Britain’s Prince Harry has earned praise in recent days for speaking up about his personal issues with mental health, the need to not stay silent about emotions, and the benefits of seeking therapy.
Describing how he arrived at a breaking point in an interview with the Telegraph, he explained it was listening to other people’s problems and realizing he was unable to be as helpful as he wanted to be that pushed him to seek help.
“You park your own issues because of what you’re confronted with, and all you want to do is help and listen, but then you walk away and go, hang on a second, how the hell am I supposed to process this?”
He then added that for every three hours of listening to people, psychologists take half an hour to process it themselves with someone else. He’s right: one of the most important traditions within the mental health world. Therapists also need therapy.
We asked four psychotherapists with extensive experience in the field to open up about how they, too, use therapists.
David Lopez, practitioner for 15 years, Connecticut
David Lopez, a former president of the American Academy of Psychoanalysis and Dynamic Psychiatry, says there are a few different reasons why therapists will seek therapy.
The first is during the training process, when therapists in training will have a supervisor and often a therapist of their own.
“Typically, people who want to become therapists have an interest in connecting with people. When they are doing therapy that need needs to be redirected, to be tamed so that it does not get in the way of not being objective,” Lopez elucidates.
What needs to be addressed in training is something called “countertransference”, Lopez explains. While a client transferring emotions they would have for someone in their outside lives onto their therapist (called “transference”) is generally considered a good thing, a therapist transferring emotions onto their client is to be avoided.
If a therapist in training was orphaned young, they may emotionally react to stories their clients bring into sessions about parents and loss, for instance. The challenge for the therapist is then not necessarily to get rid of the feelings related to loss and parenting, but to become very aware of them and become intimately acquainted with these “blind spots”.
A common blind spot might simply be witnessing a patient struggle with some kind of grief and watch them cry: a therapist may want to go and hug them, and be their friend.
“You may wish to connect with a patient for your own need, instead of applying the tools that you have been taught. But they’re not paying you to be their friends, even if a hug in that moment may feel good to give.”
Elena Lister, private practitioner for 30 years, New York
“Shockingly enough, therapists are also people,” Elena Lister says, not without a considerable amount of irony.
Lister, a psychiatrist, analyst and professor who teaches at Cornell and Columbia universities, says that there is nothing particularly mysterious leading therapists to seek treatment of their own, beyond the initial training requirements during the early years. The answer is it’s life, and life’s trying and often painful events.
Lister herself sought therapy when she lost her six year-old child to leukemia. At the time, the help she found did not adequately meet her needs, she says. Identifying this lacuna in her own field convinced her to specialize in grief and loss, meaning she could seek to be there for others in a way she had not been able to professionally find herself.
Treating patients (including patients who are therapists) who are undergoing such extreme pain means developing an ability to leave what has happened during a therapy session in the room once it is over.
“You have to be able to keep it in boundaries. Some people have gone through such tremendous suffering. You have to be fully present in the room. But if I am going to do this, it’s my mandate to not carry it to the next room. I have a duty not to.”
To keep herself upbeat and in the right mental space for all her patients, as well as of for herself, Lister says she has to do “all sorts of things. I talk to friends, to myself, to my husband. I exercise, I meditate”.
Leslie Prusnofsky, private practitioner for 35 years, New York
Leslie Prusnofsky, a psychiatrist, psychoanalyst and faculty member at Columbia University, says that in some ways treating therapists is no different than treating non-therapists.
“You’re dealing with a lot of people’s pain. Whether it is therapists or lay patients, pain is human, and human suffering is not unique to one group.”
But Prusnofsky says that treating therapists does sometimes come with its own particular obstacles.
“It can result in more walls that have to be pulled down,” he explains. This will be the case even if the therapist-patients are very willing to engage in treatment.
Part of the therapy process is trying to break through to things that are naturally being protected, he explains. There is “an unconscious resistance” that can be found in everyone, Prusnofsky says, but therapists who know the jargon may be even better than others at hiding the real root of their problems.
“Using the jargon is one of the cover-ups to stay away from the depths of what they [the therapist-patient] actually need to explore.
“If someone comes in saying they have a lot of ‘repressed anger’, you may find with time, the deeper you go, that the anger turns into sadness. What is revealed is a sense of loss or of deprivation that is harder for the person to deal with.”
David Forrest, practitioner for 50 years, New York
For David Forrest, a clinical professor of psychiatry at Columbia University, and a trained psychotherapist and psychoanalyst who also holds a private practice in Midtown Manhattan, one of the most interesting – and tough – questions that therapists go to therapy for is when it’s time to call it quits.
Forrest, whose work includes research and teaching in the field of neurology, says that asking the question of when a psychotherapist should retire is a particularly fascinating one.
“To ask how does a psychotherapist know when it it time to hang up their spurs, asks us to define the mental capacities necessary to be a psychotherapist in the first place,” Forrest poses.
A surgeon may no longer physically be able to withstand the arduous hours, or may suffer from an injury that prevents them from operating, but so long as a psychotherapist’s brain is going, when do they know to stop? Doesn’t an older therapist mean a more experienced therapist, an attribute one would seek?
Memory loss or small mental failings can affect the mind as one gets older and negatively impact remembering a patient’s complex history.
But other things may start to go with age, too, Forrest says, elements that might be just as crucial to quality therapy-giving.
Deciphering what is funny and not, for example, sometimes morphs with age.
If someone contracts frontotemporal dementia, their sense of humor tends to degrade from the more elaborate sensitivities, Forrest says. A therapist with this kind of affliction may develop a new kind of sense of humor – that is less suitable in a therapy room.
“It [the sense of humor] would no longer be deadpan and dry. It would sink to slapstick and sadistic, and the brain would enjoy low-quality humor.”
“The pun is a low sense of humor,” the psychiatrist explains, helpfully.
As for Forrest himself, a veteran of the profession: have decades and decades of practice and inquiry into the human brain started to wear him out? Such a question is one more adapted to younger professionals, he responds.
“For someone like me, there is no question of burnout.”