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Psychotherapists and their families: The effect of clinical practice on individual and family dynamics and how to prevent therapists' burnout and impairment

Posted on October 13, 2014 at 8:56 AM
****This article was published in Psychotherapy in Private Practice, 13 (1), 69-95****The Psychotherapy in Private Practice Journal is available online at: http://www.informaworld.com.


Read the full article here 

Abstract
Psychologists have paid very little attention to the effect their profession has on themselves and have consistently avoided examining its effects on their families. This paper explores the question: Are psychotherapists' families disadvantaged, or are they fortunate to have a therapist-parent who is an authority in the emotional, cognitive, and behavioral domains? Related areas that are explored are the uniqueness of psychotherapists' personalities and the effect of their practice on their personal lives. The paper focuses on the ramifications of the psychotherapists' practice on their own lives and their families', and proposes possibilities for enhancing the positive and preventing the negative effects of their careers on themselves and their intimate connections.

Psychologists have studied the effects of a variety of professions on the professions' practitioners. Physicians, career military personnel, corporate executives, political leaders, and artists are among the many who have been analyzed by psychologists. However, psychologists have failed to systematically study the effect practicing psychotherapy has on their own lives. Similarly, psychologists study the effects of every conceivable kind of family dynamic on children. They have studied the children of alcoholics and schizophrenics, disabled infants, and the children of divorce. They have compiled volumes on baby rats, infant gorillas, puppies, and bunnies. Yet they have consistently neglected to inquire into the dynamics of their own families. They have consistently avoided hypothesizing on the impact of being or living with a person who is an expert in the emotional, cognitive, and behavioral domains.
While limited attention has been given to the effect of psychotherapy on the practitioner, even less has been given to its effect on the practitioner's family. Short of a half a dozen anecdotal articles on families of psychotherapists, even fewer clinical reports on family or group therapy, a single empirical study (Goldney, Czechowicz, Bibden, Govan, Miller, & Tottman, 1979), a page or two on analysts' children in books by leading psychologists, such as Kohut (1977), Miller (1981), and Bettelheim (1976), and a thorough and thoughtful, but extremely anti-therapist biased book by Thomas Maeder (1989) titled Children of Psychiatrists and Other Psychotherapists, the field is suspiciously empty.

The resistance to attending to the complexity of psychotherapists' lives is not only reflected in the lack of comprehensive analysis, but also by the American Psychological Association's governing board and membership's reticence to set up a nationally coordinated program to identify and treat distressed psychologists and prevent burnout. Psychologists, psychiatrists, and counselors have been instrumental in the development of employee assistance programs tailored to serve the needs of other distressed or impaired professional employees. In contrast to psychotherapists, the American Medical Association (AMA) and the American Bar Association (ABA) as well as national organizations of dentists, attorneys, nurses, and pharmacists long ago established avenues for distressed professionals who are seeking help (Kilburg, Nathan, & Thoreson, 1986; Laliotis & Grayson, 1985).

The reasons for this lack of attention to the hazards of the profession are open to speculation. Many therapists claim that their professional lives have no bearing on their personal lives. Therapists may possess a prejudicial sense of grandiosity and invulnerability; they may assume they are capable of helping other professionals, but be incapable of recognizing that they themselves need help. Kottler (1987) attributes their resistance to the illusion that psychotherapy is the pure application of "scientifically tested principles and reliable therapeutic interventions" (p. 26). Other psychologists admit their reasons for not studying themselves stem from defensiveness and the professional practice of focusing all investigations on the patients (Farber, 1983).
This paper maps the complexity of the interaction between the practice of psychotherapy and the personal and familial life of the practitioner. It is based on the author's work in individual, couple, and family psychotherapy with psychotherapists and their families, and on a series of workshops conducted with such families regarding the impact of their clinical practice on their own and their families' lives. Participants were representative of all therapeutic disciplines: psychiatrists, clinical psychologists, clinical social workers, and master level trained counselors.

The clinical data gleaned from these subjects is combined with an extensive review of the literature. Together these provide a map to guide in the exploration of this rarely visited wilderland of therapists' family dynamics. This paper identifies the areas of inquiry, separates myths from realities, and critically examines the existing theories and research. In addition, to specify the strengths and weaknesses the profession brings to psychotherapists' families, the paper suggests ways of enhancing the positive and minimizing the negative effects.

The basic question posed by the paper is: Are psychotherapists' families disadvantaged, or are they fortunate to have a therapist-parent who is an authority in the emotional, cognitive, and behavioral domains?
In order to answer this, three further questions must be thoroughly investigated:
  1. What are the distinguishing characteristics of psychotherapists' personalities, and is there any truth behind the myth of the "wounded healer"?
  2. What aspects of psychotherapists' training and practice are relevant and likely to affect their personality, quality of life, and interpersonal skills?
  3. Do families parented by psychotherapists develop special dynamics due to the parents' profession? And, if yes, what is the impact of the parents' profession on their children?

Categories: Private practice

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