Why Therapists Need Their Own Therapy

(This article is primarily written for other professionals, but if you are a prospective patient, it may give you some insight into how our profession works!)

So, why should therapists seek out their own therapy? Everyone has probably heard the old joke: “people go into therapy because they’re the ones who really need it!” Well, it’s much deeper than that, and I’ll explain why.

Here are three reasons why a therapist should be in their own therapy:

1.      Therapy will help you be a better therapist!

This first reason can be both a goal and a positive side effect of entering your own therapy process. Skilled therapists, no matter their theoretical orientation, population of choice, or degree, pay attention to their own reactions to their patients. Chances are, if a patient brings up feelings of irritation, jealousy, or impatience in you (or any of the range of positive emotions too!) then they likely elicit that reaction from others in their lives as well. Skilled therapists use this information to understand their patients and to know where to target interventions.

But, sometimes our reactions are the result of something inside us, rather than being elicited from our patient. Let’s use a simple (and kind of silly) example: a patient arrives in a nice sports car that makes me feel a jealous of his ride! But, this patient has sought you out for therapy to improve his marriage and communication skills with his family. I need to be able to pay attention to and set aside that jealousy (or its even more intense cousin, envy) in order to be most effective with this patient. Now, if the patient spent the entire session describing his wild and expensive escapades in the car, that might be a signal that something more is going on than just my initial envy of his sweet car.

Sometimes we need to use our reactions to patients, and other times we need to recognize that our reactions are more about something in us than in the patient and then set aside that feeling. Here, therapy will help you get to know yourself much more deeply so that you can sort out what is you and what is someone else in your reactions to your patients. It sounds simple, but it can take a long time to really get to the bottom of things, and can even involve discussing your clinical challenges in session!

So, therapy will be helpful in understanding yourself and your patients. But, there’s an even deeper aspect to this: deep empathy.

2.     Therapy will increase your deep empathy and help you tolerate discomfort.

If you’re a therapist, you’re probably thinking “but I’m already very empathic!” and that is likely true. You probably try to put yourself in your patients’ position and think about what you would do if presented with their circumstances. You may try to regard your patients with Carl Rogers’ famous “unconditional positive regard” when other in their lives may have rejected or given up on them long ago.

However: there is even more to empathy, and it involves our dynamic with our patients (here, I’m calling it “deep empathy” for accessibility, but in the classical literature it is referred to as “concordant countertransference.”) Rather than just understanding our reactions to patients as being either from “inside us” or as “coming from them,” our reactions can sometimes come from a place of intense, deep empathy where we feel just what they are feeling in that exact moment.

Here's an example: awhile ago, I was working with a sensitive, gentle patient who seemed to subtly dismiss every suggestion or interpretation I gave her. She would often say one of two things: either “I’ve had people say that to me before, it didn’t work” or “I don’t know, that could be right but it could be wrong” and then continue at length describing her difficult life circumstances (which were, to be fair, extremely stressful and somewhat out of her control.) She had seen several therapists before me, none with much luck at helping her. As the therapy continued, I began to become more and more frustrated with myself and my seeming inability to help this woman, and she seemed to be describing more desperate and terrible situations as time went on. In a word, I began to feel both “angry” and “helpless,” which was a particularly strange word to pop into my head given that I was the therapist trying to do the helping! So, I tried a different course with her. I said something like “you know, as I’ve been listening to you talk about how truly crushing life feels to you right now, I can’t help but feel as if I haven’t been very helpful to you so far. It’s like no matter what I do, it’s not quite good enough to help make things better. It’s like I’m sitting here, desperately wanting things to get better for you, but not knowing where to turn or how to start. And then I start to get angry at myself too. I’m wondering if that’s how you’ve been feeling this entire time.” The patient looked up at me, tearing up, and heatedly said, “finally, that’s what I’ve been trying say and to get someone to understand this entire time.”

This patient did not know how to bring anger into a relationship, so she tried instead to demonstrate how frustrated she was with others in a way that was so subtle I could barely detect it. As therapy had continued, I began to feel what she was feeling all along. This was the key to changing the track of therapy: we had brought anger into the relationship, and we were able to get to know the angry and helpless side of her enough that she was able to access it when needed. For the first time in a long time, she felt as if she had some agency in life again.

This example is one of many in my clinical history where being aware of my own feelings allowed me to realize that I was experiencing deep empathy for my patient, and here’s the key: it wasn’t comfortable. It wasn’t warm and gentle and based on a therapeutic alliance that felt safe and without conflict. It was self-critical and made me feel ineffective and unskilled. Without years of my own therapy getting to know myself and learning how to tolerate these uncomfortable feelings long enough to think about their relationship to my patient, I’m not sure I would have been able to help her.

In sum, therapy will help you tolerate uncomfortable, stressful feelings long enough to use your deep empathy to truly help your patients.

3.     Because therapists are humans too.

Alright, here’s where we come back to the old joke about therapists. It turns out, despite some of our best efforts, we’re just as vulnerable to life’s turmoil as our patients. We also get into our own self-defeating patterns. We also experience trauma. We, too, encounter life circumstances that change us forever and knock us off track.

Here’s another personal story. When I first entered therapy, I said these exact words: “I’m here because I’ve read from people I respect in the field that you get better at doing therapy by being in therapy first. So, that’s why I’m here. But I don’t have anything to work on really, so I don’t know how this is going to go.” This was a big risk, especially because I was paying out-of-pocket.

Fast-forward about five years, I’m still seeing my same therapist, but at a less frequent rate. Beyond just getting better at my job, I’m still working on things of which I had no self-awareness. In previous eras, this was normal. The idea of a therapist being in their own therapy for the duration of their practice, or their lives, was just a part of being a therapist. Schools of therapy used to require this of their students. Now, to the detriment of the field, it is much less common.

On a quick final note, the job of “therapist” tends to attract certain personalities with their own strengths and weaknesses that are well-known. This is worth describing in an entire other article (which is on my to-do list), but for now I’ll just mention it to say that these personalities do very well in therapy.

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So, if you are a therapist, you should go to therapy. You’ll get better at your job. You’ll be able to tolerate a much greater range of uncomfortable feelings which will help in both your professional and personal life. And you’re a human too, so if it works for your patients, it will probably work for you.

I enjoy seeing therapists as patients. They’re typically reflective, open, and curious, but also come with a lot that needs attending to. If you read this article and feel like I could help you in therapy, don’t hesitate to reach out.