They say that mistakes are our greatest teachers. I’ve certainly found that to be true for me. When I say that counseling school didn’t really teach me how to be a counselor, this is what I think about. In school, or when you’re sitting in a training, the concepts are clear and sensible and the examples are unambiguous. It’s like that infinite, frictionless plane that they use in textbook examples of mathematics or physics. It’s not the real world. The real world has friction, and hiccups, and missteps. In my own supervision, I learned pretty quickly to not feel embarrassed or ashamed of my mistakes, but to take them for what they are: serious opportunities for my own growth as a clinician. So in this post, and a few that follow, I’ll be listing some of my many mistakes, and how they helped me become a better clinician. As a supervisor, I hope to give my associates the benefit of my missteps.
The Time I (Almost) Fell Asleep in Session
I’d heard a story in grad school about a therapist falling asleep in session and was shocked. How could you let that happen? Wow, I thought, there are really some bad therapists out there. Notice the lack of compassion, my sense of superiority, and the story I had going that I would NEVER do that.
And then I did.
It was in my practicum. I was balancing a school load, two practicum sites, and my first child—who had just gotten sick. He, his mother, and I were up all night.
Despite both chronic and acute exhaustion, I decided to power through my day of clients. After all, it would be unprofessional to cancel. I was fine for the first few, but with my last client of the day I found myself nodding off. Even though I didn’t actually fall asleep, I was fading in and out of concentration and not able to follow the thread of what my client was saying. With great effort, I pulled through and snapped back into focus. I thought I’d pulled it off pretty good. But that client never came back.
The lesson? Humility and self-care.
In retrospect, I should have canceled all of my appointments. Even the earlier sessions I did ok in were probably not my best work. Or, I should have at least taken a moment, excused myself from the last client to clear my head, own up to what happened and check in with her. Perhaps offered to reschedule or comp the fee. I probably would have been able to retain her as a client, and would have avoided creating a negative association with therapy for her.
Taking the time you need to be well is hard when you feel obligated to your clients, and it’s harder when you also depend on those client fees to pay your bills. One thing about private practice is that there are no paid sick or vacation days. It often feels easiest to shortchange ourselves.
In the long run, that strategy doesn’t pay off. If you don’t take care of yourself, your body will make you take that time at some point and probably not in a convenient way. It’s like buying something on a credit card, the longer you take to pay it off, the more it costs.
Self-Care is Needed for Ethical practice
Therapy is different than any other job you can have in the way that it is emotionally taxing. Staying present and focused for an extended period of time, feeling the feelings of the client as well as your own while also formulating a treatment strategy is exhausting. And then you do it again for the next session. And then again for the one after that. That is a real cost we pay, and one we should acknowledge. If you don’t take care of yourself, you won’t have the resources your clients need.
So was that therapist I’d heard about a bad therapist? Maybe, maybe not. Maybe he had a sick kid too. Maybe he felt like he couldn’t afford to take the day off or that he’d fail his clients in doing so. Maybe he learned that same lesson I did, and it made him a better therapist for it.