourselves to the highest ethical standards.
We are also provided with teachers and supervisors who oversee our work. In internship, we have a supervisor at our site, as well as an internship director who supervises us.
After we graduate, we are required to have a supervisor who oversees our clinical work while we gain experience toward independent licensure. During this time, and for the remainder of our career, we are also regulated by a board.
Supervision, regulation, and monitoring are foundational components to the field. They are essential to ensure that therapists are ethical and effective.
Just like all healthy characteristics though, they can become negative when they become too extreme.
Therapists can become hyper-focused on being perfectly ethical, “doing it right,” and not harming anyone - EVER. It can lead to a fault-proof mindset, where we relentlessly monitor ourselves and others.
I’ve seen this show up in therapists who directly criticize the choices of other therapists. For example, I once saw a therapist criticize another for charging a fee for her group training. She stated that the other therapist should not make others pay for vital information. This therapist thought her opinion was so “right” that it merited correcting the other therapist.
I’ve also seen therapists indirectly criticize other therapists. For example, when the pandemic started, a therapist commented on a public forum, “It would be unethical to see any client in person right now.” This indirectly asserted that any therapist seeing clients in-person was unethical.
To be called out as unethical is no small matter when our entire licensure (and therefor livelihood) hinges on behaving ethically and being approved by our governing board.
I’ve also experienced criticism and policing from other therapists. For example, another therapist told me that it was illegal for me to run a private practice without independent licensure (she failed to do her homework on the current laws of Arizona prior to addressing her incorrect concern with me).
I think the policing therapists due to other therapists is similar to individuals who are hypercritical of themselves and therefor hypercritical of others. Therapists who are steeped in self-monitoring, self-policing, and stringent standards often apply those same unrelenting standards to other therapists.
We have enough monitoring, supervising, and ethical training structured into the mental health field already. We do not need to make life harder on each other with horizontal violence.
I don’t think the unrelenting judgment of therapists will stop until we take better care of ourselves as therapists. Once we learn to acknowledge and meet our own needs as therapists (such as honoring our emotional, mental, and energetic limitations), we can stop living in a place of exhaustion, resentment, judgment, and control.
The fear of other judgmental therapists is what initially stopped me from sharing about my private practice, business strategies, or my opinions about the field.
I was afraid to make myself even more vulnerable to the criticisms and judgments of other therapists by writing and sharing my perspectives (which I discuss in my essay The Fear that Comes with Running a Private Practice Outside of the Norm).
Four things have helped me to move past my fear of judgmental and policing therapists.
First, I now understand where the hypervigilance of other therapists comes from. I can remind myself that when a therapist criticizes, it is more about them than it is about me. It helps me to detach from the pain.
Second, I trust what I see, feel, and think. My self-trust allows me to stand in my truth, my actions, and behind the words I write. Therapists will judge and criticize, and that doesn’t mean their words are any truer than my own.
Third, I know my words will resonate with those that need them. I know I am not the only one seeing and experiencing the patterns within the mental health field that I am naming and discussing (such as martyrdom mentality, and the invisible therapist myth).
Fourth, I want positive growth and change for our field. My words are a clear path toward that change. If I want horizontal violence to end, I’ve got to name it when I see it.
I do not want fear of judgmental therapists to stop any therapist from bringing their fullest self to the world. The fear is valid. The judgment will happen. But don’t let it stop you. For every therapist waiting to criticize another, there are at least two ready to pick you up and encourage you on your way.
Doing something different is difficult.
I provide consultation for therapists creating their ideal private practices.