Tag Archives: Counselor Wellness

Counselor Wellness

Counselors as human beings, not superheroes

By Bethany Bray September 23, 2019

I’m only human after all

I’m only human after all

Don’t put the blame on me

Don’t put the blame on me

These lyrics played over and over on radio airwaves in 2017 as the rock-and-blues-infused single “Human,” by British singer-songwriter Rag’n’Bone Man, topped the charts.

Given the role they play in helping others to overcome challenges and live their best lives, professional counselors are sometimes assumed to themselves be impervious to life’s challenges. But in truth, they’re “only human after all,” not superheroes. The personal and intense nature of professional counselors’ work can spill over into their lives outside of the office — and vice versa. And the very skills and instincts that make them good counselors, including a passion for helping others, can leave them vulnerable to “what if” thinking and even burnout if left unchecked.

“One of our strengths is also one of our weaknesses. We have a lot of emotion and empathy, and we have to channel it. It can be like a river that overflows its banks,” says Samuel Gladding, a professor of counseling at Wake Forest University and a past president of the American Counseling Association. “It’s kind of like water and a spigot. If you don’t turn off the water in your house, you either run out of water or pay a very high price to the water company. If you don’t cut off your thoughts about clients, you also pay a very high price.”

Clinical counselors may routinely second-guess whether they are doing enough to help clients or wonder how a client who is no longer under their care is now doing. If left unchecked, such thoughts can become all-consuming and impede on a counselor’s personal relationships and overall wellness.

Neither are counselors automatically immune to the problems with which clients struggle, from anxiety and depression to grief, trauma and unhealthy coping behaviors. Holding a counseling degree or license also doesn’t guarantee that practitioners will make all the right decisions when it comes to their own personal relationships. A misunderstanding with a spouse or partner or a discipline issue with a child can seem all the more frustrating for a professional counselor who works on relationship building and communication with clients on a daily basis.

Learning to manage such issues often comes with time, as counseling professionals gain experience. But it also takes a measure of intentionality, from consulting with colleagues and engaging in professional development activities to practicing good self-care and setting boundaries, Gladding says.

It’s also helpful to accept that it is not a matter of if: Personal and professional issues will intertwine, and challenges will crop up throughout a counselor’s career. The key, Gladding says, is recognizing them and being open to growth — the same mindset that counselors use with their clients.

“We, as counselors, have our struggles,” he says. “If we’re wise, we acknowledge them, are aware of them, and work with others to resolve them and open up. Like Albert Ellis said, we’re fallible human beings. We’re not going to be perfect, and we’re going to make mistakes.”

Blurred lines

It’s likely that counselors will face a personal crisis, loss or upheaval at some point (or at various points) throughout their careers. Counselors are no strangers to mental health disorders, divorce, trauma, addiction problems, and other issues that bring clients to therapy. In most situations, however, it is not feasible for counselors to stop working until their personal issues resolve.

The 2014 ACA Code of Ethics does not address this scenario directly. However, it does caution against practitioner impairment (see standards C.2.g. and F.5.b. at counseling.org/knowledge-center/ethics). Professional counselors are called to “monitor themselves for signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when impaired.” At the same time, the ethics code urges counselors to help colleagues and supervisors recognize when they are impaired and to “intervene as appropriate to prevent imminent harm to clients.”

This begs the question: How does a counselor know when he or she is becoming impaired? Self-awareness and honesty — with self and with colleagues — are imperative, Gladding says. Warning signs will be different for each individual but might include feeling hesitant or reluctant to go into client sessions or experiencing intense emotions, including anger, during and after sessions.

“Just like we would report a client who is a danger to themselves or others … when we see our colleagues or fellow counselors being impaired or not doing well, we have a responsibility to confront them, talk about it, and offer them help,” says Gladding, a licensed professional counselor (LPC).

Practitioners need to know their own boundaries and to be able to recognize when they are “tiptoeing on boundaries” that can signal impairment, says Jessica Lloyd-Hazlett, an LPC and an assistant professor of counseling at the University of Texas at San Antonio. Being able to admit that you’re impaired as a counselor is difficult but vitally important.

Lloyd-Hazlett experienced the depths of grief after her mother passed away in June 2018. She continued teaching through the summer, but that fall, she found herself feeling irritable, becoming easily overwhelmed, and “struggling to simply show up to class and be in front of students.”

She could still push herself to do what needed to be done, but on most days, she struggled, Lloyd-Hazlett recalls. It was then, through a combination of self-awareness and some gentle intervention and support from friends and co-workers, that she realized she needed to take a step back and seek counseling herself.

“The things that you want to sweep under the rug, those are the hardest and are the things that are going to come back and bite you,” says Lloyd-Hazlett, a member of ACA. “Realize that. Recognize when you’re trying to sweep things away.”

Although it is vital to have a support system in place, Lloyd-Hazlett says no amount of preparation will fully shield counselors from situations that can cause professional impairment. That’s why it is important for counselors to be able to recognize when they’re in over their heads and to be willing to seek help.

“In our profession, one of our responsibilities is being well so that you can bring yourself [to clients and students] authentically,” she says. “My mom’s death was a huge experience, but we have little ones all the time that give us a chance to practice self-care and self-reflection. Have an ongoing willingness to practice what we preach. [Self-care and self-reflection] can be buffers prior to coming into something severe. At the same time, there’s a measure that you can’t prepare for. It’s going to be hard and nasty. It’s important to have those skills and practices to be able to come back to, and [to] seek outside help.”

When helpers need help

Lloyd-Hazlett had assumed she was ready for her mother’s death because she and the rest of her family had so much time to prepare; her mother had been ill for more than 20 years with multiple sclerosis. When she visited her mother in hospice for the final time, they were able to share a special connection and say goodbye, even though her mother had lost the ability to speak.

Cognitively, Lloyd-Hazlett understood grief, both from her counselor training and from having personally counseled clients who were grieving. But when her mother actually passed away, Lloyd-Hazlett found that she wasn’t as prepared for it as she had thought. She describes the experience as a “ripping open,” as something that shook her to her core.

Lloyd-Hazlett was in a work meeting when she got the phone call telling her that her mother had passed away. Despite her mother’s many years of declining health, the news still came as a shock to Lloyd-Hazlett. She recalls returning to the work meeting and trying to function until a co-worker pulled her aside and urged her to take some time for herself to process the news.

Lloyd-Hazlett recommends that counselors dealing with personal issues make a point of identifying the “safe people” in their lives who won’t shy away from talking with them about tough topics and personal struggles. Determine who can “help you recognize what is going on and be there with you — not try and fix [you], but provide hope,” she says, adding that she learned that recommendation in a grief support group.

Many factors have played a role in bolstering Lloyd-Hazlett through her grief, but she says the most important was making the decision to seek individual and group counseling for herself. It was freeing, she says, to participate in group work simply as “Jessica, who is grieving her mom,” instead of “Jessica, the counselor.”

In addition, the experience of being guided and cared for by another practitioner helped her let go of nagging thoughts and feelings of “I should be able to do this,” she says. It was liberating to accept that she did not have answers at that time in her life, she adds.

Another aspect of Lloyd-Hazlett’s healing process has been learning to label her struggles as grief instead of shortcomings. After the death of her mother, Lloyd-Hazlett initially felt a sense of shame that she was somehow slacking or falling behind in her work as a counselor educator. Supportive co-workers suggested to her that she might want to rethink and adjust the schedule of classes she had set for herself. After seeking help and attending counseling, Lloyd-Hazlett came to realize that her need to lighten her workload now and then was a symptom of grief, not a personal failure on her part. In the months that followed, she canceled classes on a couple of occasions or had someone else fill in for her when she needed a break.

Lloyd-Hazlett says the experience of processing her mother’s death while working has taught her that personal struggles “are going to happen in our lives and our careers as we develop and grow.” It has also allowed her to experience the full length and depth of the grief that often brings clients to counselors’ doors, while giving her greater appreciation for the supports in her life, including her co-workers, friends and loving husband.

In addition, it has sparked an interest in providing grief work or hospice counseling to clients at some point in the future. For now, however, Lloyd-Hazlett knows she has more grieving of her own to do before she is ready to help those going through their own seasons of loss.

“The human experience is hard. It’s OK, and it’s good and beautiful,” she says. “There’s going to be loss and change [during a counselor’s career]. It’s going to be part of the process. There’s a reason why our code of ethics talks about these things. It’s not that you’re a bad counselor; it’s that life intersects.”

Challenges at home

Counselors need to remember that, as Irvin Yalom has written, counselors and clients are “fellow travelers,” says Doug Shirley, a licensed mental health counselor (LMHC) with a private practice in the Seattle area. “It’s important to tear down the model that helping professionals are healed and well. We are all on a healing path and have needs and vulnerabilities,” says Shirley, an assistant professor of counseling at the Seattle School of Theology & Psychology.

One of the vulnerabilities that can easily throw counselors for a loop, says Shirley, is when challenges arise in their personal lives that also fall directly in their professional wheelhouse. That might include a discipline issue with a child, struggling to connect with a spouse during a disagreement, or missing the cues that a loved one is sliding into substance use or mental illness.

Counselors might find themselves frustrated, thinking, “Why can’t I figure this out?” notes Shirley, who wrote an article for Counseling Today in 2012 titled “Why counselors make poor lovers.” The skills that practitioners hone to become good counselors — such as keeping a professional distance from clients’ emotions — can actually hinder their ability to make personal connections if they’re not careful, he says.

Adding to the issue is that counseling professionals typically spend their workdays seeing clients (or teaching students) who are paying — even clamoring — to hear their thoughts and feedback. It can be jarring to come home and find that they aren’t capturing their spouse’s full attention or that their teenage son or daughter views them mainly as a conduit to obtain permission to play video games or go out with friends, Shirley notes.

“We’re all people before we’re professionals. But sometimes the cart gets before the horse — sometimes the professional comes before the personal — and it keeps us from the more advanced and sophisticated work of being human,” says Shirley, a member of ACA. “We can amass a lot of head knowledge about people, psychology, health and wellness, but it doesn’t necessarily help us to attend to our own wounds.”

Shirley met and married his wife, who is also an LMHC, when he was in his late 20s. They had both spent years building their professional careers and developing their counseling skills before they met each other. However, the couple soon discovered that their counseling skills did little to help them find intimacy and connection. In fact, they were often a hindrance, Shirley remembers. As a result, they had to unlearn some of the boundary setting that their counseling training had instilled in them.

What has helped, Shirley says, is counseling, both individually and as a couple. Shirley and his wife have continued to see counselors throughout their 15-year marriage and are “doing better than ever,” he says.

Shirley recommends that counselors find a practitioner who has experience with or specializes in working with helping professionals. “We [counselors] all have this defensive structure that makes us a lousy client,” Shirley observes. “So often I’m sitting there [in counseling] and thinking, ‘Oh, I know what he’s doing here,’ wink, wink. Will I answer his question honestly [or play into his technique]? We need a therapist who understands that and won’t defer to that.”

Similarly, if counselors don’t learn to step out of the “head knowledge” gained in a graduate counseling program, it can detract from their personal interactions, Shirley asserts. “We become very top-heavy. We have all of these facts and theory, but it’s not wisdom and patience and vulnerability. Those aren’t typically the things of graduate training programs,” he notes. “For me, as an intellectual, it doesn’t always help me when I’m talking with my wife or my sons. If I have information that should help me navigate the situation and I don’t allow myself to not know [that information], I overreact and walk away with some sense of guilt or shame.”

Shirley says his best interactions with his family happen when he shuts off his counseling skills and intentionally works to “know better.” This was the case in a recent conflict with his 12-year-old son, during which Shirley’s initial reaction was to turn to discipline. But a family trip to see the new Lion King movie, where Shirley watched the father-son dynamics of the story’s main characters play out on screen, sparked a realization that allowed him to take a step back from his professional knowledge.

“As a dad, I was inclined to be too firm, too reactive, before connecting relationally and personally with my son,” Shirley says. “There needs to be a resonance between parent and child that is palpable to the kid, and that’s what was [missing] with my son. I was reacting instead of knowing better and practicing what I preach.”

Shirley appreciates the reminder he often hears from his own counselor to take “three steps back” — a call to be an observer in personal interactions. “Because counselors have set ourselves up to be knowers, we’re not very good at allowing ourselves to receive. Often, the hardest work is to be willing and able to receive,” he says. “In our personal relationships, we need to remember that all of our work is to receive from others. I’m a much better husband when I can hear and listen and receive from my wife, as opposed to feeling that I know all the answers and know what’s going on. It’s being open and taking a step back when needed.”

Leaving it at the office

“It’s so easy to go home and think about a session you just had and what you can suggest next time, the tools you can use, and how to best help [a client],” says Ashley Waddington, a provisionally licensed LPC who works in a private group practice in the Columbia, South Carolina, area.

The challenges that counselors’ humanity can bring — concern for clients who have left their caseload, second-guessing themselves, “what if” thinking, empathy fatigue — often have no black-and-white answers. Professional community, personal therapy, boundary setting and self-care become all the more important when work begins spilling over into the personal realm.

The counselors interviewed for this article cite the following ideas and techniques as being particularly helpful when it comes to counseling professionals wrestling with their humanity.

>> Connect with peers: Waddington, an adjunct instructor in the counseling education program at the University of South Carolina, is a big proponent of supervision, not only for the hours required by graduate programs and state licensure boards, but across one’s entire career. She currently has three supervisors and finds it vitally important to talk things through with professionals of various perspectives. “Counselors are lucky to have the practicum experience. Not every profession gets that,” says Waddington, who recently served as co-chair of the ACA Graduate Student Committee and co-presented a session on “survival tips” for graduate students and new professionals at the ACA 2019 Conference & Expo. She also finds support via a Facebook group for counselors in private practice, where members bounce ideas off of one another, ask questions, and share tools and techniques.

Shirley also recommends that counselors debrief with other counselors via regular consultation. He is part of a long-standing professional consultation group that meets regularly in his area, but he also seeks additional input if challenges arise between meetings. He believes it is important for counselors to consistently pursue consultation, even when things are going well, he says, to gain perspective and to benefit from the rhythm of meeting regularly with fellow counselors.

In a similar vein, Gladding recommends that counselors attend professional development events such as ACA’s annual conference to stay up to date and to seek feedback from peers on challenges that are unique to the profession. For counselors who aren’t connecting naturally with their co-workers, or for those who work alone or in a setting dominated by colleagues from other professions, Gladding shares a little advice (via lyrics from Gloria Estefan): “Get on your feet, get up and make it happen.” Counselors need to be more intentional about finding community, he says, whether online, through travel to state or regional conferences, or by other means.

“Don’t let yourself be in isolation,” Gladding says. “That almost [never leads] to good mental health. We learn from others and thrive when we’re social. We’re not lone wolves; we’re gregarious. That’s how human beings are.”

>> Write it down: Transferring one’s inner thoughts to the page can help counselors process what they’re feeling, quell rumination, and spark self-reflection. “I keep a journal, and I would be the first to say there’s research out there that [maintaining] a journal helps keep us healthier in the short and long run,” Gladding says. “It helps us be more attuned to how we’re doing and how we’re living.”

Journaling can also spur deeper thought about what is and isn’t under a counselor’s control, Gladding says. “We can check up on [clients], but if we can’t, we let it go. In the end, we don’t have complete control over people. They’re not robots,” he says.

The same process applies to people and events in counselors’ personal lives. “My oldest son and his wife are teaching French in Casablanca, Morocco. I can’t obsess about that too much, even though it’s such a long way away and a land with different customs and culture,” Gladding says. “I have to trust that they can do that and do it well.”

>> Shake it off: Maintaining a schedule of back-to-back client sessions, each with the potential to bring intense and heart-wrenching issues to the table, can be draining, both mentally and physically, for counseling professionals. Clinicians who are intentional about resetting themselves between each client are more likely to keep sessions from blending together and may be better positioned to head off burnout.

Waddington had a supervisor who kept a feather duster in her office so that she could figuratively dust herself off after each client. The ritual helped her visualize closing the prior session and preparing herself for her next client, Waddington explains.

In between clients, Waddington often steps outside, stretches, or even lays on the floor of her office to reset and clear her mind. She also finds that leaving her office and finding another secured area to record client notes after an appointment helps her find closure and “finish” the session.

It can also be helpful, Waddington suggests, for counselors to take a shower once they get home, not necessarily because they’re dirty, but to “wash off the day.” They can visualize rinsing away the heavy topics and client issues they have been wrestling with all day.

“By simply using the basic cognitive approach of reviewing our day, picking out the emotions we felt, and using them to uncover our dysfunctional thinking and belief systems, we can address them so the day’s detritus can be left at the office and not remain in our head,” says Robert J. Wicks, an ACA member, professor emeritus at Loyola University Maryland, and author of numerous books, including The Inner Life of the Counselor. “When you go to the bathroom in a restaurant, there is a reminder [to wash your hands]. The same can be said metaphorically of counseling. We need to psychologically and spiritually decontaminate ourselves before returning to the rest of our lives.”

>> Get by with a little help from your friends: While professional connections can be a vital part of a counselor’s support network, connections with friends who aren’t helping professionals can be equally as valuable and refreshing, Shirley notes.

Spend time with “those who will stick with you through the bad and good and tell the truth,” he says. “Friends who aren’t counselors are key. These are the people who will keep us sane and give it to us straight. They often have their feet on the ground more than we do.”

Wicks agrees, asserting that counselors need “a robust and balanced circle of friends” to be able to thrive. He goes into more detail on this topic in his book The Resilient Clinician. Practitioners can benefit from encircling themselves with a variety of personalities, Wicks says, including friends who will challenge their thinking; be sympathetic and supportive; keep a counselor from taking themselves too seriously through good-natured teasing; encourage a sense of wonder; provide guidance without giving answers; and spur them to be their best.

>> Take care: The introduction to Section C of the 2014 ACA Code of Ethics urges counselors to “engage in self-care activities to maintain and promote their own emotional, physical, mental, and spiritual well-being to best meet their professional responsibilities.”

When it comes to self-care, it’s important to have a plan in place before challenges arise. Not only will the methods that counselors find effective vary from practitioner to practitioner, but a self-care routine will also need to evolve to meet changing needs throughout a counselor’s career.

Gladding suggests that counselors be intentional about spending time engaging in hobbies that help them decompress and find connection. Perhaps that’s singing in a choir, playing golf, watching birds — whatever piques their interest, he says.

Wicks advocates for alone time and spending time in reflective silence and solitude. As she has navigated her grief journey, Lloyd-Hazlett has found yoga helpful, as well as trying new things such as entering some of her paintings into a local art show. Waddington recharges through reading books on mental health topics in her personal time (she recommends Yalom’s The Gift of Therapy and The Grief Recovery Handbook by John W. James and Russell Friedman).

Shirley emphasizes the importance of wellness, including nutrition, exercise, getting enough sleep, and drinking enough water. These elements are often the first things to go when counselors get stressed, he notes.

Finding spiritual community is also essential, Shirley adds. The community doesn’t necessarily have to be a religious one; it can include spiritual connections found through group yoga classes, volunteering in the community, or other means, he says.

>> Keep it real: Professional boundaries must be maintained, but occasionally, “being human” in interactions with clients or students can be a powerful way to connect, Lloyd-Hazlett says. When it comes to self-disclosing to clients or students, such as mentioning that she is struggling with a loss, Lloyd-Hazlett says she lives by the philosophy “less is more.” However, self-disclosure, when done appropriately, can also serve as an example for others to be honest and open about their own struggles.

“The question needs to be, is this going to benefit my client? What is my motivation for wanting to disclose?” Lloyd-Hazlett says. “Being a human and having a human experience is so important to the counseling relationship. We can do that through different ways, including self-disclosure. When you’re struggling, just showing that and acknowledging that can be very powerful. What that disclosure looks like depends on the client or topic and where you are in your process.”

Counselor training teaches practitioners to remain professional and keep an emotional distance from clients while in session. However, Waddington urges counselors not to hold back if they are connecting with a client during an intense moment in session.

She recalls one client who was grieving the loss of her sister, who had died tragically in an automobile accident. The client’s pain was so raw that she couldn’t bring herself to say her sister’s name out loud. Waddington found herself with tears streaming down her face in session and apologized to the client for losing her composure.

But in their next session together, the client thanked her. “She said, ‘I’ve never had someone cry with me like you did. That was the first time I felt really heard, and [I knew] you understood what I was saying,’” Waddington recalls.

>> Know that you are enough: Waddington leaves notes for herself in her office with positive messages such as “You are enough” and “You just need to show up today.” These simple reminders help her curb overthinking and the urge to come into sessions with a mindset of fixing clients. “You don’t have to have this crazy technique to do with a client. Showing up is enough. … It’s not [our] job to fix them but to show up and work with them where they are,” Waddington says.

It’s a lesson Waddington has learned over time. She recalls one client who was severely depressed and unable to work. He left his house only to come to therapy once per week. Initially, she worked with him on big goals to improve his situation, including applying for jobs.

Waddington finds it helpful to check in periodically with clients in session to see how they are feeling about their work and progress in therapy. During a check-in with this client, he gave Waddington feedback that served as a reality check for her: You can do less for me. The client was feeling guilty about his lack of progress, and his self-esteem was taking a dive as a result.

After some self-reflection, Waddington changed her approach, working with the client on smaller goals and steps that could help him feel better day to day. In turn, his quality of life improved, she says.

“One thing I’ve had to learn and practice myself is that you don’t have to have all the answers and be the solution [for clients],” Waddington says. “[That’s] not our job. It’s our job to show up and listen.”

When self-doubt kicks in, Shirley urges counselors to remember that they’re part of a bigger picture. “When we get hung up on ‘Did I do that right?’ remember that we’re all in this together and doing the best we can do. Rumination and anxiety are really common when we’re in the messy business of helping people. Whatever we’re doing, we’re doing the best we can do. And, quite frankly, sometimes that is enough. And when what we have to offer isn’t enough, we need to go out and get extra support through referral or consultation, etc. That’s not a reflection on us as people, it’s just information.”

Boundary setting off the clock

Years ago, when Gladding was a new practitioner with a young family at home, a couple he was counseling called him on a Sunday afternoon with an urgent request to see him for an emergency session.

“I agreed to see them — and soon realized that they weren’t in crisis. They just wanted to blame each other for some things,” Gladding recalls. “I learned from it and [eventually] said, ‘I’ll see you during office hours, but I can’t see you now.’ That was a mistake on my part.”

It wasn’t the last time a client would contact him outside of working hours. In one instance, a client even showed up at his home on the weekend. While it’s certainly possible for clients to spiral into crisis situations at any time of day or any point of the week, Gladding says he has learned the importance of prioritizing boundaries. If clients contact him outside of working hours, he makes sure they’re stable, ensures they have crisis hotline numbers, and agrees to see them at the next possible opening during business hours. “I don’t want to downplay [clients’ pain], but boundaries have to be there, or we don’t do anyone any good at times,” Gladding notes.

The same goes for family members or friends who approach him for advice because he is a professional counselor. Gladding says he typically uses humor to diffuse the situation and redirect their questions. There is a reason that ethics guidelines urge against counseling family members and friends — because counselors simply cannot be objective in those situations, he says.

If Gladding notices an issue going on in the lives of those he knows personally, he says that he might make a gentle observation to them about what he’s seeing — without engaging in a counseling intervention — and offer to connect them to another counselor.

“I have a colleague who is always saying, ‘Check yourself before you wreck yourself.’ I like that because we can get into trouble if we get too much into something that’s happening” in the lives of family or friends, Gladding says.

Waddington sees such situations as opportunities to coach family members and friends on the benefits of professional counseling, and then supporting them through the process of finding a counselor clinician.

“When anyone knows that you’re a therapist, the floodgates open,” Waddington says with a chuckle. “People will start sentences with, ‘In your professional opinion …’”

In those situations, Waddington has a phrase that she responds with: Do you want my ears, do you want my advice, or do you want me to step in?

“Then, I am clear about what they really want from me. Often, they just want me to listen. I can listen all day, but it’s not my job to be your therapist, and I don’t want to be,” she says. “Often, I will say, ‘Let me help you find someone to talk to.’ … It’s not my job to help my cousin get through this [problem], but it is my job to help them find help.”

 

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Contact the counselors interviewed for this article:

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Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

Books (counseling.org/publications/bookstore)

 

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

Letters to the editor: ct@counseling.org

 

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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.

Advice for the highly sensitive therapist

By Lindsey Phillips September 20, 2019

Erica Sawyer, a licensed mental health counselor and art therapist in private practice in Vancouver, Washington, knows firsthand the benefits and challenges of being a highly sensitive therapist. (Approximately 20% of the population has an innate temperament trait referred to as sensory processing sensitivity; individuals with this trait are categorized as “highly sensitive people.” Right after graduate school, she started working 40 hours a week at an enhanced care facility for adults with severe and persistent mental illness. She quickly realized that the constant needs in the 16-bed locked unit were overwhelming for her.

“It was very intense,” Sawyer says. “There were times I couldn’t even get out the door to take a break because there was a crisis with a resident trying to leave the facility, so we couldn’t open any of the doors. So, on my break time, I had to sit in an office where there were constant interruptions.”

Sawyer tried to escape the overstimulation by visiting the restroom, but she couldn’t stay long in there because there was only one bathroom in the entire facility and other people needed it.

On the positive side, she found she was able to connect with many of the residents in a way that surprised and baffled the other therapists. She realized, however, that being good at this type of work didn’t mean that it was a good fit for her.

In fact, Sawyer says she was on a path to quick burnout, so she determined to figure out what she could control — such as her work environment, her hours worked, and the type of clients she saw — and start making changes.

She went from a full-time inpatient position to a part-time outpatient position, but even that was too much because of the hours needed to get all the work done for her caseload of 70 people. “The quantity of clients, along with being assigned the higher needs cases, was far from optimal,” Sawyer says. “I was experiencing my own anxiety and had to go out to my car and do some tapping [therapy] to just manage the day.”

Now, Sawyer is working part time in her own private practice so that she can control the amount and type of clients she sees and the days and times she works. She also lets clients know that she can’t guarantee a response to an email after 5 p.m. Highly sensitive therapists have to recognize their stress points and the environments that aren’t conducive to their temperament because it’s not good for them or their clients, she adds.

Because highly sensitive people process more deeply, counselors with this trait may have difficulty leaving work at work, notes Heather Smith, a licensed professional counselor and an assistant professor of human development counseling at Vanderbilt University. It’s important for highly sensitive counselors not to compare themselves to counselors who do not have this trait, she says. Instead, they have to figure out their own needs and best practices. For example, they may need to see fewer clients per week or work fewer hours.

Elaine Aron lists some possible self-care practices for highly sensitive therapists on her website:

  • Practice “The Five Necessities” — believe your trait is real, reframe your childhood in light of this trait, heal from past wounds, don’t try to live like the other 80% of the population without the trait, and find a group of other highly sensitive people
  • Reduce therapy work time (ideally, no more than 20 hours a week)
  • Screen clients
  • Have downtime
  • Don’t take your work home
  • Charge clients appropriately
  • Find a good consultant
  • Seek out your own therapist
  • Take frequent vacations

Julie Bjelland, a licensed psychotherapist in private practice in California who specializes in working with people who identify as highly sensitive, recommends that highly sensitive therapists see no more than 10-12 clients per week. “You can’t see seven clients in a day as a highly sensitive person and be well because you’re taking in too much information,” she notes. Bjelland also suggests other ways that these therapists might reduce potential overstimulation and burnout. For example, they could increase their fees and see fewer clients per week, or they could see clients three or four times a week and then have three or four days off.

Smith, an American Counseling Association member who researches the sensory processing sensitivity temperament trait, advises highly sensitive therapists to create healthy habits to reduce overstimulation and to give their brains extra time to process. For example, counselors could schedule breaks between sessions, or they could make a point to finish their work notes before leaving for the day to avoid continuing to process this information when they get home. “Some of these practices can help over time to decrease the susceptibility to burnout,” Smith says.

Louisa Lombard, a licensed professional clinical counselor in private practice in California, makes a point to practice self-care habits. For instance, she takes a 30-minute break between clients so she can finish writing her notes, eat a snack, or engage in activities that she finds soothing, such as meditation or using essential oils.

Sawyer, also an ACA member, has colleagues who perform a ritual of literally washing their hands between clients as a way of letting that session and all of its associated information go down the drain before the next client.

Even though highly sensitive therapists have particular needs that must be addressed to avoid burnout, they also bring unique gifts to therapeutic sessions. Highly sensitive counselors “are well wired for this type of work,” Smith notes. “They’re going to process information more deeply. There are new research findings that suggest they have more mirror neuron brain activity and, thus, possibly stronger empathy.”

These counselors often have deep intuition and more attunement with others, and they tend to make clients feel safe and easily build rapport with them, Sawyer adds. As she points out, these qualities are “huge assets in being a good counselor.”

Bjelland, an author and global educator on the highly sensitive person, agrees that highly sensitive therapists have a lot to offer to clients because of these qualities. She finds that these therapists often have a strong connection with clients, are able to pick up on patterns and connections, and sometimes know things even before their clients do. She has had clients who weren’t able to reduce their anxiety even after working for years with other therapists. But within two to three weeks of working with her, their anxiety started to decrease.

Bjelland says highly sensitive therapists can benefit from thinking about the way that healers used to operate within a tribe: They had their own hut, and after they did their healing, they would spend a lot of time alone. “If you see one client, you’re going to need to process that session and then … rest and restore after that session,” Bjelland says. “Because if you take care of yourself well in this field, you can be a powerful healer.”

 

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Look for a related article, “Finding strength in sensitivity” in the October issue of Counseling Today magazine.

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist living in Northern Virginia. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

 

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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. 

The Counseling Connoisseur: Cultivating silence in a noisy world

By Cheryl Fisher March 11, 2019

Silence is about rediscovering, through pausing, the things that bring us joy –  Erling Kagge

In an attempt to reboot, my husband and I packed up our fur family and spent a week at the beach over the Christmas holiday. We got up each morning and trekked the shoreline immersing ourselves in the feel of the fresh salt air, the crash of the ocean waves and the caw of the seagulls flying overhead. We walked miles and miles each day — often in companionable silence with our cell phones off and tucked away in back pockets. Every now and then we would stop, plop down on the cool, damp sand and just be in silence.

Noise does not simply refer to sound, it includes the busyness of both internal and external environments. The constant need to “do” something and the aversion to boredom prevent the opportunity to relax the body and the mind. While technology has certainly contributed to the “skim, scan, scroll” processing of our world, it has also generated the technostress afforded by constant availability. Therefore, it is important to recognize the value of cultivating a practice of silence.

The Benefits of Silence

According to a study published in the March 2015 issue of the journal Brain Structure and Function, preliminary research on mice indicates that  as little as two hours of silence may promote brain cell growth by strengthening the hippocampus and improving memory. Additionally, some research has found that cultivating just moments of silence can lower blood pressure and heart rate, and improve relaxation and sleep even better than listening to soothing music.

Ways to Cultivate Silence

  1. Early morning moments: Invite intentional silence into your morning. Curl up in a blanket and sit in the dark allowing your eyes to focus slowly. Take a few moments to gaze at the sunrise, or inhale the fresh morning air. Ease into your day grounded and calm.
  2. Thankful mealtimes: Use the first few seconds prior to eating to close your eyes, take a deep breath and take a moment to appreciate your meal. Attending to your meal in this manner will not only provide you with a nice transition from your busy morning but welcome a more pleasant dining experience.
  3. Breathe: Throughout our busy days, we often forget about breath. We become complacent that the next breath will come without effort or thought. Take a moment to turn your attention to your breath. Are you taking full, deep cleansing breaths? Or do you inhale wisps of air? Take time to breathe.
  4. Meeting preludes: Begin your meetings at work with a five- minute practice of silence. This will allow the transition from work to the meeting agenda at hand. You and your co-workers will begin the meeting focused and ready to tackle the work.
  5. Media fast: Intentionally unplug for thirty minutes, an hour, a day. No cheating! No devices. A colleague of mine has initiated Unplugged Sundays, where she and her family members put away devices and spend time interacting as a family.
  6. Brisk walk in nature: Nature provides endless opportunities to soothe and refresh. Take a 15-minute walk around the block or on a nearby trail. When I work from home, I schedule a couple brief walks with my dogs to clear the clutter from my brain.
  7. Bedtime brain purge: Prior to bedtime, take a moment to purge all of the worries of the day. Lists of things left undone. Ruminations of concerns. Simply let them go long enough to prepare for slumber. You can use a journal to quickly write down your thoughts or just say them all out loud — quickly.
  8. Gratitude: I love to end my day with a gratitude list. I crawl into my comfy bed and immediately acknowledge the comforts of my home, my bed, my full tummy and the loving companions (my dogs and hubby) who share my life.
  9. Meditation practice: Consider beginning a meditation practice. A 20 minute practice morning, midday, or evening can promote calm focus to the day.
  10. Silent retreat: If you find that you crave longer jaunts with silence, consider participating in a silent retreat. Many retreat houses offer formal or informal retreats. Additionally, you may choose from group or individual silent retreats. I regularly schedule overnight escapes to the beach by myself to just reboot. I return ready to take on life’s challenges.

 

Modern-day living is accompanied by a cacophony of external noise and internal concerns. Our bodies and minds cannot sustain the ongoing level of stimulation without disease or disorder. Apparently, silence is golden, and it is imperative to make time for silence in our noisy lives. As counselors, we are trained to listen and sometimes we just need to unplug, retreat and refresh.

 

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Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy. She may be contacted at cyfisherphd@gmail.com.

 

 

 

 

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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.

Identifying colors to create a rainbow of cohesion in the workplace for helping professionals

By Jetaun Bailey and Bryan Gere September 7, 2018

The idea for this piece came about when I (Jetaun Bailey) was pursuing my master’s degree in counseling. I recall my professor stating clearly that burnout occurs often among helping professionals and that the average stay for a counselor employed at a mental health facility is two years.

As one of my assignments, I completed and presented a paper on ways for helping professionals to avoid burnout. However, not once in my presentation did I illustrate ways that the workplace could employ preventive services to combat burnout. At the time, my focus was on using self-care and, ultimately, I received a grade of 100 on that project. However, in reflecting on my counseling career, I realized that workplace training programs overlook helping professionals by not addressing topics related to the complex workplace dynamics that may contribute to burnout, which is likely to increase, because the demands in the counseling profession can be overwhelming.

According to Amanda Stemen’s 2014 article, “Burnout: Who’s taking care of the care takers?” management in the helping professions focuses more on clients than on employees. Many factors are related to burnout. Low salaries are one contributing factor but not the most significant. Many of us who enter the helping professions, counseling in particular, understand that we are not pursuing a lucrative career. However, lack of managerial support is believed to be a significant factor in burnout. This lack of support isn’t necessarily intentional; it is thought that many in management believe that helping professionals have innate abilities to solve their work-related problems. However, in many cases, counselors work in isolation, without support from management and peers, and know its effects.

Thus, management’s support is critical in reducing burnout among helping professionals. In speaking with Terra Griffin, a manager at an acute behavioral hospital unit for children and adolescents, she revealed that the turnover in the unit was among the highest in the hospital. Such high employee turnover costs organizations time and productivity. One of the staff’s chief complaints was management’s failure to provide them with relevant training to meet the demands of the job and promote workplace cohesion, which had led to many problems within the teams.

Stemen’s article suggested the need for professional development in addressing burnout. She reports that providing professional development opportunities customized to employees’ interests encourages growth that benefits both the individual employee and the organization.

 

Mind-mapping

One professional development approach is to employ mind-mapping concepts. This is accomplished by creating a specific topic or question so that each person in the training session can see other points of view rather than just his or her own. This nonintrusive approach facilitates group cohesion. Researcher Tony Buzan, the author of Use Your Head, developed the mind-mapping concept in the 1970s. It is designed to facilitate the sharing of ideas and concepts to solve problems.

Through observation, Griffin employed this concept in a series of training sessions simply by asking employees in a unit where turnover had been problematic a simple question: “What is your favorite color?” Initially, the employees did not seem eager to participate in the training session. Remarkably, however, when Griffin focused the initial session on that single question, changes in body language occurred among the staff immediately, as if thinking about their favorite colors had some sort of healing effect. Afterward, they were eager to share their favorite colors and the ways they identified with those colors personally.

Interestingly, although employees weren’t given information about the psychological meaning of each color ahead of time, they ended up describing them similarly to how they were presented on Griffin’s color chart. Furthermore, they could identify their similarities and differences in relation to their multiple colors. This helped shed light on some of the difficulties the employees faced in creating a more cohesive work environment.

Three therapeutic teams were present at each training session, each of which was composed of two therapists, one psychiatrist, several nurses and several behavioral specialists. During their self-exploration of the colors, Team 2 realized that many of its members shared the same favorite color, red, while the two therapists identified with blue. Incidentally, of the three groups, Team 2 was confronting the most difficulties. Many of the team members who identified with red were having difficulties sharing leadership responsibilities and were disregarding the leadership authority of the two therapists who identified, unconsciously, with blue. Once members of Team 2 were able to understand their difficulties, they began to discuss ways that their team could work more cohesively. As a result, Team 2 set team goals, with respecting one another identified as the top priority.

Instead of asking employees direct questions about their workplace problems, this exercise of looking at their favorite colors appeared to be a nonintrusive method that encouraged employees to share their differences. Griffin’s simple question elicited many answers with respect to therapeutic problems occurring in this workplace of helping professionals, and thus promoted resolutions to some stressful issues.

 

The psychology of color

Intrigued with the feedback from the staff during these sessions as they compared their favorite colors to their personalities with respect to their workplace relationships, we set forth to emulate this training. Ultimately, we implemented a similar version in a group of training sessions for graduate students who would be entering the helping profession as practicum and internship students. Their feedback and interactions were outstanding. We learned much about our students that we had not known, and this helped us revamp our practicum and internship training program for students and site supervisors.

As a result, we set out to explore how many nonintrusive, evidence-based training programs of this nature were available. We conducted a content analysis of evidence-based studies on the psychology of color. We also sought to determine the extent to which such training materials are designed to facilitate workplace cohesion among helping professionals.

Using the American Psychological Association (APA) database and electronic resources, we searched APA PsycNET, PsycINFO and PsycARTICLES from their inception through 2018. Furthermore, we used the Google Scholar search engine. The search phrases we used were “evidence-based practices on color psychology” and “training curriculum on color psychology.” The criterion for inclusion for review was that the title contained the search phrase; studies that did not meet the criterion were excluded.

After completing the content analysis, we could not find a single evidence-based study on color psychology or training curriculum related to the topic. We also were unable to determine the extent to which such training curricula facilitated workplace cohesion among helping professionals. There appears to be a significant gap in the literature pertaining to the actual use of color psychology in the facilitation of workplace cohesion in human services or among helping professionals. We did not find any specific evidence-based studies that provided empirical information on training materials on the subject that lead to workplace cohesion. The absence of this information reflects the extent to which the topic is largely unexplored and illustrates what little recognition it is accorded.

In “Colors and trust: The influence of user interface design on trust and reciprocity,” Florian Hawlitschek and colleagues indicate that the literature available on the psychology of color suggests that color preferences associated with personality influence interaction patterns in the employment setting. This illustrates that understanding the role that color preferences play in group behaviors and settings is critical to interprofessional collaborations, especially among helping professionals. Furthermore, other literature has suggested that colors have individual meanings based on a person’s cultural background or racial and ethnic group. Therefore, the influences of color should be interpreted with caution.

However, what made this training so unique is that Griffin did not use any assessment tools to determine anyone’s colors. Instead, she asked each person his or her favorite color and thus gave life to their individuality based on their cultural or racial and ethnic backgrounds without probing for any specific details (colors hold a universal meaning of harmony in many cultures). This mind-mapping technique seemed beneficial. Griffin’s leadership played an important role in helping the employees navigate through their favorite colors by connecting to their personalities and the way they fit within the scheme of their work productivity to create or disrupt cohesion.

 

Conclusion

As the dynamism within health and human service delivery creates more interdependencies, there is a growing need for professionals to collaborate to achieve better client outcomes. However, there is little information on the role that the characteristics of interdisciplinary teams play in promoting synergy that influences such outcomes.

Shared values, mutual respect for colleagues’ expertise, and patient-oriented goals and outcomes are reflections not only of the diverse interests and asymmetry of power of the various partners in care, but also differences in their personalities and preferences. Therefore, fostering workplace cooperation and cohesion is essential for effective, competent, cost-effective, culturally responsive and comprehensive service delivery.

Creating mind-mapping trainings designed to honor individual uniqueness, such as the identification of favorite colors, can help us achieve such cohesion. These trainings draw us into companionship where we can evaluate our similarities and differences through our individual uniqueness, thus creating a meaningful and purposeful work environment for helping professionals and the clients they serve.

 

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Jetaun Bailey is an assistant professor at Alabama A&M University, where she serves as director of clinical training. Contact Jetaun at jetaun.bailey@aamu.edu or baileyjetaun@hotmail.com.

 

Bryan Gere is an assistant professor at Alabama A&M University, where he serves as coordinator of clinical training in rehabilitation counseling. Contact Bryan at bryan.gere@aamu.edu.

 

Terra Griffin, a licensed professional counselor supervisor with more than 15 years of experience in counseling management, supervision and training, contributed to this article.

 

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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.

The hurting counselor

By Gregory K. Moffatt August 13, 2018

It was like someone was sitting on my chest. From the moment I awoke each day, I could barely breathe, and throughout the day, I teetered on the verge of tears. My wife and I had separated, and I thought my 20-year marriage was about to end. My heart was in shreds and, especially because I am a counselor, I was humiliated that I was failing in my marriage. I felt like a fraud in front of my students, and as I struggled through lectures, the words and ideas that left my lips — the ones that normally were energizing to me — now seemed hollow and pointless.

I also struggled to get through my clinical appointments. As one married couple talked about their own pains, resentments and disappointments, I felt so incompetent that it was all I could do not to send them out the door. My worldview — everything I thought I believed in — had been shattered.

And, of course, I also had to face my children, explain things to my extended family and tell my close friends about my troubles. One of the most painful things ever said to me was delivered by one of those people at the time, like a spear thrust into my chest: “You might be a good counselor, but you sure don’t know how to practice it at home.”

It was an impulsive statement not intended to wound me, but those words sealed my burgeoning perception that not only had my marriage failed, but the successful person I thought I had become was merely an illusion. Many times I had talked to others about how failing didn’t make them a failure, but I couldn’t apply those words to myself. I believed I was indeed a failure. Nothing had prepared me for the crippling effects of such a personal crisis on my professional sense of competence, my worldview and my sense of self.

Those days are long behind me now, but the devastating feeling of that painful period was brought back to me recently as I worked with a colleague in the midst of a similar experience. Even now, after many years of healing, that wound is still tender in my heart, and as my colleague talked to me, tears pooling in his eyes, I knew there was little I could say to ease his pain. I recognized that fractured sense of competence in his face. It was the same one that looked back at me from the mirror all those years ago.

Children or no children, short marriage or long, amicable divorce or contentious, splitting up is always painful. I loved my family, and I was willing to do anything to salvage my marriage. In retrospect, that difficult time was one of the best things that could have happened to me. It helped me become a better person, and it helped my wife and me to heal some very deep hurts and disappointments and to begin nurturing a much healthier and happier relationship — one that thrives like wildflowers today. But that experience also taught me that the pain of personal crisis, whatever the cause, can be debilitating to a counselor.

A hard fall

As a professor, writer and clinician, I had always prided myself on practicing the things I taught. Looking back on those years, maybe I succeeded much of the time, but I failed more than I realized. I suppose counselors require a sense of competence, maybe even bordering on arrogance, to take the risks we take each day. After all, we are diagnosing and treating based on a professional judgment call, and if we didn’t have confidence in our abilities, we probably wouldn’t be very good at what we do. We might otherwise stand on the riverbank, foundering in indecision, never daring to venture across.

But that confidence and self-assurance may also blind us and make our fall much harder. As is also true for politicians and religious leaders, people expect more of counselors than perhaps they should. We are, after all, human. But a personal crisis, regardless of whether it is one of our own making, is not just our own. Our pain, embarrassment and shame are inevitably known to many and reflect, however unfairly, on our professionalism. That adds to the weight of our sorrows.

The self-care paradox

There is no shortage of books and articles on self-care for therapists. A quick search in an academic database yielded almost 1,000 articles on the topic. We talk a lot about self-care in our field, but I know that I didn’t practice it well. I suspect I am not alone — and this isn’t a new problem.

My professors and internship supervisors talked about the importance of self-care when I was a graduate student in the 1980s. In 2000, Theresa O’Halloran and Jeremy Linton noted that “wellness is a concept that we as counselors often focus on more readily for our clients than ourselves.” Then, almost 20 years after that, Denis’ A. Thomas and Melanie H. Morris (2017) wrote, “Although most counselors have knowledge about self-care and convey the importance to others, the same knowledge may not translate into self-care action — often when it is needed most.” Apparently, as a group, we practitioners haven’t learned much about the application of self-care in our own lives over the past few decades.

This is such a bizarre paradox. Counselors, of all people, should know better. We are trained to take care of ourselves, and we emphasize the importance of self-care to our clients. Yet my self-confidence in those days caused me to naively believe that crisis wouldn’t knock on my door. I think in some ways, when counselors talk about self-care, it is more of an academic conversation than a real one. It may be something like the fact that we all know we are going to die someday, but it isn’t real to us until we stare it square in the face.

Divorce, death of a loved one, loss of a job and chronic mental health issues strike counselors’ homes and lives just as they do the rest of the population, and these issues are potentially just as damaging to us as they are to those who are not in the field of mental health.

I couldn’t have prevented the pain of my own crisis, but there are many things I could have done differently to prepare myself for it. My self-care habits back then were weak at best. I’d like to offer some suggestions that can help counselors navigate the sweeping effects of personal tragedy.

Find a counselor before you need one

Unfortunately for me, when the reality of my fractured marriage came calling, I didn’t already have a personal therapist. I had seen one in the past, but I hadn’t had an appointment with him in years, so long that I couldn’t even remember his name.

I should have known better. All of us learn in graduate school that we need to manage our own issues if we want to be effective therapists, and I had been through both individual and group counseling as a part of my graduate work. I thought I had done enough. I reasoned that I had worked through past issues and found a place for my own life’s traumas. Maybe I thought I had “arrived,” but I was kidding myself. Managing the past helped to some degree but not with maintaining my ongoing mental health. Consequently, I wasn’t growing either.

It is easy to rationalize that the cost of regular therapy — both in time and money — doesn’t make sense. We work hard as counselors, and for every hour we spend in our own therapy, we are also losing money because we aren’t seeing clients. But that is false economy. Even if we are managing life fairly well, it still helps to get a checkup. I get a physical every year even though I’m fine; I go to the dentist twice a year even though I don’t have cavities; and I go to the eye doctor each year even though my eyesight is OK. I should have applied the same philosophy to my mental health, getting a mental health checkup every few months at minimum.

So, there I was, in crisis and in need of a therapist, and I had absolutely no idea who to turn to. Plus, I had another serious dilemma that is common among counselors. Almost everyone I knew and trusted in the field couldn’t ethically see me as a client. They were friends, colleagues, former students or former supervisees. I’d consulted with them, taught them or socialized with them. Now I had to find a therapist in the midst of my crisis, and I was left with the phone book — something I always tell people to avoid.

If I had been maintaining an ongoing relationship with a therapist already, this part of my crisis management would have been simple. For that matter, it’s very likely that at least some of the crisis itself might have been avoided. I’ll never find myself in that place again.

Exercise, eat right and rest

Good mental health requires us to eat right, sleep right and get reasonable exercise. I call it “Moffatt’s Mantra,” something my students, interns, supervisees and clients undoubtedly get tired of hearing.

Even before my crisis, I slept poorly, sometimes getting only an hour or two of sleep a night. This went on for years, and just as I apparently had been doing with my personal life issues, I chose to ignore my sleep issues. Oddly, my sleep problems allowed me to be exceptionally productive. Getting to my office sometimes at 1:30 or 2 a.m., I wrote prolifically, publishing many books and articles as a result. But then, in the midst of crisis when I desperately needed rest, even the little sleep I ordinarily might have gotten evaporated. I was preoccupied with shame, regrets and hopes, and sleep was nearly impossible. I made an appointment with my prescriber and began taking regular sleep aids, which was critical to my healing. Almost immediately, a reasonable night’s rest helped my mood improve.

Likewise, in those days, I rarely ate breakfast and often skipped lunch, only to overeat at the meals I did have. Fortunately, I have never been one to eat junk food, but my Southern diet was full of fried foods, fats and carbs. When crisis hit, I couldn’t eat at all. My stomach was upset, and I had a hard time downing even a few bites. Over just a few weeks, I lost more than 20 pounds. Just as was true with my sleep patterns, crisis magnified my poor eating habits. A good friend forced me to eat, often sitting with me during meals — including some that he made himself — to ensure I was getting at least some nutrition.

Of the three areas that constitute Moffatt’s Mantra, exercise was the only one that came easy to me. I have always been good about getting some type of daily exercise — running, biking, swimming or even all three in one day. This is the only thing that helped me offset the fatty, fried-food diet that was my routine and prevented me from gaining unhealthy weight.

Exercise has myriad benefits. Aside from building endurance, muscle tone and a stronger heart, it also improves quality of sleep and mood in general. Research has demonstrated that attention to healthy, reasonable exercise can either lessen the demand for medication or remove its necessity altogether, even with serious issues such as chronic depression. Exercise produces morphine-like endorphins that help to balance our moods. Even moderate exercise just two or three days a week can help manage weight and increase metabolism. Seeing a thinner self in the mirror can also improve mood.

“I’m too busy to exercise” is a very weak excuse. I was very glad that I didn’t have to add exercise to my life during the crisis because I doubt I would have possessed the motivation to work out and try to get in shape.

Supervision

Most counselors engage in supervision until a license or related credential is achieved, but after that, they rarely pursue any form of formal supervision. I think that is a mistake. As a supervisor myself, I have to recognize when a supervisee’s personal life issues, whatever they may be, are interfering with clinical practice without crossing the line and functioning as my supervisee’s therapist.

It would have been wise to have a second set of eyes during my crisis to evaluate my competence and ability to work with the clients I continued to see. An ongoing relationship with a trusted mentor or supervisor not only helps make us better counselors, but our supervisors may also be able to recognize when we are off our game. We lack objectivity when it comes to our own lives — both professional and personal.

That well-known line, “Physician, heal thyself,” sounds good, but it is an unattainable goal. Looking back at my own history, I was totally blinded by limitations of maturity and knowledge as well as by my good intentions. It is only through the lens of time that I am able to see that now. There is no way I could have been fully aware back then. Retaining a mentor who could have helped identify when it was time for me to take a step back would have been advisable.

Don’t forget to play

Building a private practice takes time, and many counselors burn the candle at both ends, working late hours and weekends, and seeing 35 to 40 clients per week. Such a schedule is unsustainable without life balance.

There is a huge body of research cataloging the benefits of play. It used to be thought that play was a kid thing. That is absolutely false. Human beings — in fact, most mammals — are prewired to play. The need to play doesn’t end at some arbitrary age that we call adulthood.

In general, research demonstrates the health benefits of play when it offers enjoyment and when the participant suspends time and place in exchange for focusing on an entertaining goal, such as winning a board game, playing tag or shooting basketball. Adults who play are happier and manage stress better. Play boosts morale, improves our “marketability” with the opposite sex and reduces heart rate. A 2016 study in the American Journal of Play even demonstrated the need for play among astronauts and proposed that NASA formally develop a “playscape” for those in microgravity.

Golfing, biking, hiking, playing games with your children or putting together a jigsaw puzzle are only some of the varied activities that constitute play. My favorite play activity these days is camping, and I am in the woods at least one or two days a month throughout the year — rain or shine, hot or cold. The isolation and recreation of the mountains energizes me and recharges my batteries.

Know your limits

One of my strengths in life is that I have never once done anything simply for money. Money doesn’t own me, so nobody else does either. But it is an easy mistake to make, especially as an American, to keep striving for more — a bigger house, a larger counseling practice, more staff, one more speaking engagement, more clients and so on.

Even when your practice energizes you, there has to be something more in life than appointments. It seems so logical, however, to keep taking on new obligations, mistakenly believing that you are “building a practice” when, in fact, you are burning the bridge from both banks. Long-term goals require some sacrifice, of course, but the decision of what to do and what to cut should be based on something other than the bottom line of your bank account or an arbitrary conceptualization of success.

Another reality is that in the midst of crisis, you can’t expect yourself to perform at the same level you would when your life is more normal. When I plunged into crisis, I cut back on as much as I could. I still had to teach my classes, and I continued to see the clients on my caseload I felt I could ethically handle. But I took no new clients, accepted no new speaking engagements, put all of my writing projects on hold and cleared my calendar, canceling a number of events I just didn’t feel strong enough to manage.

You will assume that this article doesn’t apply to you

There are varied perspectives on self-care, but I particularly like O’Halloran and Linton (2000), who propose focusing on wellness in six domains: social, emotional, cognitive, physical, spiritual and professional. Prior to my crisis, I had focused only on one or two of these, even though self-care is mandated by the ACA Code of Ethics. The suggestions I have offered about self-care are a start, but if history has taught me anything, I predict that most readers will say to themselves, “That was an important article. Glad it doesn’t apply to me.” And then 10 or 20 years from now, somebody else will be writing an article for counselors addressing the need for self-care. I would love to be proved wrong.

Just because we are counselors doesn’t make us immune to the ills of life any more than an oncologist is immune to the risks of cancer. In the 1990s, when Elisabeth Kübler-Ross experienced a series of serious health issues, she recanted her “stage theory” completely. A full-page article in my local paper described her health woes and her disparaging comments regarding her theory. I thought at the time her recanting of the theory was, ironically, demonstrative of the anger stage of that very theory. Before her death some years later, she said as much and reaffirmed her personal belief in her theory and life’s work. Despite our knowledge and experience, a crisis blinds us. Affect always trumps logic.

Taking good care of yourself is not only healthy for you, it will help you better serve your clients. Even chronic mental health issues such as depression do not preclude our competence. One of the most influential people in my professional life endured a lifelong battle with depression. I had known her a very long time before she confided that information to me. But she was an amazing mentor whose words and example influence me to this day. Likewise, one of the most naturally gifted interns I have ever had was a woman who suffered major depressive disorder, marriage issues and significant self-esteem issues throughout most of her life. But when she closed her door to begin therapy with her clients, she was amazing.

Both of these women were surprisingly strong, despite their personal life frailties. I am confident that they had learned to manage their challenges — not avoid them — and had developed self-care processes that allowed them to flourish in the counseling room.

It is with some embarrassment that I share my personal failures with you, but as always, this isn’t about me. Instead, I am hopeful that sharing my struggles can help you to avoid the mistakes I made. Pain will eventually find us all. I hope that, with better preparations than I made for myself, you can be prepared to weather the inevitable storms on your own horizons.

My friend has a very long road ahead of him. Recovering when your world lies in tatters around your feet is overwhelming. But he has me — a friend and a confidant. He has his therapist. And he has the physical and spiritual health to face this daily challenge. That is a great start.

 

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Gregory K. Moffatt is a professor of counseling and human services at Point University in Georgia. He is a licensed professional counselor and a certified professional counselor supervisor. Contact him at greg.moffatt@point.edu.

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Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Related reading, from the Counseling Today archives:

The battle against burnout

A counselor’s journey back from burnout

Wellness matters

Doing our own work: A parallel process

Behind the Book: Counselor Self-Care

 

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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.