Taking in the whole of what mental health practice is today can easily leave one despairing. Newcomers looking at the situation are right to ask, “Is it worth it?” I have often been asked over the years whether it is discouraging becoming a therapist. And I admit that even after many years in this role, I still had my bleak days. One evening in my twenty-sixth year of practice, I sat down and wrote the following thoughts.
September 14, 2006
My 26th year of practice
On a bleak day I consider what practice in mental health looks like to someone starting out:
- You spend years on an expensive graduate school degree that starts you out with tens of thousands of dollars of debt.
- You cannot get the job you really want without a license, which will take you two more years or longer to complete.
- Once you become qualified to receive insurance reimbursement for your therapy you have to deal with a pile of controls and restrictions that limit your autonomy and fee-setting ability.
- And then, to top it off, you have those difficult clients who, no matter how brilliant your therapeutic advice, still leave you feeling defeated, ineffective, exhausted, and discouraged.
So why bother?
As with any job, there are days, weeks, months when the sense of satisfaction over work is elusive. All that one can feel is the numbing daily grind of seeing client after client, all with pain in their lives. And they all look to their therapist to guide them onto a happier and healthier path.
On my bleak days, it is hard to remember that I chose this career because I was seeking job satisfaction. On bleak days it is easy to second-guess my choice.
Remind me, why I am a therapist?
In the end, I am a therapist because I am called to be a therapist—and on most days, I enjoy being a therapist.
When I speak of “calling” I do not mean that it must be a religious calling, though it may be for some and is for me. But like a religious calling, it orders my days, gives me meaningful work to do. It shapes every part of my life. And like my faith, being a therapist has seeped into all of me. It is part of my skeletal structure now. Being a therapist holds me up, tells me what to do, and is a large part of who I am. It is my calling.
Yet even after twenty-six years of doing therapy five days a week, I occasionally have escape fantasies of a different type of career. Maybe I should have taken up engineering, farming, driving a truck, landscaping, woodworking, mowing grass, something different, anything different. But I know that those thoughts are just a sign of weariness. I often lose perspective over that one negative client experience out of the many positive ones I had on that particular day.
In the end, I know I am doing what I was called to do. This is what I was created to do. And on those bleak days I remind myself of my calling. My perspective returns. Life goes on. And in the end, joy wins out. For I know my place in the universe. I am a therapist.
Update: May 6, 2014
8 years later—My 34th year of practice
I had forgotten about this document until a student brought it to me from his practicum site. Apparently his supervisor, whom I never had as a student, got hold of it from some other student and passed it on to him. So I read it aloud for the class and found myself tearing up as I read. Why is that? I wondered. Here is what I’ve figured out so far.
1. Reading this reminds me of all those clients themselves and the many stories they have shared with me. I have provided over 30,000 hours of therapy. That means over 3500 clients, I estimate—plus all the spouses and children connected to them. Even though I have not met all the family members, my hope is that their lives also improved. I hope my client became a better participant with them. So reading this reminds me that if we stick with it, we are privileged to help a lot of people.
2. Reading this reminds me of the pain each of these persons brought with him or her. Obviously that pain reached a high-enough level to risk inviting a complete stranger, me, into the interior of their lives. What an odd process therapy is—one stranger sharing with another stranger about the most intimate details of life. Odd and wonderful.
3. And finally, reading this reminds me of all the bleak days I have had as I struggled to know how best to work with people. It reminds me of how hard it was at times to be with them. Their weariness, grief, and confusion could wear me down.And yet that is where we connected. That is pretty wonderful.
We go on
Nearly all the therapists I have known have this sense of calling to the profession and to their clients/patients. Therapists are therapists because they love the work that they do. They believe in the cause. They find satisfaction and fulfillment in helping people who are suffering and often lost.
It is my hope that you find that this career provides that sense of fulfillment that we all need to carry us through.
Attitude changes from my early beginnings
From nothing to something: The early years of my practice and organization