5 min readNov 15, 2021

The human condition is largely composed of suffering. There are days when the pain is so quiet, so dull, that we often forget that it is there entirely. There are days when this is the exact opposite; the ache is so terrible that you can feel it rattling through your bones, rotting through your innards like a billowing cloud of pestilence.

As a therapist, I feel that I should make it clear that this is my personal view, and doesn’t necessarily reflect the views of my practice. I do everything they taught us in graduate school. I dot my I’s and loop my P’s. I try to ensure that my clients feel safe. I listen to understand, not to respond.

I try not to let my emotions take control in the office. I’ve always been good at compartmentalizing. You have to be, in this work. Great therapists either feel too much or feel too little, and I have spent far too much time being the former. There is a lot of emotional labor that goes into this work.

I only survive by being cynical.

It’s hard not to judge the people coming into my office. It’s an innate reaction; to judge is to be human. I don’t let this affect my work, of course.

Some of the people that come in are so insufferable and oblivious I want to break my clipboard over their heads. Many are trying their damndest to avoid becoming too jaded before it’s too late. Others are trying to take the advice their friends and family gave them, trying to crawl back from that breaking point.

Many of them try to argue that their suffering has made them stronger, better. They desperately try to pin meaning to it. Anything at all would be better than knowing that this was the product of random chance, the solution to an ongoing equation of unfortunate circumstances. I usually tell them all the same thing.

“You didn’t need to be strong. You needed to be safe. You needed to feel safe.”

I’ve noticed, from years of practice, as well as over scrutinizing my own life, that we place so many awful rules and restrictions on ourselves that keep us from from forgiveness, that bar us from happiness, that lock us out of true self-love and acceptance. The most common misconception I’ve seen is that all of it has to mean something.

The religious ones fear that they’ve provoked the wrath of an angry god. The guilty ones admit that this is their penance for a life full of sin. The tired ones question why it had to be them, why any of this had to happen at all. The angry ones refuse to believe that there might be consequences to their actions.

Listening to them is not the hard part. The difficult bit is trying to tell a 40 year old man that he will never have the childhood he so desperately clings to. The difficult bit is teaching a teenager that sometimes the people that are meant to protect us do the most harm. The difficult bit is trying to see the humanity in someone so self-centered and delusional that they’ve never once reflected on themselves or the things they’ve done.

The emotional labor is spent in keeping calm, even tones. I often drink water when I mean to shout or cry. Sometimes I walk back to my desk when I can feel myself near the edge of horrific violence, verbal or otherwise.

My clients don’t know anything about me, and I’d prefer to keep it that way. There have been the occasional upstarts that try to spin their sessions on to me and my needs. They poke and prod, usually with snide comments, almost always with insensitive remarks. Those are the appointments I like best. Those are the days when I can just sit in silence, staring at someone, for an hour and thirty minutes at a time.

Have you ever really taken the time to look at someone? To take in their features? I can tell when they swallow wrong and their spit goes down the wrong hole. I know when they get skittish, because they’ll walk around my office and touch everything I’ve told them not to touch. I know when they want to talk when all they’ve gotten from me are polite smiles and measured grunts.

I see them for what they are, and that scares them. An entire lifetime they’ve spent trying to obfuscate the truth. Putting on veneers, hiding behind dozens of masks and alter-egos. So much time has been spent pretending that when the time comes for them to ask themselves who they are, the first thing they do is stutter.

I don’t take any delight in these sorts of patients. I don’t feel too strongly about my work, either. I try not to. I work to be clinical. Warm, yes, but at an arm’s length. I’m your therapist, not your father.

I try not to think about the details in my off time. I work and I go home. I drink, I laugh, I see friends, I fuck, I eat.

At the office, I’m whatever my patients need me to be. Some of them want to believe that their god still has forgiveness to spare. Many want to believe that the distance between who they are and who they believe themselves to be is not so vast that it could be mistaken for a lie. Others still want me to validate them, for someone to finally listen.

I listen to everyone. It’s what their insurance pays me to do.

Most, if not all of their issues, are systemic. They are products of vengeful lineages, family heirlooms passed down in spite of the loving homes they supposedly originate from. Many of my patients have no idea how difficult it is to actually heal, the toll it places on your body and mind. Those that do spend the rest of their lives teetering over the abyss.

To hold all the responsibility of your happiness, of your life’s work and its meaning is no small undertaking. It is profoundly terrifying in a way that many of us have not felt before. It is a primordial sort of fear. A black sludge waiting to slither down your throat, waiting to make its home among all the crevices where you bury your shame.

Why open your mouth in the first place, then? Why risk the literal and metaphorical suffocation?

To sing, of course. To laugh. To cry. To shout and to bellow and to scream and to sob and to guffaw until tears run down your face and your sides hurt too much from laughing. The ones who look bravely over the edge, the ones who face down the terrifying reality of existence, those are the patients I envy.

What the hell do they need me for?