This time I will be using my Gestalt and Psychodynamic lenses. The work that we do as therapists is often very intense and highly personal, every session, one after another, day in and day out. Over time it takes a personal toll on us all. How we handle that will vary from person to person, but I believe it is an occupational hazzard for our profession. As such it is something that we can see coming and we can therefore prepare for it to diminish the negative effects it generally has on our personal lives. By that I mean specifically our relational health and our psychological & physical health. When we do not attend to this as a question of personal life balance early enough, trouble can manifest quickly.

So when we spend many hours a day in our work setting paying very close attention to another person and listening intently to what they are telling and showing us, which will often include strong emotional aspects, many of which are hard to hear because they contain a great deal of pain, grief, frustration, sometimes angry or violent narratives, and not uncomomly desperation of many types. That is draining to be exposed to, when one is exposed to that over and over again mutiple times a day and from multiple people, it becomes very intense for the counsellor. And we have all signed up for this as part of what the work will involve, so we are there by choice. There is ample research that the constant exposure to stressful evnts directly, or any form of witnessing these kind of events or narratives can generate in the observer PTSD. That is one of the types of situations that clients seek us out to help them with so perhaps we think we should be immune to these effects ourselves. Not true, we too can suffer from these effects, but we don't often call it PTSD, we call it things like "compassion fatique, burn out or we just need a break". This is how it shows up for us personally which is serious enough, but it also plays out, and often dramatically, in our relationships, most often our intimate relationships.

Psychotherapy, in my view, is a boundaried emotionally intimate relationship that has some odd characteristics, it is very lop-sided in the sharing aspect, clients are asked to share in great detail their personal histories including many potentially very vulnerable details and emotions that the therapist is not asked to or expected to also share from their lives. This vulnerability inbalance also results in a power inbalance, which even when unintentional, it is still an active dynamic in this intimate therapuetic relationship. Now lets mutiply this event x4 per day x5 per week days x 4.2 per month and we get a huge amount of this level of exposure for someone working full time as a counsellor.

Now lets bring them home to their personal life, including their relationships, obligations with family, friends, shopping, feeding one self or a family and any personal activities they are involved in. The energy they have available after all this receiving and reponding to those clients they work with can easily have them arrive home depleted with very little energy available to give out. This says to those whom we live with, "whatever you need from me is going to come from whatever I have left over after work". while that is probably functionally accurate, over time it sends an out of balance message that may drive the relationhip into dangerous territory. We need to find a work/life balance early on in our career to be able to be the same caring and available people we are in our offices when we get home with some of that energy to give and share but this time as equals, not in the other work equation where we listen but don't share our personal history but we do give out a lot of our personal energy. It does not take long for that only partially available reality to set in at home.

When you glimpse the divorce rate in North America sitting at roughly 50%, then factor into this equation the traditional pressures on time, finances and emotions that are part of doing graduate studies. Partners of those in training are expected to do without a lot of what they would normally expect from a partner. If that level of deprivation seems like it is just going to continue on, some very serious questions can arise about the future of that relationship. It is up to us early on to recognize this pattern and find our own ways to get ahead of it not just try to do damage control as it begins to present itself.

Building in a balance that honors both sides of our lives, personal and professional. Self care is the primary way clinicians can bring about balance, or more often achieve a counter-balance to these intensity dynamics. There are many types of personal practices that can be useful in this process, both while at work and once you re-enter your private life. Physical activities that require one to move, like walking or hiking or biking or swimming or jogging, hobbies can also get us moving while having a different interest in focus. There are many kinds of meditative or contemplative practices, like mindfulness or various forms of meditations which include movements, like Thai Chi, Yoga, Chi Gong or any other spiritual practice that can also help us to re-charge our energy. Engaging in any activity that provides opportunty for meaningful inter-personal connection is a very energy sustaining activity.

There is a theme here! If we just do the kind of work we do and do not also invest in the other parts of our lives, we will not likely be able to sustain many personal relationships other than with our clients. That is already something that should be sounding some clinical alarms with possibly some ethical implications. In a relatively short time, like perhaps a couple of years or less, this serious work/life imbalance may undermine all of your other important relationships. It is a choice, my advice is be pro-active about this early and keep it on your personal and professional radar. If you have not been attentive to this balance up until now, get going on it now, it does not actually take equal parts of private life to counter-balance professional life, but there does need to be some. Because if you are not judging it accurately, others will likely be judging it from their vantage point. OK I will stop pushing now.

Next month I am going to looking at Biological Anniversaries and other Tissue Issues, please join me and see what you think. Ciao, David