One stigma Francesca Giordano would like to vanquish in the mental health professions is the notion that therapists do not need their own therapy. Giordano, a retired counselor educator and the principal partner of Veduta Consulting in downtown Chicago, says there may be no greater resource for a clinician — including supervision and personalized self-care — than regularly meeting with a therapist. And yet, clinicians’ perceptions of themselves in the opposite chair remain a blockade.
“I think in the history of our profession, there’s sometimes been a negative association with the idea of being a wounded healer, that by going to our own therapy, we are perceived to be too damaged to help,” Giordano says. “That label gets in the way instead of being able to see a clinician going to a therapist and doing their own continual work as a strength.”
Giordano’s sentiments echo a call to action in the counseling profession that has often been stampeded over by a multitude of available workshops and seminars that focus on clients’ needs first.
“Counselors are inclined to put clients’ interests before everything else,” says Stephanie Burns, an associate professor and coordinator of the clinical mental health counseling program at Western Michigan University. “The problem is that counselors can often put themselves last and overlook self-care for themselves. Much like with clients, counselors can avoid help-seeking behavior like therapy because of fear of feeling incompetent and ashamed. It becomes, ‘I’m a counselor, so I should be able to handle all of this.’ That type of self-sacrifice mindset can ultimately lead to depression and burnout.”
Stephannee Standefer, the associate program director of Northwestern University’s online master’s in counseling program, says a clinician can be masqueraded by their own shame in taking a no-counseling approach. “When I hear from students or counselors, ‘I don’t need therapy,’ I actually hear them saying they want to distance themselves from their woundedness or pretend it doesn’t exist,” Standefer says. “But if you don’t face your own pain regularly, it limits your ability to be an effective counselor.”
Self-awareness over self-demolition
Like many mental health professionals, Judith Fawell, a licensed clinical professional counselor and certified alcohol and other drug counselor, felt drawn to the field based on her own experience with therapy. The same foundational principles that she developed in her own therapy still foster self-awareness now.
“As a therapist, more than anything I’ve learned in school or the field, I draw from my memory working with my own therapist and the wisdom I got from that. It was like having the best mentor and someone who saved my life at the same time,” says Fawell, a recipient of the 2020 Award of Excellence from the Illinois Mental Health Counselors Association.
“I saw firsthand how one could benefit from seeing a therapist,” Fawell continues. “In essence, my therapy was part of my training too.”
Giordano, a member of the American Counseling Association, says that “training” period of counselors doing their own work before entering the profession is wholly necessary. She also thinks it is best to keep therapy ongoing while seeing clients.
“My belief is that the relationship you have with a client is the conduit for change, and you have to do your own therapeutic work to use yourself as a vehicle,” says Giordano, a former Illinois Counseling Association president. “My philosophy is pretty strong on the importance of therapy and ongoing therapy. Not just for students and young counselors but [for] experienced practitioners. That’s super important. It’s a false dichotomy to think that we’ve already done our own work and are ‘fixed’ or finished growing.”
Standefer agrees that the self-awareness developed from therapy is key. “When I do my own work, I know where I end and where the client begins,” she says. “I become aware of my own reactions to a client’s narrative, and I can hear it in a way that’s therapeutically effective for the client. I’m able to challenge my assumptions and raise awareness to countertransference.”
Fawell says it is naïve to not expect some clients to draw out countertransference and that counselors who are in therapy themselves often have a wider container for the psychological complexities that clients bring into session.
“As you help people, clients are going to trigger you in all kinds of ways,” she says. “They’re going to hit your nerves from the past. You have to work through those in order to be the best helper you can be. Therapy can also help you become self-aware to know whether … to refer out or not.”
Both Fawell, a member of the Illinois Professional Counselor Licensing and Disciplinary Board, and Giordano, a former vice chair on the disciplinary board, say they have noticed a correlation between clinicians who inadvertently harm their clients and clinicians who have not done their own therapy.
“I’m totally convinced that there’s a relationship to clinicians’ own stress and making poor decisions that affect clients and get them into trouble,” Giordano says. “It makes sense. When you’re not in therapy, it’s common to use defenses or block problems or even project those problems onto others. When people are in therapy, their relationship to their own problems changes. Having personal problems doesn’t have to be a bad thing, because then you have an understanding and sense of self and can integrate that into what a client is going through.”
Understanding a ‘unified phenomenon’
Burns believes counselor care and client care are a “unified phenomenon” in that they both hold equal importance to infuse the other. But too much of one form of care tends to not work in the best interest of the client.
“It’s equally as bad if you’re focused on yourself and not caring for the client as if you’re too focused on the client and not yourself,” Burns asserts. “The more mature stance is to blend the two. That makes for a better, more therapeutic relationship with the client.”
“The best way to accomplish that balance,” Burns notes, “is through therapy. … When you’re in therapy, you’re naturally more self-aware of things like compassion fatigue and boundaries. When you’re more self-aware, you have more room for empathy because you’re giving the same thing to your clients that you just gave to yourself. Without it, then it’s easy to get disappointed in clients because of how they’re managing their life or even feel personally slighted if they don’t grow.”
Ingo Weigold, a licensed professional counselor at Centennial Counseling Center in St. Charles, Illinois, sees his own individual therapist regularly and has been an active member in men’s groups over the years. He says he uses his own work as a way to stay humble.
“I never want a client to think I’m above them,” Weigold says. “I want them to know I’m sitting with them, exploring with them. That I’m in the passenger seat. It’d be so easy to develop a power complex in this field because people come to us at their most fragile states and are trusting. We have to treat that as a privilege, and I believe that entails us doing our own work.”
Weigold co-hosts a podcast, Drinks ‘n Shrinks, that aims in each episode to normalize mental health practices and humanize the clinician through exchanges with licensed therapists. It would be “pretty hypocritical if we were to say we’re above the therapeutic process. Just because we’re clinicians doesn’t mean we’re not human,” he says. “We go through things just as much as the next person. That’d be like a mechanic saying, ‘I don’t believe in oil changes. Those don’t work.’”
Giordano agrees that engaging in individual therapy as a counselor can help to remove any perceived hierarchy because the reflex of facing uncomfortable emotions is already in place to be modeled for the client. “When you do your own therapy, you don’t necessarily lose countertransference. You still feel it,” Giordano says. “But then you’re not afraid of it. You can use it to help the client and the therapeutic relationship instead of projecting or going to a safer place above the client out of fear.”
Supervision and counselor friends aren’t always enough
Marina Harris, a licensed psychologist in North Carolina, meets with a group of fellow clinicians weekly to process different cases and client dynamics. “Your self-care and support can take many different forms. Every clinician has something that works for them,” she says. “Personally, I turn to my consultation group because these are clinicians I really trust. But at the same time, it’s not the same as therapy. I support every clinician using their personal intuition of when to do their own therapy.”
Weigold admits that his own therapy can sometimes get put on the back burner, so he makes a conscious effort to supplement it with his clinical supervision sessions.
“Supervision isn’t therapy,” Weigold admits. “It’s a weird mix of therapy processing of clients and coaching. It’s more neutral and asking the question, ‘Why am I feeling countertransference?’ But it’s not necessarily processing. We want to be self-actualized and continue growing as we’re seeing clients and going to supervision about clients.”
Standefer expresses concern for clinicians who rely solely on supervision and for supervising clinicians who inadvertently become therapists to their supervisees.
“Supervision has four purposes: administrative, knowledge base of cases, ethics and ensuring client well-being. Counselor well-being doesn’t fall under that list,” Standefer points out. “If we’re taking up the time in supervision doing our own therapy, all four of those parts of supervision become weakened. You lose, the supervisor loses, and the clients lose. We’re cheating ourselves if we don’t do our own work before we come to supervision.”
“It’s very hubris[tic] and prideful for a supervisor to think that they can grossly overstate their role to be both a supervisor and a therapist to clinicians working under them,” Standefer adds.
Giordano notes that supervision has limitations when it comes to vulnerability because clinicians can get wrapped up in protecting their self-image with colleagues. “No matter how good your supervision or consultation is, there’s always that impression management component, that piece of trying to impress a boss or colleagues,” she says. “With a therapist, you can get more real and go deeper on something a client brought up or something separate you’re going through.”
Regardless of whether counselors turn to their own therapy or trusted confidants, it is essential for them to be in a space where they can be their authentic selves and remove any mask, Fawell says. She experienced this firsthand when suffering a personal loss. “Whatever the outlet, you’ve got to be able to be vulnerable,” she says. “When my son was killed, I spent a lot of time with someone I [could] trust.”
Exuding therapeutic growth versus self-disclosure
Although destigmatizing mental health is necessary in the field, Harris says self-disclosure with clients about doing individual therapy as a clinician is not always wise.
“To me, that’s more of a case-by-case and situational basis,” she says. “We always have to ask [ourselves] with that, ‘Am I sharing this to help the client and in their best interest? Or is it for a different reason?’ One way I’ll get around that is [sharing] with my clients that skills are to be learned and there are still things I’m working on. For instance, that nobody has a perfect self-care regimen.”
Burns agrees. “We do have to be really careful with self-disclosure because it has the ability to enhance the alliance or make it problematic because a lot of the worries or concerns or judgments about therapists being in therapy come from clients who don’t know how and why that’s healthy and good for their experience. They might start probing the counselor to where you’ll have to redirect the focus back to the client. Research shows that self-disclosure is highly problematic, so it has to be in the best interest of the client.”
Weigold says counselors’ self-disclosure of their own therapeutic work becomes unnecessary when they can “wear” it or exude it with quiet confidence and noticeable self-awareness. “Clients can feel when you’ve done your own work as compared to just reading it out of a book,” Weigold says. “Even if you don’t say anything out loud, they can feel you’ve been there or know a little bit about what they’re going through. You can show them you’ve come out on the other end or are growing in the moment. I know if I didn’t have my own therapeutic journey, I wouldn’t be able to connect with clients the way I do.”
Fawell concurs. “When a client says to me, ‘You’re so real,’ I think that’s their way of knowing I get them. Well, I’m so real because I’ve done what they’re doing.”
Standefer says her two decades in therapy often speaks for itself through a similar form of realness. “[Carl] Jung talks about the shadow self. I feel like we can only bring out the light when we test it out in reality, dissect it and reframe it. That is not something we can teach. You have to do it yourself first, and then [clients] can feel that energy.”
Talking about our own therapy
Standefer says that whenever she shares with students or counselors-in-training that she still sees a therapist, she experiences a “vulnerability flash.”
“Every time I say it, that I’m in counseling myself, I’m very aware of what I’m putting out there, that I’m being judged,” she says. “But I’ve come to a place where I think it’s important for the benefit of other people because it changes people’s perception of ‘she’s arrived’ to more of ‘she’s arriving.’ If I don’t express [that] I’m in therapy, then I’m subject to believing what others might project onto me. I want students to see my vulnerability in that way because it can normalize therapy in the field and encourage them to not keep their best tools in the toolkit in being their vulnerable selves.”
Giordano says there is a macro impact when counselor leaders discuss doing their own therapy on a micro level. “It’s so important for counselor educators to talk about their own therapy,” she says. “Because not mentioning it at all then reenforces the stigma, and [students] can develop this distortion that older clinicians don’t seem to need therapy, so they can stop their own hard work while they’re being available for clients. It’s actually the opposite. Doing your own work is what empowers you to be available to clients.
“We have to get past these ideas that someone needs therapy because they’re inexperienced or having a problem. We need therapy because we’re human and this is complicated work.”
Giordano adds that the modeling that comes from therapy has a trickle-down effect from a cultural perspective as well. “If a therapist represents a cultural group that isn’t known for going to therapy, whether that be race or gender, then the value of modeling takes on an added layer,” she explains.
Burns points out that private practices cannot necessarily mandate that clinicians do their own work, but it can be heavily implied or suggested.
“The workplace culture matters,” she says. “Research has suggested that age isn’t a factor on whether clinicians take care of themselves with self-care. What is a predictor is working conditions in a workplace setting. That means it really does start from the top and [it] puts an emphasis on not just supervisor support but supervisor modeling and leadership with boundaries and one’s own therapy.”
Note: The author previously held professional relationships with multiple clinicians quoted in this article.
Scott Gleeson is a licensed professional counselor for DG Counseling in the Chicago suburbs, specializing in trauma and relational dynamics. He spent more than a decade writing for USA Today, where he won national writing awards from the Associated Press and NLGJA: The Association of LGBTQ Journalists. His debut contemporary novel, The Walls of Color, will be published in 2023.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.