The most difficult part of being a counselor isn't what you may think
People often assume that the hardest part of my job is sitting with clients in emotional pain day after day. Surprisingly, that part is relatively easy for me. I've always been drawn to people's inner worlds and natually have emotional stamina when witnessing intense feelings. Most days, I feel honored and energized to support people through their most vulnerable moments.
The true challenge lies elsewhere: working within a framework I don't fully support or believe in.
My experience on both sides of the couch
As someone who has struggled emotionally at different points in my life, I've experienced counseling as both helpful and unhelpful. The effectiveness varied depending on the period of my life, the therapist I worked with, and my own understanding of the mental health field.
The counselor who made the most significant impact never gave me a diagnosis during our 12-year, on and off relationship. Instead, she normalized my feelings within the context of my developmental stages, relationships, and environments. She maintained a healthy skepticism toward medical model understandings of mental health, though I didn't fully appreciate why until I became a counselor myself.
The medical model dilemma
The hardest part of being a counselor for me is working within a medical model that I fundamentally question. The diagnoses we use were constructed primarily for scientific research, yet they aren't "real" in the way most people believe when they say "I have generalized anxiety disorder" or "schizophrenia."
Based on seeing famliy members navigate various mental health issues and systems, my mom wisely told me that diagnoses were simply categories created to sort and organize certain experiences—a perspective I still find accurate. Generally, I don't find it helpful to diagnose the people I work with. When I was diagnosed with bipolar 2 disorder by a psychiatrist, it led to years of confusion as I constantly questioned whether my behavior stemmed from "the disorder" or was simply part of being human.
Medication: a nuanced perspective
Another major challenge in the field is navigating conversations around medication. People are taught that psychiatric medications are treatments, but I view all substances—from pot to Prozac—through a similar lens. Each has the ability to alter moods and mental states in desirable and undesireable ways. Medication can be incredibly helpful in certain circumstances, but it can also cause significant harm. The decision to use any substance should ultimately rest with the individual.
Unfortunately, widespread misinformation persists about psychiatric medications:
That they're universally necessary for people who’ve received certain diagnoses
That they correct a chemical imbalance
That they must be taken for life
That not taking them causes brain damage
That they aren't addictive
That tapering off is straightforward
That side effects are mostly mild and temporary
Beyond biological reductionism
The prevalent misconception that mental distress is primarily biological—coupled with myths about medications "correcting chemical imbalances" and diagnoses being more important than the context and meaning of painful life experiences—makes my job considerably more challenging.
I don't wish to invalidate those who find meaning in a diagnosis or label. However, I frequently observe that attempts to oversimplify complex feelings and experiences don't help people in the intended ways. Many clients come to me with multiple diagnoses, various medications, and histories of trauma. Introducing a more nuanced, accurate, and compassionate framework of mental health can be difficult when they've been indoctrinated into a simpler but less helpful paradigm.
Therapy is just one path among many
There's another widespread misconception I encounter frequently: the belief that people "need" therapy to heal or recover from life challenges. This simply isn't true. What people genuinely need (other than food, housing, clothing, etc) is support, compassion, community, meaning, and belonging.
Therapy can certainly help meet some of these needs and may help resolve internal struggles that interfere with connecting to these resources. However, therapy is just one avenue among many. Throughout human history, people have found countless ways to navigate difficulties without formal therapeutic intervention.
As therapists, we need to recognize that our role isn't to ease suffering but to bear witness, tend to it, and understand it contextually. We must question whether the medical model truly serves our clients' best interests or whether it creates additional obstacles to living a meaningful life.
The hardest part of being a counselor isn't empathizing with pain on a daily basis—it's navigating a system that often perpetuates it through oversimplification, pathologizing normal human responses to difficult circumstances, and promoting the idea that life should be free of pain, suffering, or discomfort.