After 36 years in the field of mental health services and over 2 decades as a counseling practice owner, I have come to appreciate the real risks and stressors unique to my field. Unlike many careers, to achieve excellence as a counselor requires a type of servitude and giving that has the potential to suck your soul dry and render you nonfunctional. The most common question I’m asked by clients, new acquaintances, close family and friends alike is, “How do you listen to all of the horrific things that people share with you and stay sane?”
There are many layers to the answer to this question.
As therapists, we constantly hear that we need to attend to our own self care. Eat right. Sleep well. Move your body. Stay hydrated. Meditate. Do yoga. Get a massage. Relax. Take a vacation. Spend time with friends and family. Enjoy time off. Take care of your health. Get a hobby. Practice your spirituality. All of these suggestions are vitally important, but I believe there are 3 self care practices that are so crucial to your health, competency, and longevity that they are critical to being able to continue working in this field.
No matter what technique we practice as effective therapists, the common denominator is that we are exposed to our clients’ traumas and struggles on a regular basis. To be excellent therapists, we build a strong trusting rapport with our clients. We closely attune to our client’s emotions. This requires much more than just listening and impacts us personally in very physical and emotional ways that accumulate over time. Our bodies and psyches carry the burdens we are routinely exposed to. Even though we are trained to have healthy emotional boundaries with our clients, the nature of our work is draining and depleting in a way unlike most other professions.
1: Take Planned Sabbaticals
What is the difference between a vacation and a sabbatical? Vacations are typically short spans of time spread out throughout the year while a sabbatical is a planned, extended amount of time taken away from work. Taking short holidays and vacations may help us hang on but periodic sabbaticals of several weeks can truly replenish our bodies and souls. I’ll be honest with you, initially, this idea seemed more like a fantasy than reality for me. I can’t afford to have NO income for several weeks. I’ll lose my clients. My clients won’t understand. How will my clients manage without me? This just isn’t realistic. These were just some of the thoughts that kept me from taking the idea of a sabbatical too seriously. We encourage our clients to take breaks and seek balance, but how many of us role model this behavior in our own lives. Unfortunately, our culture encourages excess and imbalance in every area of our lives. We have stores open 24/7. Fast food restaurants serve super combo meals with unnecessarily huge drinks and sides. We’re encouraged to make as much money as possible, have the biggest houses, the best cars and to dress impeccably. The rat race is real; the grind is constant. In order to be healthy, we must choose to live a life counter to our culture. And, more importantly, as therapists, we work in a field where our own personal balance and self care is crucial to our survival. Many European cultures take extended “holidays” (time away from work) as a regular practice. Sometimes their “holidays” are not weeks long, but instead are months long. Can you even imagine such a luxury in our culture? We may not be able to keep up with European cultural standards but I believe we can do better. My husband and I had been fantasizing about and planning a trip to Ireland and England for over a decade. If we were ever going to actually take the trip, I envisioned being gone for 10 days to 2 weeks. Fortunately, I met a wise respected colleague who shared with me that she takes 1 month off every year. I was in awe of her commitment to her own self care and inspired to do more. She shared with me that while she was away she has never lost clients except for those who were either uncommitted or needed something other than what she could offer them. Likewise, her time away replenished her soul and created new motivation, energy, perspective for her work with clients. In other words, she was a healthier, more effective therapist upon her return. My colleague inspired me. I immediately began putting money aside to supplement my time without income, ramped up my trip planning and preparation and decided to take a 1 MONTH (yes, you heard me right),a 4 WEEKS trip to England and Ireland. I made myself accountable to my inspirational colleague who authentically encouraged me that I too could do this. I am here to validate every truth she shared. We took the trip and not only do I have no regrets but I have committed to regularly scheduled trips and sabbaticals going forward. The anticipation and planning for my next sabbatical feeds my soul and keeps my stamina and momentum in place to best serve my clients. Now, I can honestly say that I can easily foresee another 10 years or more of fulfilling work as a therapist (bringing my total years in the field to nearly 50 years). Of course, the point is not that you need to take a big, expensive trip. Take the TIME AWAY to renew yourself!
2: Practice What You Preach
It’s critical to remember, therapists are humans first. We aren’t immune to the stresses and struggles of this life. We live in an imperfect world with imperfect relationships, surrounded by experiences of relational hurts, losses and traumas just like our clients. All humans have stories of emotional injuries, injustices and personal regrets. No one can escape these experiences and if you think you have, you’re either in denial or your time just hasn’t come yet. I’m not trying to be cynical; I just say this to be explicitly clear that therapists are no exception. In fact, many of us entered this field out of a desire to better understand ourselves and seek our own personal emotional healing. Of course the good news is that the counseling profession was created to provide healing and support for these specific experiences so we can thrive in the midst of an imperfect, fallen world. As therapists, it is our mission and calling to offer this support to our clients but we must also seek this same healing for ourselves by participating in our own personal therapy. If we truly value therapy, we live what we believe. Even though we keep clear, healthy boundaries when sharing any of our personal lives with our clients, taking care of our own emotional health is necessary and critical to our ability to have the bandwidth to serve our clients. How can we encourage our clients to do the courageous work of therapy, if we aren’t willing to do this personal work ourselves? As excellent therapists, we must role model and make a personal decision to participate in our own personal therapy.
3: Participate in a Small, Personal Professional Consultation Group
Even though I arrived late to the game regarding the need for sabbaticals, I have been reaping the benefits of participating in professional consultation throughout my career as a therapist. Regular, consistent professional/clinical consultation is crucial to be a healthy, competent, reputable therapist as well as to set you up for career longevity. In the beginning of my career, when I primarily worked for agencies (community mental health centers, psychiatric hospitals, courts, and school systems) professional/clinical consultation was provided. But, as I branched out into private practice work, it became my responsibility to assure that I continued this necessary ethical practice. We may mistakenly think that once we’ve obtained the supervision required to complete our licensure, we no longer need to consult with other therapists but nothing could be further from the truth. The less we are intentionally engaged with other professionals in our field, the more likely we are to make mistakes in our decision making. We need accountability and perspective for best practices. Competent therapists can’t practice in isolation. It’s like the boiling frog analogy. If you put the frog in before the water is boiling, the frog adapts to the rise in the water's temperature eventually leading to his own demise. The same is true for clinicians. There are so many gray areas and nuances in the practice of counseling that we need each other to keep clarity and ethical perspective as we navigate the work we do with our clients. Unfortunately, I have witnessed colleagues in my profession with the best of intentions lose their license to practice and/or worse find themselves in personal danger and devastating life circumstances as a result of practicing in isolation without the support and wisdom of consultation. Not only do we need feedback and perspective from our colleagues, we also need the space to share the emotional burdens of the work we do. There is a real overlap between our professional work and personal experiences (often referred to as issues of self as therapist). In my humble opinion, committing to professional/clinical consultation with a small, diverse group of therapists is a therapist's best defense against burnout, professional risks, emotional instability and personal safety. If you are a practice owner or clinical supervisor, your staff and/or supervision meetings will not serve the purpose for your personal support. Your role in these consultations is as the leader and should include more facilitation and appropriate boundaries as the individual in authority. As a Clinical Director and/or Supervisor or Employer of other clinical professionals, you also need a safe, confidential place to receive feedback and personal support. I have found that finding a group outside of my community adds an additional layer of confidentiality and protection that allows me to be completely transparent. In a consultation group, I’ve been able to get a variety of clinical and personal perspectives, learn from others' mistakes and successes, hear creative ideas for practice development, and receive personal support. Some therapists have participated in these types of groups off and on but I truly believe the key to my own longevity in this field is credited to continuous involvement in such groups. I have been participating in a diverse, 6 person professional/clinical consultation group with other therapists for over 20 years. I have also been participating in a supervision group for a specific technique I specialize in using for over 5 years. These groups sharpen my skills, stimulate my growth and provide personal support and encouragement. These small groups are much more personal and customized to my needs than a professional group with large, open membership such as an association. It’s also an added benefit to have a network of diverse therapists that I truly know how they work to refer clients to and receive referrals from. Of course, you want to make sure the group feels emotionally safe and supportive. You may not hit the mark on your first attempt but don’t stop seeking until you find the best matched consultation group for you. Don’t stay at risk any longer. You won’t regret it and you may save yourself immeasurable turmoil and unnecessary stress.