Even Experienced Therapists Doubt Themselves - Supervision Can Help Make Sense Of It
Some weeks feel like you know what you’re doing - sessions are flowing, clients are getting better, and you finish the day feeling fulfilled.
Other weeks, though, things don’t quite click. Sessions feel disjointed, clients are having setbacks, and you feel like you’re floundering.
You start questioning yourself - why didn’t you bring that up, why didn’t you make this link, why didn’t you suggest this? Before you know it, you’re cooking dinner, or walking, or showering, and all you seem to do is replay bits of sessions in your head, thinking about all the things you should have done differently.
And then the mind does what minds do - and starts serving you up all the stories about how you’re not as competent as you thought, other therapists are doing so much better, and you’re letting your clients down. The anxiety, the shame, the insecurity follow - and even though there’s a part of you that knows not to buy into all this completely, your heart’s still pounding and your breath’s still shallow before your next session.
It’s imposter syndrome at its finest, and all good therapists get it - but if it’s starting to take centre-stage, …it might be worth giving yourself some space to notice how it’s showing up and what tends to help.
Self-doubt doesn’t mean you’re doing something wrong
When you’re in sessions with your clients, you’re great at bringing perspective, whatever shape that may take. You help clients challenge their thoughts and beliefs, looking for evidence, and helping them understand unhelpful thinking patterns. You help them relate differently to their experiences, so they get unstuck and can be themselves.
It’s trickier when it’s you, though. Your thoughts, your beliefs, your mind.
You can easily forget that the mind likes, and therefore, tends to look for certainty and “right answers” - and when it can’t find them (because therapy is, inherently, bloody uncertain and nuanced), it can default to self-doubt and even self-criticism.
You can easily forget that the mind also tends to jump to conclusions and catastrophise. So, when every session isn’t an “a-ha moment” for every one of your clients, there it goes, telling you you’re incompetent and should find another profession. Don’t even get me started on more difficult sessions, setbacks, or ruptures.
All this is part of the process and job of being a therapist - and yet, when you’re in the midst of it, your mind can easily be hooked by it all.
And I know you know this, but can I just tell you again - self-doubt shows up no matter how experienced, knowledgeable, or thoughtful a therapist you are. I’d even go as far as saying that if you rarely doubt yourself, chances are you’re not reflecting on your work enough.
When self-doubt starts to take up too much space
As with everything, there’s a flip side to this.
Yes, reflection is usually helpful. And yes, the presence of self-doubt doesn’t have to mean anything sinister about your skills as a therapist. However, where do you draw the line between “this is normal and helpful” to “I’d better address this so it doesn’t end up consuming me”?
Maybe you’re replaying sessions in your mind over and over again, and thinking about all the things you “should have” done - which may be turning into preparing more and more for sessions, or taking on extra responsibilities like emailing clients more resources.
Maybe you’re second-guessing your decisions which makes you a bit hesitant or avoidant of trying new things, and you’re finding yourself checking over your notes and on therapist groups to make sure you’re not getting it wrong.
And maybe work is starting to take over more and more of your time and mind space. You might be spending more time on notes and preparation, and struggling to switch off from clients - such that your needs are starting to fade a bit. Maybe you’re not drinking as much water, or exercise has taken a back seat, or you’ve forgotten what your hobbies are.
You might be feeling tired, anxious, ashamed, or maybe starting to burn out.
How supervision can help make sense of it
Here’s the thing, and I say this having been there myself - there can be a difference between what you think is gonna help and what might actually help.
If you’re elbow-deep in self-doubt, you might think you need more reading, more training, more knowledge and skills. And sure, if there’s actually an area of work you haven’t had that much training on, or that you’re really interested in, go for it. But really, the more “problematic” kind of self-doubt is not gonna be satisfied with that.
So, you might think that what you actually need is someone to check your work and tell you you’re doing a good job. It’s what people often do when they’re dealing with anxiety and uncertainty - seek reassurance. We know it all too well from our work with clients - because it does help, but just in the short term. In the long term, it might reinforce the message that you need someone else to validate your decisions - and by extension, you as a therapist.
Now, we all need reassurance every now and then. I’m never going to be the stern supervisor who keeps it all so professional by throwing your questions back at you, and using guided discovery to get you to see your unhelpful patterns. I’ll be there for you and with you, like a human - answering the questions you truly need answers to, while gently pointing out when you might be getting stuck, and inviting you to have a think about it with me.
Because that’s what I think good supervision should be. A space you can come to as you are, without feeling the need to perform - where you can slow down and unpack things. Where you can get answers, absolutely, but where you can also practice not getting answers - not because I don’t want to give them to you, but because there either aren’t any specific ones, or because that’s not really the problem we’re dealing with.
And by working on all these different layers, you might, bit by bit, learn to trust yourself a little more while being aware of limitations (and know it’s ok to be always learning), to notice when unhelpful stuff is showing up and know how to unhook, and to free up space for you to continue to be your thoughtful, creative self.
If you’re looking for a CBT supervisor who will be human, supportive, and also help you build more trust in your own clinical judgement…
This is something we can think about together in supervision. Self-doubt in therapists is very common, and supervision can be a space to explore it - not just to get reassurance or answers, but also to notice when what’s needed is more self-trust rather than more certainty.
You can read about how I approach CBT supervision, and also, a guest post I wrote on CBT supervision over on The Supervisor Platform, where I explore cultural humility (as opposed to cultural competence) in supervision.
Hi, I’m Carina - an experienced, but very human BABCP-accredited CBT supervisor with experience teaching on one of London’s largest BABCP-accredited CBT courses, and previously working as a Senior CBT Therapist in the NHS.
I can help with continuing to develop your CBT skills, thinking about process issues and who you are (and want to be) as a therapist, and/or getting you through your training year or towards BABCP accreditation.
Apart from “second-wave” CBT, I love ACT and mindfulness (I’m also a trained mindfulness teacher) - and also research (I’ve published a few peer-reviewed papers). I’m also often found sipping tea, having a rant, and showing my dog to my supervisees.
If you’re curious about whether this might work for you, I offer a free, no-pressure initial chat.
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