The Therapist is a Human Being
At different times in your life and for various reasons, you will not be at your best. If you are a psychotherapist, coach, teacher or really if you do anything at all…not being at your best can be frustrating. Your responsibilities don’t go away even when you need a break.
Even when things are going well and you have a wide array of opportunities, an increase in stress is not only common but normal.
- Business is picking up? You’ll have more to do and more to address as you level up.
- New Relationship? You’ll face the challenge of accepting differences and finding similarities.
- Financial windfall? You’ll need to plan effectively for taxes, helping others and in general making smart decisions.
When things are going well our stress may increase but it can be balanced by keeping a level head and not moving too fast. What about what happens when things aren’t going well (or aren’t favorable)?
- What happens when you are facing a serious medical challenge or a loved one is ill?
- What happens when your income does not exceed your needs?
- What happens when your support systems are stressed, non-existent or unavailable?
How Do Therapists Manage When They Are Not Okay?
Recently a counselor I supervised asked me how therapists manage when they are not okay. It was a great question. Our codes of ethics talk about counselor impairment. An impaired professional is someone who is not able to perform their role and may put other’s at risk. Typically, we think of this as a professional who is struggling with substance use or dependence. Another example is a therapist who is depressed, emotionally unavailable or out of tune.
We don’t typically think of it as a therapist who is simply not at their best and I’m not suggesting that we should. What I told that counselor is what I know to be true. Life happens to the therapist like it happens to the client. What we must do is be conscious of how we address our own challenges when the arise…because they will and they do.
The Grieving Therapist
The therapist who is grieving for example, doesn’t necessarily quit their job. They may or may not take a break. The therapist who is grieving needs support, perhaps their own therapy and/or friends to talk to who have gone through a similar experience. They might attend a grief support group or spend more time with loved ones reflecting on their loss and on what and who remains. The grieving therapist can’t avoid the topic of grief as it arises for the client. Nor can they expect for everyone to handle loss the same way that they do (or do not).
The Therapist Facing Their Life Being Different Than What They May Have Imagined
A therapist who is infertile and struggling with coming to terms with that reality doesn’t necessarily stop working. However, if they can help it, they might be cautious about what types of cases they take for a while if they can choose their cases. If they can’t (and even if they can) it’s a good idea again for the therapist to have their own support and even consultation to separate their stuff from their clients. Any personal loss that results in the therapist’s life not being what they expected it to be must be respected for the full weight it can have on their work.
The Therapist’s Own Relational Challenges
A therapist who is struggling in their own relationship rarely quits their work. They may or may not be able to avoid working with couples. But they cannot avoid discussions about relationships with clients. A therapist who is chronically unhappy or unfulfilled in this area of their life is prone to feeling like a fraud, which can have a major impact on their professional esteem. This therapist, like in the other scenarios, needs their own support and definitely consultation to avoid causing harm to clients based on transference and their own relational concerns.
The Therapist Who is Caregiving
A therapist who is caring for a sick child or a vulnerable adult (child) or an aging and not well parent, typically does not quit working. Most of the therapists I know are very much dependent upon generating income for themselves/their households. Caregiving presents a particular challenge for the therapist whose mind now is split between the person(s) or work in front of them and the person(s) they are responsible for back at home, school or in the hospital. As in all of the scenarios, this therapist needs support; however they also need a life outside of caregiving.
Recommendations for the Therapist’s Well-Being
Below is a general list of my recommendations based on what I do myself and what my friends who are therapists do to address when they are not at their best.
- Talk about it. Talk to someone. It may be a therapist or a friend. The key is not to be silent and suffer in silence or feel shame about not being okay. Some therapists are such accomplished listeners that we don’t share and no one even notices.
- Ask for help. Sometimes therapists are so used to being in charge that we struggle to follow our own sage counsel. Sometimes we need to ask for help and tell people what we need. You don’t have to do everything on your own.
- Set limits. Therapists are prolific givers. Whether that giving is emotional, physical, intellectual or financial; all giving requires time and energy. When you are not at your best, you can become easily depleted. Save some of yourself for yourself. Say no.
- Move more. Therapists’ work typically involves a lot of sitting. Therapists have to get up and move in order to function better. Especially when they are not at their best. Depending upon your age you may or may not feel the effects of so much not moving. Unfortunately it will catch up to you too, if you don’t keep moving.
- Block time for you. Therapists live by their schedules. Block time when and where you can so that you might address your own needs. This might be attending your own therapy, going to tai chi class, scheduling doctor’s appointments, attending to your own financial planning and insurance needs. It might be creating space to spend time with key people in your life or time alone.
- Do the basics. Rest adequately, eat nutritiously, drink enough water, breathe deeply, receive healthy touch. I am not short changing these foundational building blocks to being okay. Neglecting these needs can lead to short term, intermediate and long term health problems both physically and psychologically. We manage stress better and make better decisions when all of those needs are met.
Keep Your Head Up
Lastly, please know that many therapists can still do good work and support others even if they are not at their own personal best. However, it is important to listen to the feedback of others. Sometimes when you are not okay, it sneaks up on you. You might think you are fine and all of a sudden a client is asking if you’re okay. This happened to a supervisee of mine years ago and it was an eye opening moment.
There is no need to pretend to be okay. In-authenticity will ruin your work and professional reputation. Healthy people distance themselves from inauthentic interactions. Remember, everyone goes through challenging times.
Keep your head up.
Copyright © 2018 Ruby Blow. All rights reserved.
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