In our graduate training we all learn about creating boundaries between our patients and ourselves. This is a critical part of our education. It is intended to help us to segregate our patients’ troubles from our own, facilitating and enhancing our ability to treat our patients unhindered by becoming unduly burdened by their suffering. We are also encouraged, even mandated in some states to undergo our own psychotherapy for the same reasons.
All of this training is certainly helpful but occasionally inadequate for what our patients bring into our consultation rooms. There are just those times that a patient is struggling with a pain so similar to a pain we have suffered that the boundaries we have perfected begin to wobble and threaten to collapse. We grapple to establish that division between patient and self-trying to keep completely focused on them while pushing back the memories and emotions that threaten to overwhelm us.
I have often identified with Roberta Flack’s song “Killing Me Softly” that tells of a woman who attends a performance of a singer in moments like this. The refrain describes how the performer, in the words of his song, unwittingly unleashes her emotional pain.
What strikes me most about that refrain isn’t the pain in it — it’s the exposure. The woman in Flack’s song is sitting anonymously in an audience. A stranger, the singer, who knows nothing of her life sings it back to her anyway, detail by detail, as if he’d been reading her diary. In that moment she is both terrified and seen. It is similar to what I have experienced in sessions: my patients have no idea they are singing my song. They couldn’t know their words are brushing up against my life. And yet there it is — my story, strummed by their fingers.
There is an acceptance in psychological theory of what Carl Jung, a disciple of Sigmund Freud, called the “wounded healer” — the idea that many of us enter this work carrying some early, intimate knowledge of pain, and that this knowledge, adequately processed, becomes less a liability than a tool. It is our historical wounds that drive many of us into this profession.
The wounds are rarely singular, and rarely remain safely in the past. Life does not cease causing us pain simply because we have chosen a profession devoted to helping others survive theirs. We lose parents. We divorce, and we watch the marriages around us end. We age. We fall ill. We bury friends. We face betrayal. Each of these lays a fresh scar over the older ones, and each becomes part of the toolkit we carry into the consulting room, whether we intend it to or not.
What is so important to consider in these moments is that we are not meant to be sealed off from what our patients bring us. We are meant to utilize our scar tissue to help us recognize and then heal someone else’s wounds.
Sadly, this is one of those truths that therapists confront and are often too embarrassed to speak of aloud. Shouldn’t we be professional enough to manage such moments? Yes — we are, and we do. We don’t climb onto the couch and weep alongside our patients. We hold the boundary steady enough to guide them through their difficulty. But we do not ask our patients to heal without scars, and it would be unfair to expect something different of ourselves. Our own pasts can rear up in the middle of a session, unannounced, blindsiding us just long enough to catch our breath before we find our footing again.
Perhaps this is what it means to be a mirror rather than a wall: to be touched by what passes through us, yet remain standing. My patients may never know the particular note their words strike in me, and they do not need to. What they need is for me to keep reflecting their song back to them—steady, clear, and true—long after mine has quieted again.
