Things I Wish I Knew Before Becoming A Therapist
Updated: Jul 10
The excitement and anticipation of meeting a new client for the first time, reaching an "ah-ha" moment, and walking alongside someone on their journey through life has been one of my most passionate endeavors since beginning my career as a psychotherapist. As much as I love what I do, there are some aspects of being a therapist that have given me a run for my money. So for all you future therapists out there, or even if you're just curious about the behind the scenes thoughts of a therapist, here is a list of things I wish I knew before becoming a therapist!
1. Therapy takes a toll on your body and mind
Many people are surprised about how much sitting for long periods of time can have an affect on the body and mind. As a therapist, my day involves a lot of sitting, for at least an hour at a time, driving between offices, and typing on the computer...lots and lots of typing. The constant sitting causes strain on the lower back and shoulder muscles, while also making you feel as though you have to work that much harder at fitting in some physical activity. In addition to all this sitting, I have found an increase in my headaches and neck pain. Although headaches and migraines have always been a reality for me, the frequency of these migraine attacks has been pronounced by my busy lifestyle and stationary positions throughout the day. This is definitely something I did not prepare myself for when considering a career in therapy.
2. Compassion fatigue is real!
No matter what they say, compassion fatigue is a real and stark reality of the work that I do. Compassion fatigue, also known as "the cost of caring," is a type of mental exhaustion that is a direct result of taking on the concerns and fears of others on a routine basis. Sometimes this fatigue creates issues in emotion regulation, patience, stress management, and work performance. There is no real amount of time or type of presenting problem that makes you more "at risk" for compassion fatigue, but it is the sudden drop in work satisfaction, enjoyment for life, or drive to get up and go in the morning that tells you that compassion fatigue has set in. These moments have happened often for me in the months that I have begun my private practice and it's safe to say that I have been far too stubborn in stepping back and giving myself some much needed down time. I answer emails and phone calls from current and potential clients on weekdays, weekends, and holidays; I make accommodations for appointments that prove to be a challenge on some days, and I take criticism too personally. This is not me being hard on myself (although being self-critical is a weakness I have and readily admit to), but rather it is a realistic look into where I am making mistakes in not addressing my compassion fatigue. With this being said, it was eye opening to realize that my low mood or lack of patience with those close to me is not because I'm "negative" or "angry," it's simply been a long day at the office or tough week with client concerns that has slowly but surely made its mark.
3. Being a therapist means overthinking things ALL.THE.TIME
Now, people often ask me why I decided to be a therapist, and the answer is usually because I like to learn about people, I'm fascinated with how people think, and I like to problem-solve and get answers to complex issues. But that also means that indirectly, I have a bad habit of overthinking and questioning myself and my life! This has led me down a slippery slope a number of times and strained my relationships in more ways than one. Just because I am a therapist doesn't mean that I can give myself therapy during the times I need it. And although others would say "practice what you preach," sometimes the words just can't be found on the days we need them. When we're tired, we usually need someone else to point that out. Or when we're angry, we need someone to bring us down and tell us to take a break before things escalate. Ultimately, it's important to realize that just because you have a job title, doesn't mean you're a pro in that area of your OWN life. So, I have to remind myself that I'm not going to always know everything about every situation I am in, and I can't always solve every problem. Instead, I have to let myself enjoy moments, think less, and just live life in the moment!
4. You really don't feel like talking to anyone after a long day
I feel terrible for saying this (and I'm working on my transparency so this is a good way to start) but I find that after a day full of clients, I want nothing more than to be mute by the end of the day. In other words, I'm all-talked out! Therapy requires a lot of thinking, and most importantly, a lot of dialogue. Without the gift of the gab, I probably wouldn't have clients coming back to see me week after week. The downside; however, is the fact that I have no desire to chat come evening time. This means that my loved ones either think I'm "in a mood" or "too tired," but honestly guys....I've reached my chat limit for the day (#sorrynotsorry).
5. You are always learning new things about mental health and health care in general
One thing that has taken me by surprise is how unique and individualistic every person is in relation to their presenting problem. Although clients come to my office with concerns of depression and anxiety, it doesn't mean you know all there is to know about how their anxiety or depression affects them. In addition to this, you learn how much the health care system creates barriers for everyday people trying to access mental health care. This can sometimes be frustrating to me as a therapist because my hands are tied. I want to help my clients as much as I can, but the constraints of the medical system sometimes act as a barrier towards providing adequate care. If mental health professionals could work more symbiotically within the health care system, care could be reached to a wider range of individuals.
6. No matter how much training and education you pursue, you still don't know it all
Training and education are valuable tools in the mental health community, as the field is constantly growing, developing, and changing. No matter how much training, workshops, or seminars you attend, there is always more and more to learn. This creates competition in the marketplace among therapists, with everyone trying to specialize in their own unique ways. What I have come to realize about therapy is the vast amount of differentiation amount therapists, social workers, and psychologists in their approach to therapy. But no matter how much you think you know about what you're trained to do, you quickly come to realize how much you actually weren't aware of. So if you're thinking of becoming a therapist and think that school will be over once the degree is in hand...maybe think again.
7. Therapist friends are key
At the end of a long week, there is nothing better than hanging out with a group of friends who just understand the ups and downs of being a therapist. Confiding in someone who works in the same field as you can be the best way to decompress after a long and stressful week. Having friends to call up and hang out with is a special and rewarding part of what I do. Plus, when you need to vent about life problems, you know that your friends are good at listening, validating your feelings, and telling you when you're wrong!
8. Self-care is so important and yet so overlooked
As much as therapists advocate for self-care, finding time to actually do it ourselves is more of a challenge than I imagined it would be. My self-care involved going to the gym, spending time with friends and family, and going on weekend outings whenever given the chance. Although I have managed to keep up some aspects of my self-care routines, others have faltered as my schedule has become more demanding. It's important to reflect on these moments as opportunities to scale back, take more time to practice what I preach, and ensure that I am in the healthiest head-space I can be, so I can offer the best quality care to my clients.
9. Opening your own clinic is scary and exciting, all at the same time!
Opening a private practice is a mix emotions. It's exciting to be taking on a new endeavor as an entrepreneur; however, it's a scary feat! There is so much about private practice that you simply cannot prepare yourself for. It's not just about managing your time and making sure that you are keeping an eye on your compassion fatigue, but it also involves managing your knowledge of your business, dedication to your fiances, and all while ensuring your role as a therapist is not being compromised by the business hat you also have to wear simultaneously. That's why I strongly believe in ensuring I continue to receive monthly supervision and consultation with other professional therapists, to ensure that I do not get lost in the muddy waters of business, but rather I calmly and efficiently manage to deliver the best therapy in the best setting.
10. Be prepared to deal with the hills and valleys of seasonal changes
As much as a new season or upcoming holiday brings new changes for my clients, new seasons also mean changes to the frequency of client appointments and the way you manage your schedule. As some of my clients know, my schedule changes frequently, and this is simply to ensure that I am creating a schedule that I can manage, as well as still providing suitable availability for appointments. Since therapist burn-out is a very real part of being a therapist, a lesson I have learned (and still continue to learn) is balance. Although I want to say yes to every appointment request, I have to be mindful of giving more of myself than I can handle. Therapists are humans too and we also deal with the highs and lows of seasonal changes, whether they are positive or negative changes. Being mindful and aware of how these changes affect me is vital in ensuring I do not overwhelm myself.
I hope this has helped some of you get a closer glimpse into the "behind the scenes" thoughts of an "everyday therapist!" Being transparent in the therapy process helps me to better connect with my clients, as well as connecting with myself. I hope this post has given you something to think about, maybe in how you run your own business, how you manage your personal schedules in a hectic life, or even how you extend your time and efforts with others.
Nicole (aka, your "everyday therapist!")