In 2023, the U.S. Surgeon General declared something many of us had already intuited: the United States is facing a loneliness epidemic. The advisory didn’t pull punches. The data was blunt: loneliness increases the risk of premature death by nearly 30%. It raises the likelihood of heart disease, stroke, dementia, anxiety, and depression. That’s not metaphor, it’s physiological reality.

You can spend your whole day in conversation and still feel completely alone. You hold space for grief, trauma, shame, and fear. You offer validation, containment, and calm. But by the end of the day, after seeing eight clients on Zoom or in a solo office, there’s no one to talk to in a way that actually replenishes you.

The structural shifts toward disconnection didn’t start with COVID, though the pandemic lit a fire under trends that were already in motion. Sociologist Robert Putnam wrote Bowling Alone in 2000, diagnosing a fraying of American civic life from church groups to bowling leagues, warning that our weakening social fabric had consequences. He was right. Only now, that fragmentation is showing up not just in the lives of our clients, but in the bodies and practices of the therapists who are supposed to help.

In a 2018 systematic review published in Frontiers in Psychology, emotional exhaustion was the most frequently cited symptom of burnout (about 34% of all papers) among applied psychologists. Many reported feelings of isolation in their roles. We don’t talk about this enough. We don’t build for it in our systems. And it’s making the work harder, lonelier, and less sustainable than it has to be.

The Clinical Paradox

You spend all day fostering connection: holding, attuning, noticing, containing. And then you shut your laptop or lock your office door and find yourself relationally bankrupt. You’ve used every drop of your bandwidth helping others feel seen, and there’s nothing left in the tank for your own friendships, family, or community. And you’re not alone in that.

This is the central paradox of the work. The more emotionally available you are in session, the more at risk you are of emotional depletion after hours. And if there’s nowhere to put what you’ve absorbed, the residue builds.

Some therapists describe it as a kind of fullness with no nourishment. A saturation of stories, but with no reciprocal outlet. Others admit that the shift to remote work made things worse. What started as convenience now feels like chronic dislocation: no hallways, no breakroom, no spontaneous curbside consults “Can I run something by you?” with colleagues. 

Meanwhile, caseloads are growing. Waitlists are unmanageable. Clients are more acute, systems more broken, and there’s an unspoken pressure to always be composed, competent, and regulated. Even those in group practices or agency settings often don’t have consistent access to emotionally supportive supervision or consultation. And for those in private practice, community is often a luxury, not a built-in feature.

Many therapists feel like they should be able to handle it alone. But that expectation, whether internal or external, is part of the problem.

The Industry Isn’t Built for Connection

There’s no clean time slot for your own processing. No line item for venting, grieving, laughing, or just sitting with someone who gets it. You spend years in clinical training learning how to attune to others – but little on how to care for yourself in a way that doesn’t isolate or compartmentalize. Even things like technology or forums that are meant to support us can fall flat, offering transactional or surface-level connection instead of the safe space we offer our clients. Some of the main structural barriers to connection include:

• No time, no space: Private practice often doesn't account for peer connection, debriefing, or co-regulation. The structures incentivize independence, not interdependence, while the opportunity costs of seeking such support come as a trade of for activities that are billable
• Training gaps: Training programs often focus on clinical competence, not clinician sustainability. There’s little guidance on how to build professional relationships after grad school.
• Technology that fragments rather than connects: Zoom calls and text threads don’t substitute for meaningful interpersonal relationships.

Worse, the culture around clinical work can discourage vulnerability. Burnout gets treated like a failure of time management, not a symptom of unsupported labor. The clinicians who speak up about struggling often worry it will reflect poorly on their ethics or competence. So most just keep their heads down and keep going.

What We Have, and Why It’s Not Enough

Yes, many therapists have therapists. It helps. But it doesn’t fill every gap.

Consultation groups can be a lifeline, especially when they foster real trust. But too often, they’re narrowly focused on ethics, risk, or complicated clinical cases. Not the grief you’re carrying from last week’s termination. Not the client who reminded you of your struggling sibling. Not the hopelessness that hit you after eight straight sessions where nothing seemed to change.

Professional associations? Great for referrals, CEUs and listserv debates. Not great for being vulnerable.

Peer supervision models are emerging, especially online. But they rely on initiative and consistency: two things that are often in short supply when you're overwhelmed.

What we don’t have, not in a sustained way, is community. Not just colleagues, but people who know your work from the inside. Who can laugh darkly with you about the absurdity of FMLA paperwork, or sit quietly when you say that a client’s story knocked something loose in you that you weren’t prepared for.

Reimagining Community: What We Actually Need

So what would it look like to build a community that meets the actual emotional needs of therapists?

Let’s start by stripping the productivity layer off connection. It’s not about networking, or getting referrals, or maximizing supervision hours. It’s about metabolizing the emotional weight of this job in the company of others who can hold it with you.

That begins with moving past “support” as an abstract concept and building structures that provide actual emotional holding and belonging. We should be making peer support a professional norm, not something you scramble for when you’re nearing collapse. Built-in reflective time. Regular peer check-ins that are not optional, not performative, and not limited to clinical troubleshooting. Emotional connection as a hygiene practice, not a luxury.

And yes, policy matters here too. Licensing boards and insurance payers could incentivize relational maintenance. Give CEU credit for group participation. Offer reimbursement for structured peer support. Recognize that clinician sustainability is public health infrastructure.

It’s Not Self-Indulgent to Need Each Other

If you’re reading this and feeling the dissonance between the intimacy you offer and the loneliness you carry, you’re not alone.

I want to be very clear: it’s not a personal failing that you don’t have energy for a phone call after back-to-back sessions. It’s not laziness that you haven’t made it to your own consultation group in a month. It’s the system, the expectations, and the culture. And if we want to build something better for our clients, it starts by acknowledging what we need.

There’s no sustainable version of this work that doesn’t include your fellow therapists. Audit your own support system. Ask yourself: 

• Who do you have that asks how you’re doing, without expecting clinical insight in return?
• Who could you message mid-week with something messy or weird or funny from your practice?
• Who knows what you do in a way that doesn’t require explanation?

These relationships don’t happen by accident. They require time, trust, intention, and space. They require us to admit that we’re not exempt from the things we help others with.

This is a Collective Issue, Not an Individual Weakness

Therapists aren’t immune to disconnection. If anything, we’re at higher risk. And we model the very thing we’re trying to help our clients build. If we do this work from a place of isolation, we teach isolation.

But if we do it from a place of felt connection – real, mutual, sustaining connection – we model something else. We model a life where belonging, safety, and vulnerability are possible. A life wherein being held is not a sign of weakness – that community is something to cultivate, not something you eventually graduate from.

So here’s the question: What would it look like to build a peer community that doesn’t just help you survive your work but helps you feel held within it?

You don’t have to do this alone. You were never supposed to.