The Therapist Is Never Off-Duty

What happens when you run into your therapist? A therapist knows your deepest secrets—and may also show up at your gym. What does this do to their psyches?

By Jo Lauer, published on January 01, 2003 - last reviewed on January 31, 2008

A therapist knows your deepest secrets—and may also show up at your gym. What does this do to their psyches?

In my small community, I cross paths regularly with clients from my psychotherapy practice. They show up at choir practice, the local organic grocery store and my bank on Saturday mornings—and usually, when I'm wearing jeans, a sweatshirt, my favorite mud-stained sneakers and no makeup. The clients' ensuing social discomfort can take up space in therapy for weeks. Meanwhile, I'm left to process my own discomfort.

There are few guidelines for managing the oddities that occur within the therapeutic relationship. At the grocery store, I worry that the quart of Ben and Jerry's in my shopping cart will offend a bulimic vegan client behind me in the cashier's line, or that the chilled bottle of Sauvignon Blanc will damage my credibility with the cashier himself, another client and a recovering alcoholic. Last winter, I joined the gym to offset the sedate lifestyle of daily therapy but gave up my membership after passing a towel-clad client in the locker room.

So, once in my office, how does this make me feel? A parade of psyches sit for the 50-minute session, sharing tales of humiliation, pain, fears, irrational beliefs and dashed dreams—all things they wouldn't tell another living soul. I often recall the story of "sin eaters," ancient nomads who wandered the countryside absorbing others' pain, only to be chased away, taking sorrow with them and leaving villages purged.

There is something sacred about witnessing another's descent into the underworld of soul-searching while maintaining the belief that healing will occur. In The Art of the Psychotherapist, author and psychotherapist James Bugental writes, "We are privileged, more than most, to peer into the well of life's mystery." Privileged? Yes. But there's also something burdensome about it.

In addition to the second-hand traumatization of hearing hour upon hour of human misery, there are expectations that accompany such intimate sharing. Clients often assume I will retain the details of their lives indefinitely, which proves a great challenge to my menopausal mind.

Trust and closeness do form in the confines of the therapy office. Having been through so much together, a client's assumption of friendship seems natural. And I do hold them in highest regard, as I would a friend. I nurture their unfolding potential. I mirror the wonderful person they are beneath life's circumstances. I share their highs and lows. I remind them that they are unique and valuable. What they don't do is listen to my problems. We can't meet for tea to discuss my troubles. The container of our time together remains my office walls.

So how do we as therapists show up, day after day, to one intimate and authentic relationship after another, when our own needs aren't addressed? And how do we handle negative transferences—emotionally charged verbal tirades at unfaithful partners or unappreciative children—when they're hurled at us as though we've suddenly morphed into the offending party?

Stress-related disorders such as insomnia, anxiety, depression and addiction are common among therapists. To fend them off, my colleagues and I gather socially and in therapy groups to share our tricks for stress reduction. Having understanding friends, a good therapist and a strong connection to spirit is enormously helpful. I also frequently use imagery; donning an imaginary psychic wet suit allows me to hear and feel with compassion, to be affected without being infected by psychically assaultive energy.

To those who share my profession, I suggest the following: Find creative outlets, read, spend time alone, create peer support, laugh, eat healthy food, make your home a nurturing environment, listen to music, exercise and dream. Most important, remember why you've chosen this particular path. It's true that I sometimes marvel at the strange profession of psychology. But is there anything else I'd rather do? Absolutely not.