Caring for the Caregiver: The Mental Health of Therapists

 

By Howard M. Turney, Ph.D.

Therapists, like the general population, come in all shapes and sizes. They are represented in the fields of psychiatry, social work, psychology, counseling and marriage and family therapy. Therapists operate in a variety of work environments that include agencies, hospitals, clinics and private practice.

Just like the general population, therapists suffer from depression, anxiety, grief or any of the other diagnoses enumerated in the Diagnostic and Statistical Manual of Mental Disorders. It would be short-sighted to think that therapists are immune to mental or emotional distress. Working with patients can create its own set of problems — a phenomenon often referred to as “compassion fatigue.” Listening and responding to a patient’s challenges and barriers to good mental health can influence the thoughts, feelings and behaviors of the therapist. Compassion fatigue might lead to a dread of patients, less-than-optimal functioning or leaving the profession.

Many mental health professions have stringent training programs that bolster the mental health of providers. Initially, therapists in training receive intense supervision that challenges the therapist to think about human behavior and its complexity. Supervision is an intense examination of future therapists’ responses to observations and interpretations of patients. Early in a therapist’s career, his or her old emotional wounds may emerge into the therapist’s psyche and trigger adverse reactions to patient situations. Supervision offers the opportunity for therapist self-reflection to ensure quality of care for the patients they treat.

Throughout the therapist’s career, consultation with colleagues is essential. Consultation provides the therapist with an ongoing dialogue about the challenges and hopes of the work of the therapist. Consultation gives perspective to a colleague wrestling with difficult cases. It offers the opportunity to share frustrations of less-than-optimal outcomes. It offers the therapist a chance to consider one’s role in facilitating best practices in the ongoing care of a patient. Consultation serves as an antidote to isolation the therapist might experience in the daily routine of mending emotional wounds.

Successful therapists have experienced their own therapy, a factor that is paramount to the conduct of psychotherapy. Self-examination provides the therapist with an understanding of what it is like to share some of one’s most intimate thoughts and feelings. Even therapists have conflicts to resolve and issues to face in their own life. This work enables the therapist to establish clear boundaries between the therapist and patient. Boundaries clarify one’s sense of self and other and strengthen the patient’s self-identity. In therapy, the therapist walks alongside the patient, guiding the process and allowing emotional distress to subside.

Preparation and maintenance of the therapist is an ongoing journey that requires careful attention to one’s ways of thinking about people and the psychological injuries they have experienced. Therapists work to keep their own house in order so that productive, insightful work can occur. Mood disorders, addiction, family dysfunction and couples’ conflicts are all part of a day’s work for a therapist. With proper education and training, therapists are prepared to use their skills in a way that protects their own well-being and at the same time empowers the patient to achieve a more satisfactory way of living.

As Socrates said, “Know thyself.” This is an essential component of a healthy therapist and provides the foundation for success in therapy.

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