Becoming a Confident Therapist

Sometimes being a therapist feels like playing a game you can never win. You go to school, rack up hours, get training, and even after you’re credentialed and settled in your shiny new private practice, you still feel unsure about yourself! As so many of us know, experience doesn’t always equal confidence, and even late into our careers, we can still feel adrift. It’s no wonder that so many of us wind up burnt out—or even leaving the field altogether.

It took me years to realize that confidence doesn’t come from working long hours, or from reading dozens of thick books, or from attending dozens of professional conferences. Thanks to two encounters with wise, seasoned therapists, I learned that true confidence isn’t merely trait, but a way of orienting around the inherent uncertainty in our line of work.

Of course, I didn’t learn this lesson easily. Even after checking off all the items on my “master therapist” list of requirements—a doctorate, licensure, a full-time clinical practice—I still felt an existential angst, like something was missing. I knew I wasn’t the only therapist who felt this way.

I was sure there had to be some nugget of wisdom or insight that would bring me clarity and contentment. How did psychotherapy’s greats “arrive?” I wondered.  Where did their confidence come from? Even though I felt uncertain about my own path, I was less hesitant about asking for help. What’s the harm in reaching out to a few well-respected therapists? I thought. So I did. Sitting with the unknown felt scarier than rejection.

I sought the counsel of Bill Doherty and Sabrina N’Diaye, two therapists whose conference workshops I’d recently attended, and whose clinical confidence, skill, and wisdom was immediately apparent. Both responded that they’d happily lend me their ears, and I scheduled a Zoom call with both later that week.

The Importance of Showing Up

When I first spoke with Doherty, I told him about my idea for a book that would showcase the lessons of therapy greats to help other clinicians navigate uncertainty. “I don’t think I really struggle with uncertainty,” Doherty responded. It caught me off guard. How does someone not struggle with uncertainty?

“The truth,” Doherty continued, “is I got there early.” Like many therapists, Doherty took an early interest in community service, and before becoming a therapist, actually trained to be a Catholic seminarian. He tells me that during a seminary physics class, his relationship with uncertainty changed. In lab experiments, he saw how light behaves as both a particle and a wave, which illustrated a valuable lesson: two things can be true at once.

Bill learned early that the answer to most questions is ‘It depends.’

Pastoral training was similarly valuable. “You had to show up,” Doherty explains. Presence was an essential component, especially since he never knew where he would be called. Rather than focusing on learning and mastering a specific technique, he was focused on “showing up.”

Doherty tells me his favorite mantra is “Human behavior is the product of many weak forces,” which reminds him that there’s no “right” way to do therapy and there are many pathways to healing. Most therapists understand this on a surface level, but have trouble remembering it, especially when sessions become challenging. If there’s no right way to do therapy, then how do we know if we’re helping?

Doherty says he tries to avoid focusing too much on outcomes. “Instead of asking myself whether they’re getting better, I ask myself, ‘Was I being a therapist?’” It’s not that Doherty doesn’t care about his clients improving, but “being a therapist” is the first step. Moving away from outcomes to focus on the process. Sometimes it’s easy to get sucked into trying to be an expert or guru instead of being a collaborator.

So how should we think about outcomes, then? Doherty believes that outcomes are based on a combination of factors: the therapist, the client or couple, and outside forces. It makes me think of the trap that so many pseudo-confident therapists fall into: they follow their approach, and if the client stalls or struggles, it’s the client’s fault. There’s no room for them to be at fault, or for other outside forces at play. Conceptualizing the therapy process as one of presence and collaboration allows us to remain grounded even when outcomes seem unclear, and build confidence in the face of complexity.

Non-Negotiable Confidence

When Sabrina N’Diaye appeared on my computer screen, I was struck by how centered and confident she looked. When I tell N’Diaye this, she smiles. She responds that in the past, her colleagues actually viewed her confidence negatively, like the white coworker who told her she couldn’t work with N’Diaye because she was “too confident.”

“What else do we need to put on the table to work together,” N’Diaye replied, “because my confidence is non-negotiable.” I got goosebumps when I heard this. N’Diaye’s confidence wasn’t bravado, but a boundary. She could work collaboratively, but not if it required self-erasure.

I imagine most therapists would hear responses like the one from this coworker and spiral—but not N’Diaye. “I worked my ass off for this confidence,” she tells me, “and no one can have it.” As a Black Muslim woman who’s lived and worked in a field historically dominated by white clinicians, there’s strength in her confidence, forged in an environment where she was questioned and challenged for merely existing.

N’Diaye tells me she comes from a long line of women whose confidence was stripped from them. Her book Big Mama Speaks tells the story of her maternal grandmother (Big Mama) who suffered a stroke after an incident of police brutality. N’Diaye has encountered her fair share of oppression as well and credits the matriarchs of her family for keeping her confident in the face of it all.

She tells me how her mother once told her in passing, “I don’t know if reincarnation is real, but I hope God sends me back as a Black woman.” This statement would become a common refrain from her mother—“and it got embedded in me,” N’Diaye says. It became an inner voice of self-love.

When it comes to doing therapy, N’Diaye’s approach reflects this self-love. She tells me she stays centered knowing there are people looking for exactly what she’s offering. Then, I start to wonder: What if what I really need is to just be myself? To trust that there are people out there who are looking for what I’m offering too?

N’Diaye sees herself—and is seen—as joyful and full of love. So I’m not surprised when I hear her say, “I look at all [Black women] hold, and I want it all. I want to drink it up. You have to take the suffering and the beauty together. They are inexorably linked.” Here yet again, our work becomes a balancing act, where we hold multiple truths.

Holding Complexity

How do we hold complexity—like the idea that two conflicting things can both be true—without automatically feeling discomfort? Without feeling like we need to seek outside reassurance, or getting stuck in the illusion that if we follow a particular approach, we’ll develop confidence and competence? I suspect many therapists believe that if they follow a certain evidence-based method, they’ll feel like they’re doing a good job. But the truth is that the meaningful work of therapy comes when we hold tension without knowing what comes next.

N’Diaye’s confidence is grounded in her ability to connect to her value and live in complexity. She holds messiness without rigidity. Her confidence isn’t a shield, but an anchor. It demonstrates that when we believe in ourselves and our unique gifts, we can all find our own unique version of confidence.

After my chats with Doherty and N’Diaye, I kept coming back to the idea of being, of focusing on what’s happening in the here and now. This has helped me stay grounded, especially during intense moments in and outside of therapy, and I know it’s the best thing for me as someone who avoids conflict, even when it’s healthy conflict.

I held on to this idea recently, while working with a couple. The husband, who’d had an affair, had been resistant to therapy, and much of our work had involved getting his buy-in—but our work felt very stuck as a result. But now, I realized that much of this stuck feeling was due to overly focusing on buy-in, not on accountability. We experienced a turning point after, instead of affirming the husband’s resistance, I said he’d need to start building trust again. It felt like my heart stopped after I said this (after all, the husband was not a fan of my declaration), but I’d finally named something I’d avoided saying for a long time out of fear. Surprisingly, the husband didn’t stop coming to therapy, and our work deepened.

I’m still working on becoming a truly confident therapist. I try to keep in mind N’Diaye’s message that we all have unique value, that we’re not the right therapist for everyone—and we don’t have to be. All we need to do is be ourselves, and we’ll serve the people who are a good fit for us. It’s okay if the occasional client doesn’t like us, that’s okay. We’re not meant to be liked by everyone. It still makes my chest tighten just to write this, but connecting to my value has been an essential step in building my confidence. Likewise, I try to keep in mind Doherty’s point about not looking for particular outcomes, but focusing on my role and taking a big-picture view, which helps me more accurately view my responsibilities.

Now, when I find myself in session frantically searching for an answer, I pause. I think about what being means in this moment, for this client. I hear Doherty’s and N’Diaye’s voices, and I realize that maybe I’m searching for something that isn’t ready to be found. I remember that confidence emerges, slowly, amidst all the beautiful unknowns of therapy.