The Myth of the Untroubled Therapist
Managing our personal lives in relation to clinical work
Dr Marie Adams
11 December 2023
Summary by Frank Kelley
Dr Marie Adams is a writer and practising psychotherapist with a research interest in how therapists’ personal lives impact their work with clients. Until recently she was on the staff at the Metanoia Institute, primarily on the doctoral programmes. She is now a visiting lecturer at a number of other training centres, including the Institute for Arts in Therapy and Education in London.
Before becoming a psychotherapist, Marie had a long association with the BBC, first as a news producer on the Today Programme and, more recently, as a consulting psychotherapist to news and documentary staff.
Her book The Myth of the Untroubled Therapist is a standard text on counselling and psychotherapy on training courses throughout the UK. The second edition, extensively updated to consider the impact of COVID-19 on practitioners, was published by Routledge in September 2023.
Therapists are not immune to the range of problems their clients experience, including divorce, bereavement, illness and depression. In her talk, Marie discussed the kinds of difficulties clinicians face, based on her research involving forty different practitioners from varied backgrounds, practising in a range of modalities – CBT, psychoanalytic, integrative and humanistic.
Marie talked about what she has learned about how therapists cope during times of personal strife, acknowledging that therapists are far from immune to the kind of problems with which we assist our clients. Therapists need to take a step back and consider their own wellbeing yet acknowledges some of the challenges that we face when trying to do this.
She had a complaint made about her, and dropped, soon after qualifying as a therapist. Her research was prompted by the conversations with her colleagues at that time. In those conversations they talked about their own personal difficulties.
Her research interviews with those forty people generated a lot of data. She asked about crises in their professional life, how they handled it then, and how they would handle it in the future. She did not define the term but asked if they had been depressed. About 10% had. Twelve people contemplated suicide and four made an attempt. About one in ten, unprompted, talked about sex in an off-putting way. It seemed that dissing clients was a sign of burn out.
Marie realised that she needed to be brazen in her interviewing while attending to the ethics of permission. While researching she maintained her discussions with her colleagues which also confirmed how difficult it is for normally open therapists to talk about the personal parts of their practice.
Later she began interviews by talking about her own difficulties. She thought she had left it at the door but realised that others had guessed what her troubles were. She learned to ask, at the end of an interview, what she should have asked about.
We know as therapists that nobody says we should be perfect. But we act as if we believe it and a lot of shame emerged from her research.
The psychoanalysts had the least self reported depression. However they did agree with Freud’s view that the value of analysis is converting neurosis into everyday unhappiness. One analyst said that her experiences helped her be more in tune with her clients despair.
These kinds of therapist anxieties interfere in our being with our clients. We also are not too good with our friends and families. Her interviewees talked about not being able to look for support for personal issues in the way they would with client work. In her research she found that these feelings led to her interviewees being evasive or resistant with her, unwilling to go to therapists they knew, or waiting for their supervisors to tell them to go into therapy.
In practice it may be more helpful for the people we work with to be supportive colleagues and friends. Marie found it helpful to read her gurus, RD Laing and Eric Berne. Carl Rogers has a commendable emphasis on being real and congruent. Doing something other than work can help but few of her interviewees took time out of work. One exception was a therapist who took three periods out of work. Not taking time out was the therapists biggest regrets.
There is a quotation from Samuel Beckett You’re on Earth. There’s no cure for that.
Thank you very much to Dr Marie Adams for the opportunity to discuss an important but little talked about aspect of our working and personal lives.