Episode 3: The Weight of Other People’s Stories

In this episode of Both Sides of the Couch, Kari opens up about the unseen emotional and physical toll of holding space for others while managing her own chronic illness. She shares how, early in her private-practice career, she began noticing deep exhaustion, not just from long therapy hours, but from the intensity of listening, empathizing, and carrying others’ pain while masking her own.

Kari reflects on what it’s like to work through migraines, fatigue, and emotional depletion while still showing up as the “best version” of herself for clients, only to crash the moment sessions end. She pulls back the curtain on what emotional labor really means for therapists, and why the line between professional empathy and personal energy can get blurry.

Ultimately, Kari explores how chronic illness, self-employment, and empathy intersect, and how even the most compassionate therapists must intentionally protect their energy. She challenges listeners, therapists and non-therapists alike, to rethink self-care as a daily necessity, not a luxury.

✨ Takeaway: “Think of your energy as a luxury item.” When you treat it that way, every boundary and act of rest becomes an investment in your ability to keep showing up, for yourself and for others.

Transcript

0:01

Welcome to both sides of the couch. I'm Carrie, a therapist who also happens to be a human navigating chronic illness, which means I see life from both sides. This is where I share honest stories, lessons, and little reminders that you don't have to have it all figured out to keep showing up. Let's get into today's episode.

Kari 0:22

Today we're on episode three, and this one is the weight of other people's stories. So what I mean when I say that is the heaviness emotionally and mentally that therapists take on, especially when they're dealing with their own challenges as well. So here's my story. Early on in my private practice career, it was also a really difficult time. For me with my first diagnosed chronic illness, and I remember noticing like this heavy exhaustion after sessions. I had never experienced this outside of the private practice setting before, and it really started affecting my personal relationships. I used to be so much more extroverted. Like when I go back to, I mean I was younger, but go back to like grad school. That time I remember having a really good amount of social energy. When we're looking at, like today, right now, it's pretty low, especially on workdays. I wouldn't say I'm introverted, I just don't have as much social energy. Available to me because of the intensity of private practice, hour long therapy sessions with individuals or couples. Like there's so much intense focus that I'm giving the person on the other side that I have never done in any other counseling setting before and I don't really do outside of being a therapist, if that makes sense. So yeah, going back to. The beginning of my career in private practice, I, I didn't understand it. I remember being so confused like, gosh, why don't I like anybody anymore? I'm noticing that nobody like is really aligning with my expectations or boundaries that I have in relationships. Um, I had a therapist at the time, I remember talking about this with her pretty often, and she's like, yeah, you know, Being a therapist really changes the dynamics in relationships with others, and we are really trying to pinpoint what things were contributing to that overall and like specifically for me, I don't think I identified the piece about the emotional exhaustion tied in with dealing with chronic illnesses. Really made it just. So much harder to have, I think energy as a whole outside of work, I would hope that most of my clients really have no idea that I deal with chronic illness and that I'm fatigued and exhausted because in my, in, from my perspective, I'm on, I'm the best version of me while I'm working. And then after that, it's like I kind of deflate and to carry outside of work. So, yeah, so for example recently I've been having really bad migraines that will be on and off for weeks at a time. It's pretty much every single day. Maybe not the entirety of every single day, but I, I'm just having this really bad headache and I might be at the height of that pain. And have to go into a session. I mean, just imagine that having a really bad headache and then having to go to work and do like the hardest part of your job. It sucks. But again, with chronic illness, it's chronic. We work when we don't feel well. But yeah, so luckily, like I've mentioned a previous episode that I get to be my own boss and my job allows me to make a lot of accommodations for myself. So with the, the headaches. Right up until the session, I can have like ice or heat on my head. I can have my eyes completely shut when I go into session. I have the lights off, I do telehealth. So thank goodness for the camera making the lighting look better than it is.'cause I'm really like sitting in the dark, dark, dark, dark during my sessions. When I have a headache, I also have these like special headphones that don't bother my ears. You know, I could take medicine, I could do all these things to make it better. I have, um, a migraine stick that you roll on your forehead. I have a little migraine relief inhaler. Just a lot of things I could be using that would be harder to use if I was in office. But anyways, yeah, so it's really hard, you know, I'm in pain my head. I think if you've had migraines or headaches before, you'll understand what I mean of like anything you do involved your head in some way, like physically and mentally, and for me, eye strain is such a trigger for getting a migraine or making it worse. So in telehealth, I'm looking at a screen and. Yeah, I think even in person, my eyes are just very focused on the other person, but on telehealth, there's less to look at. You don't have a room of stuff. You don't see this big wide screen view of your client. You're seeing whatever they've got the camera focused on. So for most people it's just really their face and maybe shoulders. So the eye strain is just different. It's a lot anyways, so yeah, with a headache, any movement on my head like nodding, which I nod a lot when I'm listening. I don't know if you probably ever think about how much you nod as a therapist when you're listening, but when you have a headache, like every nod you're like, oh gosh, that hurt. Even smiling hurts speaking because it moves your head and the vibrations of my voice. And laughing. I, I do laugh a lot inside. I think we laugh a lot in session, but yeah, that causes a surge in pain too. And again, I mentioned this before, but we, we mask the pain. I mask the pain because the session isn't about me and I don't ever want my clients to feel bad if I'm not feeling well.'cause I know it would never show up to a session if I wasn't feeling well enough to work. But if you just tell your client like, oh, I have a migraine, they don't know. That I've already had this really intricate system of deciding whether I'm well enough to work or not, and how I've accommodated myself to be able to still focus with pain or not feeling well in other capacities. But yeah, you kind of, you just get through it and like I said, I don't think my clients would even notice a difference if I'm in pain versus not in pain because I mask so well. I'm still smiling. I still have the same types of looks on my face that I do when I'm not in pain. But when I log out of that session, a lot of times I notice it's my face deflates, like it falls, I'm frowning. A lot of times my hands go up to my face and I'm you know, just putting a little pressure on my head'cause it hurts. It's like the immediate shift when you click the end button. But yeah, and I think I mentioned this too, I tend to overdo it. So a lot of times if I'm not feeling well, I still have to finish my notes and billing before I can shut my computer and go recover. So it's pushing through that last little bit. And then I'll, sometimes I'm spending the rest of my day only recovering from working. That's happening less often. I'm thankful for that. But yeah, it's, it's rough out there. It is rough out there and I think I've had a hard time explaining it to people who aren't therapists, like the emotional weight. It's not what you think about when you think of a brand new baby counselor who's struggling with hearing all these awful things and they're oh my gosh, how do I get this outta my head after work? I'm thinking about work all the time. You just naturally get better at. Preserving that the longer you work in the field. So now of course I think about my clients between sessions. Of course there are sessions that really emotionally affect me. I've teared up in sessions before. I've been really sad after sessions. That definitely happens, but it's not consuming in that way for me. It's I'm giving myself a hundred percent. Present to my clients and being there for them in those minutes that we are in session together. And that is the emotionally draining piece for me. I said, I don't think I do this outside of work I am never that intense and focused as carry the human, carry the friend, carry the whatever. That's not a therapist because it's not my. Job. You know, it's just different when I'm working versus not working. If you have friends that are therapists, just remember this. They're not therapists in their personal life and they're never your therapist. So although we may be naturally better at listening sometimes and more empathetic, like you are never getting the therapist version of your friend a hundred percent, that's not what's happening. So anyways, yeah. Um, the emotional weight of going to session and holding all of that. And and then we are going through our own personal stuff like I'm sharing about my chronic illness, but I've also been through traumatic and really sad things as a human too. And definitely as a therapist, we. We still have to go and do this really heavy emotional stuff, even when we're going through it ourselves. Whereas yeah, everyone goes through that stuff. But when you work a job that isn't heavy and emotional, it doesn't take the same type of effort to prepare for it. It doesn't take the toll on you to be at work in the same way. So you'll, you'll notice a theme. I talk about self-care a lot, right? There's a lot that you can be doing. To take care of yourself every single day to deal with this stuff. But anyways yeah, so insight the lesson. I mean, I think it is what it is here. I so lucky that I can work full sentence. I feel so lucky that I can work. There are a lot of chronically ill people that cannot work, and I also feel so lucky. To have a job that allows me so much accommodation. Not every therapist can have that, and not every private practice therapist can have that either. And I recognize that and I appreciate that privilege.'cause I do wanna work. I think every chronically ill person wants to work. No one wants to be disabled. No one wants to have freedoms that other people get taken away from them because they're sick. And then I also like to tell myself nobody feels good after work to some degree, right? Like work is draining for all of us. Most people do not work a job that they would be choosing to do if they woke up that morning and had any, CHO had a choice to do whatever they wanted, right? Like most of us do not want to go to work and do a job. Uh, we wanna be spending our time maybe doing other things. Maybe there are other, like passions that we have that don't provide money or would be taken away. The joy would be taken away if we did that for work. But anyways. Yeah. I think for me too, the benefits outweigh the consequences with my job. Yeah. I, I really do like my job. I enjoy what I do. I can't imagine another job that I would be fulfilled in. I, and I really don't think I can ever go back to working for someone else. Carrie is the best boss in the world and I, I don't wanna work for anybody else. So those are kind of how I frame the difficult parts of my job. The benefits are so much higher than what it costs me, even as a person who struggles with chronic illness. And I work with so many people who struggle with chronic illness. Some of that I think, because I say I specialize it, but a lot of times, there's just a lot of chronically ill people out there and they end up in therapy for various reasons. But they all show up in they're flares too. A lot of them are working no matter how bad they feel, but I'm talking about show up for therapy, like they're in their bed. They've got their little accommodations. They're sitting in the dark, they're managing their pain and they're showing up to therapy too. So for me, I think being able to work with other people who maybe experience similar things health-wise, it does make it easier for me to feel safe at my job, if that makes any sense. I don't have to feel like. An outlier and maybe in mental health in general.'cause I think mental health to some degree is a chronic illness, right? Most people don't just have mental health symptoms for a few days and then feel better, like a cold or something, right? We're struggling with mental health chronically. So I think. Even if I'm not working with people who have chronic health issues, like to some degree showing up for therapy and working on whatever your issues are, those are chronic things and we're all in the same boat in life. But anyways, I just feel more motivated to put my needs first in the ways that I, that I can when I think about this and. I just wanna say every therapist deals with this, the emotional weight of our job. Even non chronically ill ones, even ones that aren't going through something traumatic. Right? And we still have to purposefully manage our self-care. That's something that you as a therapist, should be thinking about every single day. What do I need? What can I do? How do I make sure I'm taking care of myself physically and mentally and emotionally, occupationally education, all these different things. It's not just a like, oh, I think I'll, you know, have a sweet tree and that's my self-care for the day, like self-care. I could do a whole episode on this and maybe I will, but self-care is so many different things. And for someone who's chronically ill, you got a whole nother set of different things too. So yeah, if the takeaway here, if you're a therapist, is really just reflect on your self care plan this week. Think about if you feel overly emotionally drained because of work and what can you do to control that. I really recommend too, you have a colleague that you bounce self care ideas and plans off of. Or another therapist. Go to therapy yourself and talk about this. It's definitely not something as therapists, we should be managing a hundred percent on our own. And if you're not a therapist, I still want you to evaluate these things. Self-care is important for everybody. I talk about it with my clients who are not therapists. Obviously, it's something that everybody should be doing and is responsible for doing. It's gonna make you the better version of yourself no matter what your job is, or no matter what your role is in life. And I want to end on a quote, Taylor Swift, if you're a swifty recently said in a interview, think of your energy as a luxury item. And for me it really is. I mean, how can you manage I energy? If you look at things from this lens, it's a luxury item or it's a non-renewable resource, like whatever that is for you. So how can I manage my energy if I'm looking at it as a luxury item? And what does that look like for me? Um.

16:44

Thanks for joining me on both sides of the couch. If something you heard today resonated, share this episode with someone who might need it. And if you'd like to support the show or find more of my work, check the links in the show notes. Until next time, take care of yourself on both sides of the couch.