You can't pour from an empty cup:
Deciding when to take a sick day as a highly sensitive therapist
That “Off” Feeling We All Know
You wake up and realize you don’t feel right. There’s a tickle in your throat and some achiness in your muscles. Nothing’s terribly wrong, but you feel . . . off. It’s not awful, but you don’t feel great either.
Ughhhh, you groan. You’ve got a full day of clients scheduled. How bad is it? Should you suck it up and get through the day? Switch your sessions to telehealth? Stay home sick?
If you’re anything like me, you can go round and round with these questions and then overthink it some more. Sometimes when I feel sick, I long for the days of working at a desk job. Back then, no one expected too much of me, and it was no big deal to take a sick day. I had much less inner turmoil about calling in sick, rolling over, and going back to sleep. There was much less guilt about whether I was “doing the right thing.”
But, if you’re a highly sensitive therapist, this can spark an exhausting internal debate.
Woman sitting on couch with laptop in lap and phone beside her
Why It’s So Hard for Sensitive Therapists to Call Out Sick
I feel a sense of obligation and some guilt - what about my 48 hour cancellation policy? For the thousandth time, my brain questions whether it’s fair for me to cancel on clients when I might charge them for a late cancellation, even if they’re sick.
Blergh, I hate these decisions.
Plus, taking a sick day means there’s the stress of rescheduling clients and deciding whether to fit in extra appointments or have clients wait an extra week or two to meet again.
And, there’s the financial component - am I going to lose income if I don’t work today?
There’s a lot to consider, and it’s burdensome.
I actually find it easier when I feel terrible. There’s some relief in the clarity. I know I’m not up to working, and I’ll just have to reschedule clients. Period.
But, I struggle to make a decision when I’m somewhere in the gray area - I have a headache but it’s not a migraine and it might get better. I’m worried about my dad with his latest dialysis-related health issue, but should I take time off or distract myself by digging into work? I’m angry and overwhelmed with the political chaos and today’s edition of terrible news, but I can’t not work every time I’m upset.
Do you relate??
To Be Continued sign
Real Life Scenarios That Make Us Pause
Our team at Thrive had this very discussion recently about assessing our emotional and physical wellness and ability to work or not work. Here are some other examples of situations our therapists shared about when we debate whether to cancel clients:
Having a loved one who is in the hospital or dealing with a crisis
Coping with grief
Feeling very drained/tired/overwhelmed
Not having sick time
Dealing with a pet illness and vet visits
Feeling like your brain isn’t functioning
Having guilt about taking too much time off in close proximity to a recent vacation
Questions To Help You Decide
We also talked about what we ask ourselves to help with making the decision. Some questions we consider are:
What clients do I have scheduled, and how much energy might this session take?
For me, phone sessions take less energy than in-person or video (yay for not having to be presentable!)
Or, teen clients who may need more energy or engagement than I have to offer when I’m in a gray zone
Try to allow that it can be okay to reschedule some sessions and not others
How frequently do I see this client?
Can feel easier to cancel a session with a weekly client than with a biweekly or monthly client
Am I modeling healthy boundaries?
If I’m feeling guilty, try to explore where that guilt is stemming from.
If I’m feeling guilty for needing to rest or heal, then the guilt does not hold water, and I need to give myself the same compassion that I give to clients.
Potential Benefits of Taking a Therapist Sick Day
If you need a reminder of how it might help you AND your clients if you make the call to cancel your appointments and take that sick day, our team identified that it can help you:
Heal or recover faster
Be more present when you return to work
Have more capacity for holding & attuning
Maintain your appreciation for this work
Give your clients an opportunity to practice their self-regulation and coping skills - utilizing their resources and supports and possibly seeing how much they've grown
Feel more confident in the work you do. Stepping back to give your brain/heart/body space to breathe can bring renewed clarity and confidence.
There’s No One-Size-Fits-All Answer
Like most issues in mental health and in life, there’s no simple answer. As therapists, we live in the gray.
If you’ve ever wrestled with this judgment call of whether to show up for work and keep putting one metaphorical foot in front of the other or whether to roll back over in bed, you are not alone. These can be tricky, weighty decisions.
Being a highly sensitive therapist means we feel our own needs AND our client’s needs deeply. As deep thinkers, we consider every aspect of a decision - thoroughly and repeatedly. As deep feelers, we have a ton of empathy, and we consider the impact of our decisions.
It’s part of the beauty and the struggle of being a highly sensitive therapist.
But please remember: Your well-being is also part of your ethical responsibility. Healthy boundaries, rest, and self-compassion are essential parts of being an effective mental health therapist.
So, the next time you’re in that “Should I cancel?” spiral, pause and ask, If my client were in my shoes, what would I encourage them to do? Then give yourself permission to follow that advice.
Sending wishes that we all can take the time and space we need to rest, recover, and heal,
