In Consultation

In Consultation

When Therapists Blame Themselves: Using Regret to Deepen Our Work

By Jelena Kecmanovic

January/February 2022

Q: Sometimes I regret how I handled an issue in therapy: either what I said, or didn’t say. How do I deal with these feelings?

A: A couple of months ago, I got a fever that wiped me out. After a negative COVID test for a breakthrough infection, I found myself in a familiar professional limbo. Obviously but not severely sick, and lacking a diagnosis, I was reluctant to cancel or reschedule a whole week’s worth of clients, especially since many of them were virtual. So I ended up moving a few clients but seeing the rest. These sessions didn’t go well. I was exhausted, and it showed. The following week, I was diagnosed with viral pneumonia.

Worse than the pneumonia was the regret. Why hadn’t I listened to my body and given myself a break? I’d never even acknowledged to my clients that I wasn’t feeling my best, though I’m sure many of them noticed something was off. I still cringe thinking how my client Jim must’ve felt when I didn’t ask about the family reunion where he’d seen his estranged brother for the first time in years.

Most therapists, at one time or another, struggle with guilt and self-blame related to the work. But instead of suffering silently, I’ve found helpful ways to handle these thoughts and feelings, and even leverage them so we can grow in our work.

Practice Self-Compassion

Many therapists—myself included—are self-critical perfectionists, for whom self-compassion doesn’t come…

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