r/NDtherapists

I really need validation if I’m honest. And encouragement. But not toxic positivity that dismisses the emotion there…

I’m so distraught😩😩😭😭😭. I’ve always really struggled at school and my undergraduate actually got kicked out of school and I had to reapply. I always struggle to know what I wanted to do with my life and shortly towards the end of my undergraduate, I decided to pursue psychology and pursue to become a therapist. I already was a part of one masters program for counseling Capella. It just wasn’t a fit for me and now I finally found another program that I love and I started it this year. It’s a summer cohort program. It started in May and the first semester ended now in August, but I’m so behind in schoolwork. I have time to give it in until the 28th but I’m just so disappointed.

This year I got my autism diagnosis literally February 18 and from there on I didn’t know anything about autism really and from there on I unfortunately hit a really bad autistic burnout mid semester. . .

So bad I had thoughts of ending for weeks and I had developed issues, taking care of myself that I still have now too, and the worst part about it all is I didn’t know I was in autistic burnout. I blamed it on the psychiatric medication adjustment which part it was to, but I didn’t even know what a meltdown felt like or shut down even tho now in hindsight I know like I’ve had them on my life, but I didn’t know what they were so one point I started to feel really scared during those weekss where I thought about ending because I didn’t understand what was happening with me.

Finally caught up about a month before the semester ended to realize that I’m in autistic burnout and I think I had at one point gotten out of it and then falling back into it once again as a result of medication but also just not understanding myself at all and now I have to take a year off from school because if I push school again, I’ll just fall into a deeper burnout.

And I feel like my heart is breaking… because you gotta understand I’m finally pursuing something I love and once again, my mental health is causing issues 🥹😭 For a long time I didn’t know it was ADHD or autism now I do and unfortunately, there’s still a lot of undoing of self sabotage and beating myself up for not meeting Neurotypical standards but you know all of that doesn’t disappear just because you get a diagnosis or just because you’re finally pursuing your passion…

I already started building bonds with the people in my program. We were gonna be in every class together for the rest of the program. I don’t know. I just feel really distressed. Heartbroken about it and really wish things were different and confused if I can make it and become a therapist one day really with these conditions🫥😪🤕😵‍💫😓😓🫠

I’ll be very open I’ve been very professionally disappointed with the New York Times and their anti-Medication articles. It’s enough to have to worry about TikTok and people who have no experience or training saying medication is “big pharama” and stopping all their meds is liberating. And then there’s MAHA helping them out so they can all make money selling moon dust supplements.
The fact that the NYT seems to be in on it is mind boggling. Most of the time if you read the article all the way through you find it is balanced but all most people only read the headline. The latest one was “After 30 years of Medication a Generation Can’t Find an Exit”
It was really one person’s story of having a hard time getting off Effexor and, I believe, trying to make some career out of it. Even saying they really needed it at the time.

I’m interested in different opinions but with the population I treat medication is not only helpful but necessary and these articles are dangerous.

I just give people the statistics which have changed about people who respond well to meds with therapy versus no meds.
I explain the difference between SSRIs and other meds and how SOME have difficulty getting off Effexor or other SSRIs but most don’t.

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TLDR: I can do other types of part-time work but trying to start a job for the third time in social work spirals me to a point I have 10/10 anxiety, SI, flashbacks of being a scared and fearing for my life, feeling like a lost kid again, severely depressed and anxious, etc. And I just got my degree (as part of a career change). Why does this happen to me each time? I got offered a part time social work position and it happened again. I feel like I wasted a grad degree... I feel so shameful, insignificant, a waste of space, etc.

Context:

I'm in my early 40s if that really matters. i was diagnosed with CPTSD in early 2025 and have been having a hard time navigating my way back to a social work career that false-started twice (if that is even something I can do anymore). Here is some context if you want more background of my journey to now, as I sit here in bed trying to feel comfortable and safe (not in SI or anything, just fight/flight/freeze stuff).

I got my Master's in Social Work and my LMSW in 2024 and felt ready to go out there and be a therapist. I've always been anxious but I was excited about my new career path). That summer, my partner's father passed away and I was there to experience the whole thing from the time she found him to his final breath in the hospital. At that point, something shut off in me. I started to have flashbacks of that one night so I sought help. I saw my therapist more and then sought EMDR. EMDR helped me through that life event. Still, I felt like something "broke" in me. So we dove into my childhood/teenage/racial trauma, being bullied, traumatic experiences with the Church, and much more. At some point during my time at EMDR, I thought I was ready to finally start my career. Unfortunately, long story short, I tried twice and in the first week, I quit without seeing clients. I sobbed every day, had SI, was severely depressed, high anxiety, dissociated the entire, and more. I was so scared... Like I was a child again. After the second time trying to work, I was hospitalized then did 2 partial hospitalization stays to "stabilize" me. It was a blur after, not working, trying to find joy in life. I finally started working part time jobs (e.g., tutoring students, music related gigs). It gave me traction on my own self esteem, direction in life, finding joy and so on, BUT not with finances and bills. The program I tutored offered me a part time social work position that paid well. As soon as we talked more about the position, the same feelings of 10/10 anxiety, intense fear and somatic "holy crap I'm in danger" and "I'm a scared little child again" happens again. My sleep is starting to get affected, I'm more agitated and my music related jobs are not joyful again. Anhedonia is so real here...

So what the hell? Why is this happening again? I wanted to be a therapist, support marginalized folks, and be a social worker, but now the thought of it scares the shit out of me to a point of dysfunction. I feel lost, purposeless, and a piece of wasted life. I just need a hug so bad. I need that switch that broke or turned off to turn back on again so I can feel like myself...

Have you been through this? Is there hope for someone like me?

I want to feel less alone in this... Any support, shared experience, etc. would be helpful. Thank you in advance.

if you don’t, things can start to feel AWFUL as a neurodivergent therapist. during grad school I had a supervisor at my internship who made me doubt every single decision I made, insulted my work when I felt good about it, questioned and condemned every decision I made about care, critiqued the clothes I was comfortable wearing that didn’t give me a sensory nightmare, critiqued my facial expressions and hair, and regarded me as someone who was completely incompetent. it was absolutely miserable. i thought it was my fault and i must just have no clue what i was doing. despite getting great feedback from people at school, being in line with my peers, getting good grades.

when I finally realized it wasn’t me, I advocated for a new supervisor, and immediately the outcome was different. this supervisor is neurodivergent themselves and was immediately able to connect to me. when I wasn’t able to articulate the jargon of therapy correctly, but I could describe what I did, they would put into words ‘oh, so you did this ACT skill! so you did this Narrative skill! great!!’ and was truly supportive and validating how I show up with clients. they fought for me to wear what I wanted to wear, to prioritize my comfort, to lower risk of burnout. they gave feedback in ways that were super supportive and kind, and perfectly tailored to how my AuDHD can best receive it. nothing about my skill set changed. same clients, same work, but because i was seen by someone who was able and willing to see neurodivergent me, it was a completely different outcome and experience. i went from ‘awful therapist’ to doing ‘absolutely great work’. i went from ‘being way behind’ to ‘being exactly where i need to be as a student’ (now associate).

it might not be you. this field tries to make ND therapists NT, and punishes them for not masking enough. find someone who understands your brain and affirms it. find someone who speaks your same language. it can be so hard not to gaslight ourselves in this field as someone ND. the problem might not be you, it might be those around you and the oppressive systems of therapy.

I had a pretty rough start to my therapy career. I had no idea I was ND throughout my training or the previous 36 years of my life! It was only about 6 months after going into private practice that I hit a big burnout and realised something deeper was at play- cue an Audhd diagnosis.

I've been in some form of burnout ever since. Every year telling myself I will give it one more year but I've reached my limit and have had to admit that my business isn't working because I don't have the capacity to sustain it . I'm bone tired and terrified of going back into the job market in my 40's.

Becoming a therapist was my dream for a long time and being self employed was the bigger dream. I'm gutted to admit it's not what I thought it was. I look around at other therapists and wonder why can't I do this?

I hope I don't have to give it up indefinitely but the 2 years post diagnosis have been rough AF

TLDR: CMH non-compete may make my dreams of getting dx supervision license impossible if they dont approve to change to a non-solicitation agreement and keep my current position when starting tiny PP on side.. submitted strong proposal but SO anxious waiting for approval or denial from ED.. entire next career phase depends on getting this approval.. love my current job and team.. Country isn't USA, so process to dx licensure is different.

Long:

My CMH fits my diagnosing specialty goals perfectly (ASD/ADHD), but with high agency no-show rates I cant meet the 3k time limitted hours bc i cant count advocacy cases or intakes (which is half of my job)... I'm planning to start a virtual PP to supplement a few more consistent hours a week to ensure i can get the hours despite no shows at agency..

Apparently we have a very loose non-compete regarding employed staff providing the same service outside the agency for pay unless approved by the ED.. I submitted a proposal outlining my goals, passion for my current job, and areas ND individuals fall through the gaps I want to help fill... so minimal competent PP providers, and agency location eligibility, diagnosis eligibility, 1 year long waitlist, session cap limitation and emphasizing how I would manage ethics (i.e. only accept clients not residing in our service region or connected to the agency, etc).. i was as positive but also realistic about the agency and limitations as possible to balance advocating for my community alongside appreciation of the agency - i genuinely do love the agency. I've never had to do anything like this.

I genuinely have faith my agency cares most about meeting needs of access for ND people, and my supervisor would support me. I'm stuck waiting for the ED and hopefully change the non-compete to a strict non-solicitation agreement but need to have a meeting together. In August everyone is on vacation 😭 I'm so anxious here..

The the concept of not being able to bc of a very general non-compete is absolutely terrifying.

I am so stressed guys. I never expected my agency would have this policy (nor did my manager) so got excited about PP and my dx journey before double checking the policy manual..

I know this is personal and it depends on the subject matter being discussed. However, just curious how many clients you can see per week before it affects your mental health?
Especially for those who are caregivers and need to to take care of family (spouses, kids, parents, anyone) in the evenings. When I was single, I could just go to the gym after work or eat dinner while I watch TV and was good to go. Now, when I need to function after work, it’s so hard.

I cant find a place to add the flair, so Im posting this to seek advice. In sessions, I’m noticing i get tunnel vision on spoken content to the detriment of seeing the big picture ( aka focusing on not only spoken word, but also body language). So let’s say hypothetical client presents to session 1 , is speaking rapidly and sharing a lot about the presenting concerns , how their pasts tie into the presenting concern but their body language is pulling away , looking like they want to run away. Years ago, i would have kept going but now I’m trying to be more mindful to take that into account.
Question 1)How would you suggest handling this in real time? ( ie, go with the flow or respond based on their body language . Ie say “I’m sensing you have trepidations, can we pause and look at how you’re feeling now sharing this)
Question 2 : how to i catch myself from falling into this pattern in real time so i can respond appropriately? I believe the indicator that i am about to fall into the pattern is when they are speaking, i sometimes get overwhelmed by word vomiting, also i translate spoken word into imagery so i cant focus on body language at the same time im thinking

Question 3) any tips on how to better summarize the session is important , especially with the clients who word vomit. My brain is constantly staying full to process whats going on so it’s hard to know what main points come up that both the client and i are agreeing on to give homework accordingly. I reached out to my former supervisor who says we arent supposed to use psychotherapy notes due to hippa. Thanks!

hello! im about to start my first therapy gig. ill have a minimum of 24 clients (which i plan on sticking to just that for now)

i was wondering if anyone had any advice on how to build your schedule? how many sessions in a row is reasonable? i dont wanna work more than 4 days and need to have at least 1-2 later evenings

im ADHD and sometimes have a hard time getting back in the groove if i take a break but i know ill have to stop to eat on the late nights. i also struggle with starting later. 10-3 is definitely my prime time to be productive.

i was thinking of doing
monday: 10-7 (8 sessions-with an hour break)
tuesday: 10-6 (7 sessions with an hour break)
Wednesday/ thursday: 9-3 (6 sessions + extra hour for flexibility on scheduling and admin time)

Hello fellow ND therapists, I am bordering dangerously on bursting at the seams. I could feel it somatic ally this morning and my compassion fatigue meter is increasing exponentially as I see clients throughout the day.

I already limit the number of people I see, and I do have a therapist already. I have a psych appt next week as well so I might be asking for something alongside my ADHD meds to help manage this. Some things I'm doing/will be doing:

-Taking 2 days off next week (after a half day off) because realistically I need a vacation but want it to be away from everyone, including my spouse and pets (which is triggering guilt, too, yay!)

-Going somewhere with nature or the sea, as these things tend to calm me.

What are some of the tools you all employ?

I'm in solo PP and there have been a few challenging cases and bureaucracy things lately. I spent a lot of time, money and tears qualifying as a therapist but I can't stop dreaming about just stopping and changing field. It feels like so much respon for little profit at the end. I can get into tunnel vision but had anyone else packed it in? Any regrets?