Late at night when I get home from work I always wonder for a second if my husband will have already gotten our two year old to bed. I feel torn because I am so exhausted and would love to just come home and decompress, but at the same time there really is nothing more healing than seeing her stretch out her arms for a hug and hearing, “Mama! I missed you!” This work is incredibly emotionally draining, and sometimes I just want to be able to shut off my brain. Yet, at the same time, being a therapist is one of the most rewarding and fulfilling jobs.
To others being a therapist seems to be such a foreign, mysterious concept. Some people picture that we just sit and mindlessly talk with people, and they ask if anyone really gets better. Strangers always assume I’m analyzing their every word. These impressions could not be further from the actual experience. The business aspect of being a therapist is a constant scramble. Free moments are filled with diagnostic reports, progress notes, treatment planning, billing, authorizations, invoices, phone calls, consults, networking, scheduling, bookkeeping, researching, creating therapy tools, and attending trainings. This is the tedious filler work in order to keep a practice afloat.
The true experience of being a therapist is made up of the days spent in the office with my clients. To me, the most critical part of the process is truly getting to know and connecting with every client and every family. Being a therapist is not a sterile, anonymous, critical role. I know all my clients’ stories. I listen and picture the situations as though I was there. All of these people become a part of my life and I know them well enough to be able to help. Knowing people on this level allows me to be able to recall their past experiences, point out their strengths, help them to challenge their thoughts and apply their skills. It allows me to hold them accountable. Knowing people on this level helps my clients to feel they not only have my support but also my pride. Being a therapist means always showing up and being fully present. I may be on my ninth session of the day, but this client has waited two weeks to get here. If I am out sick there is no one to fill in and do my job for me. I am the only one who knows my clients and their goals.
I have a terrible memory for many short term things, but I remember people and I remember relationships. I have a knack for hearing a voice on TV and being able to picture the actor’s face. I suppose this helps to make me a good listener and ultimately a capable therapist. I need to be able to pick up right where I left off with a client and remember their story. The ability to connect and truly listen is what allows a therapist to recognize irrational thinking patterns and behaviors and to know how to coach a client and family in the right direction. Being a therapist is about applying what I know clinically and what I have witnessed before and teaching people to see in a different way. It is about empowering clients to be able to do this for themselves and recognize their own strengths. It is about helping clients to be what they want to be even if they think it is impossible.
The difficult part about connecting with clients is that it is impossible to avoid feeling their pain at the same time. Early in school we are taught to stay numb and impersonal, but I do not find that entirely beneficial. Boundaries are important, but the therapeutic relationship is complex. I will not deny that I occasionally tear up in sessions. I do not leave my office and stop thinking about my clients. I have their stories in my head all the time. I often worry about how someone is doing over the weekend. I ponder where some cases seems stuck and what to try the next session. I feel for the parents struggling with situations and hope some of what we talked about in forty-five minutes is helping. I often wish I could just scoop up my little clients and tell them everything will be alright. Sometimes I have to fight and advocate for a client. Sometimes I act as their voice. I work with people, and people are fragile. I care about my clients, I want to keep them safe, and I do not want to let them down.
The absolute best part of my job is the impact I can make. There are so many victories to celebrate. People do get better. They learn how strong they are and they fight for what they want. People heal, situations change, thoughts improve, families stabilize, and I get to witness that whole process. I always tell my clients how proud of them I am. I feel proud because that client and their story matter to me. I get to experience their happiness, confidence, and relief. Sometimes I even get to hear positive feedback and appreciation. These victories are so powerful. Seeing the people I care about feel better is what makes it all worth it. I am rooting for my clients, and when things improve I get to share in that happiness.
We do not become therapists to be critical. We are not trying to label and categorize everyone. We do not define people by their symptoms. We help them to overcome symptoms and situations to be who they truly are. We are not analyzing everyone we meet. The last thing we want to do during our time off is work. We are therapists because we want to help people win at life. I love to see people succeed. I love to see people happy. Being a therapist is incredibly emotionally draining, but it also fills you up with satisfaction. I am so grateful to ride this ride through the good and the bad. These connections impact me just as I impact them. There is nothing better than helping people improve their lives.
-Rebecca Tull Guarino, LMHC, CIMHP
Rebecca Guarino, LMHC, CIMHP
Rebecca is a licensed therapist and coach, certified in integrative mental health. She specializes in cognitive behavioral therapy for anxiety, and holistic home and wellness coaching for busy moms. Rebecca is a wife and mother to two little girls.
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