Five things therapists get asked by their friends

Many people get asked about their careers. But since I became a psychotherapist later in life, it has been fascinating to see what people ask me about it - especially, say, versus my other careers such as being a software engineer or a writer. Here are some of the things that well-meaning friends and relatives have asked me:

1. Are you analyzing me?

No, I am not analyzing you. I am not that smart.

I realize where this misconception comes from. We are trained to listen and pay attention to people more closely than most professions. And we do assess and treat people based on what we observe. But that doesn't mean we've suddenly gained some kind of X-ray vision about your psyche. So do I make assumptions about you based on, say, how you hold your fork? I wouldn't worry.

2. You work with crazy people all day, right?

First, the vast majority of my clients are extremely normal (and very nice) people who suffer with issues many of us share: anxiety, depression, loss, relationship problems, etcetera. And they have the good judgment to seek out new skills for dealing with them - skills that would benefit everyone. Second, people who suffer from what we call "severe or persistent mental illness" are more likely to be treated in agency or hospital settings versus a private therapist. Many of them are not "crazy" either.

My clients, however, often do work with crazy people all day. Or so they tell me.

3. You must be a “paid friend”

I certainly hope not, because friends are often the worst possible resources for mental health care.

Say, for example, a kid is acting out in school. That family's friends will probably have no lack of input on how to “motivate” this kid, when the real answer may involve doing a psych eval and uncovering a treatable neurological problem. Likewise, if someone has a fear, most friends would recommend mindless bravery (which doesn't work) instead of cognitive-behavioral therapy (which does). I am constantly being reminded that training and expertise really do matter.

4. Do you make people do uncomfortable things?

You've been watching too much reality TV. We never force people to do things they don’t want to. Even the most challenging forms of therapy, such as exposure therapy for fears or OCD, always take place at a rate that *they* choose, with lots of safety and support. In my experience getting well is normally a lot easier than staying ill, and most people emerge from therapy sessions feeling better than when they came in.

5. My last therapist was cold and distant. Or talked too much. Or asked me too many questions. Or whatever. Are you like that?

Our personalities vary like any random group of people. For example, I tend to be humorous and outgoing. Many clients like this, while others are more comfortable with a quiet listener. Some people prefer a counselor who has a step-by-step game plan for getting well (me again), while others prefer someone who can “hold space” for complex feelings. There is no right or wrong when it comes to people's preferences.

Which leads me to perhaps the most important point of all about this profession: we provide a service for people, like painters and barbers and lots of others. We do something that we are highly trained for, that hopefully makes most people feel a lot better. More than anything else I've ever done, serving them has been one of my greatest privileges. So keep asking away, I don't mind at all!