A question about the day in, day out slog and happiness

[gohogwild]

I found an interesting comment from PsyDr (hope you don't mind, if you're reading this) from 2018 that I wanted to generate some conversation around:

"3) what few people talk about in psych is that the job entails daily interactions with awful stuff. Everyone is different, and some things are easier to deal with. But it wears on you. Go ask everyone you know to tell you their worst news of the week for 8 hrs a day for 5 days per week. Repeat for the next 60,000 hrs of your life. Childhood rape. Awful spouses. Extreme poverty. Death. Having a patient you die. Having a patient commit suicide. Seriously consider how encountering this affects you and your happiness.​

​

4) anyone with a passing familiarity with the genetics of the five factors will tell you that some people are just inherently neurotic. You should consider that when considering the source."​

I'm just curious how much this resonates with people. I get that this is kind of the job description, but this is the kind of information that I just don't come across often (unless it's buried and worded in ways I cannot find). I'm an undergrad and I would be lying to say I've had any real life experience with this volume of strong emotion on a consistent basis or a real way of imagining how this would effect my happiness. Could those in the field comment on their experience or offer thoughts this brings up?

As always, thank you.

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[PsyDr]

I found an interesting comment from PsychDr (hope you don't mind, if you're reading this) from 2018 that I wanted to generate some conversation around:

"3) what few people talk about in psych is that the job entails daily interactions with awful stuff. Everyone is different, and some things are easier to deal with. But it wears on you. Go ask everyone you know to tell you their worst news of the week for 8 hrs a day for 5 days per week. Repeat for the next 60,000 hrs of your life. Childhood rape. Awful spouses. Extreme poverty. Death. Having a patient you die. Having a patient commit suicide. Seriously consider how encountering this affects you and your happiness.​

​

4) anyone with a passing familiarity with the genetics of the five factors will tell you that some people are just inherently neurotic. You should consider that when considering the source."​

I'm just curious how much this resonates with people. I get that this is kind of the job description, but this is the kind of information that I just don't come across often (unless it's buried and worded in ways I cannot find). I'm an undergrad and I would be lying to say I've had any real life experience with this volume of strong emotion on a consistent basis or a real way of imagining how this would effect my happiness. Could those in the field comment on their experience or offer thoughts this brings up?

As always, thank you.

IME: you can’t trust that guy.

 

[gohogwild]

IME: you can’t trust that guy.

LOL impressive response time.

 

[niceman]

It very much depends on what brings you happiness and how well you can adjust in difficult situations like those. It should be (but sometimes is not) part of the training to process and manage these strong feelings coming from the work you do so you can go on with your life without being affected (that much). Some people manage better. Some become desensitized. Some can't take it and need to switch roles. It is not uncommon to hear colleagues say they are not using the coping skills they teach.

Ultimately, you are the one making the decision and you won't know if it is worth it until you try. You may also understand yourself better along the way and change the course of your training. It is good to think ahead of time before you commit 5-7 years of your time. If you get into a good program, you should be able to experience different things you can do as a psychologist to make a more informed decision and see if therapy is really for you. If not? It is a versatile degree that allows you to do many different things.

 

[DynamicDidactic]

"3) what few people talk about in psych is that the job entails daily interactions with awful stuff. Everyone is different, and some things are easier to deal with. But it wears on you. Go ask everyone you know to tell you their worst news of the week for 8 hrs a day for 5 days per week. Repeat for the next 60,000 hrs of your life. Childhood rape. Awful spouses. Extreme poverty. Death. Having a patient you die. Having a patient commit suicide. Seriously consider how encountering this affects you and your happiness.

I don't feel like the content of the problems clients discuss are the issue. First of all, it was not particularly less tough to work with depressed/anxious college students - during grad practicum - than individuals that have gone through truly horrible experiences that would be too much for any movie or TV show. When I got to internship and worked with lots of psychotic disorders, homeless folks, and basically those most at need but with the least resources, the work did not make me less happy. Similarly, once I got accustomed to working with suicidal clients - DBT training during postdoc - that too was not particularly tough (tough at first but once I felt comfortable with risk assessments and phone calls I habituated and it helps to have a consult team).

I would be lying to say I've had any real life experience with this volume of strong emotion on a consistent basis or a real way of imagining how this would effect my happiness.

This is what training is for, there is no prerequisite of having your own life difficulties (if anything, it can serve as an obstacle). I had zero/zilch/nada life experience (mine or family) with even depression and especially not anything horrible (I did work with developmental disabilities but that is a different ballpark). For me, this was an effective method to build up empathy and validation skills (harder with college students that can't figure out their romantic relationships).

I found my happiness was not based on the toughness of the clients or their problems but based on other factors. I think there is a decent empirical literature on this if you look over the burnout research (as opposed to happiness). Burnout seems to be related to factors like organizational structure (e.g., the amount of control you have at work, how receptive are admin/superiors). For example, I loved the clinical experiences I received on internship but was generally unhappy due to the internship and the hospital both being poorly run and basically pushing Psychology out the door in favor of master's-level providers. My postdoc messed up when I arrived and I basically had to add an additional 10 hours a week of clinical work onto the hours they slated me for research, which was super stressful. However, I loved the work and clinical training so much that I was pretty damn happy.

Anecdotally, I find that what makes people "happy" is not the content of their job but much more related to personality traits and expectations. Some people want a great deal of recognition and authority once they are psychologists but that is less likely in a medical system. Some people want lots of money and that is also not where one starts in psychology. IMO, the people you work with makes a big difference. There is some research to show this last one; how well you are at doing EBPs. My interpretation is that being an effective and self-efficacious therapist (not necessarily a CB therapist) makes people happy while fumbling your way through work trying to apply Maslow and Rogers to everything (not just picking on the Humanists but just generally people being poor at their job) will likely be less rewarding.

Generally speaking, it seems to me, that people will be happy at their job if they like what they do, if they do it well, and if they get along with their colleagues. This is not just for psychologists or health care professionals. This applies to working with suicidal clients and cleaning out ****ters (**** these ****ing filters, toilets).

4) anyone with a passing familiarity with the genetics of the five factors will tell you that some people are just inherently neurotic. You should consider that when considering the source."​

I don't know the context for that quote but I likely score very low on neuroticism. So, take that into consideration when reading my post.

 

[Sanman]

IMO, happiness as a psychotherapist and more broadly a healthcare worker has more to do with the outlook you have towards what you are doing in your career. Many professionals, especially the young ones want to "fix problems" and "cure" people and all the ills of the world. That, to me, is an outlook that can lead to frustration and burnout.

In the words of one of my favorite TV characters. Gregory House, M.D.

"That's the difference between him and me. He thinks you do your job, and what will be will be. I think that what I do and what you do matters. He sleeps better at night."

 

[erg923]

I found an interesting comment from PsyDr (hope you don't mind, if you're reading this) from 2018 that I wanted to generate some conversation around:

"3) what few people talk about in psych is that the job entails daily interactions with awful stuff. Everyone is different, and some things are easier to deal with. But it wears on you. Go ask everyone you know to tell you their worst news of the week for 8 hrs a day for 5 days per week. Repeat for the next 60,000 hrs of your life. Childhood rape. Awful spouses. Extreme poverty. Death. Having a patient you die. Having a patient commit suicide. Seriously consider how encountering this affects you and your happiness.​

​

4) anyone with a passing familiarity with the genetics of the five factors will tell you that some people are just inherently neurotic. You should consider that when considering the source."​

I'm just curious how much this resonates with people. I get that this is kind of the job description, but this is the kind of information that I just don't come across often (unless it's buried and worded in ways I cannot find). I'm an undergrad and I would be lying to say I've had any real life experience with this volume of strong emotion on a consistent basis or a real way of imagining how this would effect my happiness. Could those in the field comment on their experience or offer thoughts this brings up?

As always, thank you.

Yes. That's part of why I left a full-time clinical service job for non-clinical service position and now just see patients one day per week.

 

[deleted106747]

I found that the cumulative total of being around/hearing about the worst took a toll, if that makes sense. I have good separation in that I can be sitting with someone in empathy doing the work, then shut it off consciously when I leave work. But over time, it wore on me. Especially with anxiety that something will happen to my kids, since I've done a lot of grief therapy with parents who lost them to drugs, suicide, random accidents. Partial solution - don't do all therapy. My job is a blend of a lot of different things and that helps quite a lot. Also, and this goes back to the debt thing a bit -having a life is important. Doing lighthearted, fun things, traveling, going out to eat (well, I hope to do the latter two soon).

 

[Fan_of_Meehl]

I don't feel like the content of the problems clients discuss are the issue. First of all, it was not particularly more tough to work with depressed/anxious college students - during grad practicum - than individuals that have gone through truly horrible experiences that would be too much for any movie or TV show. When I got to internship and worked with lots of psychotic disorders, homeless folks, and basically those most at need but with the least resources, the work did not make me less happy. Similarly, once I got accustomed to working with suicidal clients - DBT training during postdoc - that too was not particularly tough (tough at first but once I felt comfortable with risk assessments and phone calls I habituated).

This is what training is for, there is no prerequisite of having your own life difficulties (if anything, it can serve as an obstacle). I had zero/zilch/nada life experience (mine or family) with even depression and especially not anything horrible (I did work with developmental disabilities but that is a different ballpark). For me, this was an effective method to build up empathy and validation skills (harder with college students that can't figure out their romantic relationships).

I found my happiness was not based on the toughness of the clients or their problems but based on other factors. I think there is a decent empirical literature on this if you look over the burnout research (as opposed to happiness). Burnout seems to be related to factors like organizational structure (e.g., the amount of control you have at work, how receptive are admin/superiors). For example, I loved the clinical experiences I received on internship but was generally unhappy due to the internship and the hospital both being poorly run and basically pushing Psychology out the door in favor of master's-level providers. My postdoc messed up when I arrived and I basically had to add an additional 10 hours a week of clinical work onto the hours they slated me for research, which was super stressful. However, I loved the work and clinical training so much that I was pretty damn happy.

Anecdotally, I find that what makes people "happy" is not the content of their job but much more related to personality traits and expectations. Some people want a great deal of recognition and authority once they are psychologists but that is less likely in a medical system. Some people want lots of money and that is also not where one starts in psychology. IMO, The people you work with makes a big difference. There is some research to show this last one; how well you are at doing EBPs. My interpretation is that being an effective and self-efficacious therapist (not necessarily a CB therapist) makes people happy while fumbling your way through work trying to apply Maslow and Rogers to everything (not just picking on the Humanists but just generally people being poor at their job) will likely be less rewarding.

Generally speaking, it seems to me, that people will be happy at their job if they like what they do, if they do it well, and if they get along with their colleagues. This is not just for psychologists or health care professionals. This applies to working with suicidal clients and cleaning out ****ters (**** these ****ing filters, toilets).

I don't know the context for that quote but I likely score very low on neuroticism. So, take that into consideration when reading my post.

LOL, those working in certain settings should be advised that you may literally be changing your own filters, cleaning your own toilets ,(and doing your own windows, vacuuming your own floors, etc...) due to poor management and accountability within the organization. My windows have never been cleaned by staff and the carpet likely hasn't been vacuumed by janitorial staff since the Carter administration. And, yes, I have gone up and down the ladder trying to document everything, tie a red bow on it, etc. and it amounts to squat. Just buy some paper towels, a bottle of Windex and a Dirt Devil and practice radical acceptance and mindful vacuuming.

On the topic of unhappiness or burnout I'd suggest:

1) always be mindful or the limits of your influence as a clinician ('you can lead a horse to water but you can't make them drink')...as long as you spend the time with the patient giving a good effort and providing evidence-based psychotherapy (per the APAa definition) you've done what you can regardless of the outcome
2) find ways to surrender (radical acceptance) to things you can't control in the organization and find things to be grateful about anyway...it's a process

 

[WisNeuro]

My fix, do some IME work. Yes, you still put up with a lot of BS, but you are very well compensated for putting up with that BS.

 

[gohogwild]

My fix, do some IME work. Yes, you still put up with a lot of BS, but you are very well compensated for putting up with that BS.

IME? Can I have the definition?

 

[BuckeyeLove]

I see a lot of horrible **** every day. But...I have a lot of flexibility in how much I have to see. However, I know for a fact I have become a bit less human in the last 5ish years from it. Case in point: I was out on a date a few months ago with a woman I had been talking to for some time who is a pediatrician. We started talking about a case I had been working on which involved sex offending behavior, and more specifically, psychopathic sex offending behavior. She stopped me right in the middle as I was pontificating and said "It's a little concerning how calm you are talking about this." My response was that "getting paid by the hour for my opinion on this stuff makes it easier." She didn't like that response. However....we're still talking, so maybe I'm more savvy than I give myself credit.

 

[gohogwild]

I don't feel like the content of the problems clients discuss are the issue. First of all, it was not particularly more tough to work with depressed/anxious college students - during grad practicum - than individuals that have gone through truly horrible experiences that would be too much for any movie or TV show. When I got to internship and worked with lots of psychotic disorders, homeless folks, and basically those most at need but with the least resources, the work did not make me less happy. Similarly, once I got accustomed to working with suicidal clients - DBT training during postdoc - that too was not particularly tough (tough at first but once I felt comfortable with risk assessments and phone calls I habituated).

This is what training is for, there is no prerequisite of having your own life difficulties (if anything, it can serve as an obstacle). I had zero/zilch/nada life experience (mine or family) with even depression and especially not anything horrible (I did work with developmental disabilities but that is a different ballpark). For me, this was an effective method to build up empathy and validation skills (harder with college students that can't figure out their romantic relationships).

I found my happiness was not based on the toughness of the clients or their problems but based on other factors. I think there is a decent empirical literature on this if you look over the burnout research (as opposed to happiness). Burnout seems to be related to factors like organizational structure (e.g., the amount of control you have at work, how receptive are admin/superiors). For example, I loved the clinical experiences I received on internship but was generally unhappy due to the internship and the hospital both being poorly run and basically pushing Psychology out the door in favor of master's-level providers. My postdoc messed up when I arrived and I basically had to add an additional 10 hours a week of clinical work onto the hours they slated me for research, which was super stressful. However, I loved the work and clinical training so much that I was pretty damn happy.

Anecdotally, I find that what makes people "happy" is not the content of their job but much more related to personality traits and expectations. Some people want a great deal of recognition and authority once they are psychologists but that is less likely in a medical system. Some people want lots of money and that is also not where one starts in psychology. IMO, The people you work with makes a big difference. There is some research to show this last one; how well you are at doing EBPs. My interpretation is that being an effective and self-efficacious therapist (not necessarily a CB therapist) makes people happy while fumbling your way through work trying to apply Maslow and Rogers to everything (not just picking on the Humanists but just generally people being poor at their job) will likely be less rewarding.

Generally speaking, it seems to me, that people will be happy at their job if they like what they do, if they do it well, and if they get along with their colleagues. This is not just for psychologists or health care professionals. This applies to working with suicidal clients and cleaning out ****ters (**** these ****ing filters, toilets).

I don't know the context for that quote but I likely score very low on neuroticism. So, take that into consideration when reading my post.

Thank you for such an in-depth reply, I agree that perception, people, and structure are all key and should be taken into consideration.
Besides my previous question, I always think it's interesting when people with no experiences with familial mental illness or experience with depression (so I assume no experience with therapy??) go into the field. Maybe that's just my perspective because I don't come from a professionally oriented family at all so my exposure to professionals was just when I went to the doctor, therapist, etc, when I was young.
Overall, yes, thank you for taking the time to type that out, it's given me some hope and tangible reasons people are able to sustain themselves in the field.

 

[WisNeuro]

IME? Can I have the definition?

Independent Medical Evaluation

 

[gohogwild]

IMO, happiness as a psychotherapist and more broadly a healthcare worker has more to do with the outlook you have towards what you are doing in your career. Many professionals, especially the young ones want to "fix problems" and "cure" people and all the ills of the world. That, to me, is an outlook that can lead to frustration and burnout.

In the words of one of my favorite TV characters. Gregory House, M.D.

"That's the difference between him and me. He thinks you do your job, and what will be will be. I think that what I do and what you do matters. He sleeps better at night."

Hmm, I think this is a really interesting quote. I would think that because therapy is a lot of communication and teaching the client (coping mechanisms, what's going on when we feel anxiety, whatever), it would be a lot harder to divorce yourself from that idea than with medicine which seems to be more procedural and physically dependent? Because therapy is so free form, and in some ways, so simple (not philosophically, but just that it's a lot of the time a conversation), I can see a lot more people latching onto the feeling that they could have controlled the outcome "if only..."

 

[gohogwild]

I see a lot of horrible **** every day. But...I have a lot of flexibility in how much I have to see. However, I know for a fact I have become a bit less human in the last 5ish years from it. Case in point: I was out on a date a few months ago with a woman I had been talking to for some time who is a pediatrician. We started talking about a case I had been working on which involved sex offending behavior, and more specifically, psychopathic sex offending behavior. She stopped me right in the middle as I was pontificating and said "It's a little concerning how calm you are talking about this." My response was that "getting paid by the hour for my opinion on this stuff makes it easier." She didn't like that response. However....we're still talking, so maybe I'm more savvy than I give myself credit.

See, maybe you'll disagree, but I think that familarity factor is something I look forward to (again I am likely romanticizing). I think being a person that's familiar with what other people are not or even what others are scared of makes you more well rounded and human.
I psychologist I've spoken with described it as "you cannot keep a lot of your pet prejudices in this field", because he had worked in a correctional facility, a high need area, etc. He was able to meet the faces of what had previously been an abstraction that anyone would fear. He said that he still hated the serial killers, abusers, etc. But he had, had experience with what others didn't and was able to reference that than info from the news/media. I think it's probably grounding to have that perspective, even if others don't appreciate it or it's not 100% PC.

 

[borne_before]

1. My child patients will surprise with how resilient they are. For that, I am happy to be in their corner. I didn't cause their challenges, but I sure can help.
2. There is a reason we get paid for this.

 

[cara susanna]

IMO this is why it's important to be part of a patient care team. I do a lot of trauma work and hear a lot of horrible stories--especially fun when you do prolonged exposure for PTSD and get to hear the detailed narrative over and over and over again. I have found that the most essential thing is having colleagues that I can talk to and process with. People that you can check in with, or who will sometimes check in on you. That's something I learned on fellowship when I was in a specialty trauma clinic and also when I was part of a DBT team (DBT's model is a team treating one patient together). Having diversity in job responsibilities can also help. I have a part-time admin role and also have some involvement in teaching and training, which I love.

Also, remembering that it's a marathon, not a sprint. You will be more effective long-term if you do things to take care of yourself. For instance, I have made it a rule to never overbook patients, even if it would be a lot easier for me to see people that way.

 

[ccpsych16]

I’m an incoming intern for this next year, but I appreciate all the perspectives of the psychologists in this thread. This past year has been illuminating for me, and I realized how draining I find long-term therapy. I specifically applied to and ranked highly internship sites that have an abundance of clinical experiences. I like residential treatment and other brief/crisis intervention. I find it more invigorating, fulfilling, and meaningful. I know that beyond internship requirements to carry long term cases, I will NOT work in a general MH outpatient setting and instead will move toward consultation/eval/residential. I look forward to getting experience in medical settings as well, doing bedside interventions during inpatient stays for physical health reasons, etc. Seeing the same people regularly for months and months and even years is not my thing.

 

[PsyDr]

See, maybe you'll disagree, but I think that familarity factor is something I look forward to (again I am likely romanticizing). I think being a person that's familiar with what other people are not or even what others are scared of makes you more well rounded and human.

This is furiously beyond naïve.

I would doubt any expert who has been court ordered to watch a video of a child rape would agree with you. Anyone who knows which part of that act provoked the orgasm would be worse off.

 

[gohogwild]

This is furiously beyond naïve.

I would doubt any expert who has been court ordered to watch a video of a child rape would agree with you. Anyone who knows which part of that act provoked the orgasm would be worse off.

Sorry, I can't say that's what I had in mind when I said that, but I can understand what you're saying. At most I meant it in a more general sense as in applying consoling grief to others in your life who are grieving. I was not thinking of BuckeyeLove's initial example and definitely could have been more clear. As I stated in my initial post, I am an undergrad and have relatively no life experience in the arena. So forgive me for being naïve to the point of being infuriating. I have no doubt I quite literally am. That's the whole point of this post.

 

[PsychPhDone]

I found an interesting comment from PsyDr (hope you don't mind, if you're reading this) from 2018 that I wanted to generate some conversation around:

"3) what few people talk about in psych is that the job entails daily interactions with awful stuff. Everyone is different, and some things are easier to deal with. But it wears on you. Go ask everyone you know to tell you their worst news of the week for 8 hrs a day for 5 days per week. Repeat for the next 60,000 hrs of your life. Childhood rape. Awful spouses. Extreme poverty. Death. Having a patient you die. Having a patient commit suicide. Seriously consider how encountering this affects you and your happiness.​

​

4) anyone with a passing familiarity with the genetics of the five factors will tell you that some people are just inherently neurotic. You should consider that when considering the source."​

I'm just curious how much this resonates with people. I get that this is kind of the job description, but this is the kind of information that I just don't come across often (unless it's buried and worded in ways I cannot find). I'm an undergrad and I would be lying to say I've had any real life experience with this volume of strong emotion on a consistent basis or a real way of imagining how this would effect my happiness. Could those in the field comment on their experience or offer thoughts this brings up?

As always, thank you.

Agree with the others- the content doesn't usually get to me. I used to focus on trauma so I legit did hear about the very worst things people experienced over and over...and that aspect didn't make me unhappy.

Things that regularly make me unhappy: providers who don't have a good consult question/follow consult procedures, patients who yell at me, unclean/inappropriate physical work environment, lack of admin support, IT problems.

I am only emotionally affected to by a patient's actual session content (like outside of work hours) maybe twice a year.

 

[cara susanna]

Agreed. I'm far more burnt out by patients who don't have clear therapy goals or aren't actually engaging in treatment than I am hearing about horrible trauma stories from patients that are actively engaged.

 

[AcronymAllergy]

Being continually exposed to something is almost invariably going to de-sensitize you to it. In some ways, this is almost a necessity in the field. I don't know if I'd say it makes you less human, but it does change your perspective, and despite your best efforts, probably also does change the way you interact with other people at times. This is why it's so important to maintain a balance between what you do for work and what you do outside work, as well as between your different work-related activities.

All that being said, it's not always possible to know ahead of time whether the field is "right" for you, what may or may not bother you (and, as others have said, this isn't always related to the "severity" of the problems), and how much you'll enjoy the work. But the beauty of psychology is that it's such a varied field. Some psychologists just cannot work with, say, folks who misuse substances but have no trouble with childhood trauma victims or sex offenders. Others can't continually work with depressed college students but are great with the SMI population. Still others have trouble with frequent therapy work altogether but love assessment and/or forensic work. And then there's still research and industry. Interests and enjoyment frequently change during grad school, and sometimes even afterward.

And, again as others above have said, it's often the stuff outside of sessions that burns providers out the most.

 

[singasongofjoy]

Consider the wide range of what people may do with xyz degree and, as others have said, the other factors that go into your personal happiness. Some of the biggest factors for you personally might have nothing to do with the clients and their pasts & presenting problems. For example - prior to COVID I would say (and did say) I landed my dream job (besides being a bit underpaid because working for the state.... but my day to day satisfaction with the balance/variety of things my job entails makes it worth it to me). And now my job satisfaction right now is less than it has ever been except for one particularly harrowing few months of my doctoral program. It has nothing to do with the clients- they are the positive to the week - but I went from spending 50% of my day in front of a computer (and a lot of the rest of it moving around - playing or sitting on the floor, etc) and talking to people face to face (coworkers, supervisees, clients and support groups) to.... now my ass is in the same damn chair 9-14 hours a day staring at the same screen (all my evals and therapy are telehealth) and in my organization the expectation (right now) is that everyone has the camera on all the time for all the meetings (I'm on a personal crusade to change that). I NEVER would have chosen a career/job position that I thought would be 80% or more staring at a screen no matter how interesting the area- if there was a guarantee that this is what being a psychologist looks like now across the board, I'd be figuring out how to switch to a totally different career ASAP. So - Dealing with heavy client issues? How much that affects you will depend on you as an individual, how much of your day/week it is, AND (importantly) how supported you feel in your workplace and overall workplace fit.

As for the work, yeah, it would suck (for me) to hear people's trauma all day every day- but that's not the case in all psych and related positions. In fact it's quite a small part of what I focus on given the population and the types of concerns I work with (IDD, ASD) - plus I have a nice mix of individual therapy, groups, and diagnostics; supervision of students, staff- so I (usually) don't risk being too burnt out on any one thing even though sometimes I will have clients who are going through some traumatic times. Also helps to approach whatever situation with a growth and perspective-shifting mindset- you're not out to "cure" people of...what? the human condition? No. You're helping people move forward by thinking and behaving and living differently than whatever isn't working currently- and that can be defined as skills to develop. In many cases you can get plenty far in therapy focusing largely on the present and future and the wretched past is only relevant insofar as it informs the manner of teaching and practicing whatever skills you and your client are working on- not ruminating on it every week.

It's also important to figure out or further hone (which grad school helps you do if you seek out a variety of experiences) what populations / issues are on your "nope" list. If you don't think working with a bunch of people who have PTSD and a lot of trauma, don't work at the VA. Got a fairly long list of "really don't want to have to work with this on the reg" then consider becoming highly specialized in something else so that will be the bulk of your day to day (you'll still get whatever is on your "nope" list occasionally as comorbidities or whatever, but if it's infrequent, then it's easier to look at it as a personal growth or professional collaboration opportunity).

 

[singasongofjoy]

Sorry, I can't say that's what I had in mind when I said that, but I can understand what you're saying. At most I meant it in a more general sense as in applying consoling grief to others in your life who are grieving. I was not thinking of BuckeyeLove's initial example and definitely could have been more clear. As I stated in my initial post, I am an undergrad and have relatively no life experience in the arena. So forgive me for being naïve to the point of being infuriating. I have no doubt I quite literally am. That's the whole point of this post.

You corrected and handled that misunderstanding well. That's a quality that students on this forum sometimes lack to a huge degree- and a quality which will go a long way in getting the most out of your future training, whatever you decide to do. Kind of a prerequisite skill for grad school I think.

 

[affectiveH3art]

Agreed. I'm far more burnt out by patients who don't have clear therapy goals or aren't actually engaging in treatment than I am hearing about horrible trauma stories from patients that are actively engaged.

Ditto on this one. I work in a residential inpatient setting (psych/addiction/dual dx) and I really am feeling the heavy burnout of mandated OP services in addiction, inpatient mandated folks d/t addiction, and even the 28 day program addiction pts who just do not care. Oh an probably due to clients who scream, curse, spit, and challenge me (to get a rise out of me). I've realized my frustration tolerance has dropped to 2 angry, unwilling clients a day. If I go over I end up re-evaluating my life and wishing for my previous career in dental anesthesia. I would take hearing a trauma over an unwilling, unmotivated and rude client any day. At this point in my career, it seems I am working with more of the latter.

 

[ClinicalABA]

... So forgive me for being naïve to the point of being infuriating. I have no doubt I quite literally am. That's the whole point of this post.

It's also the point of this entire board! I'd suggest that folks who are prone to getting infuriated by naivete might want to avoid places where the mission (and primary reason said folks are "invited" to be here in the first place) is to help the naive! Whatever- you handled that VERY well.

As to your original question, part of a comprehensive training in applied clinical/counseling psychology should include instruction in techniques related to self-care as a therapist. While you may not be prepared for any eventuality, there is a process for "easing" you into the tougher cases. For example, you may start out in a training clinic or on a team where clients are screened out based on high risk (e.g., suicidality; psychosis). Also, being competent and confident in your clinical skills helps. As you do the work more and experience the positive outcomes of your work, you come to recognize your role in making things better. As others have posted above, you will also come to respect, appreciate, and learn from the resilience of your clients who are living with and overcoming obstacles that may seem insurmountable. It's important to distinguish between empathy for your clients (which can be constructive), and pity for your clients (which is potentially harmful and unprofessional).

Personally, a major part of my job involves telling parents that their beautiful toddler is affected by a developmental delay (autism) that will likely have life-long impacts. You learn to deliver that diagnosis in way that accurately and honestly conveys the truth about what to expect, as well as the empirically supported hopefulness that treatment will have and quick and positive impact. It's always toughest for me when the dads cry or just go quiet. Providing services via telehealth has also given me more exposure to the actual consequences of poverty and all that comes with it, as I'm now seeing the children in their homes, including shelters.

 

[PsyDr]

Sorry, I can't say that's what I had in mind when I said that, but I can understand what you're saying. I think as I stated in my initial post, I am an undergrad and have relatively no life experience in the arena. So forgive me for being naïve to the point of being infuriating. I have no doubt I quite literally am. That's the whole point of this post.

1 ) It's completely typical to have an idealistic viewpoint when you're starting out.

It's a helping profession. That very description has an optimistic view of human nature. It's not surprising that people attracted to that profession are also optimistic. There are absolutely positives to the work, which you have picked up on. In practice, you do learn things in the process of interacting with a wide variety of people. You can learn about lifestyles, hobbies, interests, different social standards, professions, sexual practices, vices, religious traditions, politics, art, science, etc . This information can be positive, neutral, and negative. You can partially limit the type of information you receive, but you cannot totally limit it.

2) One point that I think you may be missing: your social impacts of interacting with negativity.

Watch the Simpsons? You ever notice that everyone is put off by the horrible things Moe says? Notice how the main characters avoid him? That's part of the problem with this profession. Over time, you can get completely accustomed to mildly negative stuff. Doesn't affect you at all. Some of it might be pretty funny to you. But if you consistently tell your social group about your work, even if you don't think it's that negative, they'll get put off. I think that's part of what Buckeye was hinting at. You have to limit what you say to others.

3) Another point I think you may be missing: It can be hard to get social support on your very bad days.

You're a student. Let's say you have a bad day in your studies. Maybe you get a bad grade. Or a professor yells. You can go to your friends and family members, and talk about it. I'm sure they listen, they relate, and tell you some positive things. You might feel better just for getting it off your chest. That process applies to most professions.

In psychology, it's not that simple. You are very literally dealing with the extremes of human behavior. In any practice setting, you are going to encounter some upsetting things. At times, you're might want to talk about that stuff with someone. How do you think the untrained people in your social life are going to react to that information? This is one of the rationales for psychologists' peer supervision.

4) Last point I think you may be missing: Maybe you shouldn't take opinions about positivity from someone who is not an inherently positive person. That was the entire point of #4.

 

[gohogwild]

1 ) It's completely typical to have an idealistic viewpoint when you're starting out.

It's a helping profession. That very description has an optimistic view of human nature. It's not surprising that people attracted to that profession are also optimistic. There are absolutely positives to the work, which you have picked up on. In practice, you do learn things in the process of interacting with a wide variety of people. You can learn about lifestyles, hobbies, interests, different social standards, professions, sexual practices, vices, religious traditions, politics, art, science, etc . This information can be positive, neutral, and negative. You can partially limit the type of information you receive, but you cannot totally limit it.

2) One point that I think you may be missing: your social impacts of interacting with negativity.

Watch the Simpsons? You ever notice that everyone is put off by the horrible things Moe says? Notice how the main characters avoid him? That's part of the problem with this profession. Over time, you can get completely accustomed to mildly negative stuff. Doesn't affect you at all. Some of it might be pretty funny to you. But if you consistently tell your social group about your work, even if you don't think it's that negative, they'll get put off. I think that's part of what Buckeye was hinting at. You have to limit what you say to others.

3) Another point I think you may be missing: It can be hard to get social support on your very bad days.

You're a student. Let's say you have a bad day in your studies. Maybe you get a bad grade. Or a professor yells. You can go to your friends and family members, and talk about it. I'm sure they listen, they relate, and tell you some positive things. You might feel better just for getting it off your chest. That process applies to most professions.

In psychology, it's not that simple. You are very literally dealing with the extremes of human behavior. In any practice setting, you are going to encounter some upsetting things. At times, you're might want to talk about that stuff with someone. How do you think the untrained people in your social life are going to react to that information? This is one of the rationales for psychologists' peer supervision.

4) Last point I think you may be missing: Maybe you shouldn't take opinions about positivity from someone who is not an inherently positive person. That was the entire point of #4.

To #4, no worries. I think I get what you are saying, to feed it back to you to see if I'm understanding, a person can go in gung-ho and interested in the humanity of doing therapy (the interesting information), but most of the information they get will be getting is negative. They will have bad days and let their guard down and inevitably absorb some of the negativity like a sponge much like the old "you become the top 5 people you spend your time with" thing, however true that is. So while it's all good and interesting, you find that having this negativity becoming apart of your psyche to be overall less worth it than the unique human perspectives that may initially draw a person to the field. Is this more or less correct?

 

[DynamicDidactic]

I see a lot of horrible **** every day. But...I have a lot of flexibility in how much I have to see. However, I know for a fact I have become a bit less human in the last 5ish years from it.

Is this due to the forensics aspect of your job? I would like to know what makes you less human? I have not found that in my experience, but I assume my experience has been very different (don't work with children, horrific stuff happened in the past).

 

[gohogwild]

Consider the wide range of what people may do with xyz degree and, as others have said, the other factors that go into your personal happiness. Some of the biggest factors for you personally might have nothing to do with the clients and their pasts & presenting problems. For example - prior to COVID I would say (and did say) I landed my dream job (besides being a bit underpaid because working for the state.... but my day to day satisfaction with the balance/variety of things my job entails makes it worth it to me). And now my job satisfaction right now is less than it has ever been except for one particularly harrowing few months of my doctoral program. It has nothing to do with the clients- they are the positive to the week - but I went from spending 50% of my day in front of a computer (and a lot of the rest of it moving around - playing or sitting on the floor, etc) and talking to people face to face (coworkers, supervisees, clients and support groups) to.... now my ass is in the same damn chair 9-14 hours a day staring at the same screen (all my evals and therapy are telehealth) and in my organization the expectation (right now) is that everyone has the camera on all the time for all the meetings (I'm on a personal crusade to change that). I NEVER would have chosen a career/job position that I thought would be 80% or more staring at a screen no matter how interesting the area- if there was a guarantee that this is what being a psychologist looks like now across the board, I'd be figuring out how to switch to a totally different career ASAP. So - Dealing with heavy client issues? How much that affects you will depend on you as an individual, how much of your day/week it is, AND (importantly) how supported you feel in your workplace and overall workplace fit.

As for the work, yeah, it would suck (for me) to hear people's trauma all day every day- but that's not the case in all psych and related positions. In fact it's quite a small part of what I focus on given the population and the types of concerns I work with (IDD, ASD) - plus I have a nice mix of individual therapy, groups, and diagnostics; supervision of students, staff- so I (usually) don't risk being too burnt out on any one thing even though sometimes I will have clients who are going through some traumatic times. Also helps to approach whatever situation with a growth and perspective-shifting mindset- you're not out to "cure" people of...what? the human condition? No. You're helping people move forward by thinking and behaving and living differently than whatever isn't working currently- and that can be defined as skills to develop. In many cases you can get plenty far in therapy focusing largely on the present and future and the wretched past is only relevant insofar as it informs the manner of teaching and practicing whatever skills you and your client are working on- not ruminating on it every week.

It's also important to figure out or further hone (which grad school helps you do if you seek out a variety of experiences) what populations / issues are on your "nope" list. If you don't think working with a bunch of people who have PTSD and a lot of trauma, don't work at the VA. Got a fairly long list of "really don't want to have to work with this on the reg" then consider becoming highly specialized in something else so that will be the bulk of your day to day (you'll still get whatever is on your "nope" list occasionally as comorbidities or whatever, but if it's infrequent, then it's easier to look at it as a personal growth or professional collaboration opportunity).

A nope list is an excellent idea! Thank you for your response.

 

[DynamicDidactic]

To #4, no worries. I think I get what you are saying, to feed it back to you to see if I'm understanding, a person can go in gung-ho and interested in the humanity of doing therapy (the interesting information), but most of the information they get will be getting is negative. They will have bad days and let their guard down and inevitably absorb some of the negativity like a sponge much like the old "you become the top 5 people you spend your time with" thing, however true that is. So while it's all good and interesting, you find that having this negativity becoming apart of your psyche to be overall less worth it than the unique human perspectives that may initially draw a person to the field. Is this more or less correct?

I think @PsyDr is saying is that your personality, which has strong associations with your genes, are going to give you a set point. Your experiences can move that point up and down somewhat. However, a person that is higher on neuroticism will experience negative emotions (e.g., sadness, burnout) much easier than someone like me (it takes a lot to get me down). So, PsyDr and I could have the same exact job and experiences but have very different reactions. Or simply, you should learn about neuroticism and see where you fall on that dimension.

 

[gohogwild]

I think @PsyDr is saying is that your personality, which has strong associations with your genes, are going to give you a set point. Your experiences can move that point up and down somewhat. However, a person that is higher on neuroticism will experience negative emotions (e.g., sadness, burnout) much easier than someone like me (it takes a lot to get me down). So, PsyDr and I could have the same exact job and experiences but have very different reactions. Or simply, you should learn about neuroticism and see where you fall on that dimension.

Oo yeah, I love me some behavioral genetics. That said, I'm somewhat familiar with OCEAN and do score decently high on neuroticism. Although I will add, neuroticism is broken up into two subcategories, withdrawal and volatility, I am almost all withdrawal and no volatility (per the dinky self reported online test, but it seems to ring true enough).

What I've learned about myself from this is that as long as I get enough alone time (being that I'm also quite introverted) and prioritize my sleep/diet/sunshine, I'm also pretty hard to get down, which goes along with some of the advice given here. This may not compare, but I'm over crediting right now along with an on campus job and a lab position at a different college I have to commute to. Some days I cannot fully prioritize what I need to and get everything done, and it's those times I feel it. So I think, in accordance with some other advice given here, I really just have to get there, get the experience and know myself. Maybe it's poison for people like me, and that is the kind of info I'm looking for by starting this thread.

It would also be a little hard to believe that a sensitive, introverted person could not be a very good candidate for this field. Apologies if I'm coming across as stubborn.

 

[erg923]

Oo yeah, I love me some behavioral genetics. That said, I'm somewhat familiar with OCEAN and do score decently high on neuroticism. Although I will add, neuroticism is broken up into two subcategories, withdrawal and volatility, I am almost all withdrawal and no volatility (per the dinky self reported online test, but it seems to ring true enough).
What I've learned about myself from this is that as long as I get enough alone time (being that I'm also quite introverted) and prioritize my sleep/diet/sunshine, I'm also pretty hard to get down, which goes along with some of the advice given here. This may not compare, but I'm over crediting right now along with an on campus job and a lab position at a different college I have to commute to. Some days I cannot fully prioritize what I need to and get everything done, and it's those times I feel it. So I think, in accordance with some other advice given here, I really just have to get there, get the experience and know myself.

Grown men (and women) don't say "Love me some...."

This applies to "me thinks" as well. Just some friendly advice.

 

[gohogwild]

Grown men (and women) don't say "Love me some...."

This applies to "me thinks" as well. Just some friendly advice.

I'm not grown, but I will take the advice kindly.

 

[Ollie123]

Some background: I'm mostly a researcher. See patients 1 day/week for now, but am actually expecting to stop doing so in the near future and very much looking forward to it. I've enjoyed clinical work to varying degrees across various settings.

That said, lots of thoughts related to this topic. I agree with the above that the content of sessions is usually not something that bothers me. Admittedly, I don't do DBT and only do limited trauma work so that inherently limits the volume of the most-severe content I might see. The soft job factors are a concern. The constant pressure to see more patients, function as a generalist while still providing high-quality evidence-based-care (I increasingly see these as mutually exclusive), systematic barriers, etc. all bother me more.

Part of my desire to stop doing clinical work has definitely been accelerated by COVID, which in my view is really the penultimate systemic barrier. When patients are really upset about not being able to see grandma, I genuinely don't know what to tell them. Me too? That's not therapy though and I didn't go to school for so long to tell them the same thing a mildly insightful 8th grader could. There aren't many good clinical "outs" for a lot of what is distressing my present patient population. These factors are always there, but its become more apparent to me.

Related to this....its honestly boredom. Yes, every one of us is a unique special snowflake. Patients are also all the same in many ways though. This is a big part of what pushes me to research. If I want to do something wildly different one day, I have that freedom.

 

[R. Matey]

And, again as others above have said, it's often the stuff outside of sessions that burns providers out the most.

Echoing this 110%. I've worked in a wide variety of clinical settings as a master's level clinician and then as a psychology trainee. I've heard some pretty dark s***, but none of it gets me down as much as the clinical systems in which I happen to be in. The frustration has usually come with some bean counter somewhere trying to do more with less. IME, this has usually come at the cost of provider autonomy and the quality of patient care.

 

[gohogwild]

Some background: I'm mostly a researcher. See patients 1 day/week for now, but am actually expecting to stop doing so in the near future and very much looking forward to it. I've enjoyed clinical work to varying degrees across various settings.

That said, lots of thoughts related to this topic. I agree with the above that the content of sessions is usually not something that bothers me. Admittedly, I don't do DBT and only do limited trauma work so that inherently limits the volume of the most-severe content I might see. The soft job factors are a concern. The constant pressure to see more patients, function as a generalist while still providing high-quality evidence-based-care (I increasingly see these as mutually exclusive), systematic barriers, etc. all bother me more.

Part of my desire to stop doing clinical work has definitely been accelerated by COVID, which in my view is really the penultimate systemic barrier. When patients are really upset about not being able to see grandma, I genuinely don't know what to tell them. Me too? That's not therapy though and I didn't go to school for so long to tell them the same thing a mildly insightful 8th grader could. There aren't many good clinical "outs" for a lot of what is distressing my present patient population. These factors are always there, but its become more apparent to me.

Related to this....its honestly boredom. Yes, every one of us is a unique special snowflake. Patients are also all the same in many ways though. This is a big part of what pushes me to research. If I want to do something wildly different one day, I have that freedom.

Very interesting. Thank you for your response and congratulations with new position. I think I get what you're saying about people's stories repeating, I've heard that from other people also.

 

[Sanman]

Some background: I'm mostly a researcher. See patients 1 day/week for now, but am actually expecting to stop doing so in the near future and very much looking forward to it. I've enjoyed clinical work to varying degrees across various settings.

That said, lots of thoughts related to this topic. I agree with the above that the content of sessions is usually not something that bothers me. Admittedly, I don't do DBT and only do limited trauma work so that inherently limits the volume of the most-severe content I might see. The soft job factors are a concern. The constant pressure to see more patients, function as a generalist while still providing high-quality evidence-based-care (I increasingly see these as mutually exclusive), systematic barriers, etc. all bother me more.

Part of my desire to stop doing clinical work has definitely been accelerated by COVID, which in my view is really the penultimate systemic barrier. When patients are really upset about not being able to see grandma, I genuinely don't know what to tell them. Me too? That's not therapy though and I didn't go to school for so long to tell them the same thing a mildly insightful 8th grader could. There aren't many good clinical "outs" for a lot of what is distressing my present patient population. These factors are always there, but its become more apparent to me.

Related to this....its honestly boredom. Yes, every one of us is a unique special snowflake. Patients are also all the same in many ways though. This is a big part of what pushes me to research. If I want to do something wildly different one day, I have that freedom.

I usually respond with "yeah, it sucks" and then ask them what they want to do to be responsible for their own happiness? The number folks that tell me they miss grandma, but won't pick up a phone and call her is astounding. Practical goals people. We ain't starving Rwandan refugees living in a slum. Surely there is something to watch on Netflix and you can hang out with grandma in a few months.

FYI, OP, building on what PsyDr said, a hazard to your social and professional life is losing patience with people who complain about trivial B.S. when you listen to people with real problems all day. You may listen to a person dying of a terminal disease, trauma, or abuse one hour and then attempt to empathize with a 17 y.o who is sad because their parents got them a Toyota for their birthday and not the Lexus they wanted the next. I find it harder to see the latter type of person. I was once consulted to see a patient who was distressed because the rehab hospital was serving bacon with nitrates in it. That took some mental energy to get through.

 

[cara susanna]

The population that burns me out the most is chronic pain. Like, give me a BPD patient over a chronic pain patient any day*.

*I know that BPD patients often have chronic pain, so in that case it depends on how prominent the pain is clinically.

 

[niceman]

The population that burns me out the most is chronic pain. Like, give me a BPD patient over a chronic pain patient any day*.

*I know that BPD patients often have chronic pain, so in that case it depends on how prominent the pain is clinically.

As someone who had chronic pain and actively avoids working with that population, I agree.

 

[Sanman]

The population that burns me out the most is chronic pain. Like, give me a BPD patient over a chronic pain patient any day*.

*I know that BPD patients often have chronic pain, so in that case it depends on how prominent the pain is clinically.

Ironically, I loved my chronic pain rotations and hated BPD stuff. I did, however, train when pain was the 5th vital sign and we were handing out opioids like candy. I can imagine it being a bit of a dumpster fire now.

 

[cara susanna]

As someone who had chronic pain and actively avoids working with that population, I agree.

I have a chronic pain condition and actually left a social media support group for it because the group was burning me out.

 

[DynamicDidactic]

a social media support group

 

[AbnormalPsych]

The worried well who barely if at all meet diagnostic criteria for anything are really making me unhappy with the job right now.

I have people self-harming, dying, overdosing, failing organs, horrible traumas, debilitating SMI, and they can't get in because ****ing Barbara McMoneyBags in her huge mansion is sad that she has eye strain from WFH on the laptop and wakes up in the middle of the night once a week and takes a whole 15 min to go back to sleep.

My solution is that I have picked up my side work and am trying my best to do more of the things that I like in the clinic and more admin work.

 

[niceman]

I have a chronic pain condition and actually left a social media support group for it because the group was burning me out.

That is how I feel about most social media groups in general so I am glad you left.

 

[cara susanna]

Haha, it's just a support group that is through social media (specifically in this case, Facebook). So not regular meetings or anything, just people posting and getting support.

 

[deleted106747]

The worried well who barely if at all meet diagnostic criteria for anything are really making me unhappy with the job right now.

I have people self-harming, dying, overdosing, failing organs, horrible traumas, debilitating SMI, and they can't get in because ****ing Barbara McMoneyBags in her huge mansion is sad that she has eye strain from WFH on the laptop and wakes up in the middle of the night once a week and takes a whole 15 min to go back to sleep.

My solution is that I have picked up my side work and am trying my best to do more of the things that I like in the clinic and more admin work.

I’ve always seemed to find that Barbara McMoneybags shows up with eye strain and I find out a few sessions later that she really is struggling with trauma from an assault that she never disclosed before. That’s more my reason for picking up admin/teaching, varying the program.

 

[thebalmofhurtminds]

The population that burns me out the most is chronic pain. Like, give me a BPD patient over a chronic pain patient any day*.

*I know that BPD patients often have chronic pain, so in that case it depends on how prominent the pain is clinically.

That's so funny, I love working with chronic pain. Could do it all day. BPD exhausts me instantly.