On failing

You say you’re here to relax, and I believe you, but how do you manage to not feel or become involved with how your words impact the life of others? I’m doing my PhD in clinical psychology. While my life has constantly provided me with evidence to believe I can sit in front of another human and be present with them, I can’t help but feel an incredible amount of anxiety in regards to the possibility of failing them. I’m 36 thousand dollars deep into student loans, and I’m terrified I’ll fail my future patients. Yet, I look at you, and maybe you’re free of certain anxieties because you’re anonymous, but I am convinced that you have a heart and soul that beats to the pain or vanity of those who write to you. I guess I’m trying to ask, how do manage to believe you won’t ruin those you answer to?


You won’t fail your patients. You won’t break them. You won’t ruin them. It’s not like that. You will have a responsibility to your patients, but you are not responsible for your patients. They are the ones who will do the work. You will not do it for them. You will help. You will guide. Maybe sometimes it won’t be as efficient or as tidy as you would like, but that’s not failure. It’s how you will grow as a clinician.

The anxiety you feel is perfectly normal, and it can be quite useful if you channel it towards self-improvement. It can keep you frosty in the room and hungry for the latest research, but don’t let it paralyze you. Don’t allow your anxiety to become a false belief about failure.


13 thoughts on “On failing

  1. RocketGrunt says:

    My favorite therapist was a graduate student at my college who was only a few years older than me. I can’t remember any direct advice from her, but I remember so many little things that had a huge impact.

    She noticed that my hands are the biggest indication of my emotions, even when I had convinced myself nothing was wrong. I fidget like crazy the more distressed I am, and knowing that has helped me be more self aware. She sold me on the idea of forgiveness by changing the terminology to “letting go”. She dug up issues that had never before come to light without alcohol.

    We videotaped our sessions so her professor could review her work and she probably felt like she was fucking up left and right because I was one of her first clients ever. She was probably also in tens of thousands of dollars of student loans and terrified of failing me. But she was totally awesome.

    I think the point of this drunk comment is to be like Marissa. Marissa did her best despite the inevitable fear of fucking up, and by just doing her best she managed to make unprecedented progress on my mental health. Just do your best.

  2. ktk says:

    “Don’t allow your anxiety to become a false belief about failure.”

    This is one of the most profound and helpful things I’ve ever read on here. Damn. Thank you, CQ.

  3. Chris says:

    Well, as much as CQ hates Jordan Peterson, I heard something very interesting he said about treating patients. It was along the lines of how ‘even if you can immediately fix their problems, that’s not how you do it. You need to first listen, because sometimes that is exactly what they need – the be listened to as they think (because talking is a means of thinking). Then you help them determine the means by which to fix the problem, so that they develop the tools to fix future problems without your help.’

    Of something like that.

    Good luck with your studies. The fact that you care says a lot about how much you will be able to help others.

  4. Niceties says:

    I am a teacher, and I love the idea of having a responsibility to but not a responsibility for my students. That’s the perfect way to put it, and this just relieved a ton of anxiety. And also, to the asker, I wouldn’t worry too much about failing them. Unless my therapist went out of his or her way to do something distinctly unprofessional, I wouldn’t hold them accountable *my* actions. The only person who can really make your decisions is you– that’s true for everyone.

    • Chris says:

      Very nicely put. I began teaching adjunct in January, and I actually had to tell the kids, “look, I don’t care if do the work. I’m not the one paying ten grand for you to be here.”

      “That’s cold,” someone said.

      “I’m not your dad.”

      It was clearly the first time some of them have had someone be so honest.

  5. peachetender says:

    As a recent graduate and new adjunct professor, I have these same worries about teaching. I’ve cried out of anxious worry that I’ll fail my students, that I won’t reach them. This is comforting.

    • Chris says:

      Good luck to you. I find teaching to be very satisfying, and know that I’m making a positive difference, but not for everyone.

      For example, Saturday I was able to bully a 24-yo into getting his 401(k) going at work. The alternative is that he’ll be poor and gross at 65, so I feel justified. My approach was ‘what would you tell your son to do, knowing what you know now?’ and then, ‘you need to love yourself just as much.’ Last April, a kid started a savings account for her emergency fund with automatic deposits from her paycheck.

  6. KarenE says:

    Read the Bruno Bettleheim book, ‘Good Enough Parents’. It applies to parents, to therapists, teachers, doctors, politicians … pretty much everybody who has huge influence over people’s lives. (Yeah, the guy was a jerk in many ways, and messed up a LOT of people bigtime with his autism theories, but on this one, he got it right.)

    We don’t have to be perfect, or even anywhere near it. We have to not fuck up in the huge, unprofessional, unethical ways. Then for the rest, we just have to be good enough. Sometimes brilliant and amazing, sometimes pretty mediocre or off track. But averaging out to good enough, that’s all it takes. And it’s actually HEALTHIER for the kid, patient, student, etc to not have a ‘perfect’ model before them.

  7. Faith says:

    In my experience, good supervision is critical. Find a skilled, trustworthy supervisor who’s willing to walk with you through transferential issues as they arise. Even, or especially, the taboo ones-bigotry, disgust, physical attraction, etc. We all bring our weird stuff to clinical relationships. To me, it has been imperative to remain mindful of emotions and judgements during sessions. It sounds like you’re already ahead of the game because you have awareness of your experience. Keep that mindfulness; at some point you’ll be able to craft your experience into a skill set which will benefit your therapeutic relationships.

    Throughout my clinical internships and early career, I bumped up the frequency of my therapy sessions to use as a sort of supervision. We reviewed some tough cases-the ones who kept me up at night, the ones I couldn’t help, the ones who rattled me, froze me, and rendered me almost useless. But it helped me to develop clinical insight within therapeutic relationships so that I could separate my own lump of shit from my role as a professional support to others. If you’d prefer, you can also seek additional supervision of this sort as well, usually for a reduced fee (compared to a fee for individual therapy.) It’s going to give more confidence, too. You can also develop some skills with a supervisor so that you don’t act on emotions and judgments in session. Best part? It’s free, ongoing training. I guess back in the day it was a grad school requirement to be in therapy during clinical internships. It’s not a bad thing—-I’ve seen highly credentialed colleagues work their own shit through their patients…and they don’t see it either. Can’t tell ‘em nothing. Total fuckery. To me, that’s the real damage to patients and practice. Patients and families don’t pay to help me work through my shit. Without learned self-awareness and ability to keep it in a back pocket, it’s super easy to fuck it up. Odds are good that you will fuck up at some point anyway. Everybody does. Many patients have had relationships in which healthy conflict resolution didn’t happen, so working it out in session with a safe person can be beneficial in a few ways.

    It’s a constant dynamic of balancing therapeutic rapport with being an ordinary person within the confines of an intimate, professional relationship with another person. You’re not perfect; it’s ok to bring that to the table, many find it refreshing and helpful. It’s the main reason that the peer support model is so effective-there’s an inherent commonality without pretense. Patients see almost everything anyway; be prepared for them to call all of it out. They might accuse you of ruining their life or blaming you for…everything, sometimes. Use it all.

    Sorry to ramble. There’s no textbook that can teach this shit in real life, right in the moment when it counts, so I just want to share what I’ve learned to use as a semi-permeable shield from irrational guilt. I’m still learning. Good luck!

    • Staggeringgradstudent says:

      I wrote the question, thank you. It’s an honest light on a profession of dual identities. I needed to hear this.

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