Self Care 101 for Therapists

Counsellors and psychotherapists can be very good at suggesting to clients to start to develop compassion for themselves, stop destructive behaviours and to learn to self-care.  This is, after all, part of their job.  However, how high a priority is their own self-care?  How can clients assess whether their therapist is able to appropriately self-care and lastly, how good are therapists at really addressing their physical, mental and spiritual needs: the holy trinity of self-care?

I my work as a psychotherapist, I am often aware of the blindness of fellow clinicians when it comes to self-care.  Given the nature of their role in working with unconscious process and being emotionally available to clients (attunement), this is a very real risk to their clients’ wellbeing and scope for healing, irrespective of the effect this may have on their own long-term health.  Just like children swim in their parents’ unconscious like fish swim in the sea, so do our clients in relation to us.

So serious an issue is this that the BACP, in their BACP Ethical Framework state: ‘Practitioners have a responsibility to themselves to ensure that their work does not become detrimental to their health or well-being by ensuring that the way that they undertake their work is as safe as possible and that they seek appropriate professional support and services as the need arises’.

What is less clear is what self-care constitutes for counsellors and psychotherapists and what, in practice, they should be doing.  In my own training journey over a period of 5 years across two countries and three different institutions, the only reference of ‘self-care’ I ever encountered was that we, as clinicians, undertake sufficient ongoing training and clinical supervision.  Indeed, this is currently the only evidence of self-care requested by the two main professional bodies in the UK: the BACP and the UKCP.

In his 1995 book ‘Compassion Fatigue, Charles Figley suggested that there is a very specific risk for those of us engaged with this profession:‘…there is a cost to caring…the most effective therapists are most vulnerable to this contagion effect…those who have enormous capacity for feeling and expressing empathy tend to be more at risk of compassion stress…’ (p.1).  He goes on to interchange the term ‘compassion fatigue’ with ‘secondary traumatic stress’, further highlighting the emotional effects of working with traumatised clients.  With this in mind, I would suggest that a comprehensive, holistic and ongoing approach to self-care is not only essential for wellbeing, but a moral imperative.

Psychotherapy is rapidly evolving into an approach that incorporates not only the mind, but the body and the spirit directly through the relationship between therapist and client.  Therapists who fail to address their self-care needs may find themselves left behind as they are unable to authentically embody and facilitate whole life change in their clients, remaining stuck on providing mere cognitive insight – which does not lead to any change.

So what do we recommend as areas of self-care for therapists?

Keep doing your own work

If therapy is a process of healing loss and trauma and establishing and nurturing a relationship with ourselves, then the process never ends.  Being in ongoing therapy as a therapist is, after good supervision, a fundamental method of self-caring and letting go of any secondary trauma we have collected during our client work.

Be in your body

Being an effective psychotherapist does not mean that we need to be hitting the gym daily or running marathons.  However, each of us has a body and being a person who is present to their process and the world requires being in one’s body.

Any activity that enables us to feel embodied – in our bodies and present with the here-and-now is vital.  This can be a walk in nature, a swim, yoga or gardening.

Develop a daily practice

Mindfulness is all the rage at present, but for a good reason: our minds have become poor at maintaining an inner calm as society increasingly caters to our every whim – the age of instant gratification.

Mindfulness and meditation open the doors to inner peace in a physiological sense through bringing our awareness to our sensing and bodies and through cultivating an ability to be present with this felt sense.

Research is also increasingly showing that psychotherapy and a daily practice, work in conjunction with each other to help clients regulate their emotions and establish a relationship with themselves.  So, if we advocate it, we should do it!

Take regular breaks

This may be obvious but self-care is not just something to focus on at the weekend or on holiday.  Taking regular breaks throughout the day as a constant focus on looking after ourselves is as essential as planning in longer breaks.

Psychotherapists I have come to respect as clinicians, seem also to be those who have become very good at self-caring and in ensuring that they take a break at least every three months.  And if money is an issue, a break can just as well be a ‘staycation’ and a trip to Barbados – just avoid dealing with email enquiries!

Find meaning outside of work

Most counsellors and psychotherapists who work in this profession do so as it gives them a profound sense of meaning and purpose.  However, it cannot and should not be their only, or even main, purpose in life.  And nor should it be a substitute for having and enjoying healthy relationships and experiences outside of our client sessions.

Therapy is should never be a narcissistic endeavour on the part of the counsellor or psychotherapist; we are not there to facilitate a process in our clients simply because of our own inability to facilitate this very process for ourselves.  This is unethical.  It is our duty to self-care and our clients have a right to question for themselves whether we are embodying what we preach.