Clinician Thoughts

It’s been a while. Yadda yadda yadda.

Won’t be cross-posting this to Facebook; this is mostly for me to write my current thoughts and handwriting will take too long and require too many hand cramps.

Today’s supervision topic was about how I was feeling with clients and work and if those feelings were a result of my becoming a better clinician, my feeling burnt out/jaded, and/or my feeling depressed. To be honest, I don’t think we found an answer and came to the conclusion it was probably a mixture of all three.

The first is that I was able to recognize how I was showing up in a session with a client and that I had acted in a childish manner (without the client knowing). Even though I knew I could get away with it (acting childish and the client not knowing), the fact that I knew I had acted in such a manner did not sit well with me.

The second is that I noticed I was offering to meet with clients less often or even offering them to discontinue therapy all together. I told myself it was because there wasn’t more for us to do in therapy, that the goals I wanted for them didn’t seem realistic and to be honest, weren’t really goals they had expressed themselves of wanting. Who was I to impose my wants into their treatment? Besides, they were stable and managing their basic needs. But then I started to wonder if I was pushing them away because I just didn’t want to work with them anymore, that I was too tired of trying to find a way to help them improve their quality of life (knowing full well that it would be with my idea of ‘quality’) when they just weren’t in a space to help themselves to do it. So why? Why keep trying? And why was I moving into this frame of mind in the first place? Was I thinking like this because I had finally begun to realize that treatment goals in community mental health were much more basic than I had originally thought they were supposed to be?

And the final nail on the coffin is that I spent all of today in an irritable mood. I had slept enough the night before. I ate. I was hydrated. Yet I was so disconnected from everything that was occurring around me with no seemingly good reason why. Though to be honest, I had been feeling quite irritable at work for a few months now and thought it was just me finally wising up to all the shit that people did at work.

I still don’t know what’s going on. I hope this feeling is temporary. I know I can do a few things that will help and I also know I’m working on a few other interventions to see if that will make some difference. I won’t really know for sure but I guess first things first is that I need to start checking in with myself. I had missed all the signs that were indicators of my not feeling well (e.g. eating and craving more sweets, feeling more irritable at work and in life, etc.). As a colleague once told me, I need to be friends with my brain.

The Return of the Prodigal Son

The Wikipedia version

The TL;DR (too long; didn’t read) version of that parable is that there was a son who wanted his inheritance early. He squandered it away and went back to his father for forgiveness.

I share this parable to reflect and to acknowledge my good service today. One of my clients drew the parallel that they were the Prodigal Son and their inheritance was their relationship (or lack thereof) with their child. My client felt they lost their child due to their child’s refusal to have a relationship with my client. My client felt an immense sense of guilt for they felt that they had done something wrong to make that child go away, to become “lost.”

I chose one part of the parable to reframe today. I asked my client about the money the Son had squandered – where did it go? My client focused on the Son, telling me that the Son had lost the money and no longer had it. I asked again – Think outside of the Son – where did the money go? My client wasn’t following and was still focused on the Son and the Son’s actions.

I pointed out that the Son’s money left his possession but entered into others’ lives, that he paid for the services he rendered, the food he ate, the parties he threw. His money supported their businesses, their families, their services, their labor. While the Son may have “lost” his money, his money was still out there to serve another purpose. Yes, it was sad that the Son squandered his wealth, but the silver lining is that his money helped many others.

That’s what my client’s child was doing. While their child was not in their “possession,” they could still serve another purpose elsewhere. They were not lost, they were doing good work somewhere else. Watching my client’s face change as we made the connection was so rewarding. In that instant, in that moment, I was reminded of why I do what I do. I could see the wheels turning in my client’s head. That guilt my client felt was starting to lift – chip away little by little.

That moment when it clicked made everything worth it all.


n. a fundamental truth or proposition that serves as the foundation for a system of belief or behavior or for a chain of reasoning.

I have very strong principles, or at least I attempt to adhere to them quite strongly. When I fail to uphold them, I feel as if I have failed. That I am a part of that injustice against the world. Why should I benefit from one advantage? If I have spotted an advantage and I utilize it, how is that okay?

Am I paralyzed? Do I suffer from “analysis paralysis?” If so, how much of that phenomena takes a hold of my life?

Is there anyone who struggles like I struggle? Who lacks the same self-compassion that I lack? How are you supported? What keeps you held together?

I often wander between the space of too much and not enough. I struggle with the in between. If I turn in half-assed work, I belittle my achievements and never acknowledge that half of the work was at least completed. Because I can’t. Half-assed is practically no-assed work. How can I allow my reputation as this “bright” and “smart” individual be marred by this piece of work? How can allow myself to accept something so shoddy?

If I am going to commit, I must commit fully. What are these baby steps that I hope to instill in my clients? Do they believe me? I don’t believe me. Do they believe that I believe for them even when I don’t believe for me? Does it work like that? Can it work like that?

What is compassion? What is forgiveness? How do I do those things while not letting myself off the hook? Is there such a thing as a “Cheat day?” Can I survive with a “Cheat day?”