The Recovering Therapist, by Sahar Dorani M.A.

There seems to often be a misconception that therapists in mental health are always composed, and impervious to psychological angst. As in many careers, for a psychologist the role of professional may be seen as trumping the therapist’s own human emotions. Yet with all of the training that a clinician receives, the emotional difficulty of certain situations will prevail and conquer the conceptual ways that we are taught to deal with such scenarios. Understandably, conflict may arise when one is having difficulty with the exact life issue that he or she is working to help others through. This can create cognitive dissonance for an individual, such as in the example of a marriage and family therapist who is going through a divorce, or a person of the clergy who preaches while challenging and second-guessing their faith. Equal is the struggle of a grief counselor who is mourning the loss of a loved one. This was my reality during my second year of graduate school while working with adults in an outpatient therapy clinic.

            I was somewhat new to the field of mental health, and I certainly held judgments about how “I should” be able to conduct myself as a competent therapist regardless of any personal issues that I was experiencing. I was in denial about the fact that my ego and emotional states could be just as fragile as those of my clients during times of turmoil. At this time, I had just lost a close friend to suicide. He decided to hang himself in my former garage after losing a long battle with depression. There was an element of violence in the way that he chose to take his own life. While I was fortunate enough to not have directly witnessed this horrific event, I was very much a part of the aftermath: awaiting the arrival of police to the scene, calling his loved ones to inform them, and searching through his house for a suicide note and any information that could assuage the pain from the many gut-wrenching questions that I was left with. Needless to say, this event left a larger-than-life impact on me emotionally and psychologically.

While I was attemptimg to recover from this loss, I worked at the therapy clinic with several clients, including a 19 year-old female college student who was coping with major depression and who was often preoccupied with suicidal thoughts. Prior to my friend’s death, I would see my female client in session and I would feel empathy towards her for her struggle with her moods. After my friend’s death, I was so consumed with the details surrounding his suicide (i.e., “How could this have happened?”, “Were there any signs?”, “Could we have prevented this?”), that it became such a challenge just to be present in session with this client. I would not ‘tune out’ as much with my other clients during this time, but with this client, I would learn that her own obsession with suicide was triggering me to disconnect from her emotionally. The day that I realized that I needed to talk to my supervisor about this (which I had avoided and which made me feel totally incompetent) was the day when I went into the waiting room of the clinic to retrieve my client for our session, and I walked up to notice her sketching a large picture of a noose in her notebook.

            I felt that my client was not in danger of harming herself, as she would talk about suicide in a conceptual way, stating that she “wonders what it would be like to not be here,” but that she would be too afraid to end her life. She still had hope for herself and for her future. Though her situation was not likely to end in suicide, I still became emotionally unraveled following our sessions. When talking to my supervisor about this, she was incredibly supportive and assured me that it did not make me an incompetent clinician for not being sure if I could continue to work with a client who triggered such visceral feelings for me. The alternative to working with this client was to refer her to another therapist at the clinic, which my stubborn brain would not have allowed me to easily do. A tug of war ensued between my pride and my clinical judgment. After all, how could I help this individual when I would feel overwhelmed in response to her feelings of despair? It would not be fair to my client nor to myself. Between my clinical supervisor, my own therapist, and myself, I made a promise to inform the clinic if I felt that it was necessary to transfer my client.

I began talking to my client in session about her suicidal ideation. We had discussions about what would bring fulfillment into her life. She had always lacked strong communication with her parents, so our treatment focused on restoring integrity in her relationship with them (which seemed to be a major contributor to her depression). As a month and several sessions passed, my grieving process was in full force and while I still felt immense sadness, I found it to be more manageable to work with this client, and I was not emotionally ‘checking out’ anymore. We had begun doing good work in our sessions with setting goals for her to master proactive ways to handle disagreements with her parents. Things didn’t feel like they were at a standstill anymore. It was a long road to recovery, for my client and for me, but we were on our way.

A great lesson that I learned through this experience was to be able to recognize and gauge when I am becoming so emotionally involved in a case that it could become counterproductive to the therapeutic work. I learned that it is necessary for my pride to take a backseat to my psychological well-being, otherwise my work as a clinician can be compromised. While working with this client didn’t heal the emotional scars from my friend’s suicide, it allowed me to witness the progress of an individual who overcame a deep depression. Even though my client still struggled with her mood changes, she began enjoying life and had motivation to live. In hindsight, I believe that helping this client restored a sense of hope in me; this clinical case enabled me to provide the support that I was unable to offer my dear friend.