Self care and Effectiveness of the Therapist

Self care and Effectiveness of the Therapist

As psychologists, our work within the western culture and its clients, can provide profound triggers or rather, opportunities for inner growth. Various psychosocial and neurobiological factors are at work.

First, the art and science of Psychology is vastly polytheoretical. There are many pathways to healing that can lead the client and clinician astray. The overload of information on the brain activates uncertainty and self doubt mechanisms. If the pathway is not clear, clients and clinicians can experience distrust in the process and engage in cognitive errors such as imposter syndrome or being judgemental.  

Secondly, in the western world, psychology is perceived as transactional. The client attends and pays for a session with the expectation that the clinician will heal them. The psychologist is also influenced by the transactional culture and believes that they too should heal the client (an impossible standard). 

Thirdly, an important fact to consider is the cultural influences of success. All of us, therapists included, are encouraged to over extend ourselves and succeed. This breeds an underlying fear of failure. Subsequently we are trained logically as scientists and thinking or intellectualising is seen as effective and successful. In truth however intellectualisation distances us from one another, it is received as cold and authoritarian. Its progress knows no bounds and is harmful to our environment. 

With this psychosocial backdrop, there is little wonder that a psychologist’s defences can become activated. 

Defences to identify in yourself as a clinician:

1. Offering a compassionate response with a controlling agenda: clinicians can sound convincingly non-judgmental and compassionate, however when the clinician experiences inner anxiety or stress, the compassionate stance becomes a control mechanism.
2. Somatic experiences: odd physical sensations, flight or fight responses, repetitive or ritualised behaviours, ruminating and losing sleep over a client, spending too long on reflecting on the client-clinician process. 
3. Emotional and behavioural responses towards the client: frustration, fear, sadness, overly caring, worrying, intellectualising/offering too much psychoeducation, blaming, diagnostic shaming, zoning out in session, pushing a certain agenda that the client resists, lacking warmth, avoiding preparation and treatment planning.
4. Negative cognitions: I am not good at my job, I’ve failed this client, I can’t work with this case. 

 

Deactivate your Defences:

Healing one’s defences is to acknowledge the boundaries within the self and the profession. Once the boundaries are understood, understanding capacity, the client and the therapeutic model flows.

Having a clear psychotherapeutic model rather than an eclectic approach. Whilst it appears enticing to have a varied toolkit, staying focused on one thing is more effective in the long run. Prevent information overload and stay true to your interests.

Refrain from taking on the responsibility to heal the client. This creates dependency in the client. The client must do the work. 

Communicating expectations to the client of a collaborative model of therapy instead of a transactional therapeutic model.

Insisting on client homework and activities between sessions.

Be compassionate to yourself. Holding the space with a person in distress is difficult. It’s easy to make mistakes in these moments. If a mistake is made, then learn from it. What would you do next time? Check to see if it is an over-extension of your expectations or schema. If so, pull back to a balanced and healthy baseline.

Become self observational. Speak to a colleague or supervisor about your observations as a clinician. Observe frequency, intensity and duration of bodily sensations, behaviours, emotions or cognitions.

Respond rather than avoid or defend against client resistance. Neither client or therapist is right or wrong. Practising non-judgemental responses “I hear your feedback, and I’d like to explore it with you if that’s ok”.  

Remind yourself you are a good and wonderful human just as you are 🙂