Both Sides of the Couch: A Therapist's Therapist

By Jordan Mayfield, LSCSW, LCAC

A sign of a good therapist is that at some point in their life they have seen a therapist themselves. It’s hard to trust a doctor if they have not also at one time been a patient. Knowing what it feels like to sit on the “other side of the couch” is only one-way therapists can connect with and build rapport with their clients. Other important components of a therapeutic relationship are validation, trust, and integrity. The relationship between client and therapist is one of the most vulnerable relationships that exist, but it is also unique in that in some ways it is very one sided.

Clients often feel extremely close to their therapists. This level of intimacy is important, so that the client can process and work on at times difficult and uncomfortable issues in their lives. However, it is the therapist’s job to remain mostly objective and be a sounding board so that clients can determine what is best for them, not what the therapist thinks is best. In fact, and contrary to popular opinion, therapists rarely if ever offer advice or opinions. Our job primarily consists of reflecting back to clients what they are experiencing, validating this experience and offering alternative ways to think about or respond in certain situations. We also spend a lot of time providing psychoeducation to help clients make informed decisions for themselves.

Over the course of my life, I have had a handful of therapists. And the ones that I felt the most connected to and thus, were most helpful to me utilized self-disclosure as part of their therapy process. Self-disclosure is when a therapist divulges information about themselves in a thoughtful way to support their work with a client and/or to build rapport with a client. Self-disclosure is NOT becoming friends with a client and having a back-and-forth conversation during a session in which both parties are contributing information about themselves.

There are different schools of thought about what is or is not appropriate self-disclosure. In one training experience I had, self-disclosure was not seen as an appropriate intervention or part of the therapeutic process at all. This is more in line with older school psychologists in which the therapist is a blank canvas and that a client knowing anything about their therapist would disrupt if not destroy the client’s progress. I personally have seen therapists that I would put in this category, and they did not work for me. I very strongly felt a power differential at play. I was the defective and sick one and the therapist was the all-knowing “normal one” that I was supposed to follow. On the other end of the continuum, I have seen therapists that have talked so much about themselves that the session leant toward being completely unhelpful to me and more like a social gathering. Self-disclosure and how it is used is a delicate balance.

We know that talking openly about mental health issues helps reduce stigma, however in the field of psychology itself there is a pervasive belief that mental health professionals, especially therapists, should not disclose their own mental health struggles. In the most comprehensive study of faculty, graduate students, and interns in the field of psychology has found that 80% of these individuals have experienced mental health struggles at some point in their lives and 48% have a mental health diagnosis (The Conversation). Being open about a therapist’s own mental health issues, in a therapeutic way, can help normalize mental health treatment and recovery and give clients hope that their mental health struggles do not have to serve as an obstacle to develop a happy and fulfilling life. Additionally, “having personal experience with mental health challenges reminds us why our work has meaning and is worth the struggle: to help and improve the lives of real people dealing with real traumas and real emotional struggles" (The Conversation).

While I have had several therapists that I have found extremely helpful, useful, and exactly what I needed at that time in my life, there is one therapist who I felt provided me with the most helpful support at a very difficult time in my life. I saw this therapist for several years. And like many clients my life got busier, I got better, I missed an appointment and never rescheduled. I finally was in a space where I felt I could manage my life and my symptoms on my own while utilizing my existing support system. I found out about a year after this that my therapist had died somewhat unexpectedly. This news hit me hard. And while I don’t regret the ending of my process with her, I do wish I had been able to adequately express just how meaningful and helpful she was to me.

Dear Therapist,

Thank you. I appreciate all you taught me that I now have been able to pass on to others who are struggling. The number of lives you have touched through your work will be never ending. There is no greater gift you can give another human than to hold space for them and provide the support and validation they might not have otherwise received. Thank you for being this person for me.

Sincerely,

Jordan

Addressing the stigma around mental health is a public health issue. Eliminating this bias is paramount in getting people the help and support they need. Normalizing these symptoms and need for support is something therapists can do by becoming more open about their own mental health struggles. People experiencing mental health symptoms and diagnoses should not be “othered.” They should be seen for what they are, human.