What is the hardest lesson you’ve learned in your career?

[u/SUDS_R100]

We’re all probably pretty thoughtful people, but some of the most valuable lessons are the ones that are truly felt. Without over-disclosing, what’s your hardest earned clinical lesson?

[u/SUDS_R100]

I’ll start: The further I get in my training, the more I’ve seen and accepted that even good clinicians sometimes leave sessions thinking, “that did not go well.”

My hardest lesson has been that if the perfect words do exist, we certainly won’t always find them.

[u/Snoooupdawgiedawg → u/SUDS_R100]

As a clinician that recently left a session feeling that way and have felt haunted by it for the past couple days.. thank you. This made me feel less like I’m a bad therapist for having one bad session.

[u/SUDS_R100 → u/[deleted]]

Sure.

My point is that I have seen even clinicians who I really admire and that generally show the “right” traits (e.g., empathetic, kind, well-informed/trained) have sessions that don’t end “well.” I think both patients and clinicians have a general preference for everyone to leave a session cheerier and more optimistic than when they started, and it doesn’t always happen.

Even with the best training in the world, the “right” words to comfort someone or facilitate learning in a difficult situation are not always obvious. It can be a tough pill to swallow (for both parties) that no one bats a thousand.

[u/bkwonderwoman → u/SUDS_R100]

I don’t think I’d be doing real work with a client if we preferred that they are cheerier or more optimistic at the end of sessions. Sometimes it’s about being in the shit with them.

[u/MaitreyaPalamwar → u/SUDS_R100]

My boss (psychiatrist who also provides therapy) is very experienced - and even he tells us interns that the session had not gone well.

It's never going to be a world where anyone who has a set amount of experience will be free from not-so-ideal sessions - we just have to accept that as a matter of fact in our line of work.

[u/Professional_Dog8088]

Don’t take rejection, drop out, or criticism too personally. We’re not going to be a good fit for every client.

And don’t be afraid to admit that you don’t know something or aren’t sure about something.

[u/curmudgeonlyboomer]

Not every client is ready to change.

[u/llehnievili → u/curmudgeonlyboomer]

That’s some real shit

[u/PsychAce]

I wouldn’t say it’s the hardest but rather what I keep in mind, is to give people some grace.

[u/ordinaryemmah]

That you are responsible for the patients care, but not the patient themself

[u/AvocadosFromMexico_]

Generally, learning not to work harder than the client.

[u/No-Smoke9326]

It’s not my job to fix a broken system

[u/DotairZee]

be careful how you incorporate faith-based information. during practicum, I once had a client who often would say things like, "God must have wanted..." in reference to events in her life. I decided to try to align with that perspective at one point, saying, "maybe God wanted [etc.] for you," and she flipped out. "you think God wanted [horrible things] to happen to me???" no ma'am, and thank you for the lesson!

[u/TheLadyEve]

You really can't help everyone, all you can do is your best effort (and be aware of where your competency ends).

[u/SlayerDeWatts]

Get paid up front

[u/Ok-Toe3195 → u/SlayerDeWatts]

I recently switched gears and established this in my testing practice and it’s spared me a lot of headache

[u/OpeningActivity]

There is a huge difference between unconditional positive regards and being naive.