I’ve been studying a lot lately about how self-care with counselors relates to ethics and what happens to therapists during the course of their careers. This is a personal topic for me, first, because I am a therapist, and second because I’ve both dealt with my own and witnessed others’ in the field deal with being overstressed, overworked and pushing the burnout phase.
After hearing about multiple therapist suicides in the Atlanta area over the last few years, it really got me wondering how we, as a profession are supporting each other’s journey in this career. What changes can we, together, make to better address our colleagues’ if/when we see them struggle? What did we miss with these folks who were silently struggling?
We, as therapists are constantly trying to balance the needs of our clients, supervisees, students, demands of our work setting, ethics codes, laws, and potential liabilities all while dealing with the demands of our own personal life, financial strains, and our own losses, crises and life challenges.
I’ve noticed by my own observation over the last few years or so that the terms, “self-care” “vicarious trauma,” and “burnout” or “compassion fatigue” appears to have be more common themes of discussion both in trainings, blogs, conversations and other areas of our profession. I think the fact that we, as a profession are talking about and it is fantastic and opens up well-needed conversations about our own mental health as caregivers.
In fact, looking back, I can only think of maybe one or two professors in my graduate studies even approaching the issue. And I definitely don’t remember anyone in my state job as an undergraduate talking about it or paying attention to it’s effect on us. It was one of my early on supervisors that noticed it. She probably did me one of the biggest favors of my life at the time by pointing out some blind spots that I wasn’t noticing about myself, like how much I was stressing or overworking myself at the time and that I needed to take some steps to take care of my own mental health while I pursue caring for others.
According on the APA report on stress from 2015 (there is a more recent report from 2017 that focuses more on our political climate and healthcare) most of us when we’re stressed out or overstressed know it, or know we need to make a change, but feel too stressed to do anything about it or make the changes necessary to address it. It makes me wonder how many of the therapists I’ve been reading about in some of my ethics research, or cases I’ve read about counselors who made poor ethical choices and had poor boundaries with clients were experiencing the deep hole of stress or burnout that mental health professionals sometimes find themselves in. It makes me wonder, what, if any could have been done to support them before they reached that slippery slope of boundary violations and crossings.
It’s and ethical mandate for counselors to be aware of our own impairment, according to multiple ethical codes, but if, when we’re overstressed how aware are we really? Are we setting ourselves up for a catch 22? Are we shooting our wounded so to speak by sending our newbie therapists into high stress, high caseloads and high expectations? Are we setting each other up to sink or swim in the sea of conflicting demands and ethical grey areas, or sometimes outright ethical breaches?
What happens between the time we leave graduate school where ethics are preached and studied and taught and our lives in the field? How do some of us end up in organizations (not all, there are many wonderful organizations!) that contribute to toxic work environments, expectations and overworking?
I know, I know, I’m venting.
Maybe these questions are just mine.
But I believe they are important to ponder and discuss so that we can find a way to support each other in this career. Stop the fighting over political decisions between professions, find a way to pay our new therapists fairly and support each other rather than tear each other down. Pay attention to each other and build each other up. There are many, many wonderful supportive folks out there, but I think creating a culture of support and healthy self-care becomes more difficult when there are so many systemic challenges that come into play.
I know I know, it’s a blog, I’m supposed to give you tips, but all I have right now are questions. What do we do? How best can we support the mental health needs of other counselors, our colleagues, both new and experienced? Leave your ideas in the comments below, and lets work together on this.
A few weeks ago I found out a colleague who used to work on the other side of town now worked close by, so I asked her if she wanted to go to lunch or something. I had a lot on my to do list and I have been pounding the pavement so they say for a while, and so lunches in the middle of the day on the work week outside of the office have been few and far between. I was almost afraid to go because I didn’t want to set back my never-ending to-do list and miss those ever so important to me (that I set for my overachieving self) deadlines.
But I went.
And MAN am I so glad.
Sometimes, even in a setting where I work around other people I start to feel like I live on an island. I was so self-focused and focused on the day to day that I didn’t even realize how much I needed that break in my week. We talked, we relived past work experiences that had been toxic or that we had seen as off the chain, and even laughed about the craziness of a profession we call counseling.
It really hit home for me the importance of reaching out and asking for help, and asking for social interaction with others in the profession. It helps me feel like I’m not so crazy, and we’re not alone.
We can get so focused on our to-do’s, our busy schedules, and the heavy material that we carry from our clients that we can forget that there are others out there, experiencing similar things.
We are not alone.
Say it with me: WE ARE NOT ALONE IN THIS PROFESSION.
We are not on an island; we are not machines.
The more and more I study counselor self care and how stress effects us, the less I believe I can separate self care and seeking support from others from how well we can do our jobs. I found myself on more than one occasion lately needing to reach out to others for support, to reboot, revitalize, and refocus so that I can be there for my clients, supervisees, and family.
It is our responsibility as mental health professionals to look out for each other in the field and support each other. Together. Put aside our differences whatever they are and be there for our brothers and sisters in the profession. We were made for this connection. This is part of what helps us live and breath what we do.
I looked at my schedule and I asked, “what did I do to myself.” It was the week before Christmas and I looked at my calendar and realized I crammed as many client appointments as I could all week, supervision appointments, all after a full training day the week before and amidst all the holiday to dos that weren’t yet done.
Man did I feel overwhelmed. I forgot the white space. You know, the space between clients to get my documentation done, the time to wrap up loose ends from training day, pay taxes, all the fun stuff.
I worked so long last week (training week which always adds more to dos’) that my 4 year old daughter asked me, “mommy does your work close?”
Oops. I overscheduled myself again. I felt guilty about it most of the week because I miss my kids and this time of year you plan holiday activities (our holiday pancakes with Santa was kind of a bust because 4 year old cried the whole time because she had an ear infection).
I know what I was thinking when I scheduled it all. I was thinking that I needed the money and my clients needed me. Feelings like I wanted to please others and not disappoint anyone by making them wait until January for an appointment.
On the other end of it, I prayed for this. I prayed for full client load, a growing training and supervision business, and to expand myself. Growing pains.
I think this kind of thing ebbs and flows for me. I go from not busy enough and broke to overdoing it. But I kind of feel like our business, the counseling business is like that. Ebb and flow. Busy and not busy. The trick for me is, I think, is noticing when it gets too much and pulling back and making necessary adjustments, sticking to boundaries, assisting clients to move along that are ready for discharge, etc.… and stop being so hard on myself when it starts to take over and run into family life, but just to make the changes I need to make.
Sometimes that advice is easy to say, but takes a TON of courage to pull off. I have had to work very hard at setting boundaries in general and it doesn’t come easy to me. I am really blessed right now when I think about it. To have enough work that I need to pull back and set boundaries in my daily schedule, time to breathe, time to write, and time to create.
Gratitude for it helps. Gratitude and making small adjustments along the way to tweak the overworked schedule into something more balanced. I’m thankful.
How do you manage your schedule when it becomes insane? Leave a comment below with your tips. Thanks!
Recently I witnessed one of my closest friends giver her testimony in front of her church. She talked about how she struggled with some things and how God has used that in her life to help others (she is also a therapist). It took a lot of courage for her to be vulnerable, even with people she knew were supportive and loving in her life. I am thankful I was there to support her.
It got me thinking on the way home about some things.
I used to believe that as a therapist I’m supposed to have it all together all the time. We are taught as therapists to have a professional distance from our clients. We are to limit our self-disclosure with clients about our own struggles. While these limitations are certainly helpful and ethical in the professional setting so that we can be objective with our clients,(because there is nothing worse than dumping your own junk onto your clients) there is a danger that this distance can carry over into the rest of our relationships and become a protective façade that we have it all together all the time. In the beginning of my career somewhere I allowed that lie into my life, and learned how to put on a good face, and somehow believed that when I am vulnerable with my emotions that somehow I am weak. I believed that I have to pretend that I have it all together all the time.
The truth is, therapists are people who hurt and go through things just like everyone else. I have been seeing my own therapist for almost 8 years now to deal with my own work/life balance, anxieties and times when I’ve hit burnout. The more I meet with people, work with my clients, supervisees and talk to colleagues, I believe now that there is a purpose for our challenges, whether that purpose is revealed to us or not. God will use them to work through us for the good of others and ourselves.
It’s never without a purpose. That’s why I believe being vulnerable with others about our struggles is so healing. I could see the hope, joy, and peace in my friend’s face as she took the courage to share, and how the façade came down in her life and she could be vulnerable with others. It was freeing.
For more information on being vulnerable, watch Dr. Brene Brown’s Ted talk on her vulnerability research.
It’s the day after a medical procedure and I’m still recovering. I have some help the day of but then I’m up and driving around the next day. I feel 75% myself, just sore. It’s been difficult to get rest and entertain my kids and get ready for my birthday party next week. And even though I gave everyone at work notice, it seems I still get client calls and messages. My brain got overwhelmed, and I found myself in a mood. You know the one. The one where I NEED to take care of myself physically and mentally but I can’t seem to turn off the thoughts. Thoughts of the to-do’s, thoughts of cases I need to address, and thoughts of the pressure I’ve felt the last few months. The overwhelm had sunken in and I caught myself spreading myself too thin.
How do I stop when my body is saying stop, slow down, but my mind says, go-go-go? I tried all the tricks, avoiding, talking to my hubby, trying to focus on the here and now, and even giving into some of the to do’s. All signs that I need to put on the breaks and re-adjust some parts of my life so that I can take a step back and look at the bigger picture. It’s crunch time. It feels like forever, but it’s not. There will be an end. Boundaries will be set, and space will be made where it needs to be.
It’s time to focus on what’s in front of me, the little people in my life, my faith, and my family. Serving others is most of what I do and there comes a point where it can overtake your life if you’re not paying attention, and I have to pull back some places and set more boundaries. Allow others help, to take over parts of my to do list (or trim it), and allow others to adjust around me rather than myself adjusting to them all the time. It’s a difficult shift for me. I tend to want to please others, and I’m hard on myself when I say no or if I can’t make everyone happy. I allow false guilt to set in if I’m not paying attention to my thoughts. But the truth is, I will never make everyone happy all the time I am not their source of happiness or healing. I am not the answer to all their problems. I am only a vessel that God allows to work through me. Boundaries allow God to work through me and teach others to rely on Him and to open doors for them. Sometimes my saying no and setting boundaries is leaving space for God to work in someone else’s life just as much as giving Him space to work in mine. It’s a freeing experience, really, to say no to something or set a boundary somewhere because it helps guide you to your goals, so you can let go of the things you need to.
What do you need to let go of when you find yourself needing to slow down? Leave a comment below and let’s support each other’s boundaries.
Since last year I’ve been working on a lot of goals. I opened a business and started working with supervisees for the first time. I’m putting myself out there as a trainer/speaker for the first time. First, first, first.
Adding these responsibilities have really stretched me and challenged me in a lot of ways. I’m learning to experience the emotions that come with owning something with your name on it. I am by no means an expert at business, but I like the challenge and I’m learning as I go. I was looking to grow and change and challenge myself. I’m accomplishing just that, and in the process I’ve done a lot of new things I’ve never done before. It’s a very exciting time for me.
The Challenge of Uncertainty
On the other side of taking these steps to obtain my goals in the counseling field comes a lot of uncertainty. Financial uncertainty, will I have enough clients, will supervisees come to see me, and what if I work months on a training and no one shows up? Fear of failure and the unknown can easily creep in.
The thing is, change and uncertainty are very challenging for me, and probably for many others. I tend to like plans and to know what’s next. Those that know me know how scheduled I am and how I like to plan my life way in advance. Business challenges that for me on so many levels. I’m very loyal and dedicated and I will drag out a tough situation that’s not great just to avoid the change and stay in my comfort zone. On the positive, this makes me a very loyal and consistent person and I’m great at commitment, but if I don’t keep myself in check I will continue a sometimes difficult or not good for me but good for them situation, or get stuck in the mundane.
It’s Not Just Me!
I’ve noticed some of the same challenges with change and uncertainty with people that I work with. Either they hit a new milestone in their career, like getting their license and begin to explore their options, or they’ve decided to change the way they are doing something in their home or work life and dealing with the ambivalence that can sometimes follow the decision to make a change.
I read this morning on one of my favorite websites “Unstuck.com” that our brains see uncertainty as a challenge.That we try to make up something certain in our minds to deal with the uncertainty because we are wired to survive that way. This makes since in a survival situation, but it can sometimes be a stumbling block to a positive change. People tent to have trouble seeing past the ambiguity to the other side of the change. It takes a greater payout on the other end for people to walk through the uncertainty.
So Now What?
I was talking with someone I trust yesterday about some of the uncertainty I’m experiencing right now and she asked me how could I view uncertainty differently, rather than a threat? Or a fear? Well, here’s what I’ve come up with:
Change is certain.
Change is sometimes necessary.
View it as an opportunity to be creative with your life.
Write out the positives of the end goals.
Practice self-care rituals to deal with the emotions of the change.
Lean on your support, your tribe, or who ever you go to for accountability and
Practice your faith and trust in you God, and also yourself to make the right steps.
Focus on the next step right in front of you, (Thank you Oprah for this one!)
Focus on the Process not the outcome (thanks Marie Forleo!)
Look at the ambiguity and uncertainty not as a threat, but as an opportunity to be creative and make some tough decisions.
How do you deal with change and uncertainty? Leave a comment below and share with your friends.
