Have you ever wondered what a typical day for your mental health therapist may be like? Well, you are in luck because I am going to share what one of my regular weekdays looks like! Yes, I am human so not every day turns out the way I’d like it to but overall, this is what my workday looks like, hour by hour.
7:00am – Wake up!
Sometimes this is rough, but I usually start the day with my dog, Maggie, on top of me, telling me “it’s time to wake up!” I cuddle with her for five minutes and then get up. On a good day, my husband brings me coffee in bed because he knows my love language is acts of service.
7:15am – Walk dogs and Prep
Walk my two dogs, one who is 14 so it’s a short walk then home to feed the dogs and make my lunch, which is usually a salad with lots of fresh veggies and some protein.
8:00am More coffee and paperwork
While consuming my coffee I do my paperwork from the previous workday, check my emails, messages, and pay some bills (yuck).
9:00am – Exercise
Most mornings I go for a run (or walk) with Maggie for an hour. If we are lucky we make it to the beach where we both find our peace and Zen. Did I mention this involves listening to some good music and dancing along to it? I recently read an article indicating dancing is the best exercise to manage and combat depression, walking or jogging is the second one on the list. Cognitive Behavioral Therapy is indicated as the third on this list with yoga being fourth. Twice a week I go to yoga where I also find my peace and Zen. As a mental health therapist, I preach exercise and taking self-care time in my office, all day long so I try to live the life I preach (although no one is perfect).
10:00am – Get Ready
I hit the shower and get ready for the work day.
10:30am – Off to Work
I am out the door for the long commute (7 minutes) to my office.
From 11:00am to 6:00pm I see clients for mental health counseling. I have changed the names and situations of all the following scenarios. They are all fictitious but based on my 26 years of experience in the field of mental health.
11:00am-11:50am – First Clients
I work with a couple who have come in for help following infidelity. The woman has been having an affair for the last year and the husband recently found out. I have assessed for reasons why the infidelity happened and it seems the woman has not been getting her needs met for the last five years. She stated she has tried to talk to her husband but he didn’t step up to meet her needs. The wife explains that the man she has been having the affair with showed her positive attention and it developed from there. We established the affair is over and they both committed to wanting to stay together and work on the marriage. There are lots of tears during this session but I am always prepared with a box of Kleenex on either end of the couch in my office.
By the end of the session they have agreed to move forward although he is expressing deep anger towards his wife. I explained the concept of Post Infidelity Stress Disorder to them as he nodded his head. I also explained about triggers he may experience and how they both can handle them.
12:00 pm- 12:50pm – Client #2
I work with Joe, who has Dissociative Identity Disorder (Multiple Personality Disorder).
He has a history of severe trauma, beginning as an infant when he began to be sexually abused by his adoptive father. As a result, his mind fractured into different alters, 25 in total. We have been working together for five years. Currently, his alters are dormant and his mental health has improved. We talk about weekly stressors and how to manage them.
1:00pm – 1:50pm – Client #3
Bobbie comes into see me for her bi-weekly session. Bobbie and I have been working together for several years. Bobbie has a long history of trauma and is diagnosed with depression and borderline personality disorder (BPD). Bobbie experiences difficulty in her interpersonal relationships. She tends to misperceive what others say to her and then acts as if these perceptions are correct. Sometimes, after sessions, Bobbie misperceives something I have said in the session and send me a string of emails and texts, all angry. Although I have continually set boundaries with Bobbie, she continues to have difficulty in this area and when she is angry at me the boundaries are out the window.
During this session Bobbie is upset about something her brother has said or done. I listen and provide feedback in the form of a question, “Did you ask your brother if he meant that the way you are perceiving it?” The answer is usually no. I send Bobbie home with homework to check this out with her brother.
Bobbie and I also talk about how she has been able to remain sober during the last two months. This is a big Hooray for Bobbie who has a history of substance abuse!
At the end of the session I ask Bobbie if there is anything she wants me to clarify before she leaves the session. She tells me no but then sends me a barrage of texts telling me she can’t believe I had been mean about not understanding how her brother treats her. I did not respond to the texts and as a mental health therapist, my boundary is I will respond during working hours and not to a string of angry texts.
2:00pm – 2:50pm – Client #4
An EMDR session. EMDR is a technique I use to treat trauma and to zap negative core beliefs people may have. Laura has the negative core belief, “I am not good enough”. This belief affects her in many ways including in interpersonal relationships and at work.
In sessions we have been addressing the fact that the belief is not true. However, we haven’t been able to change her thinking on this belief so we decided to try EMDR. We talked about the negative core belief, the emotion that goes with it, the stress it causes her, and where she feels it in her body. I asked her what level of distress it causes her, when she thinks about the belief, from 1-10. She told me it causes her a number 9 level of stress.
Next, I position my EMDR light bar in front of her and gave her the EMDR headphones to wear. I instructed her to tell herself, “I am not good enough,” to feel the sadness (she identified), feel it in her body, and watch the light move back and forth. Then I started the equipment and timed it for two and a half minutes.
At the time completion I asked her what had happened. She reported remembering many memories of her father berating her for not doing things correctly. We discussed this and she was able to take on the perspective that there was nothing wrong with her, that her father actually had issues for treating his child like that. Following another round of the EMDR and discussion she reported the distress level had come down from a 9 to a 1. She no longer held the belief “I am not good enough” but stated, “I can’t believe my father spoke to a little girl like that”.
To complete the EMDR I led Laura through a body scan to find any stress in her body. She reports she feels some anxiety in the back of her neck. We do some deep breathing, check again, and find the anxiety/stress has been relieved.
3:00pm – 3:50pm – Client #5
Nora and John have an initial session with me during which I complete a structured interview to get acquainted and hear about their history as well as their presenting problem, the reason they are in my office.
John explains his mother has been living with them because she is getting older but the stress of having her in their home is causing marital issues hence they have arrived in my office for couple’s counseling. As I listen I hear what sounds as though John’s mother may be experiencing dementia. Fortunately, (and unfortunately), I have significant experience with different types of dementia due to having had three parents who have had it. Two have passed on and one is currently in a local Assisted Living facility. I explain to Nora and John that it sounds highly probable that John’s mother is showing signs of dementia. I listen to them supportively and with empathy. I understand what they are going through.
At the end of the session I give them a couple referrals, one to a local neurologist and one to a local neuropsychologist. Both can help determine a diagnosis and provide some medication assistance and recommendations for going forward.
I make some recommendations for ways they can improve their marriage and lessen the current stress they are under. As with all new clients I see, I offer them another appointment, which they schedule for the following week.
4:00pm – 5:00pm – Client #6
Nadia, whom I haven’t seen for several years appears as the next person on my schedule. I worked with Nadia, for three years while she was in high school. Nadia struggled in high school with acting out, sexually, with alcohol and drugs, and constant arguments with her parents. Her parents brought her to see me and we worked together during her high school years. At the time, I had attempted to find out why she was acting out but have never been able to get very deep because she wouldn’t tell me why she was so angry. Her parents were confused as well. At that time, I had helped her develop healthy coping skills, taught her Dialectical Behavioral Therapy (DBT) skills to manage her strong emotions. We had done family therapy to work on the strained relationship she had with her mother and stepfather. Nadia had eventually pulled back on the substance abuse but had told me she would never “stop smoking weed”. When she left for college I didn’t hear from her again. Now, here she was in my waiting room, six years later!
Nadia came in and the session began with her filling me in on her life over the last six years. Her parents had left Florida, she had left college and gone to live with them in New York where she eventually completed her Associates Degree and now was an Esthetician right here in St Augustine! She told me she wanted to return to therapy with me to work on what she hadn’t been able to disclose in high school. She then told me that when she was eight, a babysitter had molested her several times. Until this moment, in my office, she had not disclosed this sexual abuse to anyone. I wasn’t surprised. I knew that there had likely been some sort of trauma that had led to her acting out behavior.
I told Nadia I wasn’t surprised and told her how brave I thought she was for finally disclosing this to me. The first thing I did was inform her the abuse was not her fault. She had been carrying a lot of shame, over the years, and believed she should have been able to do something to prevent the abuse, hence, assuming it was her fault. I gave her the space she needed to cry while I listened and provided her with empathetic listening. Towards the end of the session I explained what the treatment would look like and told her it was entirely possible for her to heal from her trauma. She smiled at this and scheduled weekly appointments with me.
5:00Pm-5:50pm – Final Client of the Day
My last client of the day is James, who is diagnosed with Bi-Polar Disorder. He was referred to me, by his psychiatrist, a couple of years ago. We meet monthly so he can have a professional help to keep him on track with a healthy lifestyle in order to manage his Bi-Polar Disorder.
James, has episodes of Mania where he doesn’t sleep, spends a lot of money (that he doesn’t have) on big ticket items, acts out sexually with multiple women, and abuses substances. His psychiatrist has him taking a mood stabilizer, which helps to manage and keep the mania away.
James and I discuss his events of the last month. He is working landscaping and odd jobs he acquires through people he knows. His judgement of character is not top notch, and he often has situations where he trusts someone and they end up taking advantage of him. This month is no different. He tells me a story about a man who had promised to pay him for working on a remodel, but he was told to leave the job halfway through and never paid. We talked about remembering to check people out before committing to them. He then tells me how he had allowed someone he knew, from a past drug treatment center, to stay with him, believing the guy was sober. The man ended up stealing James’ computer, camera, and fishing gear while James was out. Although James reported it to the police his belongings hadn’t been located. James expressed frustration with himself for believing this guy to be sober. We talked about possible red flags he may have missed.
The rest of the session was spent reviewing how James has been managing himself by treating his Mind, Body, and Spirit every day. I listened and gave some input as to where he may be able to make some changes but overall, he seemed to be doing well with his self-care. I was genuinely happy about this and positively reinforced him profusely for taking care of himself over the last month and reminded him to pay attention to red flags in people.
5:50pm – Time to Head Home
Before leaving the office I return all phone calls and emails and head home! It was a positive day! I go home to relax and rest up before heading back to the office tomorrow.
As my workday comes to a close, I reflect on the variety of experiences and emotions that filled the hours of being a mental health therapist. From helping couples navigate challenging times to supporting individuals in their journey toward healing, each day brings its unique challenges and rewards. While no two days are exactly alike, the constant is my commitment to being present for my clients and helping them find their path to wellness. It’s a privilege to be a part of their lives, even in the smallest way. As I head home, I feel grateful for the work I do and look forward to the quiet moments with my family and dogs that help me recharge for another day.
If you’re struggling with mental health issues or need someone to talk to about challenges in your life, please contact me to set up an appointment.
In Kindness,
MM