The Therapist's Workbook

Self-Assessment, Self-Care, and Self-Improvement Exercises for Mental Health Professionals

Jeffrey A. Kottler

• Publisher: Wiley
• Year: 2011
• ISBN:
  9781118118016
• Edition: 2
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Mental health professionals spend their days helping others, but who is there to help them when stress and burnout threaten their own well-being? Filled with self-assessments, journaling exercises, and activities designed to facilitate renewal, growth, and change, this timely book helps clinicians help themselves with coverage of career threatening issues, such as fear of failure, loss of confidence, and the financial stress and loss of autonomy that many clinician's experience as a result of managed care and its constraints.

PART I

Confronting the Issues

CHAPTER 1

On Being a Therapist—and the Consequences of This Choice

Being a therapist has its consequences, for better and worse. On the one hand, you enjoy benefits that accrue to a professional who has devoted considerable time and energy to becoming interpersonally skilled and wise. There are things you know and things you can do that make it sometimes appear to others as if you can read minds and work magic. Indeed, you do understand aspects of effective living that remain a mystery to many others.

On the other hand, this profession offers nowhere to hide. Your worst fears are played out in sessions every day. You suffer the stresses and strains inherent to looking deeply into the core of what it means to be human—including the terrors, challenges, and torments that most people prefer to keep buried. Almost every week, if not every day, you encounter people living out the nightmares you, yourself, fear the most—addicted to drugs, out of control, mortally wounded from abuse they have suffered, depressed and suicidal, monumentally self-destructive, without hope. In addition, being a therapist forces you to examine your own motives for the choices you have made and continue to make, including the decision to be a therapist in the first place.

Why You Became a Therapist

Examining your motives for becoming a therapist is a logical place to begin this personal journey. It isn’t as if you’ve never given the subject some thought, nor been asked to recite an appropriate, usually altruistic, set of reasons that highlight your devotion to service to humankind. Surely the allure of fame and riches weren’t the big attraction; rather, most of us felt drawn to the idea that we might do some good for others—and, we hoped, for ourselves as well.

Your Hopes

When we began this journey, each of us had some fantasies about what being a therapist would be like. I pictured myself ministering to the walking wounded, healing them with a kind word or brilliant story. I hoped that my family and friends would respect what I was doing; even more important, I wished I would finally respect myself. I thought about working in the company of a dozen like-minded folks, colleagues who were wise and witty and open and caring. I imagined that I would feel good about the work I would be doing, that it would be important and valuable; it would be a true calling to which I could devote all my boundless energy.

Once upon a time, you had some definite dreams, as well hazy fantasies, about what your training would prepare you to do. List here, in no particular order, a few things you hoped to achieve by becoming a therapist.

1.

2.

3.

4.

5.

Meeting Your Expectations

In spite of what we imagined becoming a therapist might involve and what it would do for us, such expectations were often based on misguided assumptions and inadequate information. In my own case, it turned out that I learned far more than I ever thought possible about the means by which to better understand others and myself. Many of my initial expectations were exceeded with respect to learning interpersonal skills, helping strategies, and useful ways to make sense of the world. Yet I was surprised at how little I actually learned in the classroom compared to practical experiences in the field, informal conversations with classmates and instructors, and certainly lessons from my clients. I was shocked by the hypocrisy I encountered among professionals in the field, especially among those who didn’t seem to be able to practice in their own lives what they were supposedly teaching to us. Finally, I was disappointed to discover that my therapist training did not forever banish my self-doubts, as I had hoped.

Review the list you created in the previous exercise, and reflect on the items you described. Compare what you hoped would happen to what has actually taken place in your work as a therapist. For a few of the items just identified, jot down some notes to yourself about the extent to which you satisfied your expectations.

1.

2.

3.

In the space provided, consider which items you listed that you are not feeling especially hopeful about. Say something to yourself about how your dreams were compromised or abandoned.

Some Personal Motives

Let’s take it as a given that almost everyone in this field is, to some degree, committed to helping other people and making the world a better place. We all hoped that we could do something useful as a result of our therapist training. Perhaps we even thought that others might profit from the pain we suffered or the obstacles we faced in our lives.

It is a bit more challenging, and a lot more threatening, to examine the intensely personal and private reasons that may have led you to become a therapist. These motives were not part of your conscious hopes or your expressed expectations. Even now it is rare to hear therapists speak aloud about the personal reasons they do this sort of work—beyond, of course, their desire to help others. Nevertheless, many of us do acknowledge that being a therapist provides us with a degree of respectability, a feeling of self-efficacy, and a way of enjoying one-way intimacy in which we are the ones in control, the ones with the power.

I am reluctant to admit that I became a therapist because I hoped to reassure myself about my own emotional stability. The more clients I saw, the more convinced I became that I wasn’t as crazy as I thought I was. I found that I enjoyed being the one in charge of the relationship, the one who was treated with respect, as if I really knew and understood things that, quite honestly, seemed awfully vague to me. Furthermore, I really enjoyed hearing people’s stories; it satisfied my intense curiosity as a spectator. But unlike watching television, I could even tinker with the plot. And each time someone was influenced positively by my efforts, I felt redeemed, as if what I did really mattered. Because I felt so worthless early in life, to this day I don’t feel totally comfortable before I fall asleep at night unless I can identify something helpful that I did for others.

In the following list of personal motives that some therapists have acknowledged, check those items that seem to fit for you:

• Need for control
• Need for power
• Observe as a spectator
• One-way intimacy
• Understand people or myself
• Become an instrument of change
• Obtain self-therapy
• Save the world
• Rescue and heal
• Be a know-it-all
• Live vicariously
• Earn prestige and respect
• Make a decent living
• Settle into a profession

These are just a few of the many possibilities that could have influenced, and may still have an impact on, your decision to be a therapist. In the space provided, speak as honestly and openly as you can about the personal motives you have for doing therapeutic work.

Consequences of Being a Therapist

Our clients often come to us with wildly unrealistic expectations about what we can do to help them. They seem to think we have magic wands, that we will “cure” their spouses, banish their addictions, fix all their problems, or agree with them completely. We may find their innocence or ignorance amusing, if not counterproductive to our efforts; but at times, the hopes we held for what therapist training would do for us were no more realistic.

Regardless of the personal as well as professional motives at stake, a number of misconceptions were, and continue to be, perpetuated during training years. Only after we get into the field and spend considerable time facing the realities of therapeutic practice do we learn a number of difficult lessons for which we may have been unprepared. For example, clinical practice is not composed of a series of decision points at which there are only four choices, like a multiple-choice test, one of which is correct; nor are the answers we are searching for found in the indexes of books. Furthermore, some clients will not improve much no matter how hard we try, and some situations we will face will have no satisfactory resolutions.

In therapist training programs we often got the idea that we would have plenty of time to set up treatment plans and implement them. Little did we fully understand that, much of the time, we would be lucky to have a half-dozen sessions with a very disturbed client. Then there was all the paperwork and organizational politics, for which we may have been unprepared. Little did we realize that some of our most difficult challenges would come from dealing with our own colleagues!

Supply personal examples of the following lessons that directly contradict what you expected originally. Whereas some of these lessons might fit your situation, others will not; address the ones that speak most to your own experience.

• Life isn’t a multiple-choice exam.
• Answers aren’t found in books.
• What you do is often absurd.
• Your family still won’t listen to you.
• You will never feel good enough.
• You will never really understand how therapy works.
• This job...

Table of contents

• Cover
• Contents
• Title
• Copyright
• Introduction
• Part I: Confronting the Issues
• Part II: Taking Care of Yourself
• Part III: Practicing What You Preach
• About the Author