HealthyGamerGG - 5 Therapy Pitfalls You Need To Know

Episode Date: February 10, 2023

💔 Struggling with mental health? 🧠 Don't fall into these common therapy pitfalls! 💡 Dr. K reveals the top 5 mistakes to avoid in therapy. 🙏 Empower your journey to wellness with this eye-opening episode. Learn more about your ad choices. Visit megaphone.fm/adchoices

If you have a problem in your own life, actually get it fixed. You don't have to pick a profession or a career to fix an internal problem that you have or even a diagnosis that you have. There are many people that will tell you this is secret to happiness, that is secret to happiness. But if you want to know how to live the life, you must understand how your mind works only. So check out Dr. K guide. Link is in description, huh? Sometimes people tell us we'd make great therapists. We're that friend who always listens. We're that friend who really is there for people.

We will drop everything that we're doing to support someone in need. And we're very good listeners. We're like really into psychology. There are all these different things about us that sometimes make us feel, or other people will tell us, that we're gifted. And we're naturally suited to become therapists. The big challenge is that unless you're careful, the very things that may make you a gifted therapist can actually

cause you to become a terrible therapist. Those same things that can make you a good friend can actually lead to you having lots of problems as a therapist. So I'd love to share with you all today is five very common kind of pitfalls or problems that I see with people who seem to be well suited to be therapists, which will actually sort of cause them more problems as they proceed into the profession. So the first thing that I want to talk about is people who derive a lot of value out of helping other people. So some of us have this kind of identity of being a helper, right? Like, I'm a good person. And part of what makes me a good person, part of what makes me a valuable friend is that I'm there for other people. When other people are having a crisis, I'm kind of there

for them, I'm listening to them, I help them get through it. This is what makes me a really valuable friend. And if this makes me a valuable friend, certainly it'll make me a good therapist, right? The tricky thing is that if we derive our sense of identity or our sense of value from doing good for other people, that can actually be somewhat of a pitfall if you're a therapist. Now, you may be thinking, wait, how on earth does that work? Because is it the whole point of therapy that it's a profession where you get to help other people? And if I'm someone who's a helper, am I not naturally suited to be in a profession where I'm a helper? You may think so, but let's kind of look at it this way. So if you're a helper, and that's who you are, right? And you help other people because you're like, yeah, I'm a good person. I do good in the world. That becomes a part of your identity. What happens if you have an unsatisfied patient? So if you have a patient who says, hey, you're not helping me or you're making things worse, or they don't return your phone calls, or they ghost you after the first appointment, how does that make you feel about yourself? What if they start seeing a different therapist? Or what if they start telling you, oh, yeah, this isn't really working for me. I want to work with some friend of yours. Or what if they start quoting Dr. Kay in your therapy session? Oh my goodness, they started watching this guy on the internet.

And they're learning so much from him. How would you feel as a therapist? How would you be able to handle that? If your identity is that of a helper, because sometimes we'll run into patients. Like there's a great paper called The Hateful Patient, in which there's a psychiatrist, a guy named Jim Groves, who talks about certain patients who constantly need help. And what they'll do is they're help seekers, help rejectors.

And so what they'll do is they'll ask for your help, but whatever suggestions you give them, they'll actually discard. Oh, that won't work for me. Yeah, that may work for other people, but it's not going to work for me. You may know people like this in real life who are always needing help and always rejecting it, right? And the more you do, the less it helps. So you've got to be really careful because being a therapist is about being secure in your own identity, irrespective of the patient's response.

If your sense of value comes from helping other people, what that also means is that as a therapist, if someone doesn't feel helped by you, your own sense of identity will feel threatened. And as your own sense of identity is based on how the patient reacts, that's going to open you up to all kinds of manipulation or even things like burnout. Because now when someone isn't getting helped, you're a helper, right? I am a helper. I'm the one who helps. So you want to try harder and try harder and try harder and try harder because you've got to help them.

Because that's who you are. You're a helper. That's number one. Number two, kind of related to that, is that you have poor boundaries. So when I derive my sense of identity, out of health, helping other people. I feel really good about myself. So I remember this happened to me when I was younger where a friend of mine called and was in crisis. And I spent the whole night talking to that friend. And I helped them through the crisis. And Dawn came up the next day and I felt so good

about myself. They were so appreciative. Man, like we did some real good work today. It was great. Right. And I was tired the whole day. I got to sleep an hour or two and I had family over for the holidays at the time. And I was kind of a zombie the next day. And then sometimes people are calling me and they're like, hey, I really need your help and you drop whatever you're doing to help them. Sometimes we have family members who have conditioned us to behave like this, and we're kind of the emotional sponge for the family. So if you've got poor boundaries, you've got to be super careful because that may feel really gratifying.

Because even making a sacrifice for the sake of someone else makes you feel really good about yourself, right? So we're willing to compromise our own boundaries because of the importance of it. We're really helping another human being. So to hell with my boundaries, because I'm doing good work here. And that works totally fine. It can even be toxic and lead to burnout even if you're a friend. That works fine when you've got like two to five people who are emotionally supportive for on you. But what if you've got a panel of 60 patients? What are you going to do then?

What if they call you at 9 p.m.? Hey, I just need to talk. What are you going to say? No, sorry, I'm busy. Think about it, right? So a key part of what makes someone a very, very valuable therapist's friend or friend who's emotionally supportive can actually get you into trouble if you become a therapist. And once again, what you're going to have to do is, do a lot of unlearning because your instinct in that moment is going to be to help that person. But if you help that person, you're going to be headlong into burnout and compassion fatigue. Third thing to consider, sometimes people are interested in becoming therapists because they love psychology. And this is fantastic. I think it's wonderful if you like psychology, and maybe you should

consider being a therapist. But remember that part of therapy training is not just studying the parts of psychology that you like. And this is the thing that I've noticed about a lot of people who are fascinated with psychology is they're really only fascinated by whatever they're impulsively driven to. So I may be fascinated by watching, like, YouTube videos that have a ton of views on psychology, because that's entertaining. But it's not like I'm reading textbooks about psychology. So you've got to be super careful because even if you're interested in psychology, that doesn't necessarily mean that you're going to be a good therapist or that you'll even enjoy being a therapist. For the first thing you have to consider is that you have to learn a lot of psychology that may not

be naturally appealing to you. And while some of it may be appealing to you, and that's great, you have to learn a bunch of other stuff. And I've seen this actually, like, kind of the downside of this is when therapists become enamored with a particular kind of psychological approach, they can actually do their patients a disservice. Because what they're, they get so excited about a particular formulation. So I once had a colleague who was convinced that all of the men that they worked with were closeted homosexuals. And they were so enamored with this theory of like, you know, that 90% of human beings are bisexual, that they were like, this was so exciting to them and they'd read

so much about it. And then the patient walks in and then secretly like the therapist in the back their mind is like trying to think about, okay, how can I understand this person's like deep homosexual repression? Because this person is bisexual or homosexual. And so the key thing that you have to remember if you're a therapist is it's not about what you find interesting. It's about what helps the patient. And sometimes our own desires can actually get in the way of that. So even if you're interested in a particular branch of psychology, you may study that psychology and that may be really fantastic. I know I've certainly struggled with this as well. So I'm really into complementary alternative medicine and meditation and mindfulness.

And sometimes I've actually done my patients a disservice by sort of suggesting it over and over and over again. Thankfully, I learned my lesson to where now I'm sort of like, hey, you can do it if you want to, but if you don't want to, that's totally fine. Here's what else I can offer you. So a big part of being a therapist is not about the psychology that you're interested in. It's about the psychology that a patient needs. Four thing to consider is that therapy can seem really fun and exciting even. Like maybe you've been helped by a therapist and there's like, you've had some really deep sessions and that's great. Maybe you all are familiar with some of our content and things like that.

And that sounds kind of like exciting and challenging to help people and do something good in the world and all that kind of good stuff. There's so many interesting theories that you can learn, right? That's all like very exciting. People don't realize about being a therapist is that a lot of it is like really small administrative stuff. So if you suck at like turning things in on time, administrative stuff, paperwork and all that kind of stuff, I don't know if you actually want to be a therapist.

because what you don't see, even when you go see a therapist, is all the stuff that they do before and after the visit. Just to give you all an example. Scheduling, scheduling, right? Rescheduling appointments. Doing billing, doing charting, filling out medical records, doing diagnoses, talking with insurance companies, at least here in the United States. There's all this stuff around RVUs and meeting productivity requirements and licensure paperwork in different states or different cities or different countries. And keep in mind, since you are a therapist, and since you're actually dealing with patients, this stuff is actually even more important and they're more strict about it.

Because we're dealing with people who are vulnerable. We're dealing with people who have mental health diagnoses, right? Psychiatric illnesses. So your documentation has to be spot on. You have to make sure you're compliant with all the privacy regulations. So you've got to be really careful about sending emails and texting and all that kind of stuff. It's all patient information, right? So you can love all the other parts of psychology.

Gene, I think it's great. I'm not saying that you shouldn't go into therapy. I'm just saying if you're thinking about being a therapist and you suck at administrative paperwork, either you're going to run into trouble, you're going to get sued, or you're going to have to get really good at it, right? Because I can guarantee you if you're not good at scheduling patients and two patients show up or you were taking a day off and you let three of your patients know. But that fourth patient, their mailbox was full so you couldn't leave a voice message. So you called and they had no idea and they show up to your office on a day that you're on vacation, that's going to be a mess.

So be careful about the administrative work. That's point number four. And the last thing to consider, and this is something that I see far too often, is that a lot of people are interested in becoming therapists because they themselves have suffered. And it sort of makes sense. And this can actually work really well.

Like your inspiration for wanting to become a therapist and helping other people are your own sufferings. And that can be really good inspiration. Don't get me wrong. So a great example of this is Dr. Marshall Inahan. So this is a psychologist who suffer from borderline personality disorder. she's been pretty vocal about her journey. And so she, like, became a psychologist,

learned all the best techniques for borderline personality disorder, and found that none of them worked well enough. Or it felt like something was missing to her. I'm kind of paraphrasing here. And so then she started studying mindfulness. And she discovered, wow, like this stuff really helps me and seems to, like, supplement everything that I've learned in therapy and things like that.

It seems like something's really missing from therapy. And that's mindfulness. And so she learned mindfulness, got a lot better herself, and then incorporated mindfulness into psychofinding, therapy, develop something called dialectical behavioral therapy, which is now one of the leading evidence-based treatments for the diagnosis that she has, borderline personality disorder. And so there can be really good reasons or good outcomes if you suffer yourself to become a therapist and maybe you can enhance the field and you can be like Marshall Inhan.

But you got to be super careful. Because once again, becoming a therapist isn't about you. It's not about your struggles or your suffering. It's about the patient, right? And if we're going to sort of learn a little bit about ourselves, and this is where things can get really tricky, because a lot of times if we struggle ourselves, we don't want to be the patient, right? Like, it's kind of demeaning. Like, I'm not the person who needs help. I'm going to be the helper.

I'm going to learn about this myself. I'm not going to take anyone else's help. I'm going to go become a psychologist. I'm going to study this stuff for five years. I'm going to become an expert in my own diagnoses. I'm going to understand it in and out, and then I will be able to help myself. then I'll never need to be a patient because I've struggled with this and I'm going to conquer it.

And so a lot of times what we end up doing is becoming therapists in order to conquer our own internal struggles. And like I said, Dr. Linnehan's case is a really good example of how this can work. But to be honest with you, there are a couple of huge problems with that. The first is that it's way more cost-effective and time-efficient to actually be the patient.

If you have a problem in your own life, actually get it fixed. You don't have to pick a profession or a career to fix an internal problem that you have or even a diagnosis that you have. I think from an efficiency standpoint, being a patient is actually better. The second issue, and this is more subtle, is that if you sort of aren't willing to become a patient, think a little bit about why that is. If you want to conquer your illness by becoming a therapist instead of being a patient,

what do you think about patients? What kind of judgment do you have about patients? And as you are very driven, right? you're going to go and study at a very reputable institution. You're going to become the best therapist to treat this condition because it's what you suffer with. Why don't you become a patient? Because you think patients are kind of icky, right? That's what you think? That's why you can't be a patient yourself. And so as you lean into the idea that you're going to conquer this and you're not going to be weak, you're not going to be weak, you're going to be strong, you're going to study, you carry that with you. And then what kind of therapist are you going to be if you carry around the idea that patients are weak? And so it can be so devastating because oftentimes if we struggle our The last thing that we want to do is be a patient. We want to get control of the issue. We want to conquer the issue. We don't want to be the victim.

We don't want to be the patient. We want to be the conquer. We want to be the doctor. We want to be the one who's got power and is in charge. But as we give in to all of those things and select a career based on it, we may actually be setting ourselves up to miss one of the most fundamental things that you need to develop as a therapist, which is compassion for the patient position. compassion and non-judgmentalness for someone for having mental illness in the first place.

And this is where you say, okay, Dr. K, then what do I do about it? Right? What you have to do is let go of the idea that being a patient is weak. And you're like, okay, cool, Dr. K, I'm going to go ahead and do that. And that's when I tell you, okay, if you want to do that, the right way to do that is to be a patient, right? Go to therapy. Work with someone who can help you resolve your own difficulties and your own shortcomings and your own feelings of weakness. And then, paradoxically, you'll be far better suited to become a therapist. But just to summarize, a lot of us are really excited about the ideas of becoming therapists, right? Because we're interested in psychology. We want to help people. And by the way, we're talented at it. Right? We're gifted.

People tell us so. Everyone's like, man, you're such a good listener. Man, like, you're always there for me. And we derive a lot of sense of pride and identity. Sometimes we even struggle with our own problems. I've struggled with depression. So I'm going to become a therapist. And all those things, all of these things can be good. Don't get me wrong. Like an interest in psychology is definitely good for therapy if you want to become a therapist. caring about other people, definitely good for becoming a therapist. But paradoxically, a lot of the things that may make us think we're suited towards therapy can actually set us up to run into all kinds of problems, all kinds of pitfalls as therapists. So a couple of things to think about, first is your sense of identity. So is your self-worth dependent on helping other people?

Because what that sort of means is it opens you up to manipulation. Because if a patient learns, oh, hey, like subconsciously, by the way, that if I express discomfort towards my therapist, they'll, like, become an absolute doormat, right? Give me more ADHD meds. You're doing such a terrible job. I need a referral on my adderol. Give it to me. Otherwise, I'm going to start crap talking to you.

I'm going to tell you how little you're helping me, and I'm going to cry, and I'm going to throw a temper tantrum. Give me that Adderall. Then I'll tell you you're doing a good job. If your sense of identity is based on helping other people, you're actually opening yourself up to all kinds of problems. If you want to be a good therapist, your sense of identity should be completely independent of the patients. Number two, kind of related to that is you've got to have good boundaries.

Because remember, the patients that you're going to be dealing with if your therapist are going to have emotional needs, right? Like, that's the whole point, is that they are depressed or they are potentially bipolar. Or they do have borderline personality disorder. Or they do have dependent personality disorder. Or they do have narcissism. Or they have addiction problems. And if you're not careful, they will run all over your boundaries. You need incredibly strong boundaries to stay healthy and avoid compassion, fatigue, and burnout as a therapist.

Third thing to consider is an interest in psychology. Because if you're not careful, what you'll do as a therapist is get so far into a particular range of psychology that you'll start leaning into what you find fascinating instead of what is helpful to the patient. Fourth thing, and I hate to say this, but if you want to be a successful therapist, you have to be really good at crappy administrative work. Because for everything that you don't see, like so much of a therapist's, like, so much of a therapist, life is note-taking, billing, phone calls, paperwork, licensure, all that kind of crap. And you really have to stay on top of it because we're dealing with patients here so you really can't screw up.

And the last thing to consider is that some of us choose to become therapists because of our own personal struggles. And while that can end up really well, honestly, in my experience, the majority of people who become therapists to fix something in their own life almost do themselves a disservice and can sometimes even do a disservice to their patients. So even if you're gifted, which is fantastic, even if you love psychology, I'd be a little bit careful about defaulting to becoming a therapist. And if you do choose to do that, which I think is a wonderful profession, I wouldn't discourage you. The real reason we're sort of making this is to sort of share with you some of the potential pitfalls, because if you're kind of like gifted at becoming a therapist,

you may paradoxically have to work harder to set up additional boundaries, to unlearn particular behaviors, and to really work on your own identity. So even after watching, this if you've decided, hey, I'm gifted at this and I want to be a therapist. That's fantastic. All the more power to you. Hopefully with this knowledge in hand, you'll actually be able to use it for your own well-being as well as the well-being of your patients.