When the psychologist needs therapy too

Varsha Makhija, a 36-year-old clinical psychologist from Mumbai, was at a restaurant with her family one evening. “Suddenly, at 11 pm, a client called to say they were going to end their life. What do you do?” she asks, almost to herself. “You get caught in the situation, feeling responsible for someone’s life and death.” In her 15-year career as a mental health professional, Makhija has dealt with patients who have had suicidal tendencies, who suffer domestic violence, who inflict it on their partners and who make peace with it. “Four months ago, a female client described her domestic abuse to me in graphic detail, leaving me with my eyes welled up.” Psychologists are expected to be objective and not let their emotions get in the way of their job. “But we are human, too,” she says.

Psychotherapy can be an emotionally draining profession. Clients empty their hearts and minds and unload their fears and insecurities onto the therapist. The therapist could have an emotional reaction to this unloading, like Makhija’s tears in response to her client’s ordeal. This can cloud a therapist’s objectivity, impairing their ability to counsel the client. It can even trigger their own memories of events from the past, leaving them to deal with it on a professional and a personal level.


Shreya Panjwani, a Delhi-based psychologist, points to other issues as well: “Compassion fatigue, burnout and loss of empathy also tend to happen often. You need to keep assessing yourself on these counts from time to time.” So, how exactly do therapists deal with it all? They go for therapy themselves. It is mandatory in many western countries, like the UK and the US, for a licensed mental health practitioner to undergo professional and personal therapy while on the job. In India mental health professionals, who are registered with the government body Rehabilitation Council of India (RCI), are not bound by law to seek therapy. Yet, many private medical institutions insist on it and many practitioners swear by it. “You need therapy to feel like a patient, to build empathy and to process how your patients’ issues are affecting you,” says Mamta Shah, an Ahmedabad-based psychoanalytical psychotherapist, who has about six therapists reaching out to her regularly for personal counselling.



Healing Themselves
Therapists seek out peers and seniors in the field to reflect on their approach to cases, all within the realm of confidentiality, in a process called supervision. Additionally, they go for intensive counselling sessions to other therapists to discuss personal issues. All these are paid sessions, like any counselling session between a client and a psychotherapist.


Contrary to popular perception that therapists must be sorted in their lives, they seek therapy all the time. Sometimes as frequently as thrice a week.

“When I am the client, I am as much of a wreck as anyone else,” says Nupur Paiva, a Delhi-based child and adolescent psychotherapist. In her initial days of seeking personal therapy as part of her training in the UK, she would cry in every session for an entire year. “I figured I better learn to cry and talk at the same time because I was paying in pounds per minute,” she recalls. Paiva, now 41, was in her mid-20s then. “All psychotherapists, consciously or subconsciously, are in this line of work to heal themselves. Therapists seeking therapy is just them being honest with themselves,” she says.



Therapists seeking therapy is a widely known practice within the circuit, but it isn’t openly talked about outside the fraternity. “It can be a cause of anxiety to clients that their therapist needs therapy,” says Shah from Ahmedabad who spends three days every week counselling clients in Delhi.

However, counselling psychologists like Mumbai’s Ishita Pateria, 30, are opening up to patients about their vulnerabilities. “I tell a lot of my clients that I, too, take therapy. I use myself as an example so they can remove the stigma around seeking help for mental well-being,” she says. “We are in a very deep, caring and emotional profession and it is very important for us to consistently work on ourselves to ensure that we have dealt with our own issues,” says Makhija. Last year, for a brief period, she discontinued work and sought intensive counselling for personal reasons.


“While some told me not to say this out loud, many others were filled with admiration. They understood that it requires courage to ask for help.” Some of Makhija’s clients even asked her how she was doing once she was back at work and chose to continue their sessions with her.

“Clients also want to know that everyone is a work-in-progress, even their therapists.” It’s not all that simple. “Had I suffered from an eating disorder or depression, for instance, I wouldn’t have told my clients about that. I don’t think they’ll take it well,” says Pateria. In the West, she notes, people use their history of mental health disorders to get into a career in psychology and are even encouraged to do so.


During her internship at a de-addiction centre in the UK, she found that the majority of interns had been addicts in the past. Things are changing in India, too, albeit slowly. In the psychotherapy and pharmacology departments at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru, junior mental health professionals are opening up to their seniors about their stress levels and the need to find coping mechanisms. “I know of two-three junior colleagues who have sought help within NIMHANS recently.

Some have even opted to go see a therapist outside the institute,” says Manoj Kumar Sharma, a clinical psychologist in NIMHANS.

I, Me, Mind
What is it like being a therapist going for therapy? In one word: liberating.

“I find it a relief to not be a therapist, for a change,” says Meghna Mukherjee, a Noida-based psychoanalytical psychotherapist. She takes personal therapy two-three times a week and goes for supervision sessions once a week. Therapists, with their experience in the field, may have an advantage while seeking therapy. “If I were to seek therapy, I would be clear on the type of skill and therapeutic process I was in need of and would thus be able to select a suitable practitioner,” says Panjwani. Their awareness of different therapeutic approaches helps them access the form of therapy that would be most impactful in their individual scenarios.



For instance, Panjwani would prefer a cognitive or a behavioural psychologist and would be less inclined at this time to seek out an art therapist or a hypnotherapist.

It’s also different communicating with a therapist vis-a-vis a regular patient. Use of clinical terms is commonplace while discussing prognosis and diagnosis. However, not every therapist mouths jargon during their sessions as clients. “If I’m using jargon, it would mean I’m not allowing my emotions to surface. I’m avoiding conflict. The therapist would then ask me to tell what’s bothering me, instead of giving it a structure myself,” says Mukherjee. Being a therapist can also be an impediment in some cases. Many therapists often approach a psychologist with a ready diagnosis in hand and resist the latter’s line of questioning, pointing to something else.

Therapists as clients also try to seek lessons from how their counsellor interprets a situation, says Shah.

“This can be seen as resistance on their part to be a patient, which would be an impediment to reaping the benefits of therapy.” Shah has to ask them to let go of their professional baggage during personal counselling sessions. In some cases, professional learning happens involuntarily.

Pateria, for instance, discovered during the course of her personal counselling that she was a resistant client at the beginning. “I thought I was sorted but realising that I had issues made me doubt my capabilities.” Today, it helps her empathise with people who are going through the same journey. “I also don’t put too much pressure on myself to speak too often and allow the client to explore their issues to the extent they want. Because each time we interrupt them, we lead them somewhere,” she adds.

Mukherjee has learnt to make peace with the client's ambivalence, anger, or desire for a break from therapy, "because I have been there, done that". Not every therapist opts for personal therapy. However, there are those who are open to the idea. Panjwani, for instance, supports it and believes that mental health and therapy are significant.

Then there are others like Ruchita Chandrashekar, a Chicago-based trauma therapist. The 26-year-old works in a detention centre in the US. There are days when she ends up working 17 hours straight, leaving her with very little time to compartmentalise work, process it and recover from it. These days, Chandrashekar relies on peer-group consultation to cope. "On most other days, if you put three meals into you, you tell yourself, you did good".


Sometimes you have to set realistic expectations for yourself instead of setting yourself up for failure. "Often the onus of a therapist's mental health is put only on them. People don't understand that one may not have the time or the money to afford self-care. You need safe spaces to talk about that, too", says Chandrashekar. Therapy is often essential for therapists; sometimes it can be a luxury as well.