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I’m stressed.  I’m freaked out.  I’m worried.  I’m feeling uncertain with the unpleasant sense of dread and trepidation that can only happen when something ugly from the past reappears out of nowhere.  Let me be real; this is an autobiographical post.


I have moments like this in life.  These are the times when the rubber hits the road for a therapist.  This is when I am faced with a dilemma: I can either give myself over to panic or I can use the myriad of tools I teach clients every week.  After a couple of deep breaths, I choose the latter.


Let me let you in on the problem first.  I’ll try and describe the magnitude of fear it evokes in me even though it will seem trivial to you.  Sometimes in this profession we get cases that turn out to be high stress for us as therapists.  After 10 years in practice I’ve gotten really good at screening during the initial phone call.  This is so that I refer out when I’m not the right fit.  However, because I’m human, sometimes one slips past me.  This was one of those instances.  While this case was transferred to another person’s care quite quickly, it caused a few weeks of intense stress and exhaustion.  Now I’ve received a phone call that I’ll need to revisit the case.  What’s worse is, I haven’t touched on this case in years so I can hardly remember it.  All I can recall is the sense of anxiety that was paired with it.  I remember knowing I’d need to refer, and knowing how sensitive it is to tell that to a client; it’s one of the most delicate conversations a therapist ever has to have with patients.


After receiving the phone call I find myself stepping out of a time machine straight back into those dreadful three weeks.  I give myself over to stress and angst for about five minutes.  Then I take some deep breaths and decide to think.  I realize this is the perfect opportunity to practice the good coping skills I preach.  Here’s what I do:

  1. I recognize there is time before one has to return a call from a voicemail.  I think through all the legal and ethical requirements to release information about a former client.  Then I plot out what steps to take so that confidentiality is protected while still honoring the request for information within legal and ethical bounds.
  2. I remind myself, “The past is the past, and it cannot be changed.”  You’d be surprised how powerful it is to meditate on that a little bit.  Do I wish I’d never taken this case in the first place?  Unequivocally yes.  However, that choice is far in the rear view mirror, so I all I can do now is the best I can.
  3. I do some calming breathing.
  4. I think through possible outcomes.  I see I am WAY overemphasizing the worst possible outcome.  Because of my focus on that, I hadn’t initially seen all the other possibilities.  This is a common error in thinking when anxious.  Anxiety is caused by fear of a possible future event.  Usually that event is pretty unlikely.  As it turns out, we’re not very good prophets.  This is especially the case when we’re feeling anxiety.
  5. I think about how I’ve seen a few hundred clients in the past decade.  I remember that most have been really enjoyable.  I tell myself one bad instance doesn’t taint everything unless I choose to give it that level of permission.
  6. I have a negative thought creep in even after working all my coping skills.  I disenfranchise the thought quickly though by seeing it for what it is (simply a negative thought) and what it isn’t (In other words, just because I think it doesn’t make it true).  Our own negative thoughts have the power to hijack our day into “Negativeland” if we permit them.  It’s our choice to stay on the hijacked train of thought though.  I actually envision myself hopping off the train.  I feel much lighter after that.

I go into great detail about ten minutes of my day because it happens to you too.  You too find yourself shrouded in negative thoughts of what could be.  You too feel panic or fear when triggered.  I want you to know two things from today’s post.  Firstly, even therapists fight with irrational thoughts, emotions, and reactions.  Secondly, you are not stuck in your uncomfortable feelings if you’ll just put in a little work.


Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT