Theraverse . June 3, 2024

Recently read a book by Lori Gottlieb, “Maybe you should talk to someone”. It was a window into the life of a therapist, an unravelling of the journey of her own exploration with her therapist as well as those of her clients. As a psychologist who has been in therapy, it was a fascinating read getting to know Lori’s experience and the lives of those around her.

But the reason for this article, extends beyond the fascination. A meta-analysis of 17 studies found that the majority of the 8,000 mental health professionals who participated in the study have sought personal therapy at least once in their careers. Despite this fact, there is a lot of commentary about therapists being in therapy, but more often than not, as a premise to land a joke.

This article will try to go beyond the joke and address some of the common misconceptions while getting to the nitty gritty of what it really means for a therapist to be in therapy. Simultaneously, also addressing the different dynamics at play, along with suggestions on what can help to make this journey smoother.

Now before we go in, I want to clarify that when I say therapy in this article, I do not mean therapeutic interventions that are provided for mental disorders with psychotic symptoms or other psychiatric conditions, rather the talk therapy that deals with any incongruence in life, even those that are not clinical.

Misconceptions; what we tend to believe

I completely agree that a therapist being in therapy is not the same as lay clients from other walks of life, there is a scoff-worthy irony there that I’m not oblivious to. And it is true that, we are equipped to handle the ebbs and flows of life a little better than people from non-mental health backgrounds, thanks to the subject knowledge.

But, the thing about therapy that makes it so effective is not only the professional acumen of the person across the table, but also the fact that they get a chance to know you for the first time and see all that you are seeing, without the bias of having seen it, day in and day out.

I always tell my clients that I could never know them as well as they know themselves but, that “not knowing” makes for a better view sometimes.

Pope & Tabachnick (1994) conducted a large national survey about the issue of therapists as patients. They found that in a sample of 800 psychotherapists, 84% had been in therapy – and only 2 of those respondents found it unhelpful.

Despite research evidence, it can be difficult to grasp the concept of mental health professionals seeking help, especially in the Indian context as we still live knee deep in stereotypes that tell us, going to therapy signifies “weakness”. And when therapists themselves seem to be wanting professional support, it’s easy to question their competence.

But how competent a therapist is, has nothing to do with why they are in therapy. Therapists just like anyone else are not immune to break ups, role transitions, grief, trauma, anxiety, work stress and so on. So many of which could be the reason behind the onset of their therapeutic journey.

Turned tables – the perspective of a therapist being a client

“Shockingly enough, therapists are also people”

– Elena Lister (Psychiatrist in private practise for 30 years, New York)

When a therapist is in therapy, initially although the environment and the process seems familiar, as time grows, the room starts to look very different from where you are sitting as a client now. Revealing the details of your life, and operating from the perspective of someone who can be anything and everything they are feeling in that moment, is not as invigorating as it is for other lay clients, because of how foreign the experience is. Although warming up to this change can feel exhilarating, it may take a minute to settle in.

It’s so easy to switch back into the role of a therapist even as a client and say just what the therapist is looking to hear. Save them the trouble by providing them with the answers, the equivalent to self-medicating in the presence of a doctor! Because it is easier or rather familiar to be “put together” than be vulnerable.

Feeling a sense of fraternity with your therapist can make you feel obligated to be perfect and help out your therapist by being an ideal client. Rapport formation can be a very crucial element in these spaces, as this acts as the catalyst to speed up the process of going from being a “therapist in therapy” to acknowledging that you are also a client nonetheless.

What can help?

• Cut to the chase – Naturally coming from similar backgrounds would be creating an additional variable during therapy, so going in and directly addressing any such scenarios would bode for a better therapeutic alliance. For example, addressing the awkwardness when you know and use the technique the therapist is trying to implement with you and perhaps going into a conversation about it, is far easier than pretending not to know it.
• Openness – Understanding that each therapist has their own approach and way of practicing is important. Because comparing your therapist with the way you or your colleagues practice, would create an unrealistic expectation for the therapist to perform a certain way.
• People pleasing – As a client it is not your responsibility to make the therapist feel competent. So avoid over validating and pleasing to acknowledge that you know their struggles as a therapist. Because this may restrict you from taking up space as a client.
• Humor – This is a great way to process the discomfort sometimes. When your therapist is giving you homework that you have given to your clients, it’s okay to make a joke about it, as it helps lighten the weight of this irony.
• Use the irony to your advantage – Although I have spoken a lot about how difficult it can be for a therapist to be in the role of a client, it can also be extremely comforting to finally have the space, which you try to create for everyone else. So maximize this space to be your most funny, crazy, authentic and honest self.

A therapist’s therapist

“You’re dealing with a lot of people’s pain. Whether it is therapists or lay patients, pain is human, and human suffering is not unique to one group.”

– Leslie Prusnofsky, a psychiatrist and professor practising for 35 years, Colombia University.

When I mentioned in the beginning that there are several dynamics to therapists in therapy, this is what I meant. All this while we spoke about a therapist in therapy, now we move onto understanding the anxieties of being a therapist’s therapist.

When I had just started practicing, I used to stay away from clients who were also from psychology background, in the fear of being constantly evaluated as a therapist. I was concerned that it would fuel a performance anxiety that may hinder the process. But when I started seeing these clients, is when I realized that not only are they uncritical but also have more empathy if anything.

As a therapist, it is important to understand that not every client will respond to our approach the same way, but when it doesn’t resonate with clients, it is important what we choose to tell ourselves. We can either go into a spiral and define ourselves based on this experience and operate from our insecurities or understand that this is a subjective experience and curate the approach to fit the needs of the client in a better way.

What can help?

• Transparency and authenticity with your client is crucial, Example, When the client switches to the role of being their own therapist, gently remind them that they don’t necessarily have to carry that burden alone, as they too have someone now.
• Carefully using self-disclosure based on the context can help form a strong rapport with the client. But this has got to be an instinctive move based on the type of client, because going in with too much disclosure or too soon, can take away from the space that is meant for the client
• It can be nerve-wracking to share the room with another qualified professional in your own field, but it’s important to remember that it’s the human part of them that has brought them here seeking support and not necessarily the professional. So create a safe space for their vulnerability to thrive and treat them like any other client.
• Try not to assume that the client would understand what you are saying just because they may also be fluent with therapist jargon. Not all therapists practice alike and the techniques they use could be very different from yours, so always take the same time and care to explain your approach even if the client is a therapist.
• It’s okay to feel overwhelmed when the client complains about job stress and the issues that come with being a therapist. They are not expecting you to jump in and share that feeling, so you could always just acknowledge their discomfort and make them feel heard.

The Clients

Recently one of my clients asked if their stories sent me to therapy, which is when I realized that sometimes clients think of themselves as the burden that puts therapists in therapy. This is a common misconception along with perceiving therapists as incompetent. If you are a client and are wondering why your therapist is also in therapy, here are some of the reasons,

• Although sometimes work can be stressful, it is not because the clients are overburdening but because any job could cause burn out especially if it requires you to be in an accepting frame of mind. A Panama study found that 36 percent of mental health professionals had faced burnout in their careers. As a therapist, for example, if I’m having a bad day and going through something myself, I may not have the bandwidth to extend and be present for my client.
• Not always are people in therapy because they don’t know what to do, but because it is hard to do it. They may need a space to rant about how hard it is or to just feel heard and the same goes for your therapist. And funnily enough, both the client and therapist may even be in therapy for the same concern, like a breakup.
• Sometimes what the client shares in a session can bring up a specific memory or emotional flashback for the therapist, so going for therapy can help them deal with any unresolved trauma that could resurface.
• Interestingly, some could go for therapy just to understand the experience of being a client. This can change the way they view clients drastically and increase empathy exponentially.
• Sometimes going to therapy is part of the training Unlike the USA, most European countries, have a requisite number of hours of personal therapy as obligatory in order to become accredited or licensed as a psychotherapist.
• There could be a lot more subjective reasons, but this last one is my favorite. Which is the fact that they could be in therapy… simply because they want to!

Let’s hear it from the therapists themselves

“Being in therapy as a therapist gives me space to work through realizations I have in my different sessions about my therapy space and my internal space as well. As a therapist, I’m playing so many different roles with my clients. I’m accepting roles they require to realise their most authentic self in a safe space. This process also moves me closer to myself and allows me to recognize experiences different parts of me go through. Being in active therapy allows me a space to sift through all of this and integrate it into my internal space.”

– Varsha Rajesh, Psychologist, Bengaluru.

“I think it’s essential for therapists to be in therapy. It’s important to explore and identify our strengths and weaknesses. Therapy helps us understand which population we are comfortable working with, what are our underlying beliefs and to let out our thoughts and feelings. Therapy can provide a therapist with support and give the therapist the tools they need to provide better treatment for the client.”

– Nitya Vashistha, Psychologist, Delhi

Article by

Jensita Grace (In-house Psychologist, Talk Therapy Clinic)

Resources:

https://www.theguardian.com/society/2017/apr/19/therapists-go-to-therapy-prince-harry-mental-health

https://psychcentral.com/pro/why-is-it-essential-for-therapists-to-experience-the-other-side-of-the-couch#1

The Therapist As Patient (kspope.com)

https://www.therapistsinphiladelphia.com/blog/do-therapists-have-therapists/