There is a particular quality of difficulty that appears in people who work in healthcare: nurses, paramedics, GPs, psychologists. The difficulty is not in caring for others. They are, in many cases, extraordinarily good at it. The difficulty is in being cared for themselves.

It’s worth being specific about what this means. It isn’t about being bad at asking for help in a general sense. It’s about something more structural. The self has been organised, over time, around a particular position: the one who holds, who absorbs, who stays functional when others can’t. That position is not just a professional role. It has become a way of being, and it shapes what the self can receive as much as what it gives.

The culture inside these professions reinforces this. There are specific things the culture says about needing help, about visibility, about what it means to struggle in a context where you are supposed to be the person who manages. The stoicism is not accidental. It has been selected for, professionally, sometimes for years. And it costs something.

When these people do reach the point of sitting with a therapist, there is a particular kind of discomfort that isn’t quite the same as anxiety. It’s more like unfamiliarity. Being on the other side of the desk is a position the self doesn’t quite know how to occupy. Being attended to carefully, being the one whose experience is being held, produces something almost vertiginous.

The self coheres through being genuinely seen. That’s not unique to healthcare workers. But for people who have built a professional identity around seeing others, the experience of being seen can feel strange in ways that are hard to name. It requires occupying a position the self hasn’t spent much time in.

What therapy offers, in these cases, is partly what it offers everyone. And partly something specific: a consistent experience of being held by another person, which is different from holding another person, and which the self can gradually learn to inhabit without it feeling like a threat to who it is.

The capacity to care for others is real. So is the cost of never being on the other side of it.