The Desperation to Help: What to Do When You're Worried About Disappointing a Client

It’s hard saying no. For a lot of new therapists, we really struggle with the idea of disappointing someone in our care.
 
It can be easy to feel that because our clients need something, we need to be the one to give it to them. I hear new therapists say things like “but they need evening hours – they can’t make it during the normal workday“ or “they need a sliding scale – they can’t afford the full fee”.

It’s true that a client may very well need these things. Some clients are dealing with financial security and would be at risk of losing their jobs if they had to take appointment hours during the workday. Some clients have such tight budgets that they’d have to give up some of the essentials in order to make it to even an hour of therapy per month. And absolutely there are times where I’ll meet a client on these things – giving a sliding scale where I can for the clients who need it most. But it gets really tricky when we see ourselves as “the one and only” that can solve these problems or fill these gaps for our community. Remember – we all have limits. That’s what makes us human.
 
What I’d love to share with each of you is something I learned through my Somatic Experiencing training. They taught us that feeling as though we have to be the one to save the world is actually a trauma mentality.  It stems from a belief that the world is inherently unsafe, and what’s more, that we’re the only ones that can protect others and ourselves from it. I was blown away to first learn this. I just thought everyone felt this way. Through my training, I started to see things differently (and more importantly, I started to feel differently about them).
 
I began noticing what was happening in my body when I would have thoughts like “I have to fix this”. It turned out I was feeling the activation of the stress response cycle. My body was moving into fight/flight/freeze. This thought was coming from a place of desperation, scarcity, and fear. And it may seem obvious, but I’ll say it anyway: when we approach our clients from a trauma mentality, we’re of little help to them (especially if they’re dealing with trauma themselves).
 
Let me put it this way. If we’re both stuck in the whirlpool of trauma, then that means no one is actually standing on the edge, grounded and able to offer a connection to hope or aliveness. It’s just two people caught in the waters. And if you think your clients can’t pick up on this, you’re wrong. They may not be able to name it directly, but we all know the difference between what it feels like to be supported by someone who is empathizing with our pain and someone who’s overtaken by it. Our clients pick up on our nervous system cues, whether we’re in a calm place or a desperate one.
 
In order to be of real help to my clients, I had to start discerning when my actions were coming from a trauma response versus a healed place inside. I began noticing the physiological response. I noticed that I felt especially triggered when clients were talking about injustice in the court system. (Like when a family court judge grants custody my client’s abusive ex because there’s “no evidence of danger to the children” Ugh!). Now let’s be clear – we should all be angry when something so obviously wrong happens. Taking a moment to be angry with my client about what she’s going through is a pretty human response, and I think a good place to start. But as the therapist, it’s also my job not to get stuck in anger. I still need to be grounded enough in my own nervous system so I can guide her through and help her process the experience. Ideally I want to help her listen to what her anger is telling her, and understand what she wants to do with it.
 
These days, when I notice myself getting activated, I take the time to ground back into myself. When I can feel my feet rooted into the floor and stay connected with the slowness of my breath, I know I’m on the right track. I continue to do a lot of personal work on my own activation and stress response in order to help with this. (And here I can’t say enough about the benefits of doing your own personal work through as a therapist).
 
When I’m connected to my wise, grounded self, I know in my whole body that it’s okay to say no, and I want to pass on what was so clear inside me to each of you now:
 
You can hold onto yourself in the face of other peoples’ disappointment.
You can say no and still be a good person.
You can know that you’re doing enough and that doesn’t mean you have to be doing it all.
 
Here’s one more thing to think about as you work on saying no and respecting your own limits. When we take on our community problems, we allow the system to continue on as is, unchallenged and broken. Eventually there are too many clients who are failed by the system than we can support and we need to draw a line. In my experience, it’s better to draw the line before we get to our breaking point. And better to put the responsibility back where it belongs – on the broken system.