Therapist Self-Care: A Professional Responsibility (to be enjoyed)
As mental health professionals we dedicate our lives to helping others foster their own emotional wellbeing and mental health, confront and accept their human vulnerabilities, cope with life’s inevitable pains and anxieties, mourn losses throughout life, and metabolize traumatic experiences. For such a role to be sustainable, therapists (and all mental health professionals) also need to prioritize their own mental health and self-care. With increasing demand for services, administrative burdens, and the complexities of work-life balance, this is not alway easy to do and sadly therapist self-care is often neglected with sometimes devastating consequences for both therapist and the individuals they treat. Therapists may sometimes feel uncomfortable, guilty or selfish focusing on their own needs when they have been trained (or are naturally inclined) to be emotionally attuned, empathically available and focused on helping others. Understanding therapist self-care as a professional responsibility and not a luxury is an important way to characterize this essential aspect of maintaining one’s professional competence. Therapist burnout, compassion fatigue or other reactions to insufficient self-care can lead to errors in clinical judgment, emotional unavailability, gross failures in empathy, boundary crossings and violations, and other forms of acting-out. With this in mind, let’s take a moment to consider a few self-care strategies to mitigate these outcomes and to foster therapist mental wellbeing and preservation.
Set Boundaries: Though we spend our days helping clients learn to set necessary boundaries in their lives, this is not so easily applied in our own. It’s extremely important for therapists to set boundaries and separate their work life from their personal life. This can include scheduling breaks between appointments, avoiding work-related tasks during personal time, and setting limits on the number of clients they see each day. Limiting extra-therapeutic contacts (e.g., client texts, emails, and voice messages) as much as possible with a clear therapeutic frame (set out at the beginning of treatment) is also extremely important. When working from home, it is essential to have a physically separate work space so that it is easier to disengage at the end of the day.
Practice Mindfulness: Mindfulness practices such as meditation, yoga, and deep breathing exercises can be very helpful ways of staying grounded, maintaining perspective, and being present in the moment. This can also include such things as taking a few minutes to focus on breathing, taking a walk in nature, or engaging in other relaxing activities such as listening to music. I highly recommend the book “Wherever You Go, There You Are” by J. Kabat-Zinn (1994) for a helpful introduction to mindfulness in daily life
Prioritize Sleep: I know you know this but…getting enough sleep is essential for everyone’s mental and physical health! Mental health professionals should prioritize getting 7-9 hours of sleep each night to ensure they are well-rested and replenished when facing the work day ahead. Applying basic sleep hygiene practices such as having a consistent bedtime, keeping the room dark, relaxing and cool, and putting away all electronic devices can really make a difference. If you want to further support your understanding of the importance of sleep for you and your clients, I suggest the book “Why We Sleep: Unlocking the power of sleep and dreams” by Matthew Walker (2017).
Seek Supervision: Though we typically think of supervision as part of our continuing education credits, it is also of significant value for our own mental health and emotional survival. Clinical supervision is essential for mental health professionals to manage their own emotions and reactions to their work. Supervisors can provide feedback, support, containment and guidance to help navigate difficult cases, uncover and understand countertransference reactions, and maintain the reflective and mentalizing capacities of the therapist. In addition to one-on-one supervision, the unique type of containment and input provided by a group of trusted colleagues in peer-supervision is another great therapist self-care strategy.
Engage in Self-Reflection and Self-Examination: It is important for mental health professionals to take time to reflect on their own feelings and reactions to their work. This can involve journaling, talking with a colleague, or engaging in personal therapy to process their own emotions. Personal therapy in particular is important for anyone in the mental health field with direct contact and interactions with patients and clients. Some types of psychotherapy training indeed require (either formally or informally) that students experience their own psychotherapy as part of the type of personal development necessary for becoming a therapist. Regardless of whether you’re in training or a seasoned professional, a bit of personal therapy is an important part of any self-care plan.
Engage in Self-Care Activities: Mental health professionals should engage in activities that bring them joy and relaxation outside of work. This can include hobbies, exercise, spending time with loved ones, or other forms of self-care. Though this sounds simple enough, work and day-to-day family obligations can sometimes take over to such a degree that this gets pushed right off the list. It is helpful to actually schedule in a dedicated time to spend discovering, cultivating, and engaging in relaxing non-work- related activities and to respect this schedule. Here are a few suggestions from therapists I have known: cooking, walking, meditation, running, sculpting, dancing, singing, painting, cycling, knitting, yoga, piano, guitar, flute, drums, writing poetry and reading novels.
Connect with Colleagues: An abundance of research points to the importance of social support and social connectivity for mental health and overall wellbeing. The overall benefits of social support underline the importance of one’s professional connections as well. Mental health professionals should connect with colleagues and build a supportive professional network. This can involve attending conferences, joining professional organizations, or participating in peer supervision groups. Mental health work is very difficult to sustain in isolation and requires strong community support from other professionals. One popular way to connect with other colleagues is to join or start up a “study group” or “journal club” where you explore a clinical topic together in an informal seminar format (with a good dose of socializing time built in as well).
Take Time Off: Mental health professionals should take time off from work to rest and recharge. This can include taking vacations, sick days, or other types of leave to prioritize their own wellbeing. An important strategy is to plan for regular periods of time-off and to stick to this schedule with discipline and boundaries. Having a network of other therapists available to provide coverage for patients when one is away is a useful strategy to help disengage and truly have mental time-off.
Maintaining and supporting one’s own mental and physical health is essential for competent practice in the field of mental health. By setting boundaries, practicing mindfulness, seeking supervision and personal therapy, engaging in self-care activities, connecting with colleagues, and taking time off, we can prioritize our own wellbeing and continue to do meaningful work that benefits the individuals whom we guide, assist or otherwise treat. Therapist self-care is not a luxury and should instead be considered a professional responsibility not unlike the requirement for continued professional education and development. Please take good care and enjoy the rest of your day (and if you’re reading this at night in bed…..time to put it away and get some sleep)!
-warm wishes from Patricia from Note Designer-