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Key points
- Therapists are human, just like their clients.
- A therapist must identify conflicting thoughts and feelings and use their own volition.
I was out with friends the other evening, and one said, "I really enjoy seeing my therapist, but I had this intrusive thought during a session about imagining what they were thinking!" My other friend gasped, as it hadn't really occurred to her. "I definitely would not want to know! ... Actually, maybe I do … oh, God, no"
I'm a therapist and I love my job. I'm also a big advocate for the positives of therapy and trying to dismantle stigmas around the subject – particularly as a man. I reflected on this exchange between my friends and pondered on it longer than I thought I would, given the jovial, irreverent discussions we often have. I have regularly been hyperaware of my thoughts during therapy as a client, but what goes through my head when I’m in session with a client? Are there others who would want to know? How on earth could I use this as a way of positively showing people the beauty of good therapy? Why am I in bed thinking about this at 2 am?
The next afternoon, I felt very introspective (cliché therapist) and took out a pen and paper. I wanted to conceptualize my thought process as a therapist for people – and myself – to understand. My imagination stepped in, as it often does, and within moments, I began to visualize all of my thought processes around a large round table. “Damn, I have so many different types of thoughts,” I realized. That's because I’m human; we all do. I began to picture them all as varying versions of me in my head, all dressed uniquely, with differing facial expressions and distinct vocal tones. I had fragmented my thought processes into some kind of budget-theatre play, and I was delighted.
According to me — and that’s all the authority I have on this hypothetical subject — a therapist has 13 internal voices that are introduced from stage left:
The Inner Voices of the Therapist
1. Anxiety. Yes, therapists get anxiety. I’m an anxiety therapist who has recovered from several anxiety disorders, but I still get anxiety. It’s healthy, and most definitely needed, but often annoying. Anxiety shouts up in the therapy room with thoughts such as, "What if I misjudged that?”, “What if I misinterpreted what my client said?”, “What if I need the toilet so badly during this prominent moment that I…?” and, “What if they can see the mayonnaise stain on my shirt after a lunchtime spillage?” Anxiety can also crop up in other ways, usually deriving from self-doubt or fear of preserving one’s image to others.
2. Analytical. This is the voice that utilizes all our training and continual professional development. Analytical voice is wearing a suit and holding a large, heavy book while sitting at the thought table looking academic and ostentatious. It draws from theoretical orientations and modalities to help us frame our approach as therapists. For example, the Jungian therapist might be inclined to explore the shadow self, whereas the humanistic therapist may want to explore conditions of worth. The cognitive behavioral therapist might be crafting a formulation, and the transactional analysis therapist might be identifying ego states, such as why my inner child cries when I don’t have a milkshake (despite being an adult).
3. Biology. This voice screams the loudest when the therapist has necked two coffees before a client meeting and the bladder and post-caffeine jitters make biology shout over the other voices. It’s also the voice that commands our bodies to tense and our hearts to race during particularly meaningful parts of a significant therapy session.
4. Compassion. This is the voice that represents the willingness of the therapist to understand and help their clients. A beautiful, measured voice who never leaves their seat even during the difficult and challenging times. Compassion often starts as one of the loudest voices at the beginning of therapist training. It represents our willingness to help and offer unconditionality to people we don’t even know, with the optimistic belief that people will better themselves if heard and understood.
5. Critic. This is a voice that all people have, but it especially loves to pontificate in the mind of a therapist. It’s even shouting at me now as I write this post. Critic vocalizes our self-doubts and internal bullies that have manifested throughout our lifetime. Occasionally, critic can be helpful, especially as part of a wider conversation about holding ourselves to account, but in general, it often echoes negative introjections of our past lives which can creep into the therapy space. Critic is clever and imaginative but always feels like an imposter under the watchful gaze of the compassionate voice at the table.
6. Detective. This is the voice of intrigue. Detective wants to know more and is always intrigued when listening to others. It’s the voice that helps a therapist think about which therapeutic modality would best serve the client or which particular avenue of exploration would be most beneficial. It’s not intrusive but rather reflective, and, like a good detective, it doesn’t jump to conclusions but rather reflects on what has been seen, heard, and felt.
7. Empathy. This is the voice that represents the willingness of the therapist to step out of their frame of reference and into the world of the client. Empathy is an essential part of therapy, and it’s the voice that reminds us it's not about us, but rather about the person we are with. Empathy is the voice that allows us to connect with clients on a deeper level, understanding their feelings, thoughts, and experiences as if they were our own, yet without losing the objective stance needed to provide effective support. Empathy differs from compassion in the sense that the feelings are felt in someone else’s shoes, which differs from a feeling originating from our own frame of reference.
8. Escapist. Sometimes, sessions can become overwhelming, not just for the client but for the therapist too. The escapist voice is the one that looks for the nearest exit, the one that desires comfort and safety, especially if a session brings up personal feelings or challenges that the therapist has yet to fully address in their own lives. It’s the voice that daydreams about being on a beach somewhere far away, sipping a cocktail, or simply being anywhere but in the intense emotional environment of a therapy session. It’s a natural human response to seek escape from discomfort, but for therapists, recognizing and managing this voice is crucial to staying present and engaged with their clients.
9. Intuition. Intuition is a mysterious and often powerful voice that comes from a combination of experience, empathy, and a deeper connection to the unconscious processes within both the therapist and the client. It’s the gut feeling, the sudden insight, or the unexplained sense that something is significant even if it’s not immediately clear why. Intuition can guide a therapist to probe deeper into a particular area, to ask a seemingly unrelated question that opens up a new path of exploration, or to simply sit in silence, allowing space for something important to emerge.
10. Irreverence. Irreverence is the unexpected guest at the table, popping up with bizarre, sometimes dark, often humorous thoughts that seem to come from nowhere. It’s the part of the therapist that remains irreverently human, manifesting the kinds of intrusive thoughts we all have but seldom share: “What if I just stood up and started dancing?” “What if I spoke in a fake accent for the rest of the session?” It’s a reminder that therapists, like all people, have a complex inner world filled with all sorts of thoughts, not all of which are serious or relevant to the task at hand. Managing this voice is about recognizing its presence, perhaps even smiling internally at its audacity, but not letting it derail the focus and purpose of the session.
11. Saviour. The saviour voice is driven by a deep desire to help, to heal, and to make things better. It’s the part of the therapist that entered this profession with a mission to save people from their pain, suffering, and struggles. While this voice comes from a place of compassion and empathy, it also needs to be moderated with the understanding that therapists cannot “save” their clients. Instead, they can guide, support, and facilitate their journey towards healing and self-discovery. The saviour voice must be balanced with the recognition that true change comes from within the client, and the therapist’s role is to empower rather than rescue.
12. Trigger. The trigger voice is the alarm system, alerting the therapist to their own unresolved issues, biases, or emotional reactions that could impact the therapeutic process. It’s the voice that says, “This reminds me of my own experience,” or “I’m feeling a strong emotional reaction to what my client just said.” Recognizing and managing this voice is crucial for maintaining professional boundaries and ensuring that the therapy remains focused on the client’s needs. It requires the therapist to engage in ongoing self-reflection, personal therapy, and supervision to address their own triggers and ensure they can provide the best possible support to their clients.
13. Volition. Volition is the chair of the meeting, the executive decision-maker who listens to all the voices at the table and then decides which to act upon. It’s the voice of agency, of choice, of determining the course of action at any given moment. Volition integrates the insights, feelings, and impulses from all the other voices, filtering them through the therapist’s professional knowledge, ethical considerations, and the unique needs of the client sitting across from them. It’s what makes each therapist’s approach personal and unique, as they navigate the complex interplay of their internal world to make choices that serve their clients’ best interests.
As a therapist who advocates that therapy should be a shame-free option for everyone, I wanted to share these insights to peel back a layer of mystery surrounding what goes on in the mind of a therapist. Despite our vulnerabilities, the internal voices we juggle, and the constant balancing act we perform, our goal is always to meet our clients on the same level, to listen non-judgmentally, and to support them in their journey towards growth and healing.
For more, see my book, And How Does That Make You Feel? Everything You (N)ever Wanted to Know About Therapy.
References
I’ve written a book—And How Does That Make You Feel? Everything You (N)ever Wanted to Know About Therapy—in which you can see these voices in action. The book delves deeper into these insights through client case studies and reflections on my personal experiences as a therapist and aims to convey that therapists are human, fallible, and have their own vices, but are dedicated to meeting you where you are, ready to support your growth and healing.
