Any identifying information has been altered to protect the identity of the clients portrayed.
In late August of 2019 I was gearing up to see my first clients. My supervisor told me I would be seeing them on my own — no shadowing, no co-therapy. Just me and my would-be clients alone in an office that wasn’t my own.
I set the days and times I could be available on my schedule, working around my job I still held at the clinic call center and classes that continued Monday and Tuesday nights. And then I waited.
Anxious thoughts burrowed into my head — worries about who that first client might be, what problems they would present, and what they would expect of me. I tried re-reading some of my textbooks, hunting for any assurance or guide or how-to for the first session, but quickly dropped them in favor of a pint of Ben & Jerry’s ice cream and another round of Super Smash Bros. (an addictive multiplayer fighting game) with my roommate Micah.
We shared a cheap two-bedroom apartment just north of Minneapolis. As a 20-something guy I thought we had decorated the place nice enough: a few plants on the windowsill, a sunken couch with mismatched throw pillows, a pink and orange lava lamp next to the TV. The kitchen was cramped; a small cutout that barely fit a stove and refrigerator. The neighbor just on the other side of my bedroom wall had a penchant for playing jazz music a little too loud for three in the morning. It wasn’t ideal but it was markedly better than the moldy basement I had just moved out of that would flood with any hint of rain.
One night just before I headed to bed, I checked my email, and a chasm tore open in my gut. My first client was scheduled for the next morning. In the comments of the appointment were just two words: suicidal ideation. Those fearful thoughts screamed, shrieked, and set the warning alarms off. Reality sunk in like a boulder on my chest.
Up until this point it felt like I might be preparing for my first client forever — that I would just keep going to class and learning theory and awkwardly laughing with my classmates mid-mock session because I didn’t know what else to say. But this was a threshold, stepping from that season of preparing and school and “I wonder what it will be like” into this stark and uncertain and raw land of real people with real problems coming to see me for help. Me.
That night I was still just a grad student. The next day I’d be a therapist. Or at least I’d be expected to be one. And that expectation felt impossibly heavy and entirely foreign. It didn’t fit with how I felt about myself at all, like trying to put on a pair of jeans that are way too tight. I didn’t feel comfortable wearing the therapist pants.
I tried to breathe, calm my thoughts, pray, anything to ease the panic. I texted my family, my friends, and my fiancé asking for support. Part of me hoped I might get struck with some sort of sickness overnight, that the therapy gods would put me out of my anxious misery before I could utter my first and how did that make you feel? I tried to sleep but I couldn’t; my fear wouldn’t let me, and I guess those therapy gods wanted to see how this one would go.
I rolled out of bed that next morning feeling groggy and exhausted. It was a hot and muggy Minnesota summer day, cicadas buzzing harshly just outside my window. I downed my coffee on the drive to the office which helped the tiredness but inflamed the anxious jitters swarming my chest.
To make sure I wouldn’t be late, I arrived a prompt 60 minutes early. I paced around the borrowed office I was allowed to use that morning. It was decorated neatly but I felt uneasy, like I was intruding into someone’s home. As I paced, the walls felt like they were closing in. With a huff I decided a walk in the open air would help. The heat and humidity were oppressive, and I almost turned around after 10 minutes of nothing other than drab office buildings and clinics, but just past a family doctor’s office, a set of stairs led down to a small pair of ponds. Tall oak trees, their bark thick with deep ravines, generously offered shade; the ponds, dotted with lily pads and floating mallards, absorbed the humidity. Puffy white clouds lazily drifted by. It felt like a small oasis.
I found a picnic table at the far end of the pond to sit at and breathe and attempt to sort through my anxious thoughts. I tried to remember why I wanted to be a therapist in the first place, what I had hoped for when I started this uncertain journey, but it was like searching for something in a dark covered box, awkwardly identifying objects by touch alone.
I think I’m good at listening and helping people, was that what made me think this would be a good idea? People in my life, people close to me like my mom and dad and friends and even college professors thought I might be good at helping people. Was that it?
Amid the anxiousness and striking fear, the reasons coming to mind felt unconvincing, holding little weight. A slight panic rose in my chest, and I wondered if this had all been a mistake. Was I way out of my depth, struggling in the deep end and just realizing it now? 5 minutes before my first client?
5 minutes?!
I jogged back to the office, sweat beading on my brow and under my arms and through my socks. The swarm of anxiety in my chest buzzed harsh and loud like those awful August cicadas. My heart pounded so hard I could feel it in my ears. I thought about jogging right past the practice, down the highway, all the way home. Something, though, tugged me back to the office.
Gulping down a glass of water, I checked my phone one last time. Somehow in my anxious frenzy I had missed a series of text messages from those I had reached out to the night before:
You got this Ben; I’m rooting for you!
Proud of you son, you’ve put in so much work getting to this point, I’m sure you’ll do great.
Praying for you hon, you’re not alone and we love you always!
With each message I read, the frantic buzzing eased a bit. It didn’t go away completely but there was something else there now too; something soothing, like gentle rainfall. I took a deep breath in and exhaled slowly. It was time.
As I walked out toward the waiting room, I felt as if with a metallic click I had been untethered, like a small boat set out toward an ominous sea. It was unnerving. With an awkward hello I ushered the man waiting for me back to the neatly decorated office and it dawned on me that it was just him and I now. I didn’t feel ready. I thought they – my professors, my new supervisor, my unsuspecting client – had too much faith in me: that I would be okay, and I might even be helpful. I didn’t have that faith in myself — or if I did it had been shoved offstage by something dark and looming inside me. I closed the door and took a seat.
Tony was in his mid-40s. He sat hunched on the couch in front of me, his head in his hands. Hot, severe sunlight poured through the window that looked out toward a thin line of overgrown shrubs, and beyond it, someone smoking at the back of the nearby hotel.
Tony told me through tears that he lost his daughter in a car accident a year ago. Since then, hope for his own life had been hemorrhaging severely. I was shocked at how quickly he opened up to me. Without hesitation he poured out details of the accident, how he got the call from his wife who was disintegrating on the other end of the line, how they divorced six months after that.
I gave some nods and mhmms to let him know I was listening. But I was barely listening. Half my attention was frantically recording everything he said as fast as I could, trying to piece the relevant information into the appropriate sections of my diagnostic form. The other half of my attention sprinted miles ahead, trying to scope out where I might direct the conversation to be helpful. The look in his face and the tears on the ground were more than enough to turn my internal people-pleasing dial to ten.
I awkwardly prodded about whether he had thoughts of harming himself. He shifted in place on the couch and said he thought about it sometimes but didn’t have a specific plan, nor did he want to add more grief to his family. “The pain is unbearable, though” he said, looking me dead in the eye. I held his gaze for a moment then looked back down at my laptop.
Multiple times I almost asked if he had a therapist, barely comprehending that I was his therapist now. This left an uneasy feeling in my gut as I tried to imagine helping Tony beyond the first session. After gathering information and getting to know each other, what then? What do I actually do to help him? That dark and looming feeling inside me groaned and grew.
Any question that came to mind I jumped on quickly. I desperately didn’t want to stall halfway through our allotted time without anything else to say. As the hour sped on my brain felt erratic, my jaw ached and stiffened with tension, and my entire body buzzed from the gallons of adrenaline.
Finally, it was time to start wrapping up. I stumbled through a disjointed and wandering monologue about how I might be able to help. Then I took a breath. I told Tony how sorry I was for his loss, that I couldn’t begin to fathom what he might be feeling. He looked me in the eye again, and for a moment the anxiety stilled and fell silent. A warm sadness, something like a hug after a good, long cry, took its place.
I had no idea how I could be any help to Tony. Part of me still wanted to sprint out of that room and never look back and forget I ever wanted to be a therapist. But another part, a quieter and spacious part of me wanted to stay, if only to sit with him. With some hesitation I asked if he would like to schedule further sessions and to my surprise, he said he would.
When you are just starting as a clinician you don’t know who you are professionally — your strengths and abilities, your limitations, your trusty tools. You don’t know the lay of the land either — your role as a therapist, reasonable expectations for what your responsibilities truly are, what progress looks like. It’s easy, then, to fill in the gaps with fears of not being good enough and expectations that are way too high, severely unreasonable.
And that’s hard; not just for you, but for everyone. I haven’t talked to a single therapist who said those first years were easy. This sort of change and pressure often shines a spotlight on dark and hidden parts of ourselves.
I recall a conversation my supervisor and I were having about clients that struggle with perfectionism and low self-worth. She told me it’s important to explore the narrative, help them see where those feelings were planted and how they took root. Usually there was a message at some point that they have to prove their worth, that unconditional love and acceptance need to be earned.
Something about that resonated with me. Sometimes helping people felt natural, like a blooming that was bound to happen. Often, though, helping was intricately linked to duty and guilt and fear. If I didn’t help this person, would they be mad at me? Disappointed with me? Shame me? Helping was something I was good at but also felt like the only thing keeping me safe. And as a new therapist, that felt precarious.
That conversation with my supervisor wouldn’t happen for several years. The narrative I was living when I saw Tony was that I had to earn self-worth, prove that I belonged here. It added crushing pressure to those early sessions. On the surface I was learning how to be a therapist. Underneath, though, I was barely treading water, fighting to prove my worth as a person.
I wish I could go back and whisper in my ear or touch my heart in some meaningful way. But also, I now know that the valley I was walking down into — the coming years of struggle and exhaustion and pain — was the only way through. Like I tell my clients now, it’ll get worse before it gets better.
After showing Tony the way out, I shut the door of the borrowed office and sunk to the ground. I felt exhausted and relieved. My jaw was as tight as a screw and my brain was splitting with a headache. But I did it. I made it through my first session and survived. I had no idea what we would talk about next time. But I survived.
Right there next to the fear of what that shadowy valley had in store for me, a small thrill of pride ballooned in my chest.
Maybe I could do this?
Featured photo by Annie Spratt on Unsplash