Therapists Carry a Heavy, Heavy Load

The average person might think a counselor’s, therapist’s, psychologist’s or other type of psychotherapist’s job is easy. TV stereotypes show them listening to a patient’s problems, thoughtfully stroking their chin and saying things like, “So, how does that make you feel?”, then offering a single solution or two sentence answer that fixes everything. As light-hearted as that is, it couldn’t be further from the truth.

Their job is hard, sometimes dangerous and hugely taxing emotionally and intellectually. You rarely find a practitioner who can absorb the waves of negative energy that wash over them in a day’s work, then simply walk away from it all at 5:00 p.m. It was said, “Walk through mud, you come out muddy.” Therapists wade through the mud of people’s lives every day and rare is the person who can do it well and not suffer burnout or become afflicted with stress-related conditions.

This doesn’t mean social workers, doctors, nurses and other categories in the “helping professions” aren’t similarly at risk. Stories of Kentucky social workers and doctors killed in the line of duty are still fresh in most people’s minds. On the other hand, you don’t hear about many counselor and therapist casualties in the mental health field. Why?

Because if there is an untimely demise – either of the soul or the flesh – it occurs in a lonely, isolated, protracted way. It’s insidious because, unlike blood on the scrubs of emergency room staff (who deal with these issues themselves), there are few physical signs of the strain of helping people lift their burdens, cast them aside and assume a more normal existence.

Ask yourself if you could you listen to other people’s problems and have depressing conversations all day, every day. What they hear is often harsh: Painfully broken marriages, overwhelming grief, toxic anger, families adrift, cruel behaviors, physical and sexual abuse, children’s pain and problems, unrelenting mental suffering from myriad symptoms, people who’ve tried to commit suicide, lives destroyed by drugs, or dark secrets that are incredibly, horribly, upsetting to hear. Just as bad is seeing someone’s suffering continue when nothing seems to help despite your absolute best efforts. That feeling of helplessness can be crushing.

Many things wear them down, like emotional depletion. They are expected to give endlessly, constantly absorb pain and grief, and expect nothing but a fee. They work in isolation due to patient-physician confidentiality rules, meaning they listen to all of this, yet can’t unburden themselves with anyone else. If they’re dealing with a particularly dark case, that burden that can linger through their days and nights.

Then there are hostile patients, like some seeing a counselor due to a court order. Patients in that case can be difficult, dishonest, manipulative, angry or lethal. The coin’s other side is dealing with crime victims — the counselor is now drawn into the victim’s nightmare and the patient’s danger and fear invades their world.

One therapist told me, “Counseling is so unrewarding at times because, you can see a patient for a number of sessions, they leave, and then you often never really know if you made a difference or not.” That’s called a “grief cycle” because you’re drawn into the patient’s pain at each session, the sessions end, and the therapist doesn’t get closure.

Physical harm is a real possibility, too. A police detective was recently overheard asking a local counselor if a patient had ever pulled a gun on her; she replied, “Yes, twice.” “Seventeen years on the police force,” he said, “and no one has ever pulled one on me. Why? Because I deal with angry and you deal with crazy. You can reason with angry, but not crazy. You can keep your job.” While this gross explanation is colorful, it’s often sadly true.

Then there’s the legal side. There’s always the possibility of being dragged into patient’s court battles. Even worse, considering that some people in therapy have a skewed view of the world, or demonstrate unpredictable behavior or impaired judgment, they sometimes turn on the therapist and sue them or make wild claims against them.

Besides work, there’s the social aspect. People often react in one of two ways when they hear someone is a counselor. The first is fear and suspicion: People sometimes think the therapist is going to analyze or judge them. Rest assured, unless you’re going to pay for that information, they are NOT analyzing you. A mechanic doesn’t start working on his guest’s cars, nor does a therapist want to talk shop at a party.

Second: Free counseling – “What should I do?” Like doctors, people feel no compunction about pouring out details of their life and asking for advice at casual gatherings. If a session is offered, they usually don’t come in and pay for the time. It’s a no-win situation for the counselor and they get accused of being uncaring simply because they won’t drop everything to listen to that person’s troubles. People don’t consider that’s how they make their living, even though the one with troubles would likely take offense at being asked to work for free.

As if all that weren’t enough, mental health professionals are often the only thing keeping families together or helping someone hang on when everything is pulling them down. That takes more heart and strength than most people have.

Lest you think theirs is all misery and angst, those who stay with the profession get more satisfaction from their victories than most in other careers. Saving a marriage, helping someone get sober, or helping a child prevail over an eating disorder carries a satisfaction few folks know. As one counselor told me, “At the end of the day, I can usually say ‘I made a difference.’ Not every job offers that.”

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