What It’s Really Like to Be a Therapist
10.10.17

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.


The Beginning

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.

The Schooling

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.

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  • Amber MB

    This is super interesting, thank you MR! Question, as someone who hasn’t (yet) been to see therapists: is it usually useful/okay or not for the counsellor to share part of their “realness” with their clients?

    • rolaroid

      If by realness you mean their life, I would say that out of the 4 therapists I’ve had, all four told me a little bit about themselves — partners, kids, what their schooling was like. They have even told me about their vacations, but we don’t get into things that would break down the wall that is necessary in order for therapy to work. You are choosing to be incredibly intimate with someone, who will not, in turn, be as intimate with you, and you really need to accept that going in.

    • Fun Bun

      Agreed with rolaroid. Also, I think it depends on what you want and are comfortable with. My therapist is very “real” i.e. casual with occasional swearing, making jokes and I like that and it makes me feel more comfortable opening up with her. I know some stuff about her but, yes, there are still boundaries and she is good at directing the session back to the serious stuff when we get off topic sometimes.

      If you wanted someone who will be very serious and have strong boundaries around your session, thats totally ok too.

  • Autumn

    I have a couple therapist/counselor friends and they both say “don’t trust a therapist who doesn’t see a therapist”

    • CM

      I honestly thought it was a legal requirement for their license for a therapist to see a therapist.

  • Andrea Raymer

    I always feel so bad for my therapist. She takes a lot. Some days I get so frustrated with what we are doing that I end up lashing out on her. Therapy has made me think about my friend’s problems like their therapist and I really start to get a sense of the emotional burden they carry for their patients and how exhausting it must be to have to do that all day. I feel like I always need to bake her cookies or something to thank her.

  • Arden

    The point about therapists not giving advice really struck me. I often find myself asking my therapist for advice on what to do and afterwards I have to remind myself that she is a therapist, not a life coach. That can be so frustrating – I always want this person who has an outside view of my life and relationships to give me advice – but that’s not really her job!

  • gracesface

    I feel very lucky that I found my therapist in 2013. We had a few sessions, I ran out of money but I started seeing her again when I could afford it in 2014 and haven’t stopped. I went from weekly to bi-weekly to now monthly appointments that are FINALLY covered by my insurance. I’ve been in talk therapy since college and love it. About two years ago I start attending ART therapy – first a women’s group and then a DBT based (which really helped me a lot) group and now I go to individual sessions, it’s way more casual, the therapist is so caring and we do an art project each time. Highly recommend.

  • Gretchen

    Thanks for this interview! I am finishing up my master’s degree and am a therapist intern. I really feel like this is the best career choice for me and like Ms. Lyons have had some backlash (friends and family) about my decision. It does feel incredible to get to know someone so intimately and work together to find some good strategies for problems.

  • Katherine

    Q for New Yorkers and/or people who have recently been therapist shopping – besides getting a personal rec from friend, any suggestions for finding a good fit? Right now all I’ve got is a list of 300+ names from my insurance company.

    • Psychologist PsyD

      Hi Katherine,

      This is a common complain with our healthcare system. There are a few resources you can utilize to narrow your search. Therapists.psychologytoday.com is a search engine that allows you sort clinicians by insurance providers. You can also narrow your search by populations and illnesses they treat. It unfortunately only lists providers who advertise on the site, so it won’t give you a comprehensive list.

      You can also look through your covered providers and see who has significant experience treating your presenting issue. You want someone who has expertise in your presenting problem, not someone who lists 20+ diagnoses they can possibly treat.

      Also some things to think about- if gender and age of clinician matters to you and if cultural or religious convictions (if so- find someone who has experience in that)

      Hope this helps,

      A Psychologist.

  • Psychologist PsyD

    Great to see that MR is doing their part to demystify mental health and accessing mental health services.

    It should be noted that there is large distinction between a master’s level and doctoral level practitioner. The individual interviewed is a LMHC (licensed mental health counselor), which is a masters’ level practitioner. Psychologists at the doctoral level have significantly more training in individual therapy and commonly have areas of expertise such as anxiety disorders, obsessive-compulsive disorders, complex trauma, etc.

    The consumer should be aware that although the LMHC may suit their needs, their training is less than someone at the doctoral level. The plus side is their services are more cost effective, because they charge a lower rate (although i’ve seen some master’s level clinicians charging outrageous hourly rates).

    Happy to answer any other questions about the mental health field.

    Love,
    A Psychologist.

    • Janny

      I have seen a Psychologist, Psychiatrist, and currently see a LCSW (for two years strong) all for psychotherapy to try and help manage problems in my life. My current therapist has been the best fit for me (truly a life saver), and has training in EMDR and CFT which I had no idea what those words meant until he explained them to me. I guess my reaction here is just because some has a PhD or has gone to med school may not mean they are a good therapist for you. I am not a therapist, but I have seen a lot of bad ones with all different degrees and credentials. I would suggest identifying areas you are looking for help around, and finding a therapist who maybe specializes in those areas.

    • Quinnoh

      Significantly more training? Yes, in psychological testing and numbers. Psychologist are based on a ‘medical model’ ie diagnosing, where social workers look at a person in their environment and are more strength based. I’ve know plenty of psychologist who prefer to administer tests than work with people. Types of degrees don’t make better therapist, types of people make better therapist.
      Love, an LICSW with 20 years experience.

      • Psychologist PsyD

        Hi Quinnoh!

        I appreciate the feedback, but I have to disagree with your interpretation of the doctoral level training. A PsyD (a degree of psychology) or PhD (degree of philosophy) in clinical psychology has a large emphasis in coursework aimed towards evidence-based interventions, interventions for specific populations, and carrying a caseload of patients via practica experiences. Check out a model level course sequence on a school’s website some time.

        I concur with your statement that a degree that does not automatically qualify an individual to be a good clinician. It takes good training, good supervision, and good interpersonal skills.

        Kindly,
        A Psychologist (PsyD BCBA NCSP).

  • “It’s important to remember that setting boundaries doesn’t mean setting up a wall, it’s about creating a door.” I’m going to remember this. Such an interesting article!

  • Lil

    I’ve seen multiple therapists and psychologists. I’ve noticed that seeing a therapists feels like talking to an unbiased friend. Whereas meeting with a psychologist feels like talking to a nice teacher. Hope this helps someone debating about which one to see!