I Quit Being a Therapist so I Could Be a Better Husband
I asked my wife what it’s like to be married to a clinical psychologist. Her answer changed our lives.
“I love that video of your wife talking about what it’s like to be married to you.”
That wasn’t what I expected an HBO director with years of TV experience to say while on set in Brooklyn, filming a series of mental health videos for HBO that launched in the fall of 2019.
“Seriously? I did such a bad job editing that one. I sorta gave up and just threw it up on YouTube.”
“That’s what I like about it. It’s just an honest conversation about your relationship. It’s rare to see a couple talk like that.”
The YouTube video she was referring to was something I put together seven months ago for Valentine’s Day 2019. I make videos about mental health and demystify what it’s like to be a therapist. I thought it would be fun to have my audience ask my wife questions about what it’s like to be married to a psychologist. The whole video came together in a few hours. I hadn’t thought of it again until this director brought it up.
I never rewatch videos because I only see the flaws — choppy edits, bad sound, and focus issues. But, as a YouTuber trying to improve his craft, I wanted to see why this video resonated with the renowned director.
Watching it again, I kept thinking about how much I hated the way my wide-angle lens distorted our faces. But since I was filming two people in a tight corner of a small Brooklyn bedroom, I didn’t have any other options.
Then there’s a section where my wife, Nhu-An, is answering a question about how available I am to her after a day of seeing patients:
Imagine spending your entire day being emotionally there for somebody. The most I spend with other people at my job is in a meeting and that’s an hour, two, three hours at most at a time and then I get a break and I get to sit at my desk by myself with my own thoughts. I can do my own thing and think for myself. But imagine having to be in those meetings and being constantly aware and present for someone else and dealing with really difficult situations.
Nhu-An described how on days I practiced psychotherapy, I was angry, distant, and exhausted. On weekends, I was patient and present. Until we recorded this video, I didn’t know Nhu-An avoided emotionally difficult discussions and veered us toward watching something funny to help calm me down from the distress of my day.
I hated the idea of being someone who spends the day helping other families overcome difficult emotions but can’t do the same with himself at home for his family.
She never mentioned it and I never asked. Then, in the blur of trying to get the video published, I totally forgot she ever said this (some of my colleagues might say I repressed it). It didn’t sink in until I rewatched the video. It was a punch in the gut to see how Nhu-An described our relationship. I hated the idea of being someone who spends the day helping other families overcome difficult emotions but can’t do the same with himself at home for his family. I felt like a fraud.
This isn’t how it used to be. I used to talk to Nhu-An about work all the time. Sure, I had to keep my patient’s experiences confidential, but I always let her know if I had a difficult day. The stuff I loved telling her was about the kooky cast of characters in our building. Our Staten Island reptile guy who came in to help with animal phobias and was really into snakes. The uptown administrator who I started a cold war with after he took away our water delivery service but always seemed to avoid drinking our building’s tap water himself. And then there were the confused women who mistakenly came to our clinic when they were trying to get to the breast augmentation center down the hall. As time went on, I didn’t just stop talking about the challenges of my job, I stopped sharing the joys too.
Nhu-An and I met in high school in Northern California. We had lockers next to each other. I developed a crush on her because she was the only person who noticed when I got my braces off.
She became the valedictorian. I almost flunked out. She went to the Ivy League. I went to community college. I helped her become more calm and confident. She helped me focus on my future and develop a sense of urgency.
This November is the 20th anniversary of our first date. What kept us together is how much we want to help the other person grow. That means creating a space where each person can share what’s going on in their head, even if it’s terrifying or embarrassing, while the other person just listens. We try to help each other overcome struggles, stay aligned with goals, and grow from setbacks.
Sometimes helping the other person grow means helping them change into someone who is different than the person you fell in love with. Like the time I helped Nhu-An transition out of the sciences and into the arts. We’re always changing, and helping each other change is part of the adventure that keeps me in love with Nhu-An (and keeps things from getting boring). Growing from a Ferris Bueller student into a Frasier Crane therapist was the critical transformation of my adult life, and it wouldn’t have happened without Nhu-An’s constant support.
For a long time, I had a wonderful relationship with my work. I became a clinical psychologist because I wanted to help people. Specializing in anxiety in New York City gave me many opportunities to do that. I treated a wide variety of cases involving panic disorder, social anxiety, generalized anxiety, obsessive-compulsive disorder, phobias, and trauma. It was emotionally challenging and it was meaningful work. It felt like a privilege to be invited into someone’s life during one of the biggest challenges they will face and help them find a way through it.
I had exhausted everything I had at work and had nothing left for my wife.
Every now and then I’d get overwhelmed by an evaluation that revealed a complex presentation of problems that didn’t have any clear treatment plan, a parent who sent too many messages, or a patient who needed a higher level of care but couldn’t access it. But that wasn’t the norm and if it did happen, Nhu-An gave me the space I needed.
Early on, the skills I refined as a therapist made me a better husband. I got good at understanding the variety of reasons people do what they do. I became more compassionate in our marriage and I was better equipped to help Nhu-An navigate challenges in her family, with her friends, and at work. I think it’s also made me a better father to our daughter — more patient, present, and involved.
Three things changed.
- I developed a reputation as someone who’s good with “people who don’t want treatment” and gained a caseload full of unmotivated teenagers and young adults with very complex problems. In case you’re wondering what my secret was for getting young people plugged into treatment, it’s to be authentic with them and genuinely be interested in the things they like to do for fun. You’d be surprised how few adults do that.
- My department gradually increased the number of patients I was expected to see over my six years at the medical center. If you compare my productivity expectations from 2013 to 2019, you’d see a 60% increase in expected patient contact hours.
- As one of the senior therapists in our clinic, people way above my boss often asked me to see VIP patients (usually, donors to the medical center or someone closely affiliated with leadership). VIP patients are usually a headache because we are expected to provide concierge services like rapid return of messages and being on call for coaching as needed.
One or two of these changes would have been fine and are part of the job. But each happening in parallel is what messed me up. On a typical day, I’d spend nearly eight hours seeing patients, somehow returning messages in between appointments (or on the subway), and triaging crisis calls from home a few nights a week.
That’s why I was such an asshole to Nhu-An when I came home from work. You can call it burnout, vicarious trauma, compassion fatigue, or moral injury. Simply put I had exhausted everything I had at work and had nothing left for my wife.
I don’t blame my institution — they knew I was unhappy and gave me a once-a-week teaching role that decreased some of my patient hours. That helped, at least on the day I taught.
I decided the best thing I can do for my relationship with my wife is to stop — at least for now — working as a therapist.
My frustration is wholly directed at the American for-profit health care system. Hospitals make most of their money from cardiology, neurology, orthopedics, and other specialties that can bill thousands of dollars for major surgical procedures. Psychiatry departments mostly provide talk therapy and medication, low-cost procedures (by hospital standards) that generate little revenue. Administrators increase profit by having mental health teams see more patients, for the same salary, often beyond what feels sustainable.
There’s also the issue of how insurance companies make it difficult for therapists to do their job and get paid for their services.
I decided the best thing I can do for my relationship with my wife is to stop — at least for now — working as a therapist. I believe in psychotherapy and remain passionate about mental health, but I don’t think our health care system works for therapists (or patients).
As the HBO series premiered last October, Nhu-An and I were in the middle of rebooting our lives. We moved back to our home state of California. She’s got a great new job. Our daughter now lives near her cousins, aunts, uncles, and grandparents. And I got a clean, guilt-free break from my life as a therapist.
I’m figuring out what to do next. Colleagues encouraged me to start a private practice. Therapists who work independently don’t have the large administrative costs associated with hospitals and can keep all of the profit from their services. In other words, it’s a great way to make money.
But I’d like to avoid that. I want to solve the scale problem that pushed me out of therapy, to create something that helps a lot of people without hurting me, to “reboot psychotherapy.” What does that look like? No clue, yet.
For now, I’m just happy to be talking with my wife again, seven days a week.