Therapists can seem like stoic, mythical beings who exist on their leather chairs and then, once we leave the room, not at all. But therapists are people, too. Kristin Lyons, a Licensed Mental Health Counselor who works in private practice, broke down what it’s actually like to be a therapist — and a “normal” human.
I grew up in Salt Lake City, Utah. When I was 16, I volunteered to advocate for teens who’d been sexually abused. I was particularly interested because I was exploring my sexuality at the time — I now identify as queer — and SLC has a high suicide rate for LGBT youth. The organization provided an opportunity for me to work with those populations.
I quickly realized how interested I was in helping people move through how painful life can be. I also realized that if I became trained in helping others, I would be more equipped to move through my own pain in this life.
As an undergrad, just about everyone I spoke to told me not to become a therapist. “You’re going to be depressed,” they said. “You can’t take on other people’s trauma. You’re never going to make money doing it.” I didn’t receive a ton of support, but I knew this is what I wanted to do. I loved my undergraduate psychology classes.
After I graduated, I got my masters — six years total of school. Once you have your masters, you have to go through a licensing process in the state you plan to practice, which takes two to three more years. During that time, you have to get a job or placement where you see clients under supervision. Then you have to pass the state exam and submit for what’s called a limited permit. States vary in their licensing processes. I did my undergrad at Arizona State University and my graduate school program at Columbia University.
Those First Few Clients as a New Professional
I was so nervous before my first session. As a therapist, you have an intimate connection to people’s lives and well-being. I didn’t know what it was going to look like.
I started out by doing therapy with patients for five minutes, then 10 minutes, then 15. My supervisor would observe me through mirrored glass rather than by sitting in the room with me, which was nerve-wracking. But once I was there, seated, I was surprised how natural it felt to be with someone else’s pain rather than my own. I wasn’t thinking about myself.
At first I was like, “How am I going to able to talk to this person for 50 minutes or an hour?” Now time just flies by, and I want more sessions, or longer ones.
Taking on the Pain of Others
You can’t take care of anyone else if you don’t take care of yourself. It’s important to develop boundaries that feel good for you, to make sure you don’t always have your therapist hat on and do things you still enjoy. It’s important to create a schedule that supports that. I know clinicians who prefer to see six or seven patients each day, five days a week. Others may prefer to see patients all day long but take three days off. I’d rather see more clients in a day and then have days to recharge.
If my friends come to me for help and I’m tired or overwhelmed with heavy stuff in my own life, I tell them, “I want to be here for you and help you, but I’m a little deflated right now.” I have to let them know that I love them and I’m here for them but that’s all I can do: be there. Boundaries are really hard but so necessary, especially in this profession.
The thing with boundaries is that people don’t like them and have reactions to them. It’s important to remember that setting boundaries doesn’t mean setting up a wall, it’s about creating a door. “I want to be here for you but only in this way right now.” It’s a practice.
The Therapist’s Therapist
I absolutely have a therapist. I’m not a therapist all the time, you know. People will say that to me sometimes: “Aren’t you a therapist? Shouldn’t you know how to handle X?” And I’m like, “Yes, but I’m also a human. This is just how I see the world.” I struggle with what to do in my own life, too. And being exposed to trauma as a therapist, you really should be in therapy just to manage that, to help yourself manage your patients’ traumas.
What They’re Actually Writing Down
We are legally required to take notes about each session. Should anything happen, our notes can be subpoenaed. I don’t take notes during sessions, though — I find it to be distracting, so I take them after. We’re gathering data each time we meet with you to determine what your treatment will look like, what our last session looked like. My notes help me provide best practice in client care and that’s really, really important.
The Whole “Impressing Your Therapist” Thing
It’s a totally normal part of the human experience to want to impress others. We’ve been conditioned to be really put together. We live in this hierarchical society where everyone wants to be the best, appear perfect all the time. Messiness is not considered attractive or cool and that will certainly come in to the therapy room, too. I’ve had clients cancel because they didn’t feel presentable, and I was like, “Just to remind you, you can always come as you are.” If there’s anywhere to talk about this stuff, it’s in therapy. I think it takes some time to let our humanity show, or be okay with that.
Therapy is a Job
What can be tricky for me in this profession is that it’s such an emotionally charged job; sometimes it feels funny that this is how I earn my livelihood. The financial side of psychotherapy is not talked about often. When my clients cancel last minute, of course it’s okay, but also, this is how I earn my living. This is how I support myself and not many people understand that. My time and my livelihood aren’t always considered or valued, and that’s hard. You never know how many people are going to show up each week, so it’s difficult to budget.
Another thing people probably don’t realize is that I may see each patient for 50 minutes a session, but a couple hours a week go into researching what can help his or her case. I’ll consult with psychiatrists, other therapists, doctors — there’s a lot more time that goes into this job on a weekly basis than people are probably aware of.
There’s also a lot of overhead: training, office space rental, supervision (a good therapist is always consulting with other professionals, as I just mentioned, and their time often comes with a price tag), liability insurance, marketing costs to get new clients and maintain current clients (websites, therapist searches, phone lines, etc.), paying for memberships to psychological associations and groups… All of these things are truly necessary to provide top notch client care.
The Most Common Question a Therapist Gets Asked Is…
Clients often ask me what they should do. They want advice. I understand that desperation. If you knew what to do, you might not be in therapy, right? But it’s not my role to tell clients what’s best for them in their lives, unless I feel they are threatening their safety.
I can, however, help them identify a full range of perspectives rather than a narrow snapshot. I can go deeper with them into their internal experience and identify patterns in their lives that probably served them at some point but are no longer helpful. The most frustrating part of therapy is taking in that the therapist cannot make decisions for you, but a good therapist can help you explore what is going to enhance your life.
The Most Common Question a Therapist Gets Asked By Her Friends Is…
“You are analyzing me, aren’t you?”
This is complicated…and mostly untrue. I am a therapist, but this is also how I see the world as a human. At times, I have to remind the people close to me (as well as myself) that I am NOT their therapist, but instead, incredibly biased and subjective in my relationship to them. I am also not the ideal sample of a perfect human being, and even therapists share the humanity in their own lives of feeling lost sometimes. We make mistakes. We have to manage our own insecurities, rejection. We experience loss and heartbreak. We are all trying to get through this human experience as best we can. Therapists have the undeniable need to be seen and see others, just like everyone else.
I think clients often feel like their therapist has it all figured out, never gets sick or stressed, is never late due to subway delays, never feels sad and hurt. But while therapists may have valuable training in human behavior and psychological theory, they are still human, not robots, and thank god!
Finding the Right Therapist
If you are struggling to find a therapist who you connect with, I encourage you to keep shopping. It can be a frustrating process, and a ton of professionals may be a bad fit, but remain hopeful. I honor the act of courage in clients who have “poor experiences” with therapists, but who don’t lose sight of their birthright to ask for help from others when they struggle to find answers on their own. We all need that.
Kristin Lyons is a Licensed Mental Health Counselor (LMHC) working in private practice in New York City. Photos by Louisiana Mei Gelpi.