The role of a psychotherapist can be isolating, lonely, and, frankly, weird. What better way to survive this ambiguity than in a supportive community with other mental health professionals trucking along this well-traveled highway who 'get it?'
Being a therapist is weird. Some days, it can feel like we’re cruising along the open road, while other days, it feels like we’re truckers on the last stretch of a long haul. We know we need to keep our eyes on the road and our attention sharp as fatigue sets in. I remember hearing at a conference once that therapists and truck drivers are both at an elevated risk for chronic lower back pain. Both tend to sit for long hours with low-grade tension (and sometimes not so low-grade!) and a need to hold close attention.
We talk with our clients for hours on end, and while it can be deeply meaningful work, it can also be ironically lonely.
We have theories upon theories about how the whole thing works, but the science is far from definitive. We read books upon books about the science of psychopathology and technique, but the day-to-day practice of psychotherapy can feel more like that of improvisational theater or jazz.
Therapists deserve community, compassion, and protection
The relationship we have with clients is unlike any other. It's hard to think of similar relationships in our culture. It’s somewhat comparable to that with a barber, hair stylist, or any trusted professional, but it’s also quite different from those, a bit more one-sided, but also real and important for the therapist. We care deeply about our clients, and of course, we’re paid for our work - it’s hard and requires detailed and careful navigation of relationships, culture, trauma, billing - the whole thing. We’re doing much more than being a warm presence, but even that is a big deal and not easy to maintain day in, day out, hour after hour.
Overall, it’s good that being a therapist is weird. Let’s keep it weird. Therapists who are more able to lean into the ambiguity of our line of work, let go of perfectionistic responses to that ambiguity, and plainly embrace the weird are more resilient to burnout, loneliness -- that whole gnarly cycle (Holden & Jeanfreau, 2023; Wittenberg & Norcross, 2001). We need to protect ourselves as therapists as we work in ambiguity.
In a profession where our work can be so ‘weird’ and ambiguous, perfectionism is an occupational hazard. It can be fatiguing, for one, to work through the lens of perfectionism of ourselves with clients. It becomes of vital importance to recognize how perfectionism can disconnect us from each other (Rnic et al., 2021). Especially in training, the more we are able to embrace self-compassion amidst the ambiguity of learning, the better things go (especially for us perfectionists) (Richardson et al., 2020). And funny enough, the most effective therapists also tend to be the ones who judge themselves to be less effective or, put another way, humbly recognize their own imperfections (Constantino et al., 2023). Weird.
A therapist-run decentralized autonomous organization (DAO) is underway
Forming DAO is weird. Within a few months of forming the DAO, we’ve been collectively applying these skills of self-compassion (DAO-compassion, perhaps?) as we press into the world of ambiguity that is forming a DAO. And it must be weird if we are authentically leaning into the ambiguity of it all: there are no set paths for us apart from the received wisdom from traditionally structured organizations. Which parts of that tradition are useful, which are unnecessary or even hindering the pursuit of our values?
But what is a DAO?
First of all, WTF is a DAO? How do we go about working as a decentralized group? How can we show up imperfect? How do we build strong relationships that allow for a healthy and effective DAO to emerge? How do we work through tough conversations and really embrace the richness in our diversity of backgrounds and identities? It’s awkward; it’s ambiguous. We are encountering all these issues. We are engaging in deep reflection about shedding preconceived notions and thinking critically about the “normal” practices many of us have experienced in our careers working in mental healthcare.
A compassionate community of therapists has emerged
I know becoming part of the DAO has been a moving process for me. To be in a safe community of therapists who share common values around the sacredness of the psychotherapy space, the deep responsibility of decolonizing psychotherapy, and the calling to take up an antiracist ethic. A community that also values pushing into novelty and innovating new ways of protecting and supporting therapists and psychotherapy from the ground up.
As we’re firing up some of the different services TherapistsDAO offers, I had the opportunity to create a word cloud depicting the most common words used across our Slack channels. This is such a healthy, warm, and collaborative set of words - and it does capture what the relationships in our community actually feel like. DAO-compassion in action:
What yet unknown opportunities beyond the clinical room lie ahead for a bunch of therapists working collectively, creatively, and collaboratively? Watch out! We are hauling some serious freight.
10-4, good buddy. Hope to see you on the open road.
Constantino, M. J., Boswell, J. F., Coyne, A. E., Muir, H. J., Gaines, A. N., & Kraus, D. R. (2023). Therapist perceptions of their own measurement-based, problem-specific effectiveness. Journal of Consulting and Clinical Psychology. https://doi.org/10.1037/ccp0000813
Holden, C. L., & Jeanfreau, M. M. (2023). Are Perfectionistic Standards Associated with Burnout? Multidimensional Perfectionism and Compassion Experiences Among Professional MFTs. Contemporary Family Therapy, 45(2), 207–217. https://doi.org/10.1007/s10591-021-09605-6
Richardson, C. M. E., Trusty, W. T., & George, K. A. (2020). Trainee wellness: self-critical perfectionism, self-compassion, depression, and burnout among doctoral trainees in psychology. Counselling Psychology Quarterly, 33(2), 187–198. https://doi.org/10.1080/09515070.2018.1509839
Rnic, K., Hewitt, P. L., Chen, C., Flett, G. L., Jopling, E., & LeMoult, J. (2021). Examining the Link Between Multidimensional Perfectionism and Depression: A Longitudinal Study of the Intervening Effects of Social Disconnection. Journal of Social and Clinical Psychology, 40(4), 277–303. https://doi.org/10.1521/jscp.2021.40.4.277
Wittenberg, K. J., & Norcross, J. C. (2001). Practitioner perfectionism: relationship to ambiguity tolerance and work satisfaction. Journal of Clinical Psychology, 57(12), 1543–1550. https://doi.org/10.1002/jclp.1116