A new study, published in Psychotherapy Research, explores how having a career in psychotherapy affects therapists’ personal lives. The themes identified in the qualitative study, conducted with therapists in Norway, show that psychotherapy has complex implications, both positive and negative, for therapists’ personal lives.
“These themes convey a sense that being a therapist may potentially lead to openness, growth, tolerance, and creativity, while carrying the risk of becoming overwhelmed with feelings of responsibility, inadequacy, and self-doubt that can lead to isolation and despair,” write the authors, led by Marit Råbu, an associate professor at The University of Oslo in Norway.
Individuals with careers in psychotherapy, as with most careers, can experience purpose and value in their work, as well as stress and job dissatisfaction that can lead to burnout. In recent years, more research has centered on how therapists are impacted by their work in their personal lives, and how their personal lives, in turn, impact their clinical work.
One study found that psychotherapists are both more satisfied and more emotionally depleted than research psychologists. Studies have also found that stress from therapy work may carry over into therapists’ personal and family lives. “Therapists are required to connect with, then stay close to, then detach from a range of clients on a regular basis. This kind of work pattern may have an impact on the personal life of the therapist, including a lack of emotional availability to family members and an intolerance of ‘superficial’ relationships with friends,” write the authors.
Research has also shown that the impact of being a therapist differs depending on career stage. Trainees often report positive personal effects due to gaining more self-awareness, whereas mid-career clinicians tend to focus on the stress created from their jobs. Senior therapists are more likely to focus on the ways their role as a therapist has facilitated personal growth.
The present study sought to answer, “How did being a psychotherapist through an entire career affect your personal life?” The researchers interviewed 12 senior therapists in Norway using the qualitative method of thematic analysis. The participants included 7 women and 5 men with ages ranging from 68 to 86. The participants had careers as psychotherapists for a median of 40 years.
“For these senior practitioners, a professional life that involved coming close to other people encompassed experiences which they described as both enriching and burdening.”
The authors identify four organizing themes:
Theme 1: “It has been a privilege to have the opportunity to know and contribute, and to be allowed to grow personally.”
Participants reported that their clinical work enriched their personal lives. The authors describe, “The emotional side of the therapeutic relationship, to be compassionate with suffering over time, allowed insight into the strengths and resources of fellow human beings.”
Theme 2: “Facing suffering and destructiveness has been a burden.”
One participant illustrated this theme by stating, “The largest burden is the responsibility and to attend to so much suffering.” Another participant described the impact this burden has on their personal life, “To possess so much responsibility and to learn how much loneliness these patients experience. For sure I am not able to not bring some of it home with me. And that has an impact on my private life.” Participants also found work with suicidal clients to be especially draining and burdening.
Theme 3: “Being a therapist has had an impact on my personal relationships—for better or worse.”
Some participants reported that their work helped them to be more daring our outgoing, which resulted in more opportunities to build relationships with others. On the other side, one participant described how the emotional drain of their work negatively impacted their relationship with their spouse, “I was a little contactless. That means I had given so much that I was in shortage myself.” Another participant described it as, “You populate your inner life with people you don’t live your life with, and I think that can be a barrier towards other people.”
Theme 4: “I have needed to construct a way of living that allowed me to continue to do the work.”
The authors describe this theme by stating, “The burdens associated with being a therapist seem to necessitate active work of self-care, and the therapists in general talked about how they had developed greater self-compassion throughout their lives.”
According to the researchers, the “concept of work–life ‘balance’ did not offer a satisfactory way of understanding the way that therapists learn to manage their lives.” Instead, the researchers describe how clinicians “acquired a capacity to exist in parallel realities, and that one of the ways in which they accomplished this was to co-construct, with others in their lives, a set of practices that enabled them comfortably to move across contexts, such as the shift between work and home.”
The authors also note the culture in which participants conducted therapy, “Being a therapist in a contemporary managed care environment is likely to generate sources of stress and satisfaction that may differ in significant ways from the experiences of private practice therapy during periods of economic growth.” The authors identify that a prominent theme was an existential questioning of whether participants’ lives and careers were “time well spent.” They suggest that interviews from therapists earlier in their careers may have produced a different, and possibly less optimistic, perspective.
The researchers highlight that participants’ first descriptions of the impacts of their work were overwhelmingly positive. The authors conclude, “The result of this study reinforces the findings of previous research, that the personal lives of therapists are enriched through a sense of being in a privileged and valuable professional role, characterized by positive personal learning in such areas of self-awareness, personal development, and quality of interpersonal relationships.”
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Råbu, M., Moltu, C., Binder, P.-E., & McLeod, J. (2016). How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists’ experiences. Psychotherapy Research, 26(6), 737-749, doi:10.1080/10503307.2015.1065354 (Abstract)
I have witnessed horrific destruction at the hands of “therapists.” I believe Mary Richardson Kennedy’s death was caused by the cruel “therapy” of the “great” John Gunderson. Apparently she saw this bully for about six months and that was enough, I believe, to totally annihilate her. I am sure he caused her high-profile suicide. I wish this could be investigated and brought to the attention of the public. Looks like fingers were pointed straight at her as the sicko in the marriage, and Gunderson walked.
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the potential ill effects of therapy are not often studied and very seldom publicised.
I have been interviewed by researchers about bad therapy. Unfortunately I cannot find the studies on this or I would put up a link
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There have been several studies of ill effects of psychotherapy. This is a topic that is receiving an increasing amount of interest from researchers. A study that I was involved in, that includes a brief summary of previous research, can be found at:
Bowie, C., McLeod, J. and McLeod, J. (2016), ‘It was almost like the opposite of what I needed’: A qualitative exploration of client experiences of unhelpful therapy. Counselling and Psychotherapy Research, 16: 79–87. doi:10.1002/capr.12066 (abstract)
If you email me at the University of Oslo, I would be happy to send you a copy of the whole paper.
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Thanks! I would love to see that paper! I am so tired of hearing that my 20! therapists must have been “exceptions” and somehow the majority do no harm. The people i knew who completed suicide did so due to therapy abuse. Plain as day. therapists who were doing their job, it was STILL abuse. No one likes admitting this, they’d rather blame some “illness” or drugs.
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Even though the original post has nothing to do with the article, I feel compelled to respond as a therapist myself. I have been a therapist for about 8 years, and I have also seen a few therapists myself since 2004, all of whom were excellent and skillful. I think it is unfair to scapegoat therapists for poor outcomes; the truth is that therapists are rarely responsible for our clients’ choices, but of course we can make a situation worse depending on how we treat our clients. In the case you cite, I understand that Kennedy was struggling with both addiction and clinical depression (and possibly BPD), so she was unfortunately in a higher risk category for suicide. I have read that Kennedy was worried she’d lose her children in the divorce (her husband was temporarily awarded custody of their 4 kids), which is a common concern of many parents in such situations; I believe she also had a history of DUIs, which again speaks to her instability. Her husband, from some accounts, also repeatedly cheated on her which further complicates matters. She obviously felt much pain and anguish at that point in her life before her suicide. I do also understand that she was involved with AA, which traditionally has not supported treating the whole person (e.g., depression), which I think is to many alcoholics’ detriment. I do agree that there are some bad therapists out there, and I am sorry to hear that you have had a string of bad luck yourself. I work with about 20 therapists in my clinic, all of whom I believe are ethical and empathetic. Therapy cannot guarantee ideal outcomes, unfortunately. Clients suicide even with the most ethical and competent treatment team involved. Some clients do not respond well to medication management either, which is of no fault of their own. We still have a lot to learn when it comes to the human brain and mental health treatment in general. Also, treatment compliance for both physical and mental health hovers around 50%, which further complicates clinical outcomes. Doctors, nurses, social workers, and therapists are not without blame, but the truth is that our system is also somewhat fragmented and at times dysfunctional.
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Shaun, BPD has no scientific validity as a “disease,” it is only a very negative label to call a person and creates a plethora of harmful expectations. These are created mostly by therapy for BPD, since the therapist expects these negative behaviors from the client. The client then embraces BPD and becomes the role. Also, if luck will have it, the therapist further harms the client by communicating (via the “chart”) to other professionals and to insurance companies that the client is BPD, therefore, the client now has this on permanent record like a criminal history. Very few clients outright reject the diagnosis, because to do so means not only individual rejection of it, but all family members, all in his/her peer group, and all in her community must also follow suit. Will they do so? Not likely. Sadly, most believe the doctor over the patient. That’s how therapy ruins a person’s life. Most completely embrace the BPD diagnosis, becoming more and more BPD simply due to continued expectation. By the therapist, whether she/he knows it or not.
In the case of Gunderson, he didn’t even do therapy. He insulted people over and over. I don’t call that therapy. It’s abuse. He had no competency as a clinician whatsoever. From what I know, Mary attended “sessions” with this man for a considerable period. Abuse, week after week. I think that might drive a person to suicide. If I could, I would get someone to pay attention to this since I bet he harmed others, too.
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I think anyone who has been using the DSM for a while knows it is socially constructed and lacks the scientific rigor of other fields. Mental health treatment is very different from other forms of healthcare. We still have a long way to go. I do agree that the BPD dx can be stigmatizing and for some it is. However, I work with many individuals with this dx, and for them it has been a general relief. I teach them mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills from DBT, and I have found them to be helpful to clients who struggle with these various symptoms. I do believe our system tends to over diagnose and over prescribe. I am also in a system which requires us to diagnose clients in order to treat them. I would much rather treat the person from where they are at without labels, but sometimes labels are helpful.
I disagree with you that BPD is “only a negative label.” While yes it can and is sometimes used that way as a judgment of the client, it is also a useful label to understand a complex set of symptoms. In my experience one challenge with BPD is that there is much carryover into MDD, BMD, PTSD, ADHD, and addiction. It is difficult to separate out all the different symptoms to understand one thing from another.
I do not expect the clients with BPD to behave any certain way. I see a range of symptoms, from extremely mild to highly volatile. I think more and more clinicians are viewing mental health symptoms from a spectrum POV, which I think is helpful.
I will also add that I have an aunt with BPD and she’s in no treatment and alienates everyone from her life, except my poor uncle who fears leaving her would cause her to either become violent towards herself or others. This women is so difficult to deal with that she was even banned from her father’s funeral by her family. I have pretty much tried to avoid her since she kicked me out of her home because she didn’t like how I described a rug in her living room. She is very erratic and I believe is alcoholic as well. She does deserve treatment, but she has to own up to her stuff and want to change to make anything better. She thinks it is everyone else’s fault.
Regarding Mary’s hx, she had previously suicide attempts, so to place blame on Gunderson is a bit much for her SA. While I agree that any abusive person can influence someone to harm themselves, such in cases of DV, it is also just as possible that the person who is hurting has been hurting for quite some time. It is possible that Kennedy was emotionally abusive or at least neglectful of his wife and the family, which could very much been a trigger for her unhappiness. I wouldn’t be surprised if Kennedy is narcissistic and felt he could do whatever he wants. By some accounts he was the “fun dad” who placed the responsibility of raising the family on Mary’s shoulders much of the time. This I imagine was very stressful for Mary, knowing that her husband was cheating on her for much of their relationship.
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You say you don’t use psychiatric diagnosis, but are you even aware of just how many you used in that last post of yours, Shaun? We in the Movement do not use such hate speech. Even in your description of Mary Richardson Kennedy’s husband, a junior Kennedy, you described him as a possible “narcissist.” Never mind the plethora of labels dotted throughout your post. Do you speak that way in ordinary conversation, too? Shall we continue to classify humans in this manner? What other ways shall we classify? Jews, homosexuals, short people….Why not kill off the ones we do not like? Or just send them off to an island.
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Julie, I never said I don’t use diagnoses. I have to for my job and sometimes they are useful to treatment and for clients (provides relief). That has been my experience. I think your last comments are hyperbolic. I am talking from a clinical perspective. You were the one who was initially bashing therapists. You are entitled to your opinions, as am I. And yes many people use terms like “narcissist” in everyday language. When someone acts like one it can be a helpful descriptor. Again when I actually talk about my clients or to them I do not use judgmental language. I do agree that labels can be problematic, and obviously this topic touches home for you personally. I just think we all need to be aware of when we are engaging in black-and-white thinking and realize there are many perspectives and many shades of grey in these situations.
Do you believe that most people are harmed by diagnosing them with a mental health condition? I think the harm comes when they don’t get the proper (compassionate and knowledgeable) care.
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Hi, Shaun,
I have to say, as a therapist myself, I see what looks like victim-blaming in your post. If I am receiving funds to provide help to a person, it’s my job to figure out a way to help. If I take my car to the mechanic, and he can’t figure out what’s going on or how to help, he doesn’t get paid. There were certainly people I was not able to reach, but I considered it my own failure, not theirs.
I also find that labels, and Borderline in particular, provide a handy excuse to infantilize the client and to avoid facing up to the real issues behind the label. I have no objection to teaching skills to someone who wants to learn them, but so much of the DBT approach seems to focus on how WRONG the client is for “lacking emotional control,” and many therapists take a very condescending attitude toward their clients, referring to them as “she’s a borderline” or saying “she’s manipulating” or making many statements indicating severe judgment against the client. This is, in my experience, the OPPOSITE of what is needed.
I’ve been very successful with so-called “borderline” clients, mostly because I approach them with a very genuine, direct, and caring relationship that builds trust with them. Trust is the big issue for most of the people who get this label, because most have been abused and/or neglected. Treating them like children or disabled people tends to lead to resentment and disrespect, while acknowledging what pain they area suffering and normalizing their coping measures as necessary to confront the situations they had to deal with works far better, IMHO.
Anyway, it sounds to me like you are operating very much within the confines of the psychiatric paradigm. Maybe that works for you, but I never found it worked for my clients, and most of the time, once I opened the door for genuine discussion of their experience, most of them described extremely frustrating experiences, even with caring therapists, mostly because they got the impression that they should “get over it” or that their emotional damage was their own fault, or they got the message that they were permanently damaged and should lower their expectations for life. It might be really helpful to increase your perspective by taking to some clients who have hated DBT or other forms of therapy, and genuinely inquire as to what they hated about them. It might be an eye opener for you.
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Shit! Psychiatry fucks everyone who comes in contact with it! Who knew! Hehe!
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So what is this linked to get 32,000 views and why don’t they link to other things here?
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When I was having horrible side effects from psych meds, two therapists kept me sane. The 2nd one I feel tried to tell me antidepressants were bad news but unfortunately, I wasn’t ready to listen.
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Shaun F, I was overjoyed when I got a diagnosis. Know why? As a female intellectual, I was then excused from this thing I dreaded called “workplace” where I would not be valued as such, but for my body, as nothing but a cup size. I was on the verge of graduation from a prestigious college where I was doing extremely well, and after that, I was facing a life of waitressing and kissing the butt of some male boss. Ending up a patient excused me from all that. And it did so seamlessly, since aren’t all talented artists supposed to be crazy? We can’t even be brilliant without a touch of madness…which is a total romantic fiction…but it served me well anyway. For three decades until I realized it was all baloney. So yeah, I was happy. To hear about bipolar, schiz, etc. I realize now that putting me out of work, creating this new marginalized life for me, lowering my standards, lowering my quality of life, costing taxpayers millions, and really, destroying my musical career, and getting away with it…I was not even disabled! all due to diagnosis…this was a CRIME of huge proportions. I think all those doctors should be in prison for Welfare Fraud. I capitalize that because they didn’t just do that to me, they did that to hundreds of others. That adds up. If I were the average Joe Taxpayer, I’d demand accountability.
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Julie,
Disability, especially for mental health, is subjective and I hear that you are angry towards a system which you believe has failed you. And from the sounds of it, the system did victimize you as it does to others. I am saddened to hear that and I hope we can have substantial reform in order to minimize people being harmed by a system which is set up to help (I do believe it is a money making venture for pharma companies but that’s another conversation). Good luck to you.
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“shaun”, I’ve just read the whole comment thread here. I don’t know you, so I’m not talking about *you* *directly*, but I am using your comments to make some more general points. With that disclaimer, please understand and excuse some limits in my language. I know you’re sure you sound so “affirming”. You express in hollow, empty words “support” for the thoughts and feelings expressed by other commenters here. But what I see is a subtle form of gaslighting. You don’t seem willing to seriously examine the reality that the DSM-5 is nothing more than a catalog of billing codes. All of the alleged “diagnoses” in it are100% SUBJECTIVE, and have no objective reality. They are all exactly as “real” as presents from Santa Claus, but not more real. Psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology with potent neuro-toxins. And all your “therapy” is subordinated under the fraudulent regime of psychiatry. Would you suggest “substantial reform” if the topic of conversation was Nazi death camps? No, you wouldn’t. I submit that you’ve had as much professional “sucess” as you *seem* to have had, largely because you’re basically a compassionate guy, and NOT because of any inherent efficacy in your “mental health system”. Psychiatry has done, and continues to do, far more harm than good. There are precious few venues such as MiA, here, where you can hear the voices of the victims and survivors of psychiatry. You have been deliberately and systematically shielded from the TRUTH. The voices of the victims are actively suppressed. I know you mean well. But when I read what you’ve written here, I have to roll my eyes and shake my head. It isn’t just that Julie, above, *”believes”* the system has failed her, it’s that THE SYSTEM FAILED HER. There’s some doubt in your mind that the system has failed her, because you are so deeply and heavily invested in it. You’re bumping up against actual cognitive dissonance in yourself, because the TRUTH of psychiatry’s victims, – including Julie & myself, – is so at odds with what you’ve been brainwashed and indoctrinated and propagandized to believe. While yes I believe you’re basically a “good guy”, I also know that you’re (relatively) young and naive. Please remember my words in 5, 10, 20 years. The “system” as you know it, and have been lead to believe, was NOT set up to “help” people. Unless those people are rich, powerful, and PhRMA honchos. Sure, you can find a few people who will sing the praises of their pills and bogus “diagnosis”. But there are far MORE people who are either dead too young, or against/out of that crooked system. No, the problem is not that I;’m too cynical, – you’re not cynical enough. You HAVE read Breggin’s “Toxic Psychiatry”, and Whitaker’s “Mad in America”, and “Anatomy of an Epidemic”, right….????….
RSVP? ~B./ (Think of me as your elderly clinical supervisor….)…..
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