Part of being a therapist is being absolutely elastic. Clients come in with different motivations, some of them outwardly stated and some silent and under the surface. They are paying for a service (or sometimes their insurance, or some benefactor is paying for them) and they want to receive that service in a unique way. The most difficult part of the job is knowing how to meet that for each person. This can wind up leaving me feeling like I am auditioning over and over for people, trying to convince clients that I’m a valuable practitioner, who is worth their time and money. It can be an uncomfortable reality in my field. A lot of clients want a particular result without having to put much effort in. It can be exhausting.
I often meet new clients with some sort of introduction that can prove my worth. “Hi, I’m Chad. I’ve been doing therapy for this many years, and I specialize in these types of services. I try to utilize an approach that meets clients where they are, validates their pain, and also pushes them into positive growth, but this can often take time. The therapeutic relationship forms over a period of weeks. I’m here for you. Now tell me what brings you in?”
I like to think that I’m an effective therapist in most situations, and I think most of my clients would agree. I continually ask myself what my role in a given situation is, and in these situations I have to remind myself that my job is to be the therapist my client needs me to be during the time that I’m with them. They live their entire lives before and after our sessions, and there are no quick solutions. I have to listen, be attentive and consistent, and push hard, but not too hard.
I’ve had a number of clients complain about me over the years. These are isolated experiences, but they do happen. And I’m human, so every time, the negative feedback leaves me sad, frustrated, self-critical, or vulnerable.
“I felt you weren’t listening.”
“You were too tough on me.”
“You weren’t tough enough on me.”
“I told you I was suicidal and you didn’t take me seriously.”
“You should have realized I was suicidal even though I didn’t say anything.”
“You were too critical of my life choices.”
“You told my wife to find a safe place for the night after I hit her, but you didn’t even hear my side of the story.”
“You aren’t competent enough in _____.”
“You shared too much about yourself.”
“You are too closed off.”
And on and on.
On days where I see many clients in a row, I feel different parts of myself being challenged each time. Some need a coach, some need a best friend, some need a kid brother, some need a confidant, some need an emotional sponge, and some need a parent. Clients may come in and willfully withhold information, testing to see if I can sense that they are hiding something. They may come in aggressive and take out that aggression on me, their nearest target. They may come in silent, or sleepy, or in pain, and expect comfort, or nurturance, or challenge. And they expect the therapist to be fully present and adaptable to those needs, spoken or unspoken, no matter what the therapist is going through personally. (And trust me, therapists get headaches, and get sad, and have family problems, and…)
On top of that, the therapist has to be able to manage time. Sessions last for fifty minutes. Clients need a balance of reporting HOW they are doing, while being kept on a continuum of working toward their goals. (And some clients have VERY specific goals, while others have NO goals).
Most clients expect some kind of therapist who has life experience with struggle. They want to know their therapist has an understanding of depression, and anxiety, and addiction, somewhere in their personal lives, but they also don’t want the therapists to have ANY problems currently. And so self-disclosure becomes necessary. I use self-disclosure sporadically with clients. I use it to demonstrate understanding of a particular issue, to create a bit of a personal bond with a client, or to increase empathy between us. Self-disclosure is expected by most, if not all, clients, at least to a degree, but it has to be brief while also being frequent.
These interactions with clients get extremely complicated given three basic facts: 1. I am a human, who has human problems and human emotions. 2. I genuinely care about my clients, each and every one of them, even when they get on my nerves. 3. I have feelings, and I won’t always do everything right, even when expected to.
A few examples of self-disclosure follow.
“I know what that feels like. Before I came out of the closet, I went through a period of deep depression. It can be so hard to do the work it takes to get out of it, but it is so worth it. It’s the difference between hope and despair. What do you think would help you move forward?”
Or “I hear you! Being in a relationship is so hard! My partner and I fight over the stupidest things sometimes, and we see things completely differently. Communication means compromise, though. Meeting in the middle. The other day we argued about ___, and then we got through it by ___. Tell me about your last fight.”
Or “Maybe taking a break from church is a good idea for a while. You are talking about how conflicted you feel when you attend every week. I wouldn’t recommend quitting all together, but taking a few weeks off so you can get some clarity. When I was in my faith crisis years ago, I needed room to breathe, and it helped immensely.”
Self-disclosure in therapy can become tricky. It builds bonds, but those bonds have to be kept within certain boundaries. The client can’t feel like the therapist is over- or under-sharing. There needs to be a friendship without the two being friends. Co-dependency can form, as can romantic attraction, or emotional distance, or overstepping bounds. In fact, because these are human interactions, not only can they happen, but they will happen, and then they have to be managed along the way.
After 16 years in this field, I’ve learned a few things, but above all else, I’ve learned that I have to be organic. My job requires me to be knowledgeable, competent, kind, and consistent, to manage time and goals, to be accepting of everyone, to be both soft and hard in approach, to keep clear boundaries, to be human, and to be adaptable. And despite all of that, I have to realize that I’m human, that I’ll make mistakes, that I can’t help everyone always, and I certainly can’t please everyone always. I also need to know that it’s okay to say sorry, to receive criticism, and to trust myself all while doing my best to help those in front of me.
I love helping others, which is why I do what I do. It’s a calling. But it is also a job, and just a job. And I have to leave work at work and then go home. And so, like every other day, I’ll do my very best, one client, one hour at a time.