Articles

Reflections on Wellness Series

Being a therapist has its own stressors, as well as blessings. The more we can find ways to keep ourselves healthy, the better we are able to serve our clients. Being able to face our own life dilemmas in a positive way allows us to have the emotional bandwidth to be there for our clients in their times of need. Writing (either in a personal open-ended journal or with structured exercises) can be a valuable tool for us to use.

Universal Life Issues

For years, I have used my personal writing as a way to maintain or regain my emotional stability, to clarify intrapersonal and interpersonal conflicts, and to ride out rough patches in my life. Writing has seen me through a divorce, a major career transition, and the loss of loved ones.

Are you struggling with a difficult relationship in your life? Is there a major decision that you will need to make soon? Do you struggle with habits you wish you could change? Have you recently suffered a major loss through the death of a loved one or the death of a long-held dream? Would you like to get clear on a meaningful new goal to pursue in your life? Have you ever had the experience of wanting more fun and creativity in your life?

As I write these questions, I realize these are universal human issues. Clients present these issues to us. We, as therapists, face these issues as well.

Benefits of Personal Writing

Because personal writing is for your benefit only, you don’t have to worry about a stern English teacher rapping you on the knuckles when you have misspelled a word or have been “unclear about your major theme!” Personal writing is about you and whatever use you want to make of your time.

Personal writing provides many of the same benefits that good therapy does:

1. It is a safe haven for those times when life is difficult and overwhelming. On those blank pages, you can be open and honest without fear of reprisal from unsupportive others.
    
2. A personal journal can support the release of difficult emotions, including sadness, grief and anger. As I faced the inexorable decline and ultimate death of my elderly parents who suffered from dementia, writing helped sustain me through the difficult days, months and years.
    
3. Often being able to say what you need to say (even if only on paper), can reduce a sense of isolation, depression, confusion, or resentment.
    
4. You can practice difficult conversations that you would like to have with significant others in your life. In the process, you can get clear what you really need to say and be able to have a more meaningful and productive dialogue.
    
5. You can sort out different parts of yourself that get in the way of making a decision or pursuing a goal wholeheartedly. One way to do this is to write out a variation of a “two-chair intervention” by working with two parts of your self: The critic and the cheerleader, the introvert and the extrovert, the part that wants to persevere and the part that wants to quit.
    
6. Over time, you can see the progress towards your goals. Sometimes, you can also see the lack of progress, and that can motivate you to “get moving.”
    
7. Maybe you have written something and actually enjoyed the fun of it. These moments can happen in therapy as well: a sense of shared laughter and life-affirming human connection. Just for fun, look around the room and find six items. Try writing something that connects the items in some way. Each time I have done this, the beginning of a mystery novel has surfaced. Maybe that will be my next career!

Writing as a Tool for Health

If the idea of writing appeals to you, you can use it in a variety of ways:

1. Keep a daily journal.
    
2. Write only when you are struggling with a difficult issue, decision, or emotional reaction.
    
3. To get yourself started, begin with a writing prompt such as “I remember,” “I wish I could forget,” or “I want.” Using “I appreciate” or “I remember” can help you mine some wonderful memories of special people in your life. Recently I wrote one whole page of one-liners that began, “I used to be... but now...” This helped me see that I have come a long way!
    
4. Use writing to flesh out possible things to say when facing difficult conversations.
    
5. Write letters that you don’t intend to send to significant people (including yourself) as a way to release emotion, to clarify your thoughts, and to identify self-defeating beliefs.

I hope some of these ideas will prompt you to experiment with your own writing.

Judy Davidson, MFT, works for the County of Santa Clara’s Employee Assistance Program providing short-term counseling, assessments, referrals, and workshops for county employees and their families.

Is your practice of psychotherapy hazardous to your family? Does your work interfere with your family life — or is your family fortunate to have the benefit of your knowledge in affective, cognitive and behavioral domains? How does your being a therapist influence your personal life?

Although we have skills and expertise that can be very helpful in our personal relationships, being a psychotherapist does not guarantee that we will be an effective parent or a supportive spouse. When we are distressed, our families may be adversely affected. “Hazards” of our profession, which can be harmful to our families, include:

Treating Family Members as Patients

The therapist who is always rational and understanding may appear distant and uninvolved. The use of jargon or labeling can be injurious; for example, children who are often called “accident prone” may internalize this label as part of their self-concept. Although our skills may tempt us to offer unasked for insights, family members may not appreciate intrusion through unsolicited interpretations. Such gratuitous comments can lead to a suppression of spontaneity or excessive self-consciousness in family members. Or family members may come to expect us to know what they are feeling whether or not they express it openly.

Emotional Exhaustion: The therapist who comes home emotionally drained may be insensitive to family concerns which seem “small” or trite when compared to the “larger problems” of patients. Family members may feel excluded or inferior when they sense that patients receive caring attention, patience and courtesy that is not forthcoming at home. This can lead to jealousy.

Jealousy: Children or spouses may say “You talk to so many other people, you have nothing left for me when you get home.” Family members may feel that they get our full attention only if they have engaging problems.

Demeaning Tales: Some therapists share tales about their work at the dinner table. If the anecdotes are not respectful of patients, family members may worry about being demeaned themselves.

Resistance to Treatment: When we need family or couple therapy, we may create obstacles to the healing process through avoiding treatment or attempting to be a co-therapist rather than a participant in the therapy.

Advantages for the Family

Our backgrounds and skills in human relations can be a solid asset in our personal lives. As psychotherapists we have the potential to be very good parents and spouses. When we pay attention to our own stress levels and attend to our own psychological fitness, our professional training can enhance the well-being of our loved ones. We can contribute through our:

Knowledge: Our knowledge of emotional, cognitive and behavioral domains can be used in a caring way to recognize and attend to the needs of our families. We may be able to understand and facilitate the delicate balance of dependence and independence that is at the forefront during adolescence — or we may be able to help a spouse who is struggling with an aging parent.

Training and Practice: Our training, with its emphasis on empathy, communication, and self-awareness can provide the foundation for becoming a more effective parent and a more sensitive, attentive spouse.

Psychological Awareness: As a psychologically aware parent or spouse we can help family members attune to their own inner lives and thereby enhance the quality of life of the entire family.

Cautious Spontaneity: Spontaneous responses can be engaging — as long as they are not “impulsivity masquerading as spontaneity.” When we are comfortable with our feelings, we can play with our children and spouses and enjoy spontaneous expressions of humor, affection or even occasional irritation.

Positive Tales: When we can share anecdotes that show affection, hope, compassion and good will toward our patients and their struggles, our family members can benefit and we have an opportunity to relieve the loneliness of our profession. Family members learn about the diversity of people’s problems and they may become more reflective and understanding in their own relationships. When we use our psychological skills cautiously and respectfully, we can create a “home environment where empathy, compassion and connections are the rule... Both spouses and children of these (psychotherapists) are likely to trust that caring connections can heal, and that relationships are crucial for growth and emotional prosperity.”

Dr. Zur is a clinical psychologist.

Published and revised with permission from CLASP (Colleague Assistance and Support Program). Previously published in the California Psychologist in October 1996.

Reflections on Wellness Series

For helping professionals, self-care is crucial to ethical practice. There are challenges and successes when trying to practice self-care. Overcoming barriers to success can be a personal process; however, engaging in cooperative problem solving with friends, family and colleagues can be beneficial. Consider the following questions as a guide to help you get started, or to help you fine-tune your wellness efforts.

1. How do you define self-care?
2. What are the cues that help you identify the need for additional self-care?
3. How does lack of self-care impact clients/students or others we serve? How does our self-care benefit them?
4. Who have you found to be facilitators for, or what have you found to facilitate, personal self-care?
5. What challenges have you experienced to self-care practices? How have you addressed those challenges?
6. What challenges do cultural differences bring to matters of self-care?
7. How do you support your colleagues’ self-care efforts? How would you like them to support yours?
8. How do you balance the need for self-care with conflicting ethical imperatives, such as the need to confront an unethical colleague?

References:
1. Faunce, P.S. (1990). The self-care and wellness of feminist therapists. In H. Lerman and M. Porter (Eds.). Feminist ethics in psychotherapy (pp. 123-130). New York: Spring Publishing Co.
2. Porter, N. (1995). Therapist self-care: A proactive ethical approach. In E.J. Rave and C.C. Larsen (Eds.), Ethical decision making in therapy: Feminist perspectives (pp. 247-266). New York: Guilford Press.

Adapted by Cathy Hauer from a workshop handout prepared by the presenters at the Association for Women in Psychology Conference, 2003.

Workshop presenters: Barbara Gormley, Michigan State University; Michele Boyer, Indiana State University; Gail Simon, Penn State University; Laurie Mintz, University of Missouri-Columbia