When my father died at 89, I felt no hesitation in canceling my psychotherapy patients to “sit shiva” – the prescribed Jewish ritual of observing a 7-day mourning period for the deceased loved one. Sequestering with my family and welcoming visitors who came bearing food platters and memories of my dad (this was pre-COVID) served as a healing bridge to accepting my loss.

When experiencing other types of traumas that have emotionally and sometimes physically flattened me – accidents, illnesses, breakups – the decision of whether or not to take a break seemed less clear-cut. For instance, when I’d been in practice for about two years, a serious love relationship ended. I considered taking a few days off but decided keeping busy would be more helpful.

Soon after, during a session with Jeannie,* a newly divorced patient, I felt tears stinging my eyes. My patient, assuming my slight display of emotion was an empathetic reaction to her pain, said, “I know, wasn’t Jim* a creep?” and we went on to have a productive session. But I took a bathroom break to howl soundlessly in a stall before beckoning the next patient into my office. Perhaps I should have given myself a day off.

There is a reason it is said ‘doctors make the worst patients.’ Practitioners in both the physical and mental health realms don’t always take the path toward which they shepherd their patients – that is, to accept and deal with one’s hurt, versus running from it. There is no right or wrong way to handle your practice during a tumultuous time; the key is discovering the right path for you.

Below are a few ways other therapists have processed personal trauma while maintaining their practice.

Staying Busy to Avoid Trauma and Grief

In November 2020, Jacqueline Levin, a Connecticut-based licensed marriage and family therapist, lost both her mother and her aunt (one from old age; the other in an accident). She had been in practice for over 10 years and continued to work practically without missing a beat. She explained during a recent phone conversation, “While working was not a safe haven, it felt like a good place to focus. It was fulfilling.”

With formal training in Internal Family Systems (IFS), Levin told me, “When I am in ‘self’ I feel confident and connected. I have clarity. When you do something you love, time just goes by.” Levin credits her ability to keep on keeping on during a time of crisis to two factors: being in therapy herself and having a light caseload.

Another mental health clinician who kept working while facing trauma was JF Benoist. In 2002, the therapist came down with a “mystery illness.” Over the course of a few months, he lost 50 pounds and often found himself curled up in a ball with stomach cramps. During a recent video chat, Benoist, who is currently managing The Exclusive Hawaii, a holistic addiction treatment center, recalled, “I was imagining the worst. I looked skeletal.”

Throughout this ordeal, Benoist continued seeing three to five patients a day as well as leading several weekly therapy groups. He attributes being able to tuck his fear away when walking into the treatment room to the training he received in the Socratic Inquiry Method.

Considered a foundation of CBT, the Socratic Method involves asking a series of open-ended questions aimed at encouraging a different viewpoint about whatever problem is causing the mental logjam. The questions are meant to enable the person to see another perspective of the pressing problem. In Benoist’s case, his personal use of this therapy tool diffused the almost paralyzing certainty that his mystery malady would lead to his demise. He told me, “Humans have a negative thought and immediately attach to it. In my case before using the Socratic Method, I kept telling myself the story that I was dying.”

Between sessions with his patients, he allowed himself to feel grief and practice self-compassion. “I’d go for a walk and cry at the pain – there was no self-judgment.”  After 6 months, Benoist was diagnosed with Celiac disease. “Sometimes even today I want to scream, “I wish I could have a burger” but then I reframe it, “Isn’t it great I have a condition that makes me eat super-healthy?”

Letting Go: Deciding to Close Your Practice

In July 2020, Pam Wallers,* LMFT, a Boston-based marriage and family therapist began experiencing a host of debilitating symptoms that doctors variously identified as adrenal fatigue, burnout, and even multiple sclerosis. Whatever the ultimate diagnosis, the upshot was that she couldn’t carry outpatient sessions. So after 21 years of practice, she recently made the heartbreaking decision to discontinue the therapy work she loved. She confided to me, “I had no choice: I’d be on a call with a client and after 2 minutes, my body would start numbing, tingling, or spasming.”

She transferred her patients to trusted colleagues to devote all her time to her health. Initially, Wallers felt guilt that she was letting her patients down. “I wasn’t doing what I was built to do but there were days I felt I was going to die.”

As she recovered (she has yet to get an official diagnosis), Wallers realized she’d been over-extending herself – working 10 hours daily at both psychotherapy and a new consulting business. Thankfully, she is now nearly 100% back to normal physically. But being seriously sick for the first time ever caused her to make significant lifestyle changes. “My loyalty and dedication to my clients was strong.”

Wallers explained, “Clinicians are trained to walk away and not feel the heaviness but when you are always talking about pain, it weighs on you.” Today, she is growing her consulting career but not reclaiming her patients. “I know they are in good hands. I needed something light and refreshing.”

Taking a Work Hiatus to Recharge

In 2009, Megan Devine was happily married and had a thriving therapy practice working with parents whose children had behavioral issues. That all changed when her husband, Matt, drowned.

After such a monumental loss, she felt she needed to “leave the pain business, to shut everything down.” She makes clear, “I was fortunate to have the financial ability to walk away. I had an inexpensive apartment and no dependent children…”  She acknowledges, “Completely quitting clinical work is not always an option.      If you don’t have the ability or luxury to walk away, tell yourself, ‘My personal needs are not going away. I am putting them in a holding pen for the 6 hours I am with my patients because I have to pay my mortgage…. After work, I will meet my needs.’”

Initially, Devine thought she would never return to the clinical field. However, after 3 years of volunteering at a dairy farm, she resumed her therapy practice and in 2017, published the book It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture that Doesn’t Understand. Returning to work felt right – for her and for her patients, she says. “There is no right or wrong answer. It’s about how you integrate or don’t integrate your work into your ‘self.’”

Making It Personal

The only one who can ultimately make the decision about when if ever to resume seeing patients after a trauma is, of course, the therapist. The morning I returned to work after a week of sitting shiva for my father, I experienced the age-old stomach butterflies. But the sensation was more about feeling rusty than fearing I was emotionally unready to resume “the pain business.”

Unlike Devine, the death of my loved one was not unexpected and not a tragedy. And while I missed him, I wanted to reclaim my life as a healer. So that late October morning, I called my first patient into my office and asked, “What do you want to talk about today?”

Kara* said, “Oh Sherry, I had such a terrible fight with my mom. I feel awful.” I leaned in, said, “Tell me about it,” and we began the work.

*Names and identifying details changed.

 

Last Updated: May 6, 2021