A Therapist on the Other Side of the Couch

This began its life as a pitch for a certain website I'll call Fuzzbeed. Rather than let it go to waste, I thought I'd run it here. I suspect after you read it you'll see why it was only a pitch as opposed to publish, but I still hope you can get something out of it.

 Think of this guy as me. But like a way handsomer version of me. (expertbeacon.com)

Think of this guy as me. But like a way handsomer version of me. (expertbeacon.com)

Many therapists have been to therapy themselves. Some of us do so as a required component of their Masters or Doctorate programs. Others seek it out for the same reasons as anyone without an advanced degree in mental health might—depression, anxiety, interpersonal concerns, personality disorders, existential crises, or communication issues.

This may come as an unpleasant surprise to many clients. “How dare the person I see every week to straighten up my life ‘pretend’ to have theirs entirely in order?” they may find themselves reflexively demanding.

Some, on the other hand, may find it a comfort. They might say, “Oh cool. After all, who better to help me than someone who knows what it feels like directly, not just from what they have heard or read?”

I can understand both viewpoints. Sometimes we want an all-knowing all-seeing all-chill zero problems therapist to just tell us how to fix everything, damn it!, and how to never have a difficult time again. Sometimes, it is nice to just feel unjudged and supported by someone who has been where you are and, unfortunately, find themselves revisiting those mental illness haunts every now and again.

As a therapist in therapy myself, I absolutely get it.

I go to see my therapist not out of any course obligation but for my own mental health reasons. Not to brag—haha—but I have a lot of reasons to be in therapy. But the one I think is the biggest—and the one, coincidentally I’m sure, that I’m willing to tell you about—is panic attacks. Generally speaking, I am a fairly calm guy. I don’t get anxious like, “I have a test and I’m so nervous I can’t get out of bed,” “Being outdoors is too nervewracking to bother,” “This small space is making me freak!” or “I can’t stand talking to people I don’t know, I get so worried, I can barely see.” For me, my anxiety manifesting rarely but intensely in form of panic attacks that are often so bad I literally have to pound my fists on something to ground me.

I experience these moments of intense panic where I become so entrenched in them that they can feel endless. My heart races, my breathe gets shallow, I cannot stop thinking about death. I hate them.

Worse, once I get one, they tend come in bunches. One attack is usually a promise that I will experience four or five or six more in the days or weeks to come.

They often corrupt my favorite things. They creep up on me during times of quiet and relaxation, like while I am watching television or listening to music. They paralyze me when I am alone with plenty of time to think, as when I am planning out the next thing I am going to write or driving.  They overwhelm when I find myself in crowds of people at events or even shopping at Costco. Slightly too warm spaces too leave me very susceptible to the gym can sometimes be a surprising trap.

I love these activities. They are important to me. They recharge me. And yet, they are also the times I am most vulnerable to panic attacks. It is one of those cruel jokes that nature and nurture have combined to imprint on our very DNA and/or souls depending on your philosophical bearing.

 I promise this never happens in therapy. Your therapist will never laugh at you as you cry and he/she will never make you wear such an ill-fitting shirt and jacket combo that you are literally spilling out of it (psychcentral.com)

I promise this never happens in therapy. Your therapist will never laugh at you as you cry and he/she will never make you wear such an ill-fitting shirt and jacket combo that you are literally spilling out of it (psychcentral.com)

So I go to therapy. I swallow my pride. I reject years of accumulated false impressions of what it means to say, “I need therapy.” I admit that knowing how to help others is not the same as knowing how to help myself. I show up. I sit on the couch and I talk. I tell my therapist how angry I got, how stupid I acted, how alone I feel. I tell my therapist about the small victories and the big screw ups. I cry in front of my therapist, I raise my voice in front of therapist. I confess how convinced I am that I even if I get better I will never be good enough. I confess how scared I am that the damage is done, that there is no coming back from what I have already been through. I do, to put it in the parlance, the work of therapy. Some days are great and I walk out thinking I can beat the world. Some days are terrible and I do not so much walk as crawl back to my car. Sometimes I show up convinced I have nothing to say and bawl my eyes out for 35 minutes. At others, I think we will talk about this thing that happened for an hour and it still will not be enough and my therapist makes one suggestion and we are done with it in 8 minutes.

So I understand the yearnings and objections clients have to going to a therapist in therapy. The hunger for the “perfect, healthy” therapist to make you perfect and healthy too; the longing for the “I get you because I am you” therapist who gives you the metaphorical hug and recognizes that some things can’t be fixed. Of course neither therapist is “real.” In the same way the best people you know are not just one quality, the best therapists are a mix of healthy and hurt and a thousand other qualities. And that means, like the best people you know, a certain number of the best therapists out there are bound to be in therapy themselves. And some of the mediocre ones—like me—will be as well.

But there are added layers of difficulty for me. Besides the concerns about surviving mental health issues while being someone who is paid to help others with their mental health issues—how can I help someone when I cannot seem to help myself?!—therapy is still a stigmatized activity. Sure, as a therapist, I have learned how to reassure others that there is nothing wrong with seeking help but that is others. When it comes to ourselves, well, there is no class in any graduate program dedicated to a professor telling you how to argue with yourself about whether seeking help makes you fundamentally broken.

Just think of this, and be honest. A friend comes to you and tells you how hard things have been for them lately, how scared or worried or out of control they feel and how they have decided to seek therapy. Most of us were greet that news with a solemn warmth, a nod, a hug, and a “good for you” for added reassurance. Now put yourself in that place. It gets harder right? Even when you recognize that your friend is not broken or weak or crazy, when it becomes you, suddenly it is a lot harder to figure it out.

After you push past a lifetime of messages—through ethnic or racial culture, family attitudes, television, film, music, and a host of other sources—that link therapy to things being truly terrible and only for the “very sick,” it does not get easier for the therapist in therapy.

 Imagine ever having to humble yourself before this guy! After that, going to therapy would be easy! (outsetmagazine.com)

Imagine ever having to humble yourself before this guy! After that, going to therapy would be easy! (outsetmagazine.com)

For one, it is a difficult mindset to get into to go in front of someone who is both a colleague and, in some contexts, a rival and be vulnerable. It’s like Ronald McDonald paying the Burger King a visit and confessing that sometimes he just freaking hates God damn hamburgers and every time he sees another sale in the register he feels like the biggest fraud. The King might know exactly how that feels. He might have empathy for the clown. But Ronald will likely still worry that the rule of Burger Land is judging him. It is a natural thing.

The other problem as a therapist is that you know all the tricks. You know about mindfulness, about I statements, about reaction schemas. You know the first panic attack can be about anything and the ones after that are at least partially about you being afraid you are going to have another panic attack. You know bipolar disorder is a result of a complex chemical reactions in your brain and body, not a thing you can just decide to have or not. You know all this and so you can see your therapist start to cite it from a while away.

Also, it makes you feel even more powerless. If you’ve coached 10s or 100s or who knows how many people how to deal with their social anxiety but you cannot improve your own then, well, yours must be something far worse, something, perhaps, incurable, right?

Because, ultimately, being a therapist in therapy is incredibly weird and scary and confusing. But that just makes it like anyone else being in therapy. The fact that I am therapist does not make me better or worse at being a client than anyone else and it does not make the experience of therapy any more fulfilling or devastating than it is for anyone else. Going to therapy means admitting to yourself that there are some aspects of your life that you need help navigating, that you are struggling with managing on your own. That is the case if you a kid or an adult, if you are married or single, if you are gay, straight, bi, poly, ace, or still not sure where you fall. And it remains the case if you are a lawyer, a janitor, a stay at home mom, a corporate executive, a minimum wage fast worker, or, yes, a therapist.

So yes, I’m a therapist in therapy, that is true. In practice though, really, I’m just Tim Stevens in therapy. I may know the DSM-V criteria for my diagnosis better than you know yours, I may know my ICD-10 code while you don’t know yours—heck, I may know what an ICD-10 code is while you don’t but that does not change the fact that I have an anxiety disorder and you do too. That does not change the fact that I sit in the same waiting room, distractingly look over the same magazine, and pull Kleenexes from the same boxes as you. When we are in therapy, we are the same. We are struggling and we want to be better. Be us therapist or not.