Once, a client of mine commented that he often imagines a therapist as a “machine” – someone who is trained to listen, filled with psychological jargon, and then trained to say, “just the right words” Of course, he didn’t mean to hurt me in any way and I never took it to mean that.
But then I would often think about it. Just like a butcher becomes immune to the sight of mangled bodies, or the surgeon to the sight of blood, do we also not become immune to human suffering? I remember when I was affected by each story and would narrate it to family members (of course, maintaining the confidentiality) and seeing their eyes become wide – “oh! This also happens in the world?” kind of response and now I have no stories to share. Call it empathy… maturity or experience – it does make you more immune.
However, sometimes I envy the AI (Artificial Intelligence) systems to be the true machines that my client had “nicknamed” me because, at the end of the day, we are anything but machines. We do care. We do get affected by people’s stories and their behaviors. We do feel a void when we lose a client. And we do judge ourselves harshly for not doing “better” for a client.
No matter how much we detach ourselves after therapy sessions are over, clients remain an inevitable part of our lives – appearing in dreams, becoming a part of our thoughts when we read a meme/gif or listen to a podcast, or acting as a motivator when we enrich our skills to help them better. You take away clients from the therapist and we wouldn’t know what to do with ourselves.
I have tried to jot down some of the aspects in the therapeutic sphere that affects me, primarily negatively and I would love to know my reader’s view on those.
The case (s) who give you the shudders: Each client come with their unique stories, however, some can still move your core – a client with such severe OCD that she is constricted to half a bed, a client with EUPD with a completely dysfunctional family and abusive men over generations, a client with depression after undergoing intimate partner violence for years, a grown-up man with severe anxiety who is crying every day because he “doesn’t have friends”, a young girl who cannot stop hearing tormenting voices, which has taken away the opportunities she deserved, or another young girl who just cannot trust anyone enough to be able to develop friendships. You understand that you would be able to help them eventually, but sometimes, the distress is so high that all I wish for is a magic wand that can make all their troubles go away.
The client (s) we “lost” forever: Losing a client because of suicide is one of the biggest traumas a therapist can undergo. I remember the one I lost – for nights, I wondered where I went wrong, which sign did I miss, what else I could have done? For months, his face haunted me and for years, his name. For some time, I even checked his social media, hoping to see some post by him. It just felt so unreal. Similarly, losing a client because of death, expected or unexpected, leaves a void. Even if you are not judging yourself harshly, because you did the best you could, it still hurts.
The dreaded text/phone call: You feel therapy is going well and have even planned what to do in the next session. And then you get the dreaded phone call or message that the client wants to drop out of therapy and “thank you” for all the help. You ask them for feedback, you may even drop them a few supportive texts, but then there is radio silence. We may badger ourselves – “I wasn’t good enough.” “Did I say something to put the other person off?” “Are they going to come back?” “What did I miss?”, moving on to the doubt which therapist would they now go to and what would they say about you, while secretly hoping that they would realize that you were the better one; and then you finally accept as a process and move one.
The dependent client: You have been seeing this one person for months/years and they refuse to terminate therapy sessions. They may be doing alright, or would have become resistant, therefore, no matter what you do, they don’t get “better”, but they just refuse to LET GO. And every time you bring up the topic, it precipitates a mini-crisis. Yes, yes, I know the theory behind it – “gently” highlight this pattern, address the issue of termination at the beginning only, do not encourage dependency after a point yada ,yada. I know all that… but that doesn’t stop me from feeling frustrated as well as guilty for charging them money when I am not really doing anything in the session besides a regular follow-up and general chit-chat.
The client (s) who ghost you: Remember that person whom you sent the therapy session reminder, who not only disappeared during the session but refused to answer your texts or calls. Although I am grateful that it hasn’t happened with me, I can imagine, it would leave anyone feeling a wee bit “abandoned” – it’s almost like – “hey! I was trying to help you here and you think I was so easy to be disposed of.”
Client (s) who take you for granted: Clients miss sessions without informing and then re-appear with or without an apology. Now, these are the ones who truly make you feel like a machine – put in the money and it (we) would “blurt out the right things”. They forget that the therapist’s one hour is something that they have taken out specifically for them, maybe at the cost of other things like taking their kid to the park; maybe not choosing another client who may have needed that session, but it was already booked. And just to be fair, I hate it when therapists do the same to their clients. I believe that time is a very precious commodity and must be respected.
The “resistant” client: Recently, a client who had divorced her husband because of extensive domestic violence decided to go back to him. She is a well-educated, financially stable person, but I have not been able to make her understand that she is better off without a husband than with this chap. I almost felt like shaking her, to make her more prudent, or “see the truth that I have been trying to show to her over the last few sessions”. This is just one of the many situations, where you just cannot comprehend why the client cannot see or accept simple facts, why can’t they do that one basic thing that know would make them feel better? How can they be so illogical despite being so intelligent? How can they be so ignorant despite being so knowledgeable?
And then the whole concept of “seeing things from their perspective” starts dangling in front of you. Where you remind yourself that you have your boundaries and limitations, and all you can do is unconditionally accept the person and be there for them.
To summarize, behind some sugar-coated words, well-drafted statements, and technical jargon and techniques, we are as human as it gets. We experience all emotions, our judgments do get clouded by our beliefs and assumptions, we do err and are not objective in 100% of the situations.
In my opinion, a successful therapist is not the one who is unaffected by these situations, but the one who is mindful of them and learns how to deal with them before they lead to emotional burnout.
So beautifully penned. I had been thinking to write something along these lines and here I am reading this 🙂