Not long ago I had one of those days we all occasionally have in private practice—the ones that make us sit down and take stock of why we chose this career.

The days that knock us on our ass.

And that experience underlined a thought I’ve been mulling over lately, about what it takes to sustain ourselves in this profession*:

I believe a lot of us vastly underestimate how much we need to feed ourselves in order to show up for our work. Not just for this week or this year, but for the next few decades. We’re all aware of the spectre of burnout, and yet it tends to loom closer than it needs to.

We’re doing the equivalent of running 100 miles a day and eating 700 calories.

If you had a client coming into your office who was an avid distance runner eating 700 calories a day, how would you feel?

How worried would you be about what they’re doing to their body?

What would you want to say to them?

I think many of us in this profession have made a habit of starving ourselves, metaphorically speaking. And, even worse, we’ve come to believe it’s what we’re supposed to do. (All those intern years of institutionally enforced deprivation did not help.)

Yes, yes, self-care is a buzzword in the field. We’ve all gotten to that point where we’ve hit a wall and suddenly just KNOW we need a vacation, or at least should book a little hot tub time. We might even get into a mode for a couple of weeks where we’re very consciously choosing to nourish ourselves with yoga classes, home-cooked meals, weekend getaways, retail therapy, a little splurge on a night out. “I deserve this, I’ve worked so damn hard,” goes the refrain.

And usually that mentality wears off after a while, replaced with some vague guilt that we’re being “self-indulgent.” Only for the cycle to repeat as soon as we’ve reached the end of our wits again.

And yet, even when we get into “Jesus Christ I NEED A BREAK” mode, it’s often divorced from the idea that self-care is an integral component of our work, and that it carries real financial considerations. It’s not just an afterthought that’s tacked on to our professional lives.

What does it ACTUALLY cost you to be a therapist?

The cost of feeding ourselves adequately—physically, emotionally, and relationally—needs to be factored into our calculations of how much money we need to earn and how many hours we can reasonably work if we’re going to keep doing this job.

The financial realities of self-care need to be embedded in the foundation of our practices.

Those vacations (even the staycations), the hot tub time, the massages and the cocktails and the trashy novels and the Netflix subscription and whatever else you rely on to recharge your batteries—they’re all part of the cost of doing business as a therapist. Not to mention therapy (maybe you need more therapy? I’m quite sure I do), consultation, savings for when you take a couple days off work… This shit adds up.

And all too often, these costs get dissociated from our level-headed understanding of our income needs.

It’s extra hard to look at these numbers when we already know our practices aren’t earning what we need. It’s so much easier to spend the money in a fog of overwhelm and worry about it later. Again, #internlife is pretty terrible for our grip on financial reality.

But here’s what I DON’T want you to do:

Don’t fool yourself into underestimating what you need to earn to do your job well.

Most of us have a smidge of martyr/masochist in us or we wouldn’t be doing this work. (Some days make that clearer than others.) And when you add radical political values into the mix, it can feel almost impossible to allow ourselves to contemplate making a decent living. Especially when that means we’re passing along the cost to our clients, very directly. We essentially have to tell them to their faces that we need more from them in order to do our jobs. Yikes!

But let me tell you, this gets SO MUCH easier when you have a solid sense of your financial needs.

We all know this and yet it bears repeating, a million times:

We cannot do our jobs well if we aren’t taking care of ourselves.

Our intentions and politics can be noble as fuck, but if we’re starving to death, we can’t help anyone. Not the way we want to, and definitely not for the long haul.

So let’s please stop pretending otherwise. We have to acknowledge that we have needs, and then get to work putting our lives in order. For our clients’ sake, and the sake of the people who love us, and for our fucking selves!

So. Let’s get down to basics.

Do you have a budget? Like, a realistic budget that takes into account what you ACTUALLY spend, and not just what you think you should be spending?

Do you look at your financials at least once a month?

Have you set a target average fee for your private practice that aligns with these numbers, and makes room for the extra self-care you’re not giving yourself yet but really need?

If not, what do you think is stopping you? Let me know!

*I gotta give major props to Tiffany McLain of for her brilliant insights and support around thinking about the complex role of money in our profession. Her work has been foundational to my growth as both a therapist and a business owner. If you’re not already subscribed to her email list, I suggest you check it out!