Experiencing suffering often has the effect of increasing a person’s empathy over time. It is not a coincidence that many therapists have experienced significant suffering growing up, be it a trauma, abuse, neglect, a life changing injury, experiencing war, and so on. The cliche is that many of us are ‘wounded healers’ and it’s true. That’s okay, and it’s okay if you were lucky enough to not have experienced something like this yet still chose to become a therapist. 

What matters is that we attend carefully and compassionately to how our history can influence our therapy sessions. I wrote about this more in my countertransference article. I think it’s important we are gentle with ourselves and do the healing we need to, as best as is possible, before trying to do a ton of work as a therapist. It’s possible, though difficult and painful, to have significant, open emotional wounds while working with a full caseload. Everyone’s path to healing is unique of course, but we all have to do the work of healing.

Felt experience is far different than abstract or theoretical knowledge, so you can be a therapist who’s depressed without being aware of it despite all our external familiarity with the subject

Some of these difficulties will be ongoing (e.g., struggling with social anxiety at work, going back to work while still grieving a loved one, couples work after a breakup, disordered eating—anything painful you’re struggling with that a client’s story reminds you of), and that’s okay too. We’re all just human beings. Our challenges can also be an asset, helping us with motivation, accurate empathy, and to humanize our clients or various diagnoses. On tough days we might have to ask ourselves:

An ugly but important question: what does ‘good enough’ therapy look like?

New and younger therapists are, generally, more likely to experience burnout, given that some context specific risk factors are: number of client hours, heavier client content such as trauma, feeling over involved with clients, having your own history of trauma, experiencing stressors in your personal life, and having fewer social supports. When we’re newer therapists, it’s common to be given a role ‘in the trenches’, and we often want to prove we can succeed in this career as well as impress our boss. But it can get overwhelming, and then imposter syndrome kicks in—add in some countertransference aggravating old wounds while trying to appear like you’re a competent professional…It’s a common story and a tough place to be. 

The impact of grad school on mental health is well researched, and rates of depression and anxiety are much higher there (approximately 3 times higher) versus the normal population. And during the pandemic those rates for grad students have doubled! Don’t discount your own struggles. So, even if you showed up to grad school with an ACE score of zero, the training process will take its tole, and later, vicarious trauma from clients can also leave us overwhelmed and hurting. This is a good example of when to seek additional supervision. For more information, Henri Nouwen wrote a short book on the subject, though his work has a strong Catholic influence FYI.

Take care out there. I’ll leave you with this classic: “Everyone has a little bit of ‘I want to save the world’ in them. I want you to know that it’s okay if you only save one person, and it’s okay if that person is you”

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