1) Do you ever dream about me like I dream about you? 2) Is it really easy to limit your thoughts and feelings (both positive and negative) about me to our one weekly session or do these spill over? 3) What do you most love and loathe about our therapy relationship? 4) Is being a therapist just a job or is it a big part of who you are? 5) How on earth do you manage to get all your needs met outside therapy with long working hours and don’t you just want to chat the ears off your friends and family because you’ve been relatively quiet during the day? 6) Do you feel lonely as a therapist, working alone and not being able to chat about the day freely and limiting where you go out in case you bump into a client?
1. Yes, I certainly had dreams about my patients when I was in practice. (I retired three years ago). Clients who weren’t progressing were the most frequent visitors during slumber. Not, you might be wondering, sexual fantasies or friendship themes. Whatever countertransferential feelings I had occurred while awake. In that time I found myself thinking about how to improve the therapy process and reconsider the diagnostic and treatment formulation. The blackboard needed a clean wipe to look at my patient afresh and discover something I missed.
2. Yes, feelings spilled over, but not about everyone. If treatment advanced, then I didn’t find myself drawn to think about you much outside of a session. If the course of therapy was rocky, however, questions and problems grew arms and threw stones at the door to my mind. I didn’t avoid thinking about anyone, but my process was as described.
3. What did I most love and loathe about my relationship with clients? I will admit I didn’t like my patients equally. Some drained the fuel cells, some energized me. We are human, therapists and clients alike. No two people match up in an identical way. For those who gave inadequate effort, I addressed this in session. All experienced counselors understand the patient must give everything if he is to improve.
When the metaphorical cellophane wrapper of my professional life had been removed, I found the “detective work” especially captivating. That is, trying to figure someone out.
I’d sometimes get frustrated and go too far in expressing frustrations. This occurred more near the beginning of my private practice, as well. A bad idea for both my client and myself. I then had work to do on my own psychology. Increased therapeutic distance was required. And, I tried to unravel any bubbling resentments about issues in my own life, old or new, that slipped past my receptionist into the office.
With respect to what I loved, I enjoyed hearing close to everyone’s life story. Even now, I continue to do oral histories of retired and retiring musicians for the Chicago Symphony. My fascination with such things assisted, I think, to communicate a genuine interest in helping. People recognize your sincerity if you are hanging on almost their every word. I also enjoyed laughing with clients.
My ex-patients will remember my fondness for telling stories. The therapeutic message has a way of sticking with you when it doesn’t sound like a line from a clinical text.
I was delighted when people grew from our process; and grateful when I was enlightened by the therapeutic interaction and grew myself, not only as a therapist but as a human being. There is a two-way interaction here. Always. Patients understand that the psychologist benefits financially, but might not recognize how much a therapist’s life and humanity are enriched by non-sexual, intimate contact.
4. Being a therapist was much more than a job. Were it only a vocation I would have phoned it in, sounding like a poorly recorded 78 RPM disc, with as little expression as its two flat, black sides. I don’t hide disinterest well and have a poor “poker face.” I am not the most energetic person on the planet — never even close. Had I not been a counselor by training, choice, and by nature, the job would have made everyone miserable. Some said they had never experienced anyone who listened as intensely as I did. Those were the greatest compliments I received.
And, no, it wasn’t always praise I heard! But usually it was. Therapists who fail to generate approval are called ex-therapists with short careers.
5. Yes, the hours can be long. I suffered some internal conflict during the first years of independent practice. I tried to balance my desire to be the best clinical psychologist I could be, working late to support my young family, honoring my love for my wife and children with face time, answering emergency calls, and being good to myself. I had to avoid having the life sucked out of me by competing demands. I got better at this juggling act as I aged, my nest egg grew, and the kids required my physical presence less.
My work day and work week shortened by choice as time passed. I gave up carrying the now antiquated pager (in the days before cell phones), partly to reduce the crazy-making, self-inflicted wound of being on call at all times. I also discovered that when my patients knew they could not reach me past 9 pm, they found reserves of patience and fortitude to endure on their own. It is foolish for a therapist to wear himself to a nub and believe he is simultaneously providing anyone with a model of good self-care. He needs to be at his best in session, which required, at least for me, enough rest.
With respect to chatting “the ears off (my) friends and family,” two things: first, if you are tired, you possess less energy to talk. Secondly, I’m an introvert, so when the fuel tank is empty I prefer freedom from intense social interaction, not more of it. The exception was when my girls were small. I couldn’t wait to play with them and love them up.
6. I never felt lonely as a therapist. Again, my basic introversion helped with this. Plus, I found intense therapeutic interaction stimulating, as both an intellectual challenge and as social contact. I’ve been the lucky beneficiary of a wonderful spouse, amazing children, and good friends. I never avoided activities or neighborhoods for fear of running into a patient. Indeed, I don’t think the idea ever occurred to me. I did, of course, say hello to people here and there. Occasionally it was uncomfortable (probably for both of us), but nothing of lasting impact. It is usually a pleasure when I encounter former patients now.
I cannot speak for all therapists. The answers you’ve read are mine alone.
Again, thanks to Jay at Who are You Calling Sensitive?, Life in a Bind — BPD and Me, Saving Mommy, Possibly Penny, The Empress and the Fool and others who have offered questions they’d like to ask their therapist. And my appreciation to those of you who reblogged my previous efforts to answer such questions, including Spacefreedomlove, Understanding Me and Her, and Sunshine After the Rain. If I failed to credit you, let me know and I will correct my error.
I intend to address more of these “questions to therapists” in the future.