When overseeing novice counselors, one of my favorite discussions that comes up a lot is, of course, about how unique a therapist's work is. Yes, it is often incredibly hard work, but at the same time we are given an intimate front row seat for the experience of hope, pain, change and healing. (With that in mind, I highly recommend if you have not read Irvin Yalom's The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients.) If we can truly witness it at the deepest level, there is so many incredible lessons to be given.
I recently came across an article on the book The Five Greatest Regrets of Dying: A Life Changed by the Dear Leavers, written by Bronnie Ware. After years of transformative work in palliative medicine, Ware summarized much of what she had learned from her work, first in a blog post and later in a book of more than 200 pages. As I read, I took each lesson from Ware and adapted it to the unique work we do as consultants. I think many counselors will be able to refer to these repentances and teachings.
1) "I wish I had the courage to lead a life that is true to myself, not the life that others have expected of me."
The work of Virginia Satir popped into my mind as soon as I read it. It seems to me that perhaps too many of the pioneers and educators in our field want to essentially clinically clone themselves. Often times, models come with a full list of do's and don'ts. In graduate school, I was even given an acronym that taught me the exact way to sit during a counseling session. What I've always appreciated about Satir's work is that she encouraged clinicians to be her own unique version of a great therapist.
When we are new to the field, especially as interns, in a sense most of us try out the techniques and styles of those we learn from. I think that is entirely appropriate. However, problems can arise if we never grow out of them.
I will never forget that this "clinical differentiation" process was undoubtedly the first time I was confronted. In my graduate school there was a certain professor whose therapeutic way of being I almost idolized. I learned so much from him, and it happened that many of our unique styles naturally overlapped. Then one day I was challenged to see some different ways they didn't.
I had had a tough, conflicted family meeting a few days earlier and we were watching the tape under supervision. After going through an outline, my manager told me he thought I should call one of the family members and apologize for drawing the hard line I had. After the longest eight seconds of my life, I swallowed hard and said, "But I'm not sorry." I still felt I did the right thing and could easily articulate why.
My superior paused thoughtfully and said: "Then you shouldn't apologize." And that was it.
He taught me an incredible lesson that day. We all need to be open and receptive to the information we can expect from the mentors, supervisors, and others who are expected of us as advisors. And we need to purposely think about how and why we do what we do, whether it concerns the companies we work for, the clientele we want to see, or the model and theories we propose. But we should never do someone else's therapy. We're only supposed to make our own. In order to lead the “therapy life”, we should live in a unique way.
2) "I wish I hadn't worked so hard."
The point of view from which we look at quotas and session numbers is heavily influenced by our education, our job, our financial situation, our capacity, and so on. With this lesson presented by Ware, I am wondering if I am at the end of my career or at the end of my career, wish I had worked harder to see more clients, or given more individualized attention to each client I have worked with .
To put it more clearly: If I regret it here, do I regret the quantity or quality? Did I wish I had worked with a smaller number of cases to get more specialized training or to take more time to read books and research the specific needs and patterns of the clients I worked with? Or will I look back and wonder why I haven't worked on seeing more customers to help more people? Will I wonder why I haven't found a way to start my own business so that I can have more choices in my work? Do I end up regretting not following what my mind and body told me about my abilities?
I don't think there are many rights or errors here. I think our best bet is simply to make that choice more consciously. When I think ahead, I imagine that I just wish I had made my decisions with more intent – made them on purpose, rather than, in a sense, letting other factors choose a path for me.
3) "I wish I had the courage to express my feelings."
I have followed some of these lessons longer than others in order to apply them to our work as consultants. After reading this, the application immediately occurred to me.
As I write this article, I was also reading Louis Cozolino's The Making of a Therapist: A Practical Guide to the Inner Journey. There were many aspects of his openness to writing to counselors in training that I really appreciated. This is what struck me most in his many requests to approach the work with humility – admitting when we are over our heads or when we need help. What I appreciate most is how Cozolino, much like Jeffrey Kottler in his writings on counselor development (especially On Being a Therapist), points out that this never ends. We have never taken a step where we no longer have questions, uncertainties and specific problems with customers.
Furthermore, most of the excellent therapists I know even asked at some point whether they should or want to do this work. Those of us who work this through well don't keep it to ourselves. There is no doubt about this type of reaction. The path of least resistance is to speak courageously through them or, as Brené Brown (in Rising Strong) would say, "rumble" with all that a therapist does and creates within us. I think the bravest of us have realized that there is no shame in that.
As I said before, this work is hard – beautiful and hard. If we don't expect it to come with a somewhat constant dose of vulnerability, we can prepare for burnout and eventually feel regret at the end of the road.
4) "I wish I had stayed in contact with my friends."
In my eyes piggybacking on No. 3. I have little doubt that, when I look back on the end of my career, I will perhaps be even more grateful than now for the colleagues who made themselves available through these courageous people To process conversations about the difficult and emotional work that crossed our paths.
One of the dangers of the field shifting more towards private practice than towards larger agency work is how easily this can lead to a sense of isolation before we see it coming. Even when we work with people we like in these environments, for the last five minutes of the hour we are often just "ships that go by in the night". Experts in interpersonal neurobiology talk more about the importance of co-regulatory processes in therapy (see The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships by Bonnie Badenoch). We are best served to take this into account beyond our personal work with clients. I believe that the support of colleagues is not only important, but also important in order to do a good job.
In The Making of a Therapist, Cozolino shared some of his setbacks to that need and his own reconciliation over time: “Put a group of us together in a facility dedicated to helping clients and you will find at least half our time and attention is devoted to taking care of one another. I found this confusing and demoralizing for years and wondered why we couldn't put our own problems aside and just do our jobs. After much thought, I realized that this setting didn't work. Everyone in mental health, clients and caretakers, needs help, support, and healing. Trying to help customers without helping the helper ultimately fails. "
5) "I wish I had let myself be made happier."
Lately I wanted to give up the term "self-care" because it has been so overused and, I think, largely misunderstood. The last point I want to make here really goes beyond the term anyway.
There is no getting around the frequent intensity of our work and the unique stress factors that are to be found in such close and deliberate proximity to pain and suffering. Sure, there are specific things we can do about it, as I mentioned earlier (and as Emily Nagoski and Amelia Nagoski expertly point out in their book Burnout: The Secret to Unlocking the Stress Cycle). But neither can we escape the reality that as consultants we do not have the luxury of not taking care of ourselves. We cannot do our work, at least not for very long, unless we take care of ourselves.
I tell the students in my internship classes that if you are not willing to take care of your own physical and mental well-being on a daily basis, you will have to find another career. We have to take care of ourselves like it's our job. Because it is. Among other things, this allows us to be happier. Suffering as a sign of honor and martyrdom has no place in this profession. It certainly doesn't make us more effective as consultants, and it definitely doesn't make us healthier, more loving people outside of the office.
The following quote from Brianna Wiest from a blog post she wrote for Thought Catalog comes to mind so often that I think people are tired of hearing me say: “Self-care is often very unsightly thing. … True self-care isn't about salt baths and chocolate cake, it's about choosing to build a life that you don't have to escape regularly. "
If we think somewhere in the middle about the end of life, we can gain incredibly valuable insights – into our priorities, how we spend our time, our expectations, our habits and even our worldview. I think it is really important to ask yourself whether our perspectives and patterns are on paths of regret or paths of health and healing. With the appreciation for all that comes with this exploration, we then have the opportunity to have a brave, balanced, emotionally honest, collaborative and happier working life that we can look back on with pride and immense gratitude.
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Whitney Norris is a licensed professional counselor and supervisor who co-founded and works as a trauma specialist with Little Rock Counseling & Wellness in Little Rock, Arkansas. She is currently doing a PhD in clinical and translational sciences and plans to study child misfortune and prevention from a public health and policy perspective. Contact
them through whitneynorris.com.
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