I don’t even remember when Licensed Psychological Examiner with Independent Status Amy Flaherty and I first crossed paths. It seems like it must have been years ago.

Then, within the last couple of years, we’ve had opportunities to chat, collaborate, and network with each other online.

Just a few months ago, we were both involved in a conversation on Facebook talking about the need for therapists’ self-care.

When she shared a conversation that she had had with her husband, I knew I wanted her to share it – and her response to that conversation – with you.

I am delighted today to say that Amy hails from Northeast Arkansas, has been in the field of mental health for almost a decade and has spent more than half of that time in her own private practice.

So, when she accepted my invitation to guest post on this topic, I knew she would be sharing her personal experience and wisdom. Please join me in welcoming Amy to her first guest post here at Private Practice from the Inside Out!

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A Guest Post by Amy E. Flaherty, LPE-I, RPT

The Conversation Every Therapist Has

I’ve been married 10 years and have been doing therapy for almost that long.

Over the past decade, this conversation has happened in my house more times than I care to count.

See if you can relate.

Me: I’m so tired. I mean I don’t want to do anything or talk to anyone.

Husband: Why? I mean you only worked 6 hours today?

Try 10 like me.

Me: Well, my type of work is a different kind of hard than yours.

It’s emotionally exhausting.

Husband: I don’t get it. I mean you just literally sit in a chair all day and listen to people.

What is so hard about that?

Me: It just is- it’s hard to explain unless you do it.

And it’s not “just listening to people.”

Husband: On TV that’s what it seems like.

It’s just asking questions like “How does that make you feel?”

How hard can that be?

Come to my work and then we’ll talk about hard!

Me: Whatever.

You just don’t get it.

It’s exhausting.

Husband: What’s there to get?

Me: (I leave the room in a huff to call one of my therapist friends who gets it.)

Sound familiar at all?

Unless you are married to another therapist or someone who is very understanding (or is a boyfriend in a romance novel), I’ll bet something like this has happened to you, maybe not with your husband but definitely with family or friends.

The Work of Being a Psychotherapist

My guess is that you already know therapy is different than other jobs but you may find it difficult to articulate the reason you feel so drained at the end of the day.

It’s like soul-crushing, bone-weary, don’t-talk-to-me-or-I-will-cut-you exhausted.

I’m here to help you understand some real reasons why being a therapist is so exhausting.

Yes, as therapists, we may just look like we aren’t doing much, but in reality, it’s hard work, mentally and emotionally.

Let’s get to it.

Here are 6 reasons that providing therapy is hard work.

You may want to print this out to refer to it when you get to wondering why you need a massage when you just had one last week.

6 Reasons Why Providing Therapy is HARD

Reason #1 – The Stakes are High

I’ve had several jobs in my life. Some I’ve loved, others I’ve loathed.

Now, I’m happy to say I love my job on most days.

However, I sometimes wish that if I messed up, it would not be a big deal.

Like if I filed something wrong or dialed the wrong number, no biggie.

Most days in our profession, we don’t get this luxury.

A recent study found that being a mental health professional is the 2nd most stressful job in America right behind a police officer.

That’s it guys – #2!

The study also noted that the decisions most of us make on an everyday basis can have major impacts on lives.

Here are just some of the questions many of us face on a fairly regular basis.

How do we tell the parents that we are going to have to make a hotline call?

What do we say when a couple is fighting and look at you for answers to save their marriage?

When a client doesn’t come back, we worry- is it us?

What is the right time to break it to a client’s family that their loved one has a major psychological illness that will likely be lifelong?

It’s not just shuffling papers or flipping burgers for six hours.

It’s being on the spot with many big decisions every day that affect people’s lives.

Reason #2 – It’s Not “Just Listening”

We are processing information all the time.

I recently heard a Ted talk about sounds and communication.

According to this Ted talk by Julian Treasure, we can only process 1.6 conversations at a time.

Think about that.

That’s just enough for one person and a little bit of your own inner voice.

As you likely know, we as therapists don’t just listen.

We are constantly taking information in, processing this, thinking of what we should say in the that moment, and how everything relates to help move our clients towards health.

This is more than “just listening.”

Just listening and conversing in everyday situations is actually just trading microphones.

We do more than just that in therapy.

Our brain is trying to process more than just its 1.6 conversations at a time, multiple times a day with completely different issues.

No wonder we are exhausted.

Reason # 3 – An Hour of Therapy is An Hour of Work

Most people who are at their jobs for 8 hours a day only ACTUALLY do about 6 hours of real work .

If I have 6 hours of therapy from 12-6 (my schedule yesterday), I’m actually working all 6 hours.

And, if you are like me, it’s not like when those 6 hours are up, I’m clicking my heels together to sail home.

I have lots more stuff to do before and after those appointments.

I have notes to write, an office to clean, calls to make to ensure continuity of care- and that’s not even counting the B word – billing!

So, think about it in these terms – if you are working doing 6 hours of therapy, that’s equivalent to everyone else’s 8 – 10-hour shifts.

No one ever asks people who work 10-hour shifts why they are so tired – do they?

Nope!

They don’t!

Reason #4 – The Crunch

Whether you are working for yourself or for an agency, you have to keep your hours up and billable time up to keep your job and your doors open.

You don’t have the luxury of not doing work or just goofing off and still getting paid.

If you are like me, when I’m not billing, I’m not making money.

However, things still need to get done.

I still have to market, update my website and make sure my billing is in on time.

And that’s just when the days run smoothly.

What happens when your kid gets sick?

Or your office floods and you can’t see clients until the carpets have been dried out?

You just have to figure it out – there’s no vacation time and no sick time when you are working for yourself or are given a quota.

So in the middle of trying to be like Carl Rogers and provide unconditional positive regard, you have to worry if you are doing a good job and if your clients will come back.

And then what happens when your clients get better and don’t need you?

You still have to pay your bills.

I’m getting stressed out just typing this!

Reason #5 – The Extras



I’ll give you a snapshot of a typical day for me.

I may start at 10 am and plan to leave at 6 pm.

I see 6 clients during the day.

One of them goes into crisis and I have to reschedule another client for a different day because I am on the phone making calls to ensure my teenage client is safe.

I may or may not get paid for this extra time but I do it because I care and because it’s ethical.

That crisis stresses me out and I realize that I have to figure out how to bill that and how to ensure that I have an open spot for the person I had to bump.

And, by the way, I hope they don’t leave.

I understand they are important as well.

I get finished finally at 7 pm and plan to head home but realize I need to take out the trash and get some notes written before I leave.

Now it’s 7:30 pm.

I then think about who I have coming in tomorrow and realize I have a few treatment plans I need to finish before the parent comes in tomorrow to get the paperwork signed and I can keep getting paid for doing my job.

Oh – and my assistant?

Her mother is ill and so I need to also figure out how to bill stuff myself so my rent can get paid.

Yes, it is true that I worked 9 hours with no lunch break.

I “only” did 6 hours of therapy but I’m exhausted . . . from the stress of the crisis, from trying to keep my office clean, from doing the billing, and from worrying that I’m doing the best job possible for my clients.

One (of many) studies point out that this type of multitasking (What else could you call it?) is not only not efficient but it is bad for our brains.

It’s like riding on a rough road for many miles at high speeds.

You can only do it for so long until something has to give.

So, even if doing rote tasks, like entering numbers for a long period of time, it is still less exhausting than juggling the many tasks that we therapists do each day.

Reason #6 – Mirror Neurons

Mirror neurons exist in several parts of our brain but were first discovered when scientists were examining motor neurons in monkeys.

Mirror neurons are the neurons responsible for helping us understand the pain of others.

We now know that when we see something happen to others, this part of the brain is activated as if it were actually happening to us.

In therapy, we deal with the underbelly of life.

We usually don’t get to see people on their best days and we have to work through some tough problems.

Every time we see someone break down in our office or scream at a spouse, our brain is processing it as if it is actually happening to us.

Think about the last time you had a knock-down, drag-out fight with your spouse or family member.

It was exhausting, right?

Well, that’s what your brain is experiencing all day when you have clients in your office suffering.

You don’t just feel them in an “I feel your pain” metaphorical way.

You actually feel their pain.

When you experience that kind of stress and pain all day, you are going to be more tired than sitting and filing paperwork in an insurance office somewhere.

As I mentioned above, you may want to print this out somewhere to remind yourself when you start feeling bad about seeing only 6 clients in a day. It’s hard stuff.

Which parts of this ring true for you? How you have explained the difficulty of your job to other people?

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About the Author: Amy Flaherty, LPE-I is a Registered Play Therapist in Northeast Arkansas. She provides personalized training in sandtray therapy for all therapists (not just those who work with kids) through her business – the Southern Sandtray Institute. Here is where you can sign up for her free webinar and learn more about her training that leads to certification as a Registered Integrative Sandtray Therapist (RIST).