When I’m introduced to a new person and they ask what I do, I respond that I’m a clinical social worker and then explain I work as a therapist with individuals and families. The responses I’ve received range anywhere from silence (not kidding-this really happens) to a “Well…that must be, interesting/rewarding/difficult.” The best case is when someone lowers their voice and said, “I had to go to therapy once during _____. It helped a lot.”
The bottom line is, it’s interesting to be the therapist at a party. While I think I have the best job in the world, I’ve found that it makes for awkward conversation and many people don’t know what to say. But stigma isn’t going to end unless we all work to end it, and let’s face it-we as a society feel more comfortable talking about pap smears than mental illness. So I’m going to share a few things (from my perspective alone) that I think about this incredible gift of working with people. Here are some of my thoughts from my side of the room.
1. I genuinely like you and care about your well-being. Actually, if we met under different circumstances, we would probably be friends.
I feel like finding a good therapist is unique, because unlike other service providers, you’re trying to find someone that is a) skilled, and b) likeable. Alternatively, f I’m looking for a mechanic, skill level is all I care about. Same thing for a hairdresser, lawyer, plumber- I could go on and on- but likeability matters little as long as I feel I found someone skilled and honest. Some people don’t gel with us personality-wise, but there are many professions and services where that simply doesn’t matter.
Why is being likeable important in therapy? The therapeutic alliance is paramount. The relationship matters more than anything else. Feeling that you like your therapist and he or she likes, cares, and can empathize with you is key to being able to partner together to meet your goals. When you bear your heart to someone even in a professional setting, you need to be able to trust in that relationship, which is built upon caring, compassion, and trust, and I personally feel it’s most effective when it goes both ways.
2. But we can’t be friends in the traditional sense.
Sometimes I have to stop myself from emailing to find out about that job interview, funeral, surgery, or first date. Why? Because even though I do care, I won’t allow my objectivity to suffer. If I don’t maintain my professional boundaries (and these vary from clinician to clinician), I won’t be able to help you. My clinical rudder will no longer sail us in a straight line, and you are trusting me to do that for us. I do not take that assignment lightly. It’s not that I don’t enjoy chatting about light topics before or after appointments, but that’s as far as I’m comfortable with in order to do my job well. If we work together for any length of time, we’ll certainly get to know each other, but it’s still professional.
3. I am “assessing”, but never judging.
It’s hard to talk about some topics, and therapy can get pretty personal. Please believe me when I say I’m never judging you, your situation, or your choices- I’m simply assessing how all this fits together in order to meet the goals you dictate to me. I’m taking what you’re telling me and testing it on the litmus paper of what I know about your skills and challenges. I’m always looking for red flags in behavior, mental status, mood stability, and presentation. Once I get to know you well, this becomes easier and faster, and I can guess what you might think or feel in a given situation. But many times I’m wrong, and we can tease it out together. The important thing, though, is to look for it in the first place, and to work with someone that can do this with you.
4. I try not to worry when I haven’t heard from you, but I do anyway.
Only because I want the people I’ve met to do well, feel well, and be successful in whatever way they want or need to be. Sometimes it’s because our personalities don’t mix well, because I don’t have the skills you’re looking for, or maybe you’ve met your goals, but that doesn’t keep me from wondering and wishing you well.
5. I’ve participated in therapy, too, so I know what I’m asking you to do.
As a clinician, there are times I challenge your thoughts. There are times I ask you to think differently, share stories, put things into a different perspective, and even keep your appointments when you don’t feel like it. I’ve gone to therapy to work on myself, too, and I know there are times that it’s amazing, and other times where it’s really hard. Understand that I know all that I’m asking of you, and I admire you for doing it.
6. Many therapists, myself included, have had some exposure to mental illness that got us interested in the first place.
We are by nature very empathetic people. Some of us actually feel it in the gut when you walk in, whether it’s a heaviness, a taut and tangled ball, or a lighthearted mood. But if you think it’s a coincidence that we understand so well, you’re wrong. Chances are we’ve seen something firsthand with someone we love, felt something firsthand by way of a diagnosis, difficult life experience, or we simply grew up as the friend who always listened and understood, but some combination of things brought us to this field. Our personal lives typically don’t get shared in the office, but they can certainly lend themselves well. Add solid clinical skills to a good imagination, and it’s easy for most of us to understand what you describe and put ourselves in your shoes.
7. I am truly honored that you chose me.
There are a million therapists out there, and I never take it for granted. Ever. To be a small part of the larger healing fabric that connects all of us, even for a short time, is something for which I will never be anything less than awed and appreciative. I tip my hat to your courage, your perseverance, and your amazing journey- and I am honored that you chose me to travel with for any length of time.
These are just a few items I think of regularly in my work. Of course, you’re always free to take it or leave my opinions, but please take on mental health for yourself and those you love. Someone you know might be struggling and you may not know it. Be brave and start a conversation, regardless of which side of the room you may find yourself.