The Very Best That We Can Offer To Clients Is Ourselves (A Post for Clinicians & Helpers).

As clinicians, we are built from the ground up to disregard ourselves. This begins in our training process, when we are instructed on how to listen well to someone. It is made clear that we are ears, not mouths. We’re warned not to bring too much of ourselves into session with us, so as to keep a trained and steady focus on the most important story in the room: the story belonging to the client.

At the conclusion of our schooling and supervision, we are all required to sit for a test that is meant to demonstrate our clinical knowledge in order to obtain licensure. There are expensive classes offered to us on how to take this test correctly. We pass this test.

When we finally begin practicing, many of us panel with insurance companies. An individual seeking therapy obtains a list of covered clinicians in their area from said insurance companies. Via this process, clinicians are relegated to a handful of faceless people on a printout list. Because of this, it is very unlikely that a potential client finds a therapist that is a good fit on the first try. Clients must get very lucky, decide to settle for who they end up with, or jump from one therapist to another until the right one is found. 

We receive pressure from our field, our peers, and sometimes ourselves, to become the tabula rasa, one in a vast sea of others. In spite of this, we do good work, and continue to bring our cumulative skills, trainings, and expertise with us into sessions. 

I think it’s essential that we bring ourselves, and our stories, into sessions with us, too. 

Who we are matters. 

I mentioned that clinicians are tested in order to obtain licensure. Generally speaking, these exams test procedural knowledge. Which is important. To a degree. The exams question what a quality therapist might do. They speak not at all to who a quality therapist might be.

Exams are unable to gauge our individuality and ability to connect with others. The way that we present, dress, and speak; the manner in which we greet people and sit across from them; how we gesture with our hands, when and how we laugh, when and how we choose to set boundaries; our points of eye contact and our choice to look away; how we listen, what we hear and focus in on – these are all the things that make us who we are as practitioners. And all of these intangible qualities, none of them teachable, are the building blocks of the therapeutic relationship, the true and singular element that keeps our clients choosing to return to us, week after week, year after year.

Try and test that. 

Our community matters.

A friend of mine recently shared with me that she knew her therapist was right for her, not because of the therapist’s specialty, chosen modality, or level of professionalism, but because the therapist revealed that she worked sometimes at kink cons as the resident therapist on duty to help people feel safe trying new things. For my friend, that disclosure meant more than clinical experience or years in practice.  

My friend says, “I 100% of the time seek therapists that are ACTIVELY and openly queer, kink-aware, and pro-sex work because I find those that aren’t fixate on the wrong parts of my self-work.”  I find this statement powerful and revelatory. It isn’t just important that she feel her therapist relates to her or understands the language of her community. Having a therapist that is part of her community is essential in order for her to begin to  communicate and feel truly heard. 

We do well to openly share with clients the communities to which proudly belong, how we identify, and where our allegiances lie. For some clients, these admissions are necessary in order to establish a basic feeling of safety before they even begin their work. 

Our past matters. 

It can be deeply uncomfortable for some of us to share about our own struggles. Sometimes, in the middle of the night, I worry about some elements of myself that I’ve made public. I know that this is not unique to me; I’ve heard many therapists express this sentiment. How do we wrestle with our own issues and checkered histories? What should we disclose, and what should we keep to ourselves? If we are flawed, can we be experts? Are we valuable only once we’ve figured everything out? 

In a course in grad school, I had a strong reaction to a film we watched in class, which struck a personal chord with me. As I am vocal to a fault, I shared my reaction, which felt initially negative and undesirable, with the course instructor. Rather than shame me, she mercifully gave me ample space for my intense response. She cited the importance of the stories that we tell ourselves, about ourselves, and how they add value to our clinical practice as we understand, accept, and integrate them. In a nutshell, she said, clinicians do not need to be ashamed of being the people they are.

How liberating.

Our stories of addiction, or disordered eating, or abuse, or grief, or codependency, etcetera ad nauseam, can become our most powerful assets as clinicians. They allow us to know how it feels to sit in the client’s seat. They are testaments to our own very hard work. Of course, we do not have to (and should probably not) dump all of these things in front of our clients. But – we can respect our battle scars. We can carry these parts of ourselves into sessions with confidence, care, intentionality, and pride. We can learn from them, and allow them to inform who we are as practitioners. 

Conclusion 

I hope it is clear that I am not suggesting that clinicians should make therapy sessions all about themselves. Obviously, it is not best practice to  relate every client’s experience back to our own, or to overshare, or to wax philosophical about our personal life’s lessons. That is just obnoxious, and poor form. 

What I’m pointing to here is our humanity – the people that we are before, after, and during sessions. We belong to unique communities. We identify in specific ways. We have causes to which we are deeply committed. Things have happened to us. We have done the work, and we have more work to do.

To embrace the elements that make up who we are, to celebrate them, and to share them when appropriate, creates room for deeper, richer, and more authentic work. 

 

Originally posted on my blog, Common Humanity, at Psych Central.com. To read more, visit https://blogs.psychcentral.com/common-humanity/
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Some frequently asked questions and useful answers.

Online therapy works in the same way as in-office therapy, but is done online, similar to a Skype or FaceTime conversation. Clients are able to have sessions from home, work, or any other convenient location. We meet with clients using a HIPAA-compliant secure platform.

Online therapy allows you to work with us from the comfort of home, or any private location of your choosing. For some, the screen provides an added layer of comfort that makes the challenging work of being vulnerable in therapy a little easier.

Online therapy also creates the unique opportunity for you to work with us without the constraints of proximity! The practice was born in Keene, New Hampshire, but has since grown to service clients anywhere in Massachusetts, Pennsylvania, Connecticut, Vermont, New Jersey, Florida, and New Hampshire.

Online therapy is a great option for clients that travel for work, for college students that go home during the summertime and do not want a break in their sessions, and for anyone with a challenging or inconsistent day-to-day schedule. It is an excellent choice for clients seeking a therapist with a particular specialty that they are unable to find support for locally. Some of our clients report that online therapy makes the vulnerability element of therapy a bit less intimidating.

No. For some clients with more complex symptoms or safety concerns, having a local therapist that is readily available is important in case of crisis or the need for a higher level of care. Online therapy is also a challenge for clients that do not have access to a private, quiet space to be “in session” for the hour, or for those that do not have adequate internet connectivity.

There are several reasons why we don’t accept insurance. The most important are:

Confidentiality. Insurance companies require that your information be shared with them in order to pay for services. We prefer that clients’ information is kept as confidential as possible.

The pressure to diagnose. Insurance companies require that clients are given a mental health diagnosis in order to pay for therapy. We have found that many clients benefit from therapy, but do not meet criteria for a diagnosis. Not using insurance allows clients to access therapy without being given a mental health diagnosis.

Flexibility and freedom. Insurance companies dictate the length and number of sessions they will authorize, as well as when a client is no longer eligible for the benefits of therapy. Because we do not work with insurance panels, you and we can collaborate to determine your individual needs regarding session length, frequency of sessions, and when to terminate therapy.

While we do not accept insurance, many clients choose to submit receipts to their insurance companies to receive reimbursement via out-of-network benefits. We are happy to provide these receipts for you! Please check with your insurance company for details on your benefits.

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