When I am supervising rookie counselors, one of my favorite discussions that often arises naturally concerns how unique the work of a therapist is. Yes, it is often incredibly tough work, but at the same time, we get an intimate, front-row seat to the experience of hope, pain, change and healing. (Along these lines, if you haven’t read Irvin Yalom’s The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients, I highly recommend it.) If we can truly be witnesses to this on the deepest level, there are so many incredible lessons that we are privileged to receive.
I recently came across an article about the book The Top Five Regrets of the Dying: A Life Transformed by the Dearly Departing, written by Bronnie Ware. After years of transformative work in palliative care, Ware summarized much of what she had learned from her work, first in a blog post and later in a 200-plus-page book. As I read, I found myself taking each of Ware’s lessons and adapting them to the unique work we do as counselors. I think that many counselors will be able to relate to these regrets and lessons.
1) “I wish I’d had the courage to live a life true to myself, not the life others expected of me.”
The work of Virginia Satir immediately came to mind when I read this one. It seems to me that perhaps a few too many of the pioneers and educators in our field want to, essentially, clinically clone themselves. Often, models come with a complete list of do’s and don’ts. I was even given an acronym in graduate school that taught me the exact way to sit during a counseling session. What I’ve always appreciated about Satir’s work is that she encouraged clinicians to be their own unique version of a great therapist.
When we’re new to the field, especially as interns, most of us do, in a sense, “try on” the techniques and styles of those we’re learning from. This, I think, is totally appropriate. Problems can arise, however, if we never grow out of that.
I’ll never forget the first time I was undoubtedly confronted by this “clinical differentiation” process. There was one specific professor in my graduate program whose therapeutic way of being I nearly idolized. I learned so much from him, and it so happened that much of our unique styles naturally overlapped. Then, one day, I was challenged to see some distinct ways in which they didn’t.
I had had a tough, conflict-ridden family session a few days previously, and we were watching the tape together in supervision. After talking through an overview, my supervisor told me he thought I should call and apologize to one of the family members for drawing the hard boundary that I had. After what felt like the longest eight seconds of my life, I swallowed hard and said, “But I’m not sorry.” I still felt I had done the right thing and could easily articulate why.
My supervisor paused thoughtfully and said, “Then you shouldn’t apologize.” And that was it.
He taught me an incredible lesson that day. We all need to be open and receptive to the information we can glean from what mentors, supervisors and others expect of us as counselors. And we need to be intentional about how and why we do what we do, whether that involves the companies we choose to work for, the clientele we choose to see, or the model and theories we posit. But we were never meant to do someone else’s therapy. We are meant to do only our own. To live the “therapy life,” we are meant to live uniquely.
2) “I wish I hadn’t worked so hard.”
The standpoint from which we view quotas and session numbers is greatly influenced by our training, workplace, financial situation, capacity, etc. With this lesson presented by Ware, I find myself wondering whether, at the end of my career or end of my life, I will be wishing I had worked more to see more clients or given more individual attention to each of the clients with whom I worked.
To put it more bluntly, if I have regrets here, will I regret quantity or quality? Will I wish I had worked with a smaller caseload in order to pursue more specialized training or to take more time to read books and research about the specific needs and patterns of the clients with whom I worked? Or will I look back and wonder why I didn’t work to see more clients in order to help more people? Will I wonder why I didn’t find a way to branch out on my own so that I could have more choices in how much I worked? Will I end up regretting that I didn’t follow what my mind and body were telling me about my capacity?
I don’t believe there are many rights or wrongs here. I believe our best bet is simply to make this choice more consciously. When I think ahead, I imagine myself wishing only that I had made my choices with more intention — made them on purpose instead of letting other factors, in a sense, choose a path for me.
3) “I wish I’d had the courage to express my feelings.”
I sat with some of these lessons longer than others in applying them to our work as counselors. After I read this one though, the application came to mind immediately.
While writing this article, I’ve also been reading through Louis Cozolino’s The Making of a Therapist: A Practical Guide for the Inner Journey. There have been many aspects of his candidness in writing to counselors-in-training that I have appreciated. This has stuck out the most to me in his many pleas to approach the work with humility — to admit when we’re in over our heads or when we need help. What I most appreciate is how Cozolino points out, much like Jeffrey Kottler does in his writings about counselor development (especially in On Being a Therapist), that this never ends. We never hit a stride where we no longer have questions, insecurities and specific struggles with clients.
Beyond that, most excellent therapists I know have at some point even questioned whether they should or want to be doing this work. Those of us who work through that well don’t keep it to ourselves. Doubts aren’t built for that kind of response. The path of least resistance is to talk through them with courage or, as Brené Brown would say (in Rising Strong), “rumble” with all that being a therapist does and will continue to bring up in us. I think the bravest among us have come to realize that there’s no shame in that.
As I said earlier, this work is tough — beautiful and tough. To not expect it to be accompanied by a somewhat constant dose of vulnerability can set us up for burnout and, eventually, at the end of the road, perhaps regret.
4) “I wish I had stayed in touch with my friends.”
In my mind, this one piggybacks off of No. 3. I have little doubt that when I look back at the end of my career, I will perhaps be even more grateful than I am now for the colleagues who made themselves available to process through these courageous conversations about the difficult and emotional work that crossed our paths.
One of the dangers of the field shifting more toward private practice than larger agency work is how easily this can lead to a sense of isolation before we see it coming. Even when we work with people we enjoy in these settings, we’re often just “ships passing in the night” during the last five minutes of the hour. Experts in interpersonal neurobiology are speaking more to the importance of the co-regulatory processes in therapy (see The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships by Bonnie Badenoch). We will be best served to keep this in mind beyond just our one-on-one work with clients. I believe that getting support from colleagues is not just important, but actually essential, to doing good work.
In The Making of a Therapist, Cozolino spoke to some of his pushback on this need and his own reconciliation of it over time: “Put a group of us together in a facility designed to help clients and you find that at least half of our time and attention is dedicated to taking care of each other. For years, I found this confusing and demoralizing, and I wondered why we couldn’t put our own problems aside and just do our jobs? After much reflection, I realized that this attitude doesn’t work. Everyone in mental health, clients and caretakers alike, needs help, support and healing. Trying to help clients without helping the helpers ultimately fails.”
5) “I wish that I had let myself be happier.”
Lately, I’ve been finding myself wanting to abandon the term “self-care” because it’s so overused and, I think for the most part, misunderstood. The last point I want to make here really goes beyond the term anyway.
There’s no way around the frequent intensity of our work and the unique stressors found in such close and intentional proximity to pain and suffering. Sure, there are tangible things we can do about that, as I’ve mentioned earlier (and as Emily Nagoski and Amelia Nagoski expertly highlight in their book Burnout: The Secret to Unlocking the Stress Cycle). But we also can’t escape the reality that, as counselors, we don’t have the luxury of not taking care of ourselves. We can’t do the work we do, at least not for very long, unless we tend to ourselves.
I tell students in my practicum classes that if you’re not willing to make attending to your own physical and mental well-being a distinct aspect of your job day to day, then you need to find another career. We have to take care of ourselves like it’s our job. Because it is. That’s how we let ourselves be happier, among other things. Suffering as a badge of honor and martyrdom has no place in this profession. It certainly doesn’t make us more effective as counselors, and it definitely doesn’t make us healthier, more loving people outside of the office.
The following quote from Brianna Wiest, from a blog post she wrote for Thought Catalog, comes to mind so often for me that I think people are tired of hearing me say it: “Self-care is often a very unbeautiful thing. … True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape from.”
Thinking about the end of life while still somewhere in the middle of it can bring incredibly valuable insight — into our priorities, how we spend our time, our expectations, our habits and even our worldview. I think it is really important to ask ourselves whether our perspectives and patterns are forging paths of regret or paths of health and healing. Then, with appreciation for whatever arrives with this exploration, we have the opportunity to cultivate a courageous, balanced, emotionally honest, collaborative and happier work life that we can look back on with pride and immense gratitude.
Whitney Norris is a licensed professional counselor and supervisor who co-founded and works as a trauma specialist at Little Rock Counseling & Wellness in Little Rock, Arkansas. She is currently pursuing her doctorate in clinical and translational sciences, with plans to study childhood adversity and prevention through the lens of public health and policy. Contact
her via whitneynorris.com.
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