019: The Burnout Traps of Being a “Good” Therapist: Perfectionism, Fear of Disapproval, and More

April 15, 2024
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All things therapist burnout and how “good therapist” conditioning shows up. Dr. Jen Blanchette discusses the concept of ‘good therapist conditioning’ and how it affects therapists in their careers. The host identifies five reasons why this conditioning shows up (and how they are burnout traps): perfectionism, fear of disapproval, sense of responsibility, cultural expectations and societal norms, and identity attachment. The conversation explores how these factors can lead to self-doubt, reluctance to make changes, and a sense of loss when considering alternative career paths. The host encourages therapists to break free from these pitfalls and prioritize their own needs and happiness. 


  • Good therapist conditioning can lead to perfectionism and a fear of making mistakes as well as burnout.
  • Therapists often feel a strong sense of responsibility for their clients’ well-being.
  • Cultural expectations and societal norms can reinforce traditional gender roles and influence therapists’ perception of themselves and their careers.
  • Attachment to the identity of being a therapist can make it difficult to consider alternative career paths.
  • Therapists should prioritize their own needs and happiness and not be afraid to make changes.

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Speaker A: This is the finding joy after Burnout podcast, a podcast for therapists and mental health professionals. Together, we unravel burnout and find our road back to joy. Here’s your host, Doctor Jen Blanchette.

Speaker B: Hello, therapist. Welcome back to the program. It’s just me today. I am talking to you a little bit about good girl conditioning, being a good therapist. So even if you are male identifying, certainly feel like you can apply this, because I think as therapists, we get kind of good person conditioning. If you’re a good therapist or if you’re a this type of therapist, then you would do these type of behaviors, right? So we’re going to dive into that. So I have my top five reasons why good therapist conditioning shows up for us in our careers, in our practice, as therapists in general. So let’s dive into it. A little update here in the state of Maine, it is March and it is gray. It’s been rainy. Yeah, I was just reflecting on. So part of what I’m doing now is working in school. And I don’t know what happens in March. It’s just like mid March is kind of heavy if you’re working in a school because it’s the longest month, you have the most school days that month. I love the natural breaks that the school calendar gives us. So that is lovely to have those natural breaks. So there’s not as many of those. And I’m from the mid Atlantic and really, like, it’s a hard month. It’s like not spring here at all. In Virginia, where I’m from, it’s spring, but it’s not spring, y’all. Not here. So dealing with that. But we’ve actually. My daffodils are up for the first time in March since I’ve lived in Maine, which is crazy. So there’s signs of hope all around me. The change is coming. And I had just had a really hard week. I mean, you know, kind of received some. Some pretty difficult feedback on one of my reports. And I felt that good therapist or psychologist, so that good psychologist kind of stuff wash over me. Like, my kid fractured his finger, which actually ended up not being fractured. We went to an orthopedic doctor, and they were like, yeah, they read the x ray wrong. It’s just sprained. So I was like, great. Thank you for all of the urgent care visits and all of that. That was fun. But I did not do my best work I did about, I don’t know, maybe it was a c level report. Like, when I looked at it, I was like, okay, that I could have done better on that for sure. But I wasn’t in a good place that week. I had a lot going on emotionally in my house. I felt that sense of self judgment come up, that I didn’t do a good job. I’m probably not going to be asked to renew my contract next year. So I go to this dark place, all of a sudden that the sky is falling. I’m going to get fired. I’m not going to have this job. I’m going to have to go back to doing therapy full time. All the things start happening for me. Even if I do all of the thought work. I put myself into a CBT frame. I can do myself EMdr on myself. But you know what? I think we forget that sometimes our brains just give us garbage. And it’s kind of like we need to do garbage in, garbage out. Okay. I don’t even need to look at this thought. I don’t need to go to therapy and tell my therapist I do have a therapist. So I bring this up. In therapy, I can try to do some strategies of observing the thought moving through the emotion. And it took a few days, certainly. I always kind of do a lot of self judgment around needing to outwardly process. When I’m activated with other people, it almost feels like I need to regurgitate all of those feelings that I’m struggling with. And eventually I got there, but it wasn’t pretty. And I thought about not only that experience, but also an upcoming interview that I have with Felicia, quote unquote the bad therapist, which will be our next episode. And I thought about how much we are trained to do things right and how it feels if we don’t get them right in our careers. And I think that’s with any job like people generally. Unless you’re a narcissist, you want to do a good job, right? You don’t want to let people down. But I think for therapists, we have a unique blessing and curse, right? We want to care for people so deeply, and that is a beautiful thing. It’s often at our detriment and it’s often us coming to the ends of ourself. At least I know that is for me and many of the therapists that I talk to. So I wanted to dive into that topic. It gave you a nice, vulnerable share on what’s going on in my life, about feeling like I did not do a good job and I had to sit with myself about being okay with that. Let’s talk about good therapist conditioning. So top five reasons why you need to be a good therapist. And you want to be a good therapist, but it’s likely causing you problems. Number one is perfectionism. So our therapist training emphasizes attention to detail, accuracy, and adherence to established protocols. I was in training at the time where CBT was like the gold standard for everything. Everybody gets CBT. Everybody. You’re gonna put them in a thought record and, you know, we’re just gonna make sure that we go by this evidence based protocol and you’re good. We get extensive feedback and are expected to continually refine your skills. And really, I think that fosters this perfectionistic mindset that we have to be a certain type of therapist. We have to reflect back to the client in a certain way that may not be authentic, to how we talk, to how we interact with people, and we fear making mistakes or falling short of expectations that can make us really resist change. And it also can be perceived as a failure to meet professional standards. I think for therapists who are trying to get out of one to one therapy, it can really manifest in a reluctance, a constant questioning of yourself to explore any new career paths perhaps, or take risks that deviate from the familiar security role as a good therapist who takes insurance, who fits the mold, who stays in the agency job, who does all the things that we think should be done by a therapist who is kind of toeing the line, so to speak. I remember in my training, you know, I think I thought a little bit differently from many of my fellow trainees. I hadn’t come, I’d come into my doctoral program with just some different backgrounds. So I trained at a christian integration. I trained at a. Let me say this better. I trained at a christian integration program in Christianity and psychology and talk about the layers of good girl conditioning for someone who is raised evangelical Christian as well as someone who was training to be a psychologist, that those two things kind of double down on. If you’re a good Christian, if you’re a good therapist, you do these types of things. And even in the practice of christian psychotherapy, which I moved away from actually as a, I closed my practice, or maybe it was like the year, during the year of closing my practice, I moved away from it. I still identify as Christian. So I will state that, however, I really struggled with my faith, with my expression of faith and how I was practicing openly, seeing clients who also had a christian faith, because of the differences in how I experienced my faith and how they experienced my faith. And often they would believe I was a certain type of Christian or a certain type of therapist, and you must believe these types of things if you identify in this way. And a lot of times, I didn’t. And as you know, if you’re a therapist, we don’t share our political beliefs or our religious leanings. And it’s interesting. So I really see myself as an expert in religious diversity as well, because that training really taught me not to impose any of my beliefs, even if I identified as, okay, you’re a Christian. I’m a christian therapist. At that time. Right. At that time, then we have a certain understanding, but we don’t have a certain understanding. And my training really taught me to incorporate the spiritual or religious beliefs of my client and not my own. And I saw there’s so much variability, even in just the christian faith, of how someone would show up and how, you know, like, I would say catholic clients, for example, or someone who is greek orthodox or someone who was very fundamentalist christian, someone who was very liberal in their christian beliefs. And so I had a range of people who were like, yoga is the devil. Am I certified yoga teacher, by the way, and all the way to kind of more open, spiritual christian beliefs, where it was, you know, it informed their faith, but it wasn’t so much an adherence to their belief structure. So, anyway, that’s a little, like, offshoot off ramp sidebar into a little bit of my background. But I think it’s. I think I kind of waited in those waters of perfectionism for quite some time and didn’t listen to, like, the incongruence that I felt inside of me that was important that I noticed, but I kind of put it down, and I think that comes up in different ways. So if you don’t identify with a faith or with Christianity, whatever, that’s fine. I think just for you to notice how you need to feel like you need to conform based on your training or based on the beliefs of our profession. So, number one, that was perfectionism. Number two is fear of disapproval. So we’re trained to value our clients feedback and prioritize positive outcomes, and that can create a fear of disappointing clients or supervisors. I know early in my career and even, like, throughout my career, what am I talking about? I wanted my clients to get better. That’s human like. We don’t want to see human suffering. Human suffering is no fun for anyone. Right. We want to have a positive reputation, avoiding criticism from. From our clients. Right. We want to do a, quote, unquote, good job. I just think that’s natural that we want to do that, but I think that fear of disappointing clients. And I could see that in when I raised my fees, when I needed something for myself. So let’s say I needed to. I can’t work on Fridays anymore, and I knew the client could only work on Fridays or could only see me on Fridays. I had to disappoint them. Right. And that didn’t always. I didn’t always navigate that well. I think because I wanted to be seen as competent by my supervisors or by the people that. That knew me in the field. I wanted clients to feel like they were cared for. And I think we’re constantly in a state of wanting that approval from our clients and from other people because of how much care we’re giving. And I think there’s just almost, like, our clients are kind of like this egg we need to protect, and if we disrupt the nurturing. You know, I think of, like, when you. I don’t know if, like, in middle school, you guys made, like. Like, had. I can’t think of what the thing is. Like, you had to drop the egg from a certain thing. It was a science experiment, and so you had to create some kind of casing for this egg. And I kind of think of clients in that way. Like, we’re taught we have to constantly buffer for. For any. Any things a client might be negatively experiencing. When that’s not life. It’s just not life. Of course we’re going to be responsible and make sure that we’re doing things in an ethical way and not trying to, like, intentionally hurt somebody. But, you know, I just heard something like, did you kick a puppy? Do you really have something to feel guilty for? If the answer is no, then really, you just look at it at face value. I did not do anything that is unethical or anything that I need to feel guilty about. But we, I think, constantly have that voice in the back of my. Of our heads of, you know, do no harm, do no harm. Do no harm. And we interpret things that we think is harm, that are not harm to our clients. So, number two is fear of disapproval. Three is sense of responsibility. I was talking with one of my coaching clients about that fear or the sense of responsibility, the clinical responsibility and the weight of it. My metaphor for that is often like a parenting relationship. Okay, I know we’re not our clients mothers or fathers, but it’s heavy. And I think we have this sense of clinical responsibility that can morph into other things. We have a sense of duty and responsibility. Of course, we have to care for our clients, for their well being, but I can’t think of any other provider relationship where it feels this heavy emotionally. The care of the client feels not life or death, but sometimes it does, right? In the case of someone who might be suicidal or might be in crisis. And I think it’s that sustained holding of a client and their issues that creates a weight on us, really. I kind of think of like, where do I feel that my body, like, I just, I can almost like imagine, like that weight that on my chest when I used to have it. And sometimes it didn’t feel so heavy. Sometimes it really did. On my last podcast, I talked a little bit about feeling more free this vacation. I think that was the biggest thing, is that I didn’t have that clinical burden of having clients that I knew I was responsible for. And I think this commitment to our clients can really extend in a reluctance for us to prioritize our own needs. Right. Our own career satisfaction or personal growth. I think it has its stay in practices. So most of the time I’m helping therapists who have a private practice leave their private practice or really like revamp it. So if you have a fixer upper, like, let’s fix that practice up and see if you can. If you want to be a therapist and stay in your private practice, great, do it. I’m all for it. Like, it works for some people, for other people, it just doesn’t. And so I think that is one of the key points things is that clinical responsibility of feeling like, I cannot let people down. I what? Where are these clients going to go? So that is, number three, sense of responsibility. Number four is our cultural expectations and societal norms often reinforce traditional gender roles and expectations, which can influence therapists perception of themselves and their careers. Female therapists, I’m talking to you, or female identifying therapists in particular, may feel pressured to conform to the good girl archetype, prioritizing the needs of others over their desires and ambitions. Now, often I think about my role in my family, which was often, I was quieter, I was the quieter child. I didn’t need as much from my family, and I kind of would kind of go with the flow in most of my relationships. I didn’t really express a lot of needs or wants or desires, and often looked to other people to tell me maybe what they wanted, and I would go with that. I think that can lead us to a lot of self doubt. In the therapy room, I see posts often of therapists feeling like they’re incompetent, that they feel like they don’t know what they should be doing so that leadership, even in the session, feels hard for them. I didn’t have that. So when I was in therapy, most of the time, I felt pretty like, I can do this. I know what I’m doing. I have a plan. So that was intact. But I think when I got into difficult therapeutic relationships and felt really stuck, that would definitely come up for me. So when therapists are considering changes in their practice or changes in their career, I think those societal expectations of, you’re a caretaker, you’re someone who digs in, you stay the course, you’re not going to leave someone behind. Right. Those values, I think we internalize because we were raised to be caretakers, to be the ones who don’t leave a situation when other people do, who will sit with the pain of people when other people won’t. And that is what we do as therapists, it comes at a cost, and I think it can be hard for us to feel like we want something different. I think just after a year of not being a therapist, I have finally come to the point of just saying, like, I wanted something different. It didn’t really even have to be this big drama that I made it up to be. I think for the past year, I’d really told people like, you know, I burn out of my private practice. I left my private practice, I quit my private practice. And now, just recently I’ve said, yeah, I just needed a change. I just needed something else. And so it became more about me versus the work, me failing. I’m gonna get emotional, because I often think that we go to that place of failure. We failed our clients, we failed our private practice. Other therapists could do it. I couldn’t hack it. And that’s just not true. You can also just want something else. You can change your mind. So anyway, I just want you to hear that, because I think a lot of times we don’t consider that it’s okay to just change your mind. And this will segue into my last point, identity attachment. We spend so much time in our training and professional development that gives a strong attachment to our identity as therapists. It’s hard to think about something else because we’ve spent an inordinate amount of time to get here. So to change it often means looking at who we are, our sense of self, because the role of the therapist is often intertwined with us, with the person that we are. And I would say you continue to have that person inside of you. It doesn’t go away. You don’t go away, but it can make it really hard for you to envision yourself doing something else, especially if it’s very different. For me, it was a, like a sidestep, a pivot into doing, you know, more assessment, because I’m a psychologist, but I think I could get to the point where, you know, I don’t use my license. I could see that happening if some opportunity presented itself. So it’s just interesting, like, the pivots in my mind that I’ve made more recently when things come up to just say, like, well, you know, I really need to think about my job supporting my life versus the other way around. My life supports my work, my job, because now I see my first imperative to be my family and my children, and really, me too. Like my happiness, I should have put that first. But there’s the good girl in there, right? She’s still there. There’s always work to do. I think the thought of leaving behind the familiarity and the secure identity of a therapist can bring up so many thought feelings of loss and reinforce our attachment. I am having trouble speaking this morning. Whenever I talk first thing in the morning, I notice this. So you’re getting, like, really raspiness from me. Water is better. As I’m rounding out this podcast, I think that sunk cost fallacy. I’ve talked about that on the podcast a bunch. So we put so much into our careers that it can feel like we’ve. We’ve lost, like we’ve lost all of that time, all of that energy. And for what? To burn out of a career? To not have clients feel appreciative of our work that happens to not feel really attached to it anymore. And that can be hard to sit with. I’ve sat with it. It is tough. But on the other side of it, I would say there could be something better. And if you are truly miserable and unhappy in what you’re doing, then you need to change something, because the cost of not changing is so much. I know this. Believe me, I know this. So I would leave you just with the thought of, how can I break free of some of these pitfalls? How can I just notice them when they come up? Sometimes it’s hard to make the complete pivot, to say, okay, this has taken me a year of being out of the field to come to these realizations. So if you’re just beginning to start that work, to start to say, like, this isn’t it, for me, at least in the way I’m doing it. Maybe you’re an agency. Maybe you’re in private practice. I work mostly with private practice owners that are just like full and miserable and don’t know what they created, created a Frankenstein practice that they could change it to work for them or they can get out of it if they need to get out of it. That work is sometimes in therapy, sometimes in thoughtwork, sometimes in just having support, but it’s also in just noticing that some of it is from your conditioning and it’s out of your control. Like, you have just been taught to think and do things in this way, and so you have to start to notice them when they come up and notice that you don’t have to do them that way anymore if you don’t want to. So some of it is permission. So with my coaching clients, a lot of times I just say, hey, if you need permission, I grant it. By the way, you don’t need my permission, but if you needed it, then do it. Sometimes we just need that little nudge to keep going forward. For me, that was my husband nudging me to something else because he knew I was very unhappy. And I thank him for that so much. So I will leave you with that. If you need support with any of this, reach out to me. I’ll include my email. Just drop me an email. I’d love to hear from you. I also have a couple of freebies that might be helpful as you’re thinking about. This one is my before you quick guide, which I might revamp because I think I’m just going to make it simpler for you guys to kind of identify that maybe the top three reasons you want to quit, it’s in there. But there’s like journal problems and stuff right now, so I’m going to clean it up. And also there’s my money guide. So I help therapists identify, like, how to make money now versus like launch a coaching practice and maybe I’ll make money in a year. No, no. If you need a change, we cannot wait a year. That’s not going to work. So I really have you think about like, how to change something now because you need to do it. Likely. All right, I will talk with you guys in a couple weeks. I have a guest coming on and I’m excited to share that with you.

Speaker A: Thank you for listening to the joy after Burnout podcast. Be the first to hear new episodes by following the podcast and your podcast player. This is an informational podcast only. Any information expressed by the host or guest is is not a substitute for legal, medical, or financial advice.


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