The training of a psychotherapist includes, among other things, learning certain skills of emotional self-management, which create a separation between emotions and their expression. They are trained to recognize their feelings, even strong negative ones, toward their clients, but not to express these emotions during sessions. They learn to keep a professional attitude of "unconditional positive regard," even when this is not what they genuinely feel. These practices are justified, when appropriate, by the needs of the client. The client is simply that a paying client and the purpose of the therapeutic experience is the client's own insight and growth, which the therapist is there to support and facilitate.
I was reminded of these principles recently while reading Arlie Russell Hochschild's influential 1979 study, 'The Managed Heart: Commercialization of Human Feeling'. Hochschild's work examines various professions, including doctors and social workers, but her primary focus is on flight attendants, particularly those trained by Delta in the 1970s. The training of flight attendants resembles that of therapists: they are taught to manage their internal feelings about passengers to ensure that their experience is as pleasant as possible. Some of the guidelines given to flight attendants in training are more explicit than those given to aspiring therapists. For example, flight attendants are instructed to smile frequently, which is generally not expected of therapists. However, the overall tone is quite similar.
Hochschild's main argument is that a specific category of workers is expected to perform "emotional labor" which involves not the manipulation of machines or money but of feelings, both their own and those of others. This emotional labor is compensated though not always adequately but it also comes at a cost. The emotional worker experiences a disconnection from their own feelings and sometimes shuts down entirely, or "goes robot," as one of Hochschild's interviewees described it. The emotional laborer, in one way or another, pays for their work and it is typically women who do much of this emotional labor.
According to Hochschild, one difference between the work life of a flight attendant and that of a psychotherapist is that the former undergoes explicit training and supervision on managing emotions, while the latter is taught to internalize certain standards through exposure to their profession. However, as the training of social workers and other potential psychotherapists becomes more standardized, this line is beginning to blur, and the kind of explicit instruction in emotional self-management that was once the domain of flight attendants is now spreading to the education of people in professions that traditionally allowed for more individuality.
Only recently has this aspect of therapeutic practice been acknowledged in academic literature. James Clarke of Curtin University in Australia and his co-authors have published several papers detailing the emotional labor done by psychotherapists and its contribution to a significant issue for therapists: burnout, especially the component involving "emotional exhaustion." The emotional work done by therapists takes a toll, one which Clarke and his colleagues suggest might be addressed by the same strategies that benefit clients, particularly psychological flexibility and self-compassion.
As Clarke and his co-authors note, this work has generally not been done, and psychotherapy has not been included in many large-scale studies of emotional labor. Why not? I suggest that one reason is that many psychotherapists would not understand themselves as engaging in emotional labor. The flight attendant is engaged in a service profession and is required to maintain a certain façade to provide good service. However, the psychotherapist typically does not perceive themselves in this way. They see themselves as engaging in a "relational" experience with their client, one that transcends the more mundane demands of, for instance, the service industry.
But it is possible that this framing of the psychotherapist's work only makes things worse by distancing them further from their emotional labor. The flight attendant can talk to coworkers about rude passengers and sometimes act out in small ways. Hochschild tells of one flight attendant who "accidentally" spilled a drink on a difficult passenger. These forms of decompression are not generally available to the practicing psychotherapist, who is asked to understand their client as compassionately as possible, even outside of therapy sessions. One of the dangers of emotional labor is losing a sense of where one's professional self ends and where one's true self begins. This is a danger that is particularly acute for the psychotherapist, whose emotional work runs very deep.
So I think the practicing psychotherapist has much to learn from Hochschild's study. Despite their superficial differences, there is a profound similarity between the role of the flight attendant and that of the psychotherapist, and in some ways, the therapist's situation is worse. It is a further question whether this should lower our estimation of the emotional labor involved in psychotherapy or whether, on the contrary, it should raise our respect for the work of flight attendants.