Therapy for Therapists: What Compassion Fatigue Is Really Asking of Us

What does compassion fatigue feel like for a therapist? • Why do I feel numb or irritated with my clients? • When is it time for therapists to have therapy of their own?

Therapy for therapists is often talked about as good professional practice, but I think it is something deeper than that.

Being a therapist requires us to continually sit close to grief, betrayal, trauma, fear, heartbreak, and loss. We ask our clients to turn toward difficult emotions, listen to their bodies, notice the places they disconnect, and make space for what they have spent years avoiding.

But therapists need somewhere to do that work, too.

For me, understanding therapist compassion fatigue has meant looking beyond caseloads, vacations, boundaries, and traditional ideas about self-care. It has meant asking what happens to all of the emotions that arise in me while I sit with another person’s pain—and what happens when I continually ask my nervous system to push those responses away.

Yesterday was just another typical day in America for me. I woke up, got my kids ready for the day, and headed to the gym. I got my nails done, had a parent-teacher conference, got my kids to their after-school activities, and had a few sessions with clients. Before heading out for my own tennis practice I scrolled social media and saw a few reels about yet another horrifying story of rape culture - the Cornell rape case was all over the internet. I could feel the familiar mix of outrage and sorrow enter my body. I googled Cornell 7 to find a CNN story and get the basic facts about the case.

I didn’t have time to fall apart over it the way I did when I heard about the Motherless website. I closed my phone, closed my eyes, and sent a little prayer to the victim knowing I’d return later. After tennis practice I sat in my driveway and opened my phone. I read Lissa Rankin’s substack post, The “Free Pussy” SnapChat at Cornell & Why We Can’t Become Numb to the Next Horrifying Story of Rape Culture.

But after reading it, I did feel numb. I didn’t throw open the door to my home in outrage and tell my husband angrily about what I had read. I didn’t pick up my phone and text my friends to tell them about my devastation and heartbreak. I walked in, sat down, and asked my son about his day. We talked about what time my daughter would be home and ate dinner. 

Life just went on. 

Since having a kundalini awakening in 2022 and becoming fully embodied I can’t dissociate for very long. It’s been less than 12 hours and sitting down to write about compassion fatigue in therapists brings up a well of emotion as I think about my own process yesterday. 

I have to be careful about the amount of news and social media I ingest. Stories like the Cornell rape case, Motherless and the Epstien files wreck me. My body physically hurts, and I cry - sometimes for days. 

There are times when I wish I could turn it off and not feel so deeply, but I know that this is what makes me fully human. 

My soul came here to feel. 

It came here to love and be loved, and to help others remember how to do the same. My ability to feel what another person feels is what makes me a good therapist, but it’s my soul’s calling that makes me an amazing healer. 

But what happens when the things that make you amazing at your work - your love, humanity, connection, and compassion become the things that your nervous system tries to protect you from? 

Why Therapists Need Their Own Space to Process

In 2008 I became an intern at a community mental health center, and I had my very first session with a client. I was given a folder with hand-written information about the person I’d be seeing which included a completed intake. Reading it over, I learned she was 30 years older than me, and was seeking therapy after the death of her best friend. When I walked in and sat across from her, I immediately felt tightness in my chest and a constriction in my throat. The air felt dense and thick with grief. 

The session is a blur as I try to remember it now, but I recall not knowing exactly what to say. I defaulted to asking her to tell me about her friend and their relationship. I nodded as she filled the space with sadness and tears. My chest and throat ached from the softball sized ball of grief I felt in my own body. 

After the session I met with my supervisor to discuss how it went. She told me how to assess clinical depression and how to make an appropriate referral for a medication evaluation.

I didn’t say anything about the physical response I had in that session or in the subsequent sessions. At the time I believed my job was to help my client stop feeling so much grief, and if I carried some of it with me then it was a sign I was helping. For years I’d feel responses in my body to the emotions my clients expressed and I called it compassion. 

The woman who lost a child, the couple on the brink of divorce, the infidelities, the betrayals, the car accidents and sexual assaults. One session at a time I’d open the door and my heart to whatever my clients brought me. When those 50 minutes were over, I’d walk to the bathroom, wash my hands, refill my drink, and stretch for a couple seconds before greeting the next client. 

When Holding Space Starts to Change You

A couple years before I began my own healing journey, I started to notice that at the end of my longest days with clients, my body would feel physically exhausted. I’d go home and try my best to be present with my family. I’d have trouble sleeping and wake up the next morning feeling hung over without having drank any alcohol. My whole body hurt and I had a headache. I bought expensive chairs to support my spine, took breaks to eat and take walks between sessions, and eventually I’d stop giving myself fully to my clients. 

I began to feel some callousness about the things I’d hear on repeat. Miscommunication between a couple was just par for the course. The pain they felt would subside eventually if they began to understand their patterns and changed their behaviors. I became bored and numb during sessions. 

When I started to feel numb I’d plan a vacation or take time off, thinking that a change of scenery would help me feel renewed. Most of the time it did. But it was only because I’d have several days of disconnection from my clients. I’d do my best not to think about them and stay focused on my trip and the people I was with. When I returned it wasn’t long before the same pattern emerged. 

When I started using psychedelics everything in my life changed, including my career and the way I showed up for my clients. I woke up the morning after my second journey feeling like there were bees buzzing through my veins. I could actually hear the vibration of my own blood and energy coursing through me. It was as if the medicine connected all the tracks that had been separated through social conditioning and childhood trauma and made my entire being feel whole and connected.   

Being embodied and feeling fully alive meant that I could no longer move into numbness without my body sending off warning bells and red flags. I could no longer stuff down the responses I had to my clients. It turned out the pain that showed up in my body had nothing to do with my chair or need for a vacation - it had everything to do with what I was holding and not responding to in my own internal landscape. 

In grad school and in my internships I had learned about countertransference and how it could impact the way I interacted with my clients if I wasn’t careful. I learned it could drive me to make the session all about myself, cross boundaries, or reject clients if I wasn’t careful. I was taught to shut off any of my own responses and only reflect back what I saw in my clients, and it was often seen as shameful whenever a fellow student brought up their own feelings toward a client in group supervision. 

As I began waking up to myself and my body I also began to wake up to the culture I have been living in. The way I was taught to manage my countertransference was not happening in a vacuum. My training existed in the same culture I did - the one that had taught me how to override my body, ignore or contain inconvenient emotions, keep focused on productivity and perform the roles that were expected of me. 

The paradox is such a mind-fuck. Being taught to help people tune into their internal and emotional experiences while simultaneously being taught to be suspicious of my own. This creates an unspoken us-them dynamic in the therapy room. The therapist is supposed to play the role of the healthy one, the one who supposedly has all their shit together and the client is the person struggling and needing our help. 

There are so many things wrong with this, but I’ll save my rant about colonization and the white men at the forefront of psychological advancement for another time. Ailey Jolie wrote a great article about that here.

The Problem With Asking Therapists to Leave Themselves Outside the Room

In order to maintain that distinction I was taught to leave parts of myself out of the room. The thing no one taught me was that in order to avoid compassion fatigue, I had to lean into the very things I had been taught to avoid and shut down. My own body and emotions have always provided a wealth of information about the processes that were happening in the room. 

I'm not a mirror simply reflecting back what I'm seeing. I am a human who feels deeply when someone tells me something horrifying. I no longer want to remain the “healthy one,” and I no longer want to uphold the “I know. You don’t.” mentality that plagues our culture. 

When I use this lens to look back on that very first client experience, what I now see is that my assignment was never to help her feel less pain. It was to help her feel her grief in a safe and supported way. She was actually the one with all of the experience because she knew grief in a way that I didn’t. My lack of knowledge and inexperience made me stop talking and make space. The tightness in my throat and chest alerted me to her deep sadness and pain so that I could attune and respond to her with care. 

This is the way that I’ve learned to sit with my own feelings and it’s an invitation for you to sit with yours. 

Compassion Fatigue Isn’t Always About Doing Too Much

My belief is that when we therapists experience compassion fatigue, the act of pushing down our own emotional responses is actually what makes us feel exhausted. 

It takes a lot of energy to show up and act as if another person’s story doesn’t impact you. Without the proper guidance, outlets, and space to safely feel and respond to your client’s stories and pain, pushing it down and disconnecting become the safety your nervous system chooses and over time the exhaustion takes over. 

Compassion fatigue keeps you from holding the frame for your clients. It pulls you out of your own energy and you stop holding them accountable. You stop challenging them where you’ve stopped with yourself. You being tired isn’t just about being tired in relation to them. It’s about being tired in relation to yourself and your own unprocessed emotions. 

Therapy for Therapists Means Having Somewhere to Put What We Carry

But Alicia, I don’t have the time/money/energy to process my emotions. 

These are the things I hear most about why people can’t possibly allow themselves to feel. But truthfully, they just don’t feel comfortable allowing themselves to feel. Tears are free, and in the beginning it might take longer than you’d like to move through something, but eventually you get good at it. It does take energy, but so does pushing it all down. 

My practice has completely changed as I have learned to allow LOTS of space for my emotions. 

I cry in my car after I drop my kids off at school, and in my driveway when I get home. I cry on the phone with my friends and we even spend whole weekends dedicated to feeling and processing while our kids aren’t around. When I’ve had a long day at work, I come home and instead of watching tv on the couch I sit in the bath and invite my body to tell me about all it’s been holding. Sometimes that leads to tears, and other times it leads me to my own deeper processes around the triggering things I’ve heard that day. 

When a client tells me that they have lost someone they love, I don’t try to hide the tears that well up in my eyes. And when someone who has spent years healing and growing with me as their therapist tells me they’ve finally fallen in love, I let those tears come too. And guess what? I haven’t taken over a session or made it about myself by letting myself feel. It’s a simple connection of humanity that says, I see you and I care for you, therefore I feel for you. 

Their grief doesn’t become my grief, and I don’t need them to take care of me or my emotions. I can feel deeply and know what belongs to me and what belongs to them.

But Alicia, isn’t that overwhelming? 

Yes, sometimes it is. But you know what else is overwhelming? Walking around like a zombie, feeling numb and disconnected, scrolling past horrific news stories on your phone because you no longer have the capacity to let another one in. 

When I allow myself to feel the weight of what I’m seeing and hearing and truly emote, I come out on the other side with more capacity for love and connection to others. As the news about Jane Doe and the Cornell 7 will continue to unfold in the coming weeks, I’ll allow my body to show me how it wants to process. For now, I’ll let the tears fall - a symbol of the preciousness I carry that helps me remain human, embodied, connected, and alive. 

What Therapy for Therapists Can Look Like

Being a therapist is a sacred practice. It requires that we attach, attune, and remain open to our client’s stories, and those stories have the ability to trigger our unhealed parts. But where do we go to do that work? In January I’ll be opening the doors to my Healing Circle for Therapists, where a small group of us will gather weekly for 6 sessions to slow down, turn inward, and make space for what we’ve been carrying. There will be a short guided meditation and an invitation to sit with some of the uncomfortable truths we inevitably find ourselves experiencing. We’ll use brainspotting and IFS techniques to guide us inward, each person engaged in their own private internal process while surrounded by a community of therapists doing the same. And since doing your own work shouldn’t be a luxury, pay-what-you-can pricing will be offered. If we are going to continue asking our clients to turn towards themselves, listen to their bodies, and feel what they’ve spent years pushing away, we need a space to do the same. 

If you’d like to hear more about the January Therapist Healing Circle when registration opens, join my mailing list and I’ll send you the details.   

Alicia Taverner, LMFT, is a licensed marriage and family therapist who helps couples heal after infidelity, years of resentment, and the exhaustion of feeling stuck in the same painful patterns.

Her work helps partners begin to understand each other again, rebuild appreciation, and create lasting change with a focused, supportive approach. Alicia uses brain based techniques, including Brainspotting and ketamine assisted psychotherapy, in an intensive format that gives couples more room to heal without the start and stop of weekly sessions.

Learn more about Alicia’s work with affair recovery intensives, relationship therapy, and ketamine therapy, or visit her About page.