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For this four-part series, therapist.com sat down with Frank Anderson, MD, to talk about his experience in private practice. Anderson is a therapist, psychiatrist, author, and speaker with three decades of work specializing in trauma treatment. Here’s his advice on how therapists can manage the stress of day-to-day work in private practice.

I remember at the beginning of my career, I got so overwhelmed by the amount of pain I was sitting with on a daily basis. I remember coming home after doing inpatient work at the hospital and feeling totally overwhelmed.

Sitting with people in pain activates our own pain, which is why it’s so important to figure out how to take care of ourselves as therapists. Here are some strategies to consider.

Explore empathy through group supervision

Thinking about a client from a client’s point of view, as opposed to a therapist’s point of view, can be difficult, but it’s one of the biggest skills you can learn.

I’ll never forget this one client I was really struggling with. I was getting really irritated with her. When I went to a supervision group and I was asked to embody my client while somebody else played my role as the therapist, it was incredibly powerful. As soon as I embodied her, I felt the pain she was feeling on a much deeper level.

When you’re on the outside, you have a certain perspective as a therapist, and you think you know what clients are feeling or what underlying mechanisms are driving their behavior. Supervision groups are such game changers because they force you to get out of your own head by taking on the role of your clients.

Find a way to clear the energy

If you find yourself thinking about your clients after work, it’s a sign that it’s affecting you, and you need to release it. Another sign is that you’re irritable with your family after you come up from work.

I like to practice a little meditation in between sessions with each client. This basically involves clearing the energy I’ve picked up with them, offering them love and compassion, and then opening space for my next client.

When my workday finishes, I clear everything I picked up during that day. Sometimes this stuff just accumulates and you’re not even conscious of it, so I’d really recommend being aware of all that you take on during the day.

Set healthy boundaries for yourself

We’ve all been through a global trauma. There’s been this experience of up and down, managing the ebbs and flows of this pandemic, and we as therapists are also experiencing it—going through the very same ebbs and flows that our clients are going through.

It’s important not to become overly frustrated by the fatigue, the depression, and the level of overwhelm that our clients are in. We need to do what’s best for us, too—because we can’t sustain elevated cortisol levels on an ongoing basis. Our cortisol levels become depleted, leaving us feeling exhausted.

In my case, for instance, I used to see clients nine hours a day, five days a week over Zoom. I had to admit to myself that I couldn’t do this anymore. I’ve since scaled back to seven hours a day, just three days a week.

Practice awareness and look for balance

As therapists, it’s our job to do our best to see things from our clients’ perspectives, and even to feel what they’re feeling—because theoretical orientation only goes so far. Balancing this with good self-care is key, but it took me a long time to get to a place of learning how to let go of what I was carrying around with me as I helped people work through their problems.

We encourage you to find what serves you best in releasing your work-related stress, so you can spend quality, connected time with yourself and your loved ones outside the therapy room.

For more insights from Frank Anderson, check out the first three installments in this series:

• What it’s like to start your own private practice
• Common struggles for new therapists in private practice
• Tips for new therapists on growing a private practice

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