Can you talk the talk if you haven’t walked the walk?: why therapists need to be clients themselves

One of my greatest strengths as a therapist is the fact that I am human.  I am achingly human.  In school, they try to teach therapists-in-training how to set boundaries between yourself and your client — how to leave the feelings, emotions, and process of therapy in the office so that it doesn’t affect your home and personal life.  On the other hand, we are taught (and it is reinforced) that having empathy is a primary asset of a great therapist.  So….being able to “walk in my client’s shoes” should help me become a more dynamic therapist, but I also need to learn to leave those shoes at the front door.  Whew!  This is one of my biggest challenges currently in my career.

Being able to feel and connect with clients can help build that relationship that allows the client to feel safe and secure to risk what it would be like to make some changes in his or her life.  I think that this ability to empathize deeply with clients can ignite a charge of positive progress in the therapy, and I also think that this quality needs to be carefully monitored.  Therapists are at risk of burn-out if they don’t engage in self-care on a regular basis.  And I think that being a client ourselves is one of the highest forms of self care — for several reasons.

I have had clients ask me if I have been in therapy myself.  Honestly, I can’t imagine not having been in therapy, and I am quite open about it.  When I chose my career path (or it chose me…), much of the drive and inspiration that took me there came from experiences and growth I have had in my own years of being a client in therapy.  I learned valuable tools to help myself find peace and happiness and I also learned a lot about the therapy process itself.  How could I know that I wanted to be a therapist if I’d never laid on that couch?  I couldn’t imagine it.  In my training program, we were encouraged to attend therapy ourselves, and though it was not required, it was given to us for free.  This, my university and professors thought, helps to build an amazing counselor — one who knows what it’s like to be across from the therapist, one who is open to working on his/her own issues, and one who can process the anxiety and awkwardness of a first therapy session with you — because they’ve been there.

I am writing about this today because I feel it is crucial for our interests and most especially for the interests of our clients that therapists engage in self-care.  A therapist who is burned out and has no outlet to process will have challenges being present for his or her clients.  I also think that if we are in therapy, or have been in therapy, we are showing a commitment to the therapeutic alliance itself.  We believe in it.  We respect it.  We are just like everyone else.  I get the sense that sometimes therapists are regarded as “in power” or “the leader” in the therapy room.  This, in my opinion, is furthest from the truth.  The client is the expert of his/her own life and story, and the therapist is the listener and sometimes the guide.  I know that if I was a client today and my therapist shared with me that he/she has been in therapy at some point in their lives, I would feel very connected to my therapist — that he or she is a person, just like me, who has things they need to work out, just like me.  And they care enough about themselves (and their clients) to talk to someone about those issues.

Going back to the start: I am human.  This serves me well sometimes, as it enables me to empathize and connect with clients on a very real level.  This also challenges me sometimes, as I work to define my own emotions in my own life.  Therefore, I go to therapy.  Going to therapy, though it can come with all sorts of pre-conceived notions and judgments, is the act of a strong and resilient person — someone who cares enough about him or herself to commit the effort to making a better life for themselves.  I’m not going to lie — it often takes a lot of hard work, patience, and honesty.  But for me, those three are virtues in the handbook of freedom and happiness.  Being a client in therapy has made me a better woman, therapist, friend, family member, and citizen.

What has it done for you?

Projecting care inward: why are we more compassionate with others than with ourselves?

I admit: I am guilty.  On the scale of 1-5, testing how much self-compassion we have (1 being lacking in self-compassion and 5 being high in self-compassion, with 3 being the average), I scored a 2.13.  Maybe I am even a hypocrite.  Why is it that so many of us in the helping profession have no difficulty offering unlimited amounts of empathy and compassion to those that we work with, but when it comes to treating ourselves with that same kindness, it’s nearly impossible?  I think that many of my friends and colleagues that help others — counselors, social workers, nurses, caregivers — could empathize with this statement.  I also am certain that many other folks, even those who have no training in garnering empathy and compassion skills, could agree that showing self-compassion is difficult.  As one friend put it:  “we are our harshest critic”.  Those of us who have a career in helping people are ethically expected to engage in self-care, which in turn means treating ourselves with kindness and respect so that we can be psychologically fit to work with our clients.  That can be hard to do if we criticize ourselves more than accept ourselves.

What is self-compassion?   According to a well-known blog on the New York Times’ website, self-compassion refers to “how kindly people view themselves”.  The article also talks about “new research” showing that giving ourselves a break and accepting our imperfections may be the first step towards better health.  This philosophy doesn’t seem too new to me, but the fact that we neglect to do this rings all too clear.  People who score high on the test of self-compassion tend to have lower levels of anxiety and depression and a higher quality of life.  Seems simple, doesn’t it?  The more you offer yourself kindness and acceptance, the less depression you will feel.  Take the test of self-compassion and see how you score.  Is it what you expected?   Higher? Lower?  This test is set up as “26 statements meant to determine how often people view kindly of themselves and whether they recognize that ups and downs are a part of life”.  The latter part of that statement is KEY to coping with life:  we all have ups and downs, we can get through them, and you are not alone.

Kristin Neff, who is featured in the article and known as a pioneer in the field of self-compassion warns that “the biggest reason people are not more self-compassionate is because they worry about becoming self-indulgent.”  This is interesting: there is perceived to be quite a fine line between offering ourselves kindness and being seen as someone who indulges themselves so much that they care more about their own needs than others.  These two poles seem pretty different to me but for those of us who are sensitive and perceptive, it can be a battle to determine what defines self-compassion and what defines self-indulgence.  Some self-indulgence is okay, even healthy, but when is it too much?  I think that our culture influences us to indulge ourselves to excess and this in turn can ignite our fears of falling too deeply into this trap.

A further point by Neff:  “I think that self-criticism keeps people in line”.  So, therein lies the complexity of this question.  Self-criticism is believed to help keep us from going overboard into the land of excessive self-indulgence.  However, self-criticism is the antithesis to self-compassion, and so an effort to limit indulgence can in fact cause us to become very critical of and hard on ourselves.  With all of this teeter-tottering between compassion, indulgence, and criticism, no wonder our society is riddled with anxiety about achieving perfectionism!

Cultivating self-compassion instead of choosing self-criticism is difficult, however it can lead to longterm happiness and can help alleviate emotional issues.  Neff cites an example of women who struggle with emotional eating.  If a group of women really want to have some doughnuts, but criticize themselves for perhaps having eaten some a few days ago or for even wanting to eat the doughnuts, then the stress of this self-criticism will project them into a uncontrolled episode of emotional eating.  However, if these women treat themselves with self-compassion and give themselves permission to have some doughnuts because they taste delicious and they really want some, then they will not over-eat.  Compassion breeds happiness and peace, while criticism breeds depression and self-hatred.

Where are you on the scale of self-compassion?  If you are high, then that is wonderful!  If you are lower than you would like to be, I encourage you to write yourself a “letter of support”, as you would for a friend trying to get a new job.  Cite all of the wonderful things about you and why you deserve to be treated (by yourself) as a kind, intelligent, beautiful human being.  Then read this letter out loud to yourself — you will be amazed at how empowering it feels!