Tag Archives: Self-care

The Hope Chest: Finding calm within the storm

By Kim Johancen-Walt November 13, 2014

We have all taken seminars, classes and workshops focused on the importance of self-care. These forums generally highlight the importance of taking care of ourselves outside of work. We talk about the importance of finding balance, taking spin classes, kickboxing or engaging in hobbies such as drumming or knitting. But despite our best efforts to make self-care a priority, there are times when many of us still find ourselves feeling fatigued, increasingly irritable and disconnected from our Calm1personal relationships.

When we are merely burned out, all of those pickle ball classes we participate in or blankets we crochet can work to rejuvenate our spirits so we can continue engaging with our clients and within our own lives. Sometimes, however, we find ourselves unable to bounce back, stretched beyond our natural elasticity and resilience. Through our daily exposure to trauma, we are at risk of developing tilted vision without even recognizing that it is happening. At these times, our self-care may not be enough to prevent us from doubting our ability to effect real change for the people we are trying to help. Activated and overwhelmed, we can lose our way, maybe even seeing our clients as problems rather than people.

Vicarious trauma is like a slow-moving virus that weakens our muscles and compromises our immune system. The reality is that we are all at risk. As a therapist in the field for many years, I understand the weight of trauma both personally and professionally. I engage routinely in self-care, take mental health days as needed, strive to find balance and do my best to resist the urge to isolate when I feel particularly stretched. But it is important to remember that distraction alone is not enough to help us heal from the impact of trauma, whether that trauma is direct or vicarious. Sometimes, no matter what we do outside of work to protect ourselves, we still can’t stop the disease from spreading; we merely slow it down. We have to find a way to stop the poison from permanently impairing our system.

We can find openings with our clients to build our own resiliencies along with theirs. By reflecting on these sacred conversations, we can learn valuable lessons that allow us opportunities to heal within the storm. Longevity as a therapist comes from using (rather than avoiding) our exposure as a way to build immunity and ultimately to become even better healers. On-the-job resiliency training involves deepening our understanding of the value of human connection for ourselves, remembering that pain and discomfort are an essential part of living fully and that helping others is a direct pathway to helping ourselves.

 

Powerful connection

“Patricia,” 36, lived alone and had come to therapy for issues related to the loss of relationships in her life, including a long-term boyfriend and the unexpected death of her mother several years earlier. Patricia was motivated to heal and live a fuller life. Her motivation was evident not only in her regular visits to my office but also in her diligence to practice various techniques and strategies in between sessions. She was also dedicated to other healing practices, including her work as an artist, seeing an acupuncturist and attending yoga on a regular basis. But despite all of these efforts, Patricia continued to talk about feeling stuck in the abyss and unable to find her way out.

She started coming to therapy frustrated, telling me over and over again that she was doing everything she was supposed to do to take care of herself, yet nothing seemed to be working to stop the pain. After acknowledging her incredible efforts along with her frustration, I reminded her that although she was engaging in several meaningful practices, she was doing all of these things by herself. We discussed how as human beings we absolutely cannot heal in isolation. We need each other. Rumi’s teachings remind us that it is the relationship that hurts, but it is also the relationship that heals. After exploring this concept, we discussed how Patricia could begin cultivating more meaningful relationships in her life moving forward despite a fear of further rejection and abandonment.

When the constant exposure to trauma begins to cloud our vision, our connections to peers, friends and family members are threatened as we begin to show the same symptoms of numbing and constriction that our clients exhibit. Whether we see our own therapists or choose to spread it around to our existing support network, others remind us that we are good, that we have experienced success in many areas of our lives and that we make a difference. In other words, we are reminded that it is not all bad. In graduate school, we are taught that the relationship with our clients is paramount to any therapies, skills or strategies we offer. Connection (or reconnection) is the most powerful medicine available to heal the isolation that comes from trauma.

 

Painful experience

As Patricia began to accept that building relationship outside of therapy was essential to her healing, we began to work with the rawness of her past through a broader lens of human experience. As she discussed moments when the emotional pain was so intense it threatened to split her open, I encouraged her to remember that her pain was not uniquely hers. Although experiences of loss may differ greatly from person to person, it is something we all have in common. Embracing the painful experience is an essential part of what it means to live fully. Through this practice, Patricia began to connect to others more deeply, growing in awareness that there were people everywhere who knew the pain of loss, the feeling of heart-crushing grief and the ache of abandonment.

As therapists, we remind ourselves — as we remind our clients — that the inevitability of change ensures us that pain, just like joy, will not last indefinitely. It is with this knowledge that we remind others to keep moving, to keep breathing and to not give up. It is the not giving up that is most essential. Remembering (or experiencing) the universality of pain can be incredibly humbling for us as healers. No one is immune, and life does not pick and choose who gets clobbered. It is through this knowing that we find humility and the sweetness of shared experience. We find our way and the courage needed to withstand the violent storm raging around us.

 

Tasting our words

Patricia eventually decided to take her painting to the next level by becoming an art instructor at a local studio. She discussed how it brought her happiness to know she could help others through creative expression and also by helping her students build confidence in their abilities to create beautiful paintings. We discussed her decision to help others as part of her healing because it allowed her an opportunity to reap the benefits of receiving what she gave away. Patricia’s choice to become a teacher helped her cultivate purpose, connection and success.

Therapists with potentially compromised systems are at risk of abandoning ship by closing their offices temporarily or, in some cases, leaving the field altogether. And although there is value in taking a self-appointed sabbatical, a radically different choice would be to continue showing up in the chair. The fact is, we cannot do the work we do as counselors without compassion, however difficult it may be to find at times. By keeping our hearts open so that we can be there for others, we effectively resist the urge to disconnect from ourselves and from the people that matter most in our lives. We are either open or we are not. By tasting our words, we offer comfort and reassurance to ourselves as we offer comfort and reassurance to others.

No one is immune to the impact of trauma, the devastation of loss and the activation that reminds us that although we are therapists, we are also carriers of the virus. Through our connections to the

Image of a calm lakecaring others in our lives, we are able to integrate our own trauma stories while keeping a larger perspective. By helping our clients work through painful feelings, we are humbled, remembering that the experience of loss is an essential part of what it means to live fully. Furthermore, by helping others we can remain open, resisting the urge to close ourselves off from relationships and from our own lives. It is the work itself that helps us heal.

Perhaps over time we can treat ourselves with greater compassion and gentleness, not waiting to seek support but rather asking for it when we need it most. Perhaps by remembering our shared experience, we can hold steady in the storm. Maya Angelou spoke about how the universe continues to present us with opportunities to learn valuable lessons over and over again until we finally “get it.” Whether trauma comes in the form of personal experience or from the ongoing exposure to the trauma of others, this is an important concept for the wounded healer.

What is the universe trying to teach you?

 

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Kim Johancen-Walt writes “The Hope Chest” column exclusively for CT Online. She is a licensed professional counselor with almost 20 years of experience. Her clinical experience includes working as a therapist for La Plata County Human Services, where she helped develop a treatment model for adolescents in Durango, Colorado. She has presented her clinical work at mental health conferences nationally, including at the annual conference for the International Society for the Study of Self-Injury. Additional clinical experience includes a position as assistant training director and senior counselor in the Counseling Department at Fort Lewis College. She currently operates a full-time private practice in Durango. Contact her at johancenwaltks@gmail.com.

 

Previous columns:

The Hope Chest: The GIFT of therapy

The Hope Chest: Unpacking the hurt

 

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The inner life of the counselor

By Robert J. Wicks and Tina C. Buck April 28, 2014

inner-lifeA psychiatrist’s wife once questioned him about why he was so faithful in going to see Zen master Shunryu Suzuki for mentoring and guidance. His response was simple: “Where he is, is where I want to be … in that place of sanity.”

One of the greatest gifts we can share with those who come to us for counseling or supervision is a sense of our own peace, resilience and healthy perspective. However, we can’t share what we don’t have. It is as simple as that. And so, for those of us in the counseling profession, strengthening our own self-care protocol is not only an important undertaking for ourselves, but also a gift to our clients and colleagues.

To enjoy and share our signature strengths as counselors, we must:

  • Be willing to let go of that which is nonessential or destructive
  • Practice a greater sense of self-regulation
  • Incorporate at least a brief informal mindfulness practice in our day
  • Embrace approaches that help us maintain a healthy perspective regardless of the darkness that may be encroaching on our professional and personal lives

To encourage some movement toward these goals, this article will “dust off” and emphasize what is essential to remember about the value of “alonetime,” mindfulness and self-nurturance. In addition, we will offer several ideas on integrating these concepts through the practices of personal debriefing, rituals for renewal and releasing judgment.

Our bodies, minds and spirits are the instruments that we bring into our sessions as counselors. Our view of ourselves both as individuals and clinicians affects how we engage our clients, express our thoughts verbally and share our essence. Thus, knowing ourselves is a foundational element of self-care. With this awareness, we need to continually challenge and encourage ourselves by asking an overarching question: What do we seek for our own lives, and how does that translate into a mission or theme for our vocation as counselors? If we know what we are working toward, then we will know when we go off course — as all of us surely will at times.

There are occasions, of course, when the workload will be extremely heavy, and there is little we can or probably should do about it at that moment. However, if we find ourselves working 60 hours a week in private practice and missing our teenager’s sporting events, our anniversary and other things that we hold dear on an ongoing basis, then we know that adjustments need to occur. Also, by having a balanced life and valuing the fragility and impermanence of our human state, we are more likely to remain in the moment and be attentive to who we are and what we are doing now. Whereas, if we are too tired, hungry and/or stressed, we naturally have a tendency to lose focus and make poor judgments such as crossing boundaries and seeking inappropriate gratification from our clients, students or colleagues because the resources we are drawing from in our own lives are so sparse or currently unavailable. One of the best ways to ensure this scenario does not develop or is caught early on when it does is to place greater value on periods of alonetime.

 Valuing and accessing ‘alonetime’

We become vulnerable to physical, mental and spiritual decay when we do not slow down long enough to invest in ourselves consistently. However, when we appreciate, explore and enjoy designated and spontaneous time alone and gentle-clear reflective periods within ourselves (what we are referring to here as “alonetime”), we can lessen and more quickly withdraw our projections, become easier on ourselves and become less discouraged when personal or professional successes aren’t granted. Instead, we may feel a sense of inner ease and intrigue about the life we can live that is before us right now rather than constantly being postponed into some uncertain future.

Although as caregivers we live in an especially demanding, bustling world, there are simple, effective ways to uncover and enjoy crumbs of alonetime. In doing this, we can also:

  • Uncover the existing resistances to seeking more space in our lives
  • Access more readily the surprises about ourselves that are getting lost in the busyness of the day and our practice
  • “Positively contaminate” the rest of our day with the new learning and “unlearning” that becomes possible during even brief periods of mindfulness

Sitting with mindfulness

Experienced counselors and clinical supervisors are not surprised when the following paradox is present in those they guide (or even in themselves): Often we are gentler with our clients than we are on ourselves as counselors.

We possess the capacity to make each session we have with someone fresh and new. But first we need to approach ourselves — especially during periods of silence and solitude that we have set aside or that unexpectedly appear — with no preconceived notions of what will happen and without picking up leftover thoughts from earlier in the day. Our goal is to empty our minds so the most relevant ideas reveal themselves. The stability and awareness offered by informal and formal mindfulness meditation practice counters unproductive movements. This helps us to:

  • Recognize the importance of focusing on personal and professional faithfulness to the process of counseling rather than on specific successes we want — even if we believe those successes are for the client’s benefit
  • Appreciate when we are becoming too easily upset — often over the wrong things such as a client being late or resistant or wishing to change therapists — and missing what life is offering us in all interactions and events
  • Uncover personal character traits, habits and rules that continue to sap life’s freshness for us
  • Limit our dwelling on the past or rushing through precious moments of our life by living with “if, then”
  • Note when we have a tendency to spend too much of our time in a cognitive cocoon of judgment, worry, preoccupation, resentment, fear and regret, thus missing the chance to experience life’s daily gifts
  • Gently confront ourselves when our emotions alert us that we seem unable or unwilling to see transitions as being as valuable as our destinations, even though transitions make up much of our life
  • Increase our sense of intrigue about ourselves, including both our gifts and growing edges as persons and counselors
  • Limit instances in which we a) project faults onto clients or colleagues whom we don’t see as supportive, b) shoulder an inordinate amount of self-blame or c) stay immersed in discouragement when we don’t succeed as we would like

What we are emphasizing is that a mindfulness practice allows us to psychologically lean back and, in the process, more often get onto the psychological lane of greater inner freedom — the very same lane we call our clients to merge onto.  Silence, solitude and mindful moments have the power to stop us in our tracks and make us ask: Why, especially as counselors, are we continuing to live in ways that are not renewing?

If we are brutally honest with ourselves during those reflective times, we might wistfully respond, “We must live this way. We have no choice. It is practical and normal, so there is really no other way. As a matter of fact, most of my colleagues live this way — even the ones I admire or who were my teachers and supervisors.”

Paradoxically, when this helpless response occurs, the first gate to new inner freedom opens to some degree because in our hearts, we know that what we are telling ourselves is not true. So, once this portal is nudged open a bit, we can begin to access a healthier, freer perspective because even if we choose to ignore or unconsciously forget the portal, it never closes completely again. And that is what the permanent gift of leaning back for the first time (even in the reading of this article) offers us.

Self-care, self-knowledge and expanding our resiliency range

Self-nurturance is a sense of full awareness that requires attention to self-care and self-knowledge, as well as a desire to maximize our resiliency range. It also necessitates a spirit of unlearning and relearning. This exploration is undertaken in more depth in the books The Inner Life of the Counselor and The Resilient Clinician, but for our purposes here, it will suffice to ponder a few central themes to set the process in motion.

  • Patience and pacing: If we are moving so fast that we cannot catch our “psychological or spiritual breath,” we may be losing the purpose behind why we became counselors in the first place. By practicing mindfulness with ourselves and when we are with our clients, we will receive more, and so will they.
  • Chains of the past: Most counselors have gone through their own personal therapy and extensive supervision, but there may be a tendency to forget that unfinished business doesn’t disappear once and for all. How we have addressed the past will affect our lives and our sessions. We know that if we view the memories as bad, then we will want to deny, avoid or embrace them in ways that are not helpful (for example, self-blame). On the other hand, if we look at our past with a sense of intrigue, the results can be strikingly positive. Likewise, if we can accept our growing edges, we can be better counselors and more integrated persons.
  • Immature and/or unproductive thoughts and behaviors: As counselors, we are constantly assessing our clients’ stage of change and ever watchful for relapse. Often, it is hard to turn this spotlight back on ourselves and objectively examine what we are doing unless we have made the time to reflect.
  • Gratitude: Many of us in the profession feel that counseling “chose” us. But as we struggle to build our careers and manage busy practices, we can forget the core reason for the work that we do. We need to focus and reconnect to our purpose.
  • Self-care protocol: Developing a self-assessment and guide to enriching our personal time alone encourages us to explore our thoughts and beliefs more carefully. Likewise, it also challenges us to align our actions with our authentic selves and to refresh and renew our inner beings. A self-care protocol should especially include personal debriefing approaches, rituals for renewal and ways of releasing judgment.

Personal debriefing

As we journey with those who come to us, we provide a safe holding space where they can experience their emotions, process their hurts and, in time, heal. Similarly, as we reflect their emotions, we strive to model and teach our clients about self-regulation and debriefing. Given the intense work, it is also imperative that we process the emotions within ourselves in a deliberate way so we don’t become unnecessarily vulnerable to the point of poor self-regulation.

As counselors, all of us experience physical and emotional exhaustion, anxiety that a client is not getting better or wants to change therapists and, if we are honest, even boredom with what the person is sharing, who the client is or the problem being presented. As a result, we can and sometimes do become hypersensitive when the client is able to zero in on our own unfinished business, lack of knowledge or personal issues. That is why it is worthwhile to conduct a daily  “countertransferential review” in which we systematically reflect on our feelings, cognitions and beliefs.

An end-of-the-day review might include basic questions such as:

  • What made me feel sad or angry?
  • What overwhelmed me?
  • What sexually aroused me?
  • What made me extremely happy or confused me?
  • What was my responsibility given these reactions?

Quiet reflection at the end of the day can reframe our perspective, help us to be kinder to ourselves and jettison that which is beyond our control, especially when that reflection is accompanied by scheduled and specific actions and routines that refresh us.

Rituals for renewal

A thoughtful personal ritual can help us center ourselves, create order and offer comfort. For example, rising early to enjoy a cup of coffee while sitting propped up in bed for about a half-hour may allow us to awaken slowly, appreciate the joy of being alive and center ourselves for the day ahead. We let any thoughts that arise move through us like a train. We do not stop the thought train, hop on and indulge the issue that comes up. Instead, we merely notice it nonjudgmentally. It can be faced or possibly solved later. After this initial part of our ritual, perhaps we can share a cup of coffee with a significant other, chat and watch the morning news. This second part of the ritual opens up space for us and between us and those we love before we are bombarded with all of the day’s events and experiences.

The best time of day for such rituals is based on personal choice. The key is carving moments out of the day when we can stop, breathe and enjoy what is before us. It is not the length of time that is important but rather our willingness to be aware without effort or judgment. Without this practice, we run the risk of rushing through our lives in a cognitive cocoon, while deluding ourselves that this is all life has for us. If we choose the latter, we will find ourselves disconnected and depleted until there is nothing left for self, let alone clients, colleagues, family and friends. Not surprisingly, the extremely busy clinician needs a ritual more than others because it offers the needed space to recharge if the work is to continue in a good way.

Other simple but potentially powerful rituals might include:

  • Taking a brief walk — not a “think” — in the morning, at the end of the day, during a break or after a client cancellation. In this way, we can experience all that is around us rather than being in a cognitive cocoon.
  • Practicing meditation or simple mindfulness techniques
  • Involving ourselves in activities in which we simply “flow,” such as playing music, racing, researching areas of interest, creating or preparing something with love, volunteering or writing
  • Playing with pets

There are so many rituals that renew. What other ones come to mind for you? How can they be expanded and built upon? When under stress, we need to ask ourselves the very questions we ask our distressed clients.

Releasing judgment

As counselors and people involved in so many renewing and depleting activities, we can have greater sensitivity to stressors that may be present and learn how to recognize those stressors early. We can also adopt healthy attitudes and approaches for bouncing back and even learning from their presence. The ability to allow information to flow over and through us without passing judgment is an essential aspect of mindfulness.

In The Mindful Way Through Depression, Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn detail how people can release themselves from chronic unhappiness by the way they face all of life. Their suggestions are also relevant to counselors and how we greet aspects of our lives that we don’t like. They ask us to examine our feelings during our sessions and through the rest of the day and question “negative” emotions instead of avoiding, retreating or attacking. They also ask us to explore the real facts about a situation rather than dwelling in the “shoulds.” By retooling our perspectives with more positivity, we can better begin to see people in a more balanced way and experience events for what they really are.

By employing an attitude marked by openness, intrigue and hopefulness, we minimize self-condemnation and projection. Instead of playing host to discouragement, there is greater opportunity to learn and go deeper. What follows are some examples of “energy sappers” that we may need to uncover and confront.

  • Scheduling clients back to back, which leaves no space to take a breath or psychologically decontaminate ourselves prior to the next session
  • Developing a style of living that is not in line with the guidelines we offer to clients, family members and friends
  • Failing to carefully diagnose situations, resulting in our demonstrating a “tyranny of hope” that risks having goals for clients that are impossible/impractical for them to reach given their personal and other resources
  • Overlooking the effects of workaholism, including ongoing fatigue, emotional distance and/or overidentifying with clients
  • Responding sharply, flatly, cynically or intellectually to inquiries or feedback

The good news is that with a little attention, these issues can be resolved. With ongoing diligence and a willingness to prune all that takes us away from our purpose, unexpected gifts will become evident, even when things are difficult. As the literature on posttraumatic growth teaches us, this can be the case even with significant stress or trauma.

Being a counselor is truly like being in treatment for a lifetime because the process and content of what makes life good for people is our daily fare. If counseling is done in the right spirit, with good support and supervision and a sense that it is a “wisdom profession” that can transform even failure into something that makes life deeper and better, this profession can bring joy and fulfillment equal to the richest vocations in the world.

Because we step into strangers’ lives and hear their intimate, powerful, poignant stories, we must be prepared to journey with them as they achieve greater integration of their perceived past and present selves. By uncovering the source of what has held them captive, they can choose freedom and grow into their futures. A steady practice of alonetime, mindfulness and self-nurturance shores up our resilience so we can remain true to our clients and ourselves. What could be better than that?

 

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Knowledge Share articles are adapted from sessions presented at American Counseling Association conferences.

 

Robert J. Wicks, the author of The Inner Life of the Counselor (Wiley), The Resilient Clinician (Oxford University Press) and, most recently, Perspective: The Calm Within the Storm (Oxford University Press), is professor emeritus at Loyola University Maryland. He is currently involved in presenting on clinician self-care to state counseling associations. Contact him at rwicks@loyola.edu.

 

Tina C. Buck is a licensed graduate professional counselor at Carroll County Youth Service Bureau and group facilitator for the Abuser Intervention Program in Montgomery County, Md. Contact her at tcbuck@loyola.edu.

 

Letters to the editor: ct@counseling.org

Taking care of yourself as a counselor

By Lynne Shallcross January 17, 2011

Taking care of yourself as a counselorAnyone who has flown on an airplane and listened to the flight attendant before takeoff has been cautioned what to do in the event the oxygen masks fall from the ceiling: Put on your own mask first before trying to help someone else. Counselor wellness experts say that idea has mileage on the ground, too.

Helping yourself first is a principle that applies directly to counseling, says Sandra Rankin, a member of the American Counseling Association who runs a private practice in Austin, Texas. “If you’re gasping for air, you can’t help other people,” says Rankin, who is also earning her doctorate in health psychology from Walden University. “Counselors who neglect their own mental, physical and spiritual self-care eventually run out of ’oxygen’ and cannot effectively help their clients because all of their energy is going out to the clients and nothing is coming back in to replenish the counselors’ energy.”

Although most counselors are familiar with self-care — even preaching the concept religiously to clients — many find it a challenge to put the concept into practice in their own lives. Wellness experts say as life gets busy, counselors may tend to assume that they can, or even should, handle problems and stress on their own. But, these experts caution, counselors who ignore their own needs will find their outlook on the profession going quickly downhill.

“Wellness is one of the critical factors in being a healthy counselor,” says Stephanie Burns, an adjunct professor of counseling at Heidelberg University in Tiffin, Ohio. “We are asked as professionals to provide a tremendous amount of empathy to our clients. We often listen to very tragic and emotionally difficult stories. We are offering this empathy to the client and offering a place to share these stories, yet our profession is not meant to be a two-way street — the client is not there to provide us empathy. So, somehow, when you do that work on a daily basis, you have to have an outlet to receive things back. Otherwise, you end up depleting yourself and you don’t have anything more to give.”

Elizabeth Venart, a private practitioner in Ambler, Pa., who served on the ACA Task Force on Counselor Wellness and Impairment, says offering empathy is imperative in the profession, but this also opens the counselor up to feeling the client’s pain. “While vital, being emotionally attuned and available to clients increases our vulnerability in the work,” she says. “And, yet, we cannot be effective in our work if we are not emotionally attuned and available. Within the counseling relationship and within the moment-by-moment interplay of each session, this is the ultimate balancing act — finding ways to stay attuned to clients while maintaining a strong and deep connection with our own experience.”

The path to finding that balance begins with recognizing warning signs and not feeling ashamed of them, Venart says. “It is important for counselors to understand that there are risk factors inherent in the work and that noticing signs of stress or distress is a sign of health, not impairment. None of us is immune to the effects of the work. When counselors can view their emotional responses to their work as an expected part of empathic engagement rather than something they are doing wrong, they are more likely to seek support, talk about stress with colleagues and engage in self-care practices to support their overall wellness.”

Wellness is especially important because counselors are one of the primary instruments in their own work, says Gerard Lawson, associate professor of counselor education at Virginia Tech. “It’s impossible to separate who I am as a person from the work I do as a counselor,” says Lawson, who chaired the ACA Task Force on Counselor Wellness and Impairment. “If I’m not well, that’s going to get in the way of me being able to tune into the needs of my clients.”

Venart, who is also founder and director of the Resiliency Center, a community of private practitioners offering healing services, community education programs, professional development trainings for helping professionals and other services, echoes Lawson’s sentiment. “Counseling is a profession dependent upon our ability to be authentic and attune empathically because it is through this process of careful attunement that healing and growth occur,” she says. “Research consistently demonstrates that the quality of the therapeutic relationship is more predictive of counseling outcome than any other factor. Since the self of the counselor is an essential component of effective counseling, it is vital that we nourish our own wellness. When we are well, we are better able to connect with our clients, more attentive and creative in our work, and less likely to make clinical errors or violate boundaries.”

Counselors should make it a priority to walk the talk and model wellness for their clients, Lawson says. “It’s not to say we need to be perfect all the time, but we need to be aware. If you’re telling your clients to do it, do it yourself.”

Venart agrees. “We need to be aware of the messages we teach clients when we honor boundaries or neglect to set them, when we take a day off to nurture our health or come into work sick, or when we model joy and curiosity or unintentionally share the flat affect of our unresolved grief or depression.”

It’s important that counselors make a habit of checking in on themselves, Venart adds. “Because counselor wellness and impairment are on a continuum from well to stressed to distressed to impaired, it is critical that we continually monitor where we are on that continuum and address any early signs of stress so we don’t move further down the continuum. We are instruments of healing. If we don’t keep our own instrument tuned, we won’t be useful in promoting wellness in others.”

A self-checkup

Determining how “well” you are as a counselor can start with only a few clicks of the mouse, says Burns, an ACA member who has offered wellness workshops for counselors. She points to resources that came out of the Task Force on Counselor Wellness and Impairment, including handouts on risk factors, assessment tools and more, all available on the ACA website at counseling.org under the “Resources” tab. “It can be hard because of our work schedules and the fast pace of life to know how we’re doing,” Burns says. “All those resources are free, and counselors can download them 24/7. It’s a way for counselors to check in with themselves and figure out where they’re at.”

Leslie Kooyman, an assistant professor in the Counseling and Educational Leadership Department at Montclair State University, says mild feelings of resentment toward certain clients or feeling burdened by certain clients can be a subtle indicator that something isn’t right. Other indicators, Kooyman says, particularly for experienced counselors, are regularly feeling lost in terms of what direction to take with clients and sloppy logistics, such as starting sessions late or allowing sessions to go past their scheduled end time.

Unexpected events can throw a schedule off course, but that should be the exception, not the rule, says Kooyman, a member of ACA. “We all have good days and bad days, good sessions and bad sessions. You’re not always 100 percent, certainly.” But, he cautions, a pattern of such issues might signal the beginning of burnout.

Rankin says other warning signs include feeling irritated about clients, experiencing a low level of energy, having problems develop at home, viewing the world and the people in it as unsafe and losing your sense of humor. Paying attention to the physical and mental symptoms of stress is important, she says, as is taking action to alleviate those symptoms instead of ignoring them and simply hoping the situation will fix itself. “Unfortunately, many counselors use stress as an indicator of the quality of work they are doing, believing they are being ineffective if they experience even a hint of stress,” she says. “What counselors need to remember is that stress and the accompanying symptoms are indicative of how the work is affecting them.”

One of the ways Rankin keeps her wellness in check is by participating in a peer support group with a handful of other counselors. The group meets at someone’s office or goes out for lunch or coffee roughly once every other week, although group members meet more frequently when they feel the need. They are careful to go someplace neutral so whoever is having the worst week can get away from his or her work environment, Rankin says.

In one instance, a counselor in the group was experiencing explosive growth in her practice and was seeing between 40 and 50 clients per week. Some of these clients were outside of the counselor’s specialty and were not as enjoyable for her to work with. The counselor found herself exhausted and with precious little time left over for herself or her family. “When we as a group confronted her, she said it had happened before she knew it and [she] didn’t know how to get out of it,” Rankin says. “Being counselors, we probed into why she was ’suddenly’ overwhelmed with clients she did not want and was constantly working. Like our clients, she used every excuse in the book, including the very real ’If I don’t work, I don’t get paid’ argument.” The group helped her brainstorm options and potential solutions, and after she chose a few, the group gave her deadlines and held her accountable.

“She hired a local company to do her insurance reviews, started referring clients not in her specialty, set boundaries with her existing clients so she was not taking their calls at all hours of the day and night, and went for her own personal counseling to address issues she was using work to avoid,” Rankin says. “It took about a month for all of these changes to be put in place, but by the end of the second month, she was experiencing some relief and returning to her old self. It’s been over a year now, and she actually has more free time than ever.”

Making room for life

When Lawson worked as a counselor in an inpatient setting, he remembers rehashing each day in his mind during the car ride home from work. He would go over the clients he had seen, what he had done well and the things that hadn’t worked. “I was literally taking it home with me,” Lawson recalls.

That winter, Lawson repeatedly found himself getting sick, which previously had been a rare occurrence for him. It took a little while, but he eventually realized stress was taking a toll on him physically, so he determined to make a change. On his drive home, it was necessary for Lawson to cross a river. He decided that crossing the river would signify the end of his work day, at which point he would shut off and leave thoughts of the counseling office behind. “It sounds corny,” he says, “but it was a cleansing moment for me at the end of each day.”

A variety of ways exist to improve self-care, and Venart contends that self-awareness is the first step in creating lasting change. “Create and pay ongoing attention to the balance in your life — balance between work and play, giving and receiving, accomplishing tasks and doing nothing,” she says. “Learn simple strategies to nurture yourself within your day, including nourishing [yourself] with enough water, good nutrition and movement and exercise.”

Among Venart’s other recommendations are venting and problem solving with colleagues, taking a walk, journaling, practicing mindfulness and taking advantage of clinical supervision and peer support groups. Venart keeps herself motivated by maintaining a folder of thank-you notes and success stories from her work with clients. “I refer back to them regularly as a way to remind myself that this work really makes a difference, especially on those difficult days.”

Career-sustaining behaviors are often unrelated to work itself, Lawson points out. Aim for a rich life outside of work, which might include taking vacations or “staycations,” spending time with family or a significant other and making time to meditate or pray. Lawson sometimes asks counselors what they do for leisure outside of work, and he routinely hears responses such as volunteering with the American Red Cross or hospice care. “Those are wonderful things to do but very similar to the rest of their professional lives,” he says. “At some point, you need to do something with another part of your brain, not something where you’re caring for others or putting others’ needs ahead of your own.”

Kooyman advocates integrating relaxing activities such as yoga, deep breathing and listening to music after sessions but says counselors should protect their well-being in session, too. “Wellness is also about being able to take care of yourself in the moment,” he says, “and that’s a little more challenging.” He provides the example of counselors being honest about the days they’re available to be in the office instead of stretching to accommodate a particular client.

Another example is setting limits when negotiating fees with clients. Kooyman, who worked in private practice for 10 years, did pro bono work but was also realistic about having to make a living. At times, he says, counselors can be too client-centered and end up giving more than they should. “If we’re not really comfortable with what we’ve decided, it’s going to eat away at us,” he says.

Maintaining boundaries is a crucial element of self-care, Rankin says. “A lack of professional boundaries can create feelings of being overwhelmed, bitter and angry. Too many counselors have not learned what boundaries are, so they meet with or take calls from clients outside of office hours, do not set office hours or work overtime when there is no real need. Basically, they put clients before their own family, friends and self.”

Setting boundaries means taking vacations and holidays, Rankin adds. That can be a tough decision, especially for private practitioners who aren’t bringing in income if they take a day off, but getting away from work is extremely important, she says. “Long or unusual work hours, large caseloads, caseloads with a high amount of trauma, no vacation or off days and no holidays all contribute to counselors becoming unhealthy in mind, body and spirit and therefore impacts the quality of care provided to clients.”

Keeping up with the literature in the field can also promote wellness, Lawson says. When counselors read the latest research and understand new aspects of a concept or problem, it can remind them to view clients as people rather than the problems they represent. Reading the professional literature can also help counselors guard against taking cookie-cutter approaches with clients, Lawson says. Also a proponent of journaling, Lawson says research has shown that people who journal on a regular basis are less susceptible to illness.

Rankin points to research showing that personal therapy and/or clinical supervision can help counselors stay happy and healthy in their work. However, she says, many supervisors are unaware of the importance of self-care, and many counselors don’t seek supervision beyond their internships. “For example, many counselors I have worked with, as well as counselors I have had as clients, do not understand the difference between emotional attachment and empathy. Learning the difference while in clinical supervision would have decreased their risk of compassion fatigue and burnout. Those that were my clients may not have needed therapy had they learned the difference.” If clinical supervision is not an option, Rankin recommends finding a peer consultation group.

Venart recommends that counselors sort their to-do lists into tasks that are truly essential and those that are not. She recalls a counselor in one of her peer consultation groups who told a story about resenting her husband’s ability to relax and informing him there were no days off in their household. “While believing this assertion wholeheartedly as she was expressing it to him, she had to laugh at herself as she was recounting the story aloud in our group,” Venart says. “She realized it wasn’t OK with her for him to have a ’day off’ because she had never considered the possibility that she, too, might be entitled to regular downtime. We explored the undercurrent of beliefs that drive so many of us to push hard without resting, to put others before ourselves and to deny our basic needs for rest, nourishment and pleasure. Yes, some of the tasks of work and parenting and taking care of a home are essential, but some are not. Counselor wellness is sustained when we take an ongoing inventory of what’s truly important and make sure we’ve made ourselves a high priority on our running list of things requiring care.”

In the process, Venart adds, don’t forget to appreciate the lighter side. “Infuse a sense of play into your life. A sense of play can help you and your clients remember that life need not always be so serious. I have a playful little wire figure of a girl sticking out her tongue that reminds me that humor is healing. Clients love this little figure and have commented that her silly irreverence inspires them to speak their mind and see the humor in situations.”

Not second nature

If wellness is ingrained in the foundation of counseling, why doesn’t self-care come more naturally to counselors? First and foremost, Lawson says, people who end up in the helping professions are naturally inclined to take care of others. Plus counseling, by design, is a one-way caring relationship. At times, Lawson says, counselors let that work mentality “leak over” into the rest of their lives, allowing every relationship to become a caretaking relationship.

“Those drawn to work in counseling may have learned at an early age to become other-focused rather than self-focused,” Venart confirms. “As a result, they may not feel they need or deserve the same nurturing [that] they accept others need and deserve. They may have exceptionally high standards for themselves and yet be compassionate and forgiving of the shortcomings, mistakes or inconsideration of others.”

There’s also a deeply rooted idea that as Americans, we should be self-sufficient and pull ourselves up by our bootstraps, Lawson says. “I would argue it’s good practice to say, ’I need help.’ Asking for help isn’t a sign of weakness. It really is a sign of the commitment to the work that we do.”

The work itself can stand in the way of wellness, Rankin says. “Many counselors struggle just to get through the day, so self-care takes a backseat to limited time and fatigue. Plus, some work environments make it difficult for therapists to engage in self-care because of unusual or long work hours, large caseloads and little or no support.”

In addition, like most people, counselors can grow “comfortable” in their discomfort. Even when their work environments are filled with stress, fatigue, anger and resentments, it can still feel “safe” simply because they know what to expect, Rankin says. Trying to change that work environment, even if for the better, can move counselors out of their comfort zones. “But, as I tell my clients, while you’re helping others, who is helping you? Your work should be only a part of your life,” Rankin says. “Boundaries, including a commitment to self, must be in place so there is a balance and distinction between your work life and your personal life.”

Counselors who have children can feel as though there’s even less time to think about personal wellness, Venart notes. “Counselors who are parents may struggle with feelings of guilt for not being more emotionally or physically available for their children,” she says. “As a result, they may tell themselves they must devote all their nonwork time to their children and that it would be wrong to take time away from the kids to nurture themselves. Yet, when we pay attention to and nourish our own needs, it is far easier to be mindfully present with those we love.”

Although counselors may be full of wellness tips for others, knowledge doesn’t always translate into action for themselves. “We are not so different from our clients when it comes to this,” Venart says. “There is often a gap between what we know in our heads to make sense and how we live our lives.”

“Counselors may have more information about effective self-care practices, but they are as vulnerable to internalized negative messages that discourage or discount self-care as their clients,” she continues. “In addition, counselors may have a false belief that they should be able to heal themselves, that their training as a counselor somehow means they don’t need outside support and that the wellness practices that work for everyone else are somehow too simple for them or just not necessary.”

How can counselors infuse what they know into their day-to-day lives? There’s no easy fix, Burns says, but it can be done. “It’s just like we tell our clients: If we want to see a change occur, we have to take ownership of what we want to see happen and do it. We have to make a choice, take ownership of it and then act on it.” Set a goal, but make it an attainable one, Burns recommends. “We can overwhelm ourselves [if we think] that we have to implement all of these things instead of just focusing on one thing and taking it from there.”

Taking a step toward wellness doesn’t equate to doing everything perfectly from here on out, Lawson says. “I don’t really care that you’re doing it just right,” he says. “I’m more concerned that people are paying attention and making efforts toward it.”

Having a supportive environment can help immensely in improving counselor wellness, says Lawson, who recommends that counselors talk with colleagues about their personal needs and struggles and solicit support for the changes they are trying to make. At Virginia Tech, Lawson came up with a rule to support wellness and life balance: No shop talk over meals. “It’s a small thing, but it can make a huge difference in a work setting,” he says. “But you need someone else to buy in as well. It’s awfully hard to do alone.” Start by finding one person to make changes with, but don’t be surprised if two people turn into a trio and then a culture of wellness catches on, he says.

Venart concurs that peers can make all the difference. “Peer support can be incredibly effective in improving self-awareness and supporting positive growth and wellness,” she says. “Creating personalized wellness goals and committing to them in the company of colleagues can support counselors in turning plans into reality.”

Shedding the day

A foundation for wellness should be built before counselors even enter into their professional lives, Lawson says. “In counselor education, we don’t do as good of a job teaching about risks and how to avoid them or manage them if you bump into them,” says Lawson, who makes an extra effort to talk with his students about wellness in the hopes the message will stay with them when they become professionals.

To help establish this mind-set, Lawson encourages his students to change their clothes after they return home from their internships at the end of each day. “You’re [figuratively] shedding the day, and you can move on to the evening with your family,” he says. “It’s a tiny ritual, but it’s those sorts of things that help us separate our professional life from our home life. The ritual becomes a habit and, over time, that habit becomes part of maintaining your own wellness.”

Kooyman, who teaches school and community counselors, often asks his students to make a list of activities they enjoy doing and then to be deliberate about incorporating enough of those activities into their daily lives. Burns also brings up wellness with her students, asking them how they give attention to the many facets of their lives. Creating a supportive atmosphere for counselor wellness in graduate school is crucial, she says. “That’s a good sandbox. If it can be incorporated there, then those skills can be transferred over when they’re working full time as a counselor.”

As a whole, counselor education programs must do more to promote and teach counselor wellness strategies, Venart says. “While current programs or individual professors may discuss the importance of self-care, I believe it is vital that this focus be interwoven throughout graduate training programs and that students and professors alike be challenged to engage in wellness practices and modify behaviors that clearly impair their functioning, including workaholism. I have a friend currently enrolled in a holistic nursing program where practitioner wellness has been integrated into every aspect of their training. The importance of self-care is overtly discussed and modeled by faculty, and the curriculum of each course includes an emphasis on self-assessment and reflection as well as the development and implementation of concrete wellness plans and practices.”

Venart reminds students and professionals alike that although self-care can appear large and looming at times, the process begins with just one step. “As we see with clients, it doesn’t usually require a heroic effort or a complete life makeover to generate really positive results. Sometimes the smallest changes can make the biggest impact. Never underestimate the power of a restful eight hours of sleep, exercise and good nutrition throughout the day. Lunch with a friend can lift our spirits, and taking a Sunday off to rest and play can help us recharge for the week.”

 

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Letters to the editor: ct@counseling.org

 

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