“A burden and a privilege” – clinical psychologists look back on their life’s work

By Christian Jarrett

Anyone who knows anyone who is a clinical psychologist or other kind of psychotherapist will know about the stories they carry in their minds and hearts. Stories of other people’s struggles, pain, trauma, hurt, love and sometimes, wonderfully, recovery. When the psychologist returns home, the stories stay with them, but now in a parallel world of partners, children, friends and mundanity. What is this life like for the psychologist and her loved ones? How do they cope?

Some clues come from in-depth interviews with nine senior psychologists and three senior psychiatrists in Norway, published recently in Psychotherapy Research by Marit Råbu and her colleagues. The interviewees – 7 women and 5 men, aged 68 to 86 – had worked as psychotherapists for between 35 and 56 years and some were now retired. All had started out their careers with a psychoanalytic orientation, but several had since branched into other approaches, including cognitive therapy.

Asked to reflect on their life’s work, a recurring theme in the therapists’ comments was that it had been a privilege, a humbling experience to come so close to other people’s lives, to witness their pain and suffering and see their sometimes remarkable ability to cope and adapt. The therapists described how this insight had affected their own personal growth as they “used different parts of themselves with different clients”. It had also enriched their own personal relationships, they said, by teaching them to be humble and accepting of others.

However, the interviewees also described the burden of feeling so much responsibility for clients, and being exposed to so much suffering. If anything, they said that age and experience had made them more sensitive and there was an accumulating effect of “sorrowful things” over the course of a career.

One of the most difficult challenges had been working with suicidal clients, feeling helpless in changing abusive situations, and in the worst cases, dealing with the grief of a client taking his or her own life. Some spoke of a guilt at not being to provide enough support to their clients. “That is perhaps the heaviest part,” said one therapist, “to possess so much responsibility and to learn how much loneliness these patients experience.”

This stress affected the therapists’ own personal relationships. “You populate your inner life with people you don’t live your life with,” said one, “leaving little room for more than perhaps your closest family.” Others described how they withdrew from any conflict with their spouses, and perhaps tolerated too much just for an easy life at home. One male therapist said his wife described him as “contactless” when he returned from work.

But overall, the therapists spoke of their careers as having enriched their lives, and how their role had become a vital part of their identity. They had coped, they explained, by constructing with their close relatives a way of managing the burden of their clinical work – they described the importance of self-compassion and of protecting one’s inner space. The researchers said “this involved the cultivation of other interests, socialising with others outside of the profession, making music, painting, and taking care of the body by exercising in a variety of ways.” All but one interviewee was active in the arts, such as playing a musical instrument or painting. The therapists also highlighted the benefits of time spent in nature, and the importance of “collegial support or supervision” throughout their career.

Qualitative, open-ended research of this kind produces rich material for analysis and reflection, but inevitably at the cost of methodological control, making it hard to know how much the findings apply generally or only to the small sample of interviewees.

The researchers acknowledged that their own “humanistic and relational orientation” may have influenced the questions they asked and the way they interpreted the answers. Also, the nature of the sample (lifelong therapists) may have led to biased accounts simply by virtue of the fact these therapists had all chosen to stay in psychotherapy for their entire careers. Reflections on working in psychotherapy from therapists who have chosen to re-route into research or teaching might be very different.

The interviewees’ perspectives will also likely have been shaped by their having embarked on a career in psychotherapy at a time of great freedom and optimism for the profession. Clinical psychologists starting out today may be confronted by different challenges, such as funding cuts, intense scrutiny of therapeutic outcomes and a demand for highly systematised forms of therapy.

How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists’ experiences

The findings of this research are to be dramatised in a co-production between the two largest theatres in Norway, with premiere February 2017.

Christian Jarrett (@Psych_Writer) is Editor of BPS Research Digest

5 thoughts on ““A burden and a privilege” – clinical psychologists look back on their life’s work”

  1. I’ve been a therapist for 40 years, and have specialized in all kinds of abuse, as well as the treatment of sex offenders. Having also supervised many therapists from different educational institutions, and looking at my own personal experience, I want to offer this: it has become increasingly obvious over time that the exposure to others’ pain and challenges is a potential downfall, for sure. However, those therapists that either come from, or figure out that their our need to help can have a destructive “dark side”. If (when) we have poor boundaries that get in the way of their own balanced lives we risk burnout.
    Our competence to grow in awareness in these areas appears to also be influenced by the focus of our training. To the extent that we are clear about the reality of our psychological AND emotional AND spiritual boundaries and mission – PARTICULARLY that we are a kind of “fancy dancer” in our own space, and need to trust that IF we dance well we will influence the most people around us to grow in good ways (as opposed to thinking it is our responsibility to change anyone!) is fundamental to actually attaining a balanced life! THAT appears to be hugely influenced by how much working on ourselves, and in articular our pain and or anger and or fears in our origilal attachment relationships, especially letting our own past pushed aside wounds to become conscious, (the wounds that we wanted to leave behind, and just be strong and help others), significantly influences our inability or ability to get closer and closer to what the Buddhists recommend: to be fully engaged, without attachment. I might add that this is similar to transference/counter-transference issues, and it is sad that working on one’s own difficult pasts, or aspects of our pasts, appears to be way less focused on these days in our liability fearing, income motivated graduate programs. It is through understanding my own limbic responses and their true origins, as well as breaking down the masks that we therapists can sometimes wear, that appears to have given me the ability to still get up every morning and look forward to what I will learn and feel each day! : ) !! (Of course, paperwork is a different kind of challenge! ; ) Burnout appears to often be the result of a kind of compulsion to be there for our clients at the expense of our own lives. (Dysfunctional boundaries dictated by a kind of compulsion to be validated externally through helping) Mine, and plenty of my supervisees’ patterning this way appears to have had their roots in an over-responsible and/or parentified self that remains externalized and “martyrized”. Intervention through us assuming the vulnerable role of being a client at different times throughout our lives appears to bestow the blessing of more healthy boundaries. Difficulty “making time” for this appears to be exacerbated by poor training that often more superficial and less personalized. Ironically, it uses the same defenses (projection, rationalizations, compartmentalizations, minimizations, etc) and survival patterning, (fight/flight responses, including emotional double lives way…including our judgments and irritation as threats to something in us!) This could be why so many friends and clients have made statement to me re how many therapists often do not seem real in sessions … or comfortable in social situations, and just come across as awkward, weird, odd, etc” In our personal and professional lives…learning to be genuine and channel tools and theories through, and not us through them is a widely stated maxim in school, but we are given few models. I honor often the ones that did influence me – Satir, Erickson, Bucky Fuller, Pearls, Olney, and many more less famous but equally brilliant…including friends, several teachers in junior and hi school, and college, as well as medicine men, monks, and by mom and dad- the latter, not always easily, and with the limits inherent to their generation! They are the ones that not only gave technique and understanding ,,,but the acquired skills needed to eventually learn how to bring myself to relationships in measured, increasingly more fully, and non-aggressively. Last thing: (I had no intention of going this long): This collaborative process reminds me of learning to parent 3 kids w increasing efficacy! SEEMS I could never burn out being any part of such beautiful unfoldings…including the sharing of their pains, wh only serve to deepen understandings and the level of intimacy, and therefore, the meaning and compassion in our lives. I am as likely to get “burnt out” soaking in Montana sunsets, the mountains that seem to always change, my grandkids’ or childrens’ or lover’s or clients’ smiles .. or giggles…or tears.., as they continually impart a sense of awe!
    Be well and balanced, all you healer types…therapists, brothers, sisters, mentors, moms, dads, grandpas, and grandmas! : )

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