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Self-Care for Therapists
“No one who, like me, conjures up the most evil of those half-tamed demons that inhabit the human beast, and seeks to wrestle with them, can expect to come through the struggle unscathed.” -- Sigmund Freud
All therapists and helping professionals, including creative arts therapists, massage therapists, physical therapists, psychotherapists, psychologists, social workers, educators, and others who provide specialized services to clients, must sign off on their particular credentialing field’s Code of Ethics. Found in every Code of Ethics is a statement about monitoring one’s own physical, psychological, social, and spiritual well-being when engaging with clients. In order to provide our clients with the best possible treatment, we must be at our best, and in order to be at our best, we all need to take care of ourselves.
Therapist self-care and well-being is often overlooked in this fast-paced world with the multitude of requirements and demands put on helping professionals, whether it be increased paperwork and documentation, productivity, or stretching ourselves thin in order to help more clients. So how do we self-care? How do we unwind from the intensity of our individual practice and client issues?
The answers to those questions will be unique to each of us, yet have common threads as well. Some of us will find solace in gardening, crafting, dining out with friends, attending a play or movie, exercising, joining a book club – your list of self-care activities will be unique to your personality, interests, and likes. The common threads resonating with all of us is the need for personal outlets away from the job, the need to find activities that bring us pleasure and replenish us, the need for supervision and mentoring, and the need to connect with our kindred spirits – therapists like us who can identify with the stressors that accompany our line of work.
One easy solution to keeping connected is to attend the many conferences and workshops presented each year. Each helping profession usually puts on an annual national conference in addition to regional conferences and local workshops. There is something magical about mingling with others who engage in similar types of work. By attending conferences and workshops you will learn new ideas and techniques, see old friends and make new ones, and leave rejuvenated and energized.
Secondary Trauma and Compassion Fatigue
Another aspect of therapist self-care is to be knowledgeable about secondary trauma and compassion fatigue. As helping professionals we listen to clients’ stories of depression, anger, fear, pain, trauma, or other issues and may absorb some of this emotional residue. If we do not have avenues to purge all the toxic elements absorbed, we may develop secondary trauma or compassion fatigue.
Secondary trauma and compassion fatigue are not burn-out. Burn-out is more related to the day-to-day stressors of the job, whereas secondary trauma and compassion fatigue are directly related to what we absorb from our clients’ material.
Secondary trauma may occur when issues clients bring to us are similar to issues we may have encountered in our lives. Compassion fatigue may occur when issues clients bring to us begin to exhaust our ability to work effectively. Signs of secondary trauma and compassion fatigue may include any of the following:
- flashbacks (about our own issues/experiences)
- triggers / buttons that a client may push (about which we are sensitive)
- beliefs we have that are challenged by our clients
- old wounds re-opened
- nightmares (perhaps about something a client has shared or we have witnessed involving a client)
- guilt, shame, rage
- unsuccessful at separating professional work from personal life
- becoming fearful of a client (personal safety)
- daydreams / re-enactments about a client’s issues (or our own which have been stirred up by client)
- adrenaline rushes
- feeling unfulfilled by your work or feeling you are unsuccessful in helping clients
- avoidance / denial / isolation (you may begin to blame the ‘victim’)
- zoning out (particularly during client-contact time)
- sleepy / trance-like behavior
- personal depression
- feeling estranged from others
- overworking yourself
- physical symptoms: sleeplessness, appetite decrease or increase, panic or anxiety attacks, hyper vigilance, hyper alert – easily startled
- there may be other characteristics not listed here that are experienced
It is vital as helping professionals to recognize the symptoms of secondary trauma and compassion fatigue. If you experience any of the above signs or symptoms, realize that you are not alone and that secondary trauma and compassion fatigue are treatable. Work to establish and maintain a healthy balance between your professional work and personal life. Make a concerted effort to keep your body, mind, and health in good shape by eating well and getting plenty of sleep. Another important part of therapist self-care is to engage in our own personal therapeutic process in addition to the supervision process that is part of our work. Being a therapist in therapy is a good thing.
Exercise also helps, so taking a walk with a friend, riding your bike around the park, joining a gym or exercise group are some examples of simple steps you can take toward self-care and personal well-being. It is also important to connect with others as much as possible as part of your self-care routine. Develop a solid network of professional and personal friends with whom you can connect when you need a boost. In addition, ensue or strengthen creative outlets such as drawing, painting, photography, dance, acting, writing, crafting, and other similar stimulating activities. Take up a new hobby.
Below is a list of links to websites or books offering information about stress, burn-out, self-care and well-being. Some of the sites offer ideas and strategies for self-care. Others list signs and symptoms of therapist stress and burn-out, questionnaires you can take to assess personal burn-out, as well as continuing education opportunities related to therapist self-care.
Amazon.com – The Therapist’s Workbook: SelfAssessment, SelfCare, and SelfImprovement Exercises for Mental Health Professionals by Jeffrey A. Kottler
APA publications (www.apa.org/pubs/books/431687A.aspx) - Caring for Ourselves: A Therapist’s Guide to Personal and Professional WellBeing by Ellen K. Baker
- www.e-psychologist.org (Caring for Ourselves as Psychologists)
- www.continuingedcourses.net/active/courses/course058.php (Leaving It At The Office – Taking Care of Yourself)
- www.zurinstitute.com/burnoutcourse.html (Therapist’ Burnout: Professional, Personal and Familial Aspects of Burnout)
- www.siteceu.com/runningindex.html (Running On Empty: Self Care for Therapists)