What I wish I knew before I became a psychotherapist.mp4

I'm clinical psychologist Dr. Ali Mattu and I'm going to tell you the 10 things I wish I knew before I became a therapist. Number one, you will be constantly humbled by how much you don't know. The more I do this work, the more I've begun to understand how complicated mental health is and how complicated families are and how much medical illnesses impact mental health and how there's a world of medical illnesses that I don't know about and never been exposed to. So there's a lot of uncertainty that you have to face in the world of therapy. You have to be someone who, when your treatment doesn't work as expected, that you can learn from that setback, that you can see failures as opportunities to grow. Number two, it is deeply meaningful work. My job is to help people navigate, overcome some of the most difficult experiences they will have in their lives. What a privilege. I get to be a part of their journey in finding growth and finding their own meaning and purpose. I had to turn the AC off because otherwise you wouldn't be able to hear me and there is a heat wave in New York City so this is getting pretty hot. Hopefully I don't look too sweaty. Number three, being a therapist is tough on your body and it's tough on your mind. Most of my day is spent sitting in my chair with my butt on the chair for at least an hour at a time and then I very briefly go to get my next patient, write a quick email, send a quick voicemail or maybe if I'm lucky, run and pee or scarf down a snack that keeps me going for the next hour. That's not a healthy lifestyle and that's caught up with me over time. I have more back pain, I've gained more weight, I have to work harder and harder to get more physical activity and more time outdoors during the work week. But what's even more difficult is the impact doing therapy has on your mind. I am with people as they're going through very difficult experiences and the more you do that kind of work, it starts to make you question things as well. It's something called vicarious trauma where you might start to actually question your beliefs about the world, about other people, about the future based upon working with so many people who have gone through trauma themselves. And there's also something called compassion fatigue. It can be very draining to do a large volume of this work. You have to get very good at understanding your own emotions, learning how to manage your own emotions, learning how to tolerate distress, learning how to get help, really being able to take care of yourself if you're going to be doing this work full time. Number four is probably my favorite thing and that is having a lot of therapist friends is amazing. It's so nice because they're all such good listeners. They know how much to listen, how much to validate, how much to problem solve, how much to push me, how much to help me just sit and accept. Oh, it's when I'm going through tough stuff. It's the best to have therapist friends, self care. Number five, you're going to deal with stupid turf wars. What kind of degree you have, the training you've experienced, the orientation you have, the environment you work in. All of these things become huge political fights and probably the biggest one is the discipline and degree. Whether you have a master's degree, a PhD, a PsyD, a psychiatry MD or a DO. People who are trained in certain models or schools of thought or have certain degrees become very much invested in that approach and that philosophy. I've been guilty of this myself. We have a hard time as a field uniting across these different differences we have and advocating for mental health and for our patients. Number six, most therapists will never get rich doing therapy. When you work as a therapist, your income is directly related to how many people you see. Most people will reach a ceiling where you've seen as many people as you can see in a week. You can't fit in more patients to generate more income. So then maybe you can raise your fees if you're someone who's not participating in insurance, you're out of network provider. But at some point, you're going to reach the limits of that as well. If you're thinking about going into this field and you don't want to be purely seeing patients on a one-on-one basis to generate all of your revenue, you need to think of yourself as a business and have multiple streams of revenue. Not just have all your income based on one-to-one patient encounters, but to have workshops that you do on the side. Workshops that you might do for schools at a very low or free rate, but those generate other opportunities like doing workshops for businesses that might be able to pay more money or doing continuing education training for other therapists. Maybe you're going to be developing media or training resources, things like that. You want to have, or consulting is another way to earn some revenue on the side. You want to have multiple streams of revenue so you aren't dependent purely on just seeing patients one-to-one because you're going to very quickly hit your ceiling of how much you can do and how much you can charge. And at that point, that's it. That's how much money you'll make and that's probably not going to change that much over time or if anything, it might go down based on how insurance reimbursements go nowadays. Speaking of money, this is a good time to thank all of my patrons for supporting this channel and I want to thank my brand new patrons, Emily, Samar, Lars, and Pippa Chi. Thank you for becoming patrons of The Psych Show. If you want to help me make more of this kind of content and get behind the scenes features in return, consider becoming a patron of The Psych Show. Number seven is you are getting into the customer service business. That means being super responsive to messages that you get, returning emails and voicemails in a timely manner, giving people receipts and forms that they need when they ask for it, making your office very comfortable, making it nice, making it welcoming, being able to offer people water or tea or coffee if you can. Number eight, you will have a lot of independence. You are largely the only one in the room who gets to say what happens in that therapy session, how you manage it, how you approach it, how you use therapeutic skills, what type of treatment you use, how you implement it. You're kind of your own boss in that situation. Number nine, mental health is set to be massively disruptive. The vast majority of everything therapists do, it hasn't changed much in the last hundred years. Most treatments are still based upon one person talking to another person in the same room. Maybe sometimes one person working with a group of people in the same room. If you've seen my video on why it's so hard to get good therapy, you know that we're never going to have enough therapists to meet the mental health demands of all the people who need support. It's not going to work in this model, this one-to-one or one-to-group model. So the field of mental health is ripe for disruption, for developing AI that is going to work throughout apps and help a vast majority of people who may never be able to access in-person treatment. For more media-based support, like what I try to do on this channel, for gamification of mental health, for telehealth platforms where a person in one part of the country can work with a variety of people in other parts of the country. If you are in grad school right now, if you're in this field and you're early in your career, get some training and exposure to different types of computer science, app building, and get trained in interventions that weave in technology, virtual reality, telehealth types of presence. Because this is really where the field is headed, and I can't wait. I can't wait to see that disruption because things need to move forward. Number 10, know the growing market. Therapy is a business. Just like every other business, there are markets that are growing and there are markets that are shrinking. Right now, if you are going into this field, make sure you have training and knowledge and experience in markets that are growing. That includes addictions. It includes issues related to mental health and aging. It includes childhood-related problems. It includes the world of trauma and treating trauma. There's a bunch of other growth areas in mental health. Make sure you have training in one of these things because that's where there are more people presenting that need support. That's where you can get a lot of reimbursement if you're in the insurance model. Whatever you're doing, make sure you have training and experience in something that people need help for. What questions do you have about life as a therapist? If you're a therapist right now, what do you wish you knew before you got into this field? Let me know in the comments below. 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