Every so often, I come across some questions in sessions, from random people who find out I'm a therapist, or from complete strangers on social media. The anonymity of therapy can create a space of wonder and even be something taboo (although the latter seems to be shifting with time). There's space left for social media to fill in the gaps as to what goes on in mental health care. Sometimes there is gross misrepresentation from sources that have zero training or validity. Other times, there are solid key points that are mentioned. The following points bring up some common themes I've seen from the 11 years I've been a clinician. The answers are solely my own opinion, although I'm guessing many therapists out there might connect in some way. Without further ado, here are some things you've wondered about your therapist.
DOES MY THERAPIST ACTUALLY CARE ABOUT ME?
I sure hope so. I can only speak for myself, but yes, I definitely care about your mental health. I didn’t go through 13 years of college, a career change, 11 years of private practice, all while getting paid an income that undervalues mental health if I didn’t care (This is my unique path to get here. Not all therapists have this path). This isn’t to be confused with care that comes from family and friends. Care from family and friends is love and that’s different than the care you’d receive from a therapist. I care about your progress through the challenges you overcome and show up for. I show up on time, I communicate back to you in a proactive timeline, I’m flexible enough to model healthy boundaries. I won’t explicitly tell you I’m proud of you because it’s more important that you’re proud of yourself. When you find that place, then I’ve done my job. I’m proud of your wins and I’m right here to point out what you’ve overcome. It’s not my place to pat you on the head and tell you platitudes. I believe in your ability to overcome so much, that you don’t need my platitudes. I don’t feel sorry for you. You don’t need my pity. I care so much that I have more faith in your ability as a human than you might give yourself credit for. If you’re tempted to not believe me, why would I lie? There are easier, less emotionally heavy, more lucrative occupations if I’m in the business of scamming or lying.
I’ll also add that I’m a human being full of emotions and feelings. I feel scared sometimes, I feel lost, I feel happy, elated, overwhelmed, at peace, and so much more. Despite what you know about me, I don’t only live in my therapy chair in this one room that we meet. I've had family deaths, I have wins, I have family emergencies sometimes, I have dull days, awesome days, productive days, and so much more outside of the therapy hour. I do my best to heal and take care of myself so I’m the best version for both of us. I’m not perfect, but I can say without a shadow of a doubt that I do my best when I show up. All the same stuff you see on social media, I see too. The politics affect me too. Climate change impacts me. I have good days in my relationships, and I have challenging ones. I’ve had failures in my life just like I’ve had successes. I’ve been in therapy. Point is, because I’m not an asshole, I care.
DOES MY THERAPIST EVER THINK ABOUT ME BETWEEN SESSIONS?
Yes. But not in the way you might think. It’s my absolute responsibility to protect your privacy from the rest of the world (unless there’s a reason to question your safety). I hold space for your vulnerability with great respect and I’m honored that you trust me with your thoughts, fears, and dreams for the future. Because of this, I never share your personal details with anyone. This even goes for any case consultation or notes. If a stranger were to pick up session notes, they wouldn’t know it's you. If I need to check my own clinical decisions, it’s done with you remaining anonymous. As far as discussing anything about our sessions to friends or family. Absolutely not. I value you too much to ever dream of gossiping. Not only does that feel unprofessional and unethical, but it feels gross. Plus, I work hard to keep healthy boundaries. Sessions stay in my office. If they need to be processed because I’m a human, it’s done intentionally. Then I’m able to transition to my personal life. Since I’m not perfect, I will say I had a tough day or a lighter day so my support system knows where my head’s at. And if for whatever reason your notes and name are shared, it’s because you’ve consented to a release of information and will have awareness of it.
Also, between sessions, I do research. A lot of research. It’s important for me to maintain my own levels of updated knowledge so I’m delivering the best care I can. It’s also impossible for me to know everything. So, if something comes up in session that I’m more ignorant to, I research. And I research with you in mind. I do my best to advocate for you behind the scenes so I show up as the best clinician I can be. We meet for an hour, I’ll work on administrative tasks for about 10 minutes, then research for a few hours between sessions. This goes for every client, every session, every week. I'm lucky and very grateful to have this career and enjoy the challenges it brings.
WHAT DO YOU WRITE ABOUT ME IN YOUR NOTES?
All the latest juicy gossip. Of course I’m joking. Sometimes I'll jot down a few words during sessions, which get translated to Progress Notes after we're done. I usually write highlights from our session. Job changes, relationship changes, medication changes, moving changes, worksheets we did in session, homework I promised to send, etc. Usually, the notes are to jog my memory since again, I’m human. I want to make sure I remember that you’re married, for example. That might be incredibly neglectful if I forgot such an important detail. So, I write that down. Notes are very sterile and factual. Judgment doesn't have a place in our work together, so there's none of that. Notes might read like, “Client mentioned they are getting married in 2 weeks” or “Client reports they are feeling better on their decreased medication.” For my purposes, it helps me to look back and ask how your wedding went 2 weeks later. Or to check in with your new medication dosage. By writing down the medication, for example, it offers me the chance to look up side-effects, precautions, and dosage if it’s something I’m not super familiar with.
“RETAIL THERAPY IS CHEAPER THAN REAL THERAPY” sign at HomeGoods *sarcastic laughter follows*
Ah, one of my favorites. Don’t forget the classic, “Wine is cheaper than therapy.” If a quick win and dopamine hit work for you, awesome. You might actually not need therapy, or you might be in denial about deeper issues. For a moment though, let’s break down a stereotype of the cost of therapy. I charge $150 a self-pay session and I also accept about 30+ insurances. Most people use insurance, and their copay is $0-50. Chances are if you have insurance, you’d have it whether you used the mental health coverage or not. Also, the plan you choose is not up to the clinician. It’s not the therapist who is responsible for the high deductible. That’s the insurance company. So, let’s break down the self-pay rates. I graduated with about $50k in student debt from my master’s degree alone. I spend 1 hour face to face with you, and several hours behind the scenes doing research for our sessions. I don’t have 40 clients a week, I have about half of that, which is my sweet spot . So really, I make about the salary of a manager at McDonald’s. My choice, to choose the school I did. My choice to take on the clients I do. My choice to charge what I do. My choice to offer sliding scale for those who truly need it. My choice to apply for grants that advocate for clients that need it. My choice to work in this industry. My choice to have side hustles to make up for the difference in salary. Let’s not forget, it’s also my choice to care (as listed above).
WHY ON EARTH DO YOU WANT TO SIT AND LISTEN TO PEOPLE’S PROBLEMS?
In short, I don’t. I listen to stories of resilience and courage. I get to be invited into someone’s head. To sit with their fears and their dreams. To meet people at some of the worst moments of their life, and step foot on their journey. I can’t imagine a more humbling profession. Therapy can be raw at times. It will be scary (it’s scary for the therapist too sometimes). It's hard to sit in a space of pain and grief with someone knowing there's absolutely nothing I can say to fix it. Good thing that's not what therapy is about. Sometimes it's enough to hold space for someone as they explore their worth. You aren't broken, you don't need fixing, you are enough.
I am a better human because of being a therapist. Day after day I talk to people that have overcome or are working through immeasurable odds. I see the effects of the nasty sides of humanity, and I also see the best of humanity all in one spot. The most courageous humans I’ve ever met are astronauts, and my clients. If you’re in therapy, you have guts. So, I’d prefer defining my day to day as, I get to sit in the presence of some of the most courageous people on the planet. Hearing about their past, working as a team to get through challenges, and watching them grow to make humanity better.
Exploring Space and Inspiring Earth,
Sharife
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