Some Tea on Being a Therapist

There tends to be a lot of mystery surrounding therapy and what therapists are actually taught, so I thought it might be helpful to share my hot take.  Please note that this is purely a reflection of my personal experience and opinions and sentiments should not be applied universally.

What are therapists taught?

This is a question I contemplate regularly.  I once heard that graduate school is the most expensive form of therapy you can get, which honestly seems plausible.  I know that grad school changed me, but I’ve never been able to pinpoint when or how it happened.  I’m also perpetually amazed by the amount of things I wasn’t taught.  A counseling degree typically requires 60 credits, whereas a majority of graduate degrees are only 30 credits.  One would think that leaves you very prepared for “the real world,” but in retrospect, it was merely a sampler platter.  

So what *did* I learn?

A few vastly oversimplified takeaways:

Oftentimes our [student] questions would be answered by professors with “it depends.”  In essence, life is full of nuance and there’s not typically a “right” or “wrong” answer to anything.  As humans, we like to put things into boxes, but reality doesn’t work that way.

Grief is so much bigger, more complex, and universal than I ever realized.  (I hope to expand upon this in a future post.)

Prior to graduate school, most of us [students] had been in therapy and understand the vulnerability expected from the client’s side of the couch.  By the end of grad school, you understand it all-encompassingly.  [Mitch Hedberg, anyone?] The amount of discomfort brought on by in-class activities and assignments (aka “doing the work”) was honestly quite humbling.

Even though graduate school still feels like an enigma, I can confidently say that I learned a lot from what was unspoken.  The most engaging and impactful professors unassumingly infused counseling skills into their teaching methods.  Essentially, they quietly modeled the presence required to help others heal and illustrated the profound impact that role models can have, for better or for worse.

There was also a lot of un-learning that quietly took place, akin to reparenting.  Growing up, society teaches us to conform and not show weakness.  As a counseling student, my imperfections were met with grace; my vulnerability was praised; and my unique perspectives were encouraged. When given the freedom to do so safely, our authentic selves can emerge and our shadows (the hidden and repressed parts) can be discovered and integrated into our self-identity.  That notion is essentially my philosophy on therapy–the closer we get to our core selves, the easier it is to move through life.  Going through this unlearning process was an essential component of my own unmasking.

The things I wasn’t taught…

As a disclaimer, this is just a reflection based on my personal experience.  I may have missed or forgotten things that I was supposed to have learned.  Society and our collective understanding of mental health have changed significantly since my graduation.  I don’t fault anyone for these shortcomings.  I still believe I received a quality education and am grateful to my mentors.

The field of psychology is complicated.  There are multiple paths you can take to become a therapist.  I was clueless to the vast array of degrees, licenses, and educational paths.  I thought that a psychologist is someone who studies psychology.  As it turns out, being a psychologist is a specific career path and requires a doctorate degree.  Even being in the field, I still don’t fully understand all of the credentials behind clinicians’ names or what their scope of practice is.  If you’re looking for a provider and feel confused and overwhelmed, that’s totally understandable.  The good news is, specific credentials tend to be less important than finding someone you connect with.

Back to the notion of a sampler platter… there are definite holes in the curriculum for becoming a counselor, but it’s simply not possible to teach everything there is to know.  So we’re taught broadly applicable counseling skills and are introduced to the existence of diagnoses, schools of thought, and common human challenges such as substance abuse, grief, and cultural implications.  We learn how to be a good therapist, but not necessarily an in-depth or concrete method for doing so.  Specificity tends to develop through experience and specialized training.

The concept of neurodivergence has existed for several decades but became mainstream during the pandemic.  I started my schooling in the fall of 2019, in my mid-30’s, just as societal understanding began to evolve drastically.  This is when the seed was planted for the unraveling of my own diagnoses.  I do not recall formally learning a thing about ADHD, autism, or the vast array of conditions that fall under the umbrella of neurodivergence in school.  So how did that become my specialty?  It’s something that I became immersed in while on my own journey of self-identity; something that I was deeply curious about that became a monotropic interest;  and something that I developed a lot of firsthand experience with.  Much of my professional career has been spent working closely with kids, and in doing so, I’ve been able to witness the vastly different expressions of autism and gain a solid understanding of the four distinct clinical and genetic subtypes that are now recognized. 

(By the way, this study supports the fact that a large subset of autistic people may meet typical developmental milestones.  This finding is a significant contributing factor to the notion that autism has become more prevalent.  Many adults have lived decades without a diagnosis.  They were always autistic, they just weren’t always counted.)

There are many other things that I wish I was formally taught, but you get the gist.

What are some challenges of being a therapist?

There are a lot of things that will break your heart—and it’s not what you might expect.

I feel competent in managing the heaviness that comes along with secondhand exposure to trauma. What I have trouble with is working within broken systems and accepting the powerlessness I feel when someone has exhausted every possible resource.  Sometimes seeing behind the metaphorical curtain can lead to weariness and cynicism.

Another thing that has been particularly heartbreaking is having to terminate relationships with clients and hearing things like they’re “used to it” and “every time I get a good one [therapist] they leave.” Many jobs, especially for new therapists, have unhealthy expectations and are generally unsustainable both financially and emotionally, often leading to high rates of turnover.  This dynamic leaves a lot of really good people stuck grappling with the cost of self-preservation.  Sometimes choosing your own wellbeing means taking on the weight of ending therapeutic relationships while inherently knowing that the relationship is an integral part of a client’s success.

A third challenge is the cognitive dissonance that comes with being human while being in a role that is often idealized as all-knowing.  When I’m unable to practice what I preach, it can spiral into shame, imposter syndrome, and existential crises.  Although I’d prefer to believe that I’m superhuman, I have to remind myself that I’m imperfect just like every other person on the planet and that my humanness often serves as an asset.

What do you love about being a therapist?

I feel humbled, grateful, and privileged to be able to know people on an intimate level and sit with them when through some of their most vulnerable moments.  My sense of awe continually grows as I witness incredible resilience, gain new perspectives, and inadvertently learn things from my clients.

Personal growth doesn’t exist on a linear timeline or have a definitive ending point, which can make a therapist’s professional sense of worth feel fleeting.  That said, I love when I reframe something and see a light bulb go off in a client’s head.  I love when someone comes to therapy proud and excited that they overcame a hurdle we had previously discussed.  I love seeing people persevere even when life kicks them in the ass. These glimmers make it all worth it. Despite the imperfections of our current mental healthcare system, therapy has helped millions of people. I’d call that a win.