One of the primary reasons I went into the mental health field was to help people, yet there were times early on when I wasn't sure I was accomplishing this goal. I used to spend a lot of time worrying about this. I worried about it so much, in fact, that it became a distraction. I began to dread seeing those patients who didn't seem to improve. They made me feel helpless and ineffective. I eventually started to dread going to work altogether. I didn't want to see patients at all anymore.
I considered a career change. In search of guidance, I even completed a few online career assessments. To my chagrin, every assessment suggested "therapist," "counselor," or "social worker" as good career choices for me.
I became depressed. I hated my job but felt I'd invested too much in my education and training to do anything else. And honestly, I couldn't think of anything else I wanted to do. I started counting the years until retirement but that made me even more depressed: I had at least forty years to go. How was I going to make it?
And so obviously something had to give. I did a lot of soul-searching, a lot of reading, and some self-help exercises. At some point it occurred to me to stop pressuring myself to "make people better" and instead try to focus on just being present with my patients. I decided to simply do the best I could with patients, regardless of the outcome. I made a sincere effort not to take it personally when a patient didn't improve. "You can't help everyone," I told myself. "Just do the best you can."
Work became more tolerable as a result of these changes. I learned to accept that there will always be patients who don't get better. There are lots of reasons for this, many of which have nothing to do with my ability as a therapist.
Now fast forward. I am nine years into my career. As a therapist, I am more genuine and more engaged with my patients than I was early on. I don't spend much time thinking about how helpful I am...it's a slippery slope and I don't want to start sliding. I just do my job the best I can and hope some people benefit from it.
Last week, I had a very rewarding experience. Our clinic runs a two week therapy group for active duty service members who have experienced some sort of combat trauma. A former patient of mine sometimes speaks to the group about his own experiences with trauma and its aftermath. I know he does this but I've never had the chance to sit in on one of these talks. Last week the opportunity arose.
My patient walked to the front of the room and introduced himself. He then turned and pointed at me. "The reason I'm here today is because of that woman right there." I was a little embarrassed when everyone turned to look at me. My patient continued. He talked about being in Afghanistan and about the difficulties he encountered there. He talked about coming back home and the problems he started having. He related his attempts to seek help, the first of which was disheartening. Finally, he talked about coming to our clinic and starting therapy with me.
My patient shared what he learned in therapy and identified what he found most helpful. He shared things I'd said and insights he'd achieved as a result. He seemed to remember everything we'd ever discussed. I, on the other hand, had forgotten what we'd talked about until I heard him speak.
It's not that I don't think about patients after they've moved on from therapy. Often I recall a specific patient and think to myself, "I wonder how he/she is doing now." I have never, however, remembered a patient and thought, "Wow, I really did a great job helping him/her." It's just not something I do, primarily for the reasons I mentioned earlier. When my former patient talked about the work we did in therapy it was almost like he was talking about some other therapist. It wasn't until later that I said to myself, "He was talking about me. I did that." And it felt really good to know that I helped.