You are a human being in the real world and sometimes your life, like a taco, is going to fall apart. You still have a job to do. Some jobs are easier than others when heavy things are going on. Therapy isn’t one of them. You can take a sabbatical, maybe, cancel your clients for a day or two, or a week, but probably not much longer than that. Or you can keep working and get by. What to do is a very personal choice and depends on many factors that you will have to weigh. You might seek supervision about transferring your caseload while things settle down or how to proceed.
Doing the minimum Get up, take a shower, and get dressed. You can do the minimum if you have to for now. That may mean not shaving, not dressing well, or not styling your hair. It’s alright to do what you can. Even the minimum can be a lot sometimes. Go easy with yourself.
Being there for your clients when you don’t have anything to give Therapy is part conversation, part technique, part education, and part entertainment. When you’re depleted in your personal life, you may not feel able to do those things. Just show up. When the part of conversation that is yours drags, use silence; you didn’t choose to be a clown and don’t have to entertain all the time.
What do I say? But what if my clients notice I’m not myself, not cheerful, not energetic? Own it. Use it as a teaching moment to say “we’re all going through stuff and we all get by sometimes, even me, even you.” Let it be okay to not be okay all the time. Demonstrate the principles you teach. I also like the analogy “Sometimes I’m at 100% and I can give 100%, but sometimes I’m at 30% and that’s what I can give.”
How much to share Keep it to yourself to be ethical and process your stuff in your time. Use a blanket statement like “I’m just going through some things right now” or “things are just rough right now.” You don’t have to reassure your clients that you’re fine if you’re not, promise them you’ll be alright if you’re not sure you will be, or worry them unnecessarily. You also don’t want them guessing about your personal life, prying, or following up on your issues – that’s your job for them, after all.
Get therapy Don’t hesitate to get yourself therapy. Find one who is a good fit for your needs. Process your stuff. Do your homework. Be a good patient. It’s okay if you just cry the whole time. Sometimes just thinking about my therapy appointment coming up makes me cry because I’m holding it together the rest of the time until then. If you can’t cry in therapy, I don’t know where you can. Express any countertransference as it comes up.
Self care Oh boy is this a hard one! Sleep, eat decently, journal, get some gentle movement in like a walk, and drink water. Oh, and socialize and do your hobbies. You know, all that stuff you tell your clients about. I know you don’t want to and feel like you can’t; do what you can, then do a little more. Oh, I know how hard it is but you have to in order to have a chance at getting out of The Pit, and you need out. Even spending one minute on a self care activity can be progress, so mark that progress and go forward.
Referring out and consultation If there are certain topics that are too close to home right now (relationship issues, parenting issues, whatever the thing may be) or certain populations you cannot deal with right now, stop taking those new cases and refer out your existing similar cases. It’s the ethical thing to do, to let them continue their treatment with someone who has the capacity for them if you currently do not. Unsure how to do this or to whom to send them? Seek consultation. Ask your peers for recommendations on how to handle things that are sensitive for now. Consider taking a sabbatical if it’s possible for you to take a leave for awhile while you get things sorted out. Tell your clients only the brief statement you prepare in advance that does not inure them, like “I’m stepping away from my practice for now and am uncertain when I will return, but am providing you with 3 capable therapists to choose from that work with your needs and insurance. I’m emailing your their contact information and a link to their websites so you can decide who to work with.” Consultation can help you set up referrals and a statement like this. It probably won’t feel good to do, but having done it will feel like relief and will minimize countertransference.
Know that this, too, will pass. What is happening is hard, but you will persevere. You have survived every bad day so far. Keep going. Be gentle with yourself.
Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, New York, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.
If you do not already have one, I highly recommend starting a Mastermind Group for you and your colleagues.
Short-Term Therapy 