Therapist in crisis? When the professional and personal roles collide
The world feels quite tumultuous these days. As a therapist, the U.S. elections and the COVID-19 pandemic have been taking up a lot of space with my clients — causing anxiety and deep feelings of unrest. It has also been an incredibly hard couple months for me personally. I’ve had to ask myself some difficult questions regarding self-disclosure with clients and also about self-care for myself.
Therapy in the age of the internet and social media raises a number of ethical considerations about the boundaries between therapist and client, and also speaks to changing social mores of our time. I am a drama therapist, and a part of my clinical training involved utilizing the body as a source of knowing, along with more traditional cognitive resources. Over the past few months, I’ve come back to my own body for answers often: What feels most ethical in my gut? What disclosure is in service of my clients and the physical space we co-create in our sessions? What boundaries do I need for my own self care?
A simple Google search will tell you that my mom passed away on January 16th after an open heart surgery at the age of 69. What you won’t read is that my family and I spent eight awful (and surprisingly special) days in the hospital with her in a coma trying to process the impossible concept of her dying before we removed life support. You also won’t read that during this time my two year old son had the flu, and a few days before my mom went in for surgery, I slipped a disk in my lower back, causing severe sciatica pain. Along with the general unease in the world right now, 2020 has been rough so far for me. Painful, devastating, sleepless and slow. (Reminder: it’s only the middle of March.) Through it all, I’ve also maintained my private practice. In doing so, I’ve made very intentional choices around how this personal crisis would interact with my professional role.
Therapists are human. We hear this time and again. And yet, the protection of certain personal details of my own life as therapist often serves to cultivate a healing space where the focus can solely be on the client and their needs, desires, concerns, or fears. As we know, therapy is different from sitting down with a friend over coffee.
At its best, the therapist can be a mirror or transitional object for the client, allowing the client to gain a truer understanding of self and clarity about growth. If the client is concerned for the therapist or feels guilty about burdening them with their own struggles, this space is threatened. And yet, the therapist still brings with them all the feelings of loss and hurt that make them human into this therapy room. How do I as clinician remain true to my own grief while also maintain a level of distance from it so as not to fall apart? How do I share what is important for both the client and myself without taking up space that does a disservice to both our our goals?
Of course, I took some time off. A few clients knew that a family member was going in for surgery because I had to reschedule at the last minute. Most clients understood when I shared that I had to attend to a family emergency for a week or two. But then I went back to work. I found that my greatest joy and peace in those couple weeks after my mom passed was either in sessions with clients or with my 2.5 year old son. The roles of therapist and mother helped guide me through the sickening “business of death” that happens after a loved one dies. I found comfort and strength in holding space for others — or just playing dinosaurs.
I disclosed the details to only a couple clients who either asked directly or knew information through other connections in the community. With those people I shared briefly that my mother died, but I then made a point of telling them that while I appreciated their concern, I was receiving support and help in my own therapy. This space was respectfully theirs.
While this was an ethical choice, it also was necessary for me to maintain a professional boundary. I couldn’t touch the well of breathsucking grief that lay beneath the surface with my clients for fear of being flooded. Nor did I want to. I utilized other spaces for that processing, and I still am finding those spaces — in my own personal therapy, in peer supervision, with friends and family. In circles with women. Alone on a mountain where I spent a night solo. I am taking care of myself, but I also am finding comfort in the structure and the simplicity of the therapy space with my clients. Where the focus is not about me. Where I can lend my heart and body to listening and being with someone else.
We are hurt in relationship to others, also known as trauma, and the thinking is that we must be healed in relationship as well. There are many words for this healing dynamic — one name is therapy. However, healing relationships can take on many different shapes and power structures. While the primary goal of therapy is healing for the client, I experienced a profound source of healing while holding space with my clients.
Is this caretaking impulse me trying to avoid my own grief? Maybe. But maybe it’s also a way for me to deal with the impossible in managed doses. There is no “right” way to deal with grief (as they say). It would be unethical to work through my grief on my clients’ time, but connecting with other human beings, holding boundaries for them, empathizing with their feelings and struggles, and sharing in their joys or small successes — this is also a deeply fulfilling way of being in relationship.
Which leads me to questions I am exploring today. In a co-created space such as therapy, how much do you feel is appropriate for a therapist to share? Do you appreciate it when your therapist shares personal details? With personal information so easily accessible online, do you seek out your therapist’s information? Do you Google them?
And for you clinicians, how to you deal with the moments when your professional and personal identities collide? Might it be that when our own humanity shows up in the therapeutic space, we are tapping into a larger transpersonal connection that serves as a cornerstone for a corrective emotional experience? I wonder.