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.
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.
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 email@example.com.
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Related reading, from the Counseling Today archives:
“The battle against burnout”
“A counselor’s journey back from burnout”
“Doing our own work: A parallel process”
“Behind the Book: Counselor Self-Care”
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.