Healing the healer: How counsellors overcome the stress

Counsellors and mental health therapists are at times overwhelmed by reflected stress. How do they avoid burnouts?

Earlier this year, Kanchan Rai, Delhi-based mental and emotional wellbeing coach and founder of Let Us Talk Foundation, faced a unique predicament. One of her clients, an 18-year-old boy who had been showing considerable improvement following her line of counselling for depression, found himself going back to square one when he unexpectedly lost his mother.

An experienced coach, Kanchan was used to dealing with all kinds of mental health issues without getting overwhelmed but the teenager’s condition affected her deeply. The reason: she had a son of a similar age and, therefore, the young man’s grief, at some level, resonated with her. “Moreover, I had lost my mother years ago, and it had taken me a while to come to terms with the trauma, so I could empathise with his feelings. But what pained me more was that the tragedy threatened to derail all the progress he had made over the past few months,” says Kanchan.

Being a therapist is tough even in the best of times. But the challenges of modern-day living, increased mental health awareness and the internal and external pressures exerted by a job that requires oodles of patience, empathy and understanding, have made it exponentially harder. Not surprisingly, a lot of therapists, despite their best efforts to prevent it, find themselves at the receiving end of immense reflected stress. While their training provides them with the armour required to brush off negative emotions or at least deal with them effectively, there comes a time when the carefully-constructed barriers break apart. And that’s when the healer herself requires healing.

Why burnout occurs

Incidentally, for all the conversations surrounding mental health, one major issue has not got the attention it deserves: therapist burnout. “Burnout happens when therapists expend more energy or try to take care of others without protecting themselves first,” explains Lee Whyberd, renowned energy healer and founder of Lee Wellness Meditation Centre in Dubai.“It is essential to take breaks now and then and seek to recharge energetically because, for energy healers, this is quite critical.”

While most counsellors are aware of the need to distance themselves from the narratives of their clients, it requires a huge effort to be detached while being empathetic. “Every therapist has a story, but no matter what the story is, burnout is a real phenomenon,” says Tania Kawood, Dubai-based energy healer and founder of TK Holistic. Tania could perhaps serve as an embodiment of this reality. Not too long ago, she lost two of her close relatives within a few months of each other. Her method of coping with grief: denial through immersing herself in work. “I took a deep dive into work which meant interacting closely with clients. While the approach helped me detach myself from my own emotions, my clients were going through a lot and gradually it started affecting me as well. I realised I was taking on too much and needed to take a step back,” she recalls. “I told myself to just stop and take that long-overdue break.”

Like most of her peers, Tania believes that being a healer or counsellor is a conscious and not just an incidental choice. Therapists, more often than not, would have experienced a challenging journey themselves which may have lead them to the path of helping others tackle their emotional traumas. Hence, to be really effective at what they do and offer an impartial view of a situation, the first need is to pay attention to their own wellbeing.

Anne Jackson, clinical therapist, life coach and founder of onelifecoachingme.com believes that working on oneself is a “lifelong process”. “It took me seven years to work on myself before I became a therapist,” says Anne, emphasising that a counsellor should reach a place whereby they don’t get triggered even if a client says something triggering. The only way to reach that position? By clearing their own clutter and working through their grief first. “For instance, if you have gone through a difficult divorce and haven’t sorted out your pain, a patient going through something similar could impact you.”

She cites the example of her late cousin, a famous child psychologist in Portugal who had a fabulous practice but couldn’t withstand the pressures of her own life. “I used to advise her to consult someone to sort herself out first. Unfortunately, a lot of therapists shy away from working on themselves, they think they are fine.”

But why do counsellors not realise the dangers of being dragged into the whirlpool of extreme emotions they often have to deal with? Ego (often called ‘spiritual ego’ or ‘therapist ego’), the eagerness to prove themselves, an enhanced sense of responsibility towards their clients and lack of self-care are some of the reasons, say experts. Adding to the complexity is the fact that the relationship shared by a therapist with his or her client matters more than the type of therapy, training or even the actual problem for which consultation is sought. “To have a good relationship, there has to be an attachment, a bond and a connection between the coach and the client,” says Dr Catherine Frogley, clinical psychologist at Lighthouse Arabia. “This bond goes both ways. I am also very much impacted by my clients and what they bring into the therapeutic journey. I feel I accompany them through difficult life experiences, and in doing that we are both changed at the end of that journey.” How to ensure the change is not negative is the big challenge.

It’s not always internal

However, not all burnout is caused by unprocessed personal emotions. External factors play an equally key role and the factors that trigger insecurities and stress in other professions affect the field of therapy too. For instance, independent therapists, not attached to a clinic or hospital, may find themselves taking on more sessions than they can handle, given that they are paid by the hour. “They won’t certainly put their clients into danger but may push themselves to the extreme to meet the demands placed on them,” says Anne.

Inability to create a work-life balance, being ‘over available’ to clients who tend to cling to them, the suppressed guilt of not being able to do enough, the lack of resources to manage mental healthcare requirements… the list of burnout causes run long.

Over and above, in a pandemic year, the problems have been exacerbated like never before especially since the therapist and the client would have essentially been facing the same issues. “I have definitely seen a rise in loneliness, depression, anxiety, post-traumatic stress and eating-related difficulties during the past 18 months. The toughest part about being a therapist during

the Covid-19 pandemic is knowing that there is such a need, yet you can only see so many people and only do so much,” says Catherine adding that as a psychologist working with children, she missed seeing them and using play-based strategies to support them at this tough time. Similarly, Kanchan recalls that in the first three months of lockdown in early 2020, nearly 2,800 new clients approached her platform, a number that peaked as the months passed. “Among all my cases, around 40 per cent pertained to grief counselling,” she says.

Most importantly, the pandemic took away distraction techniques that people commonly used for combating stress. “Work and socialising are techniques of distraction. With the lockdowns, the distraction techniques were taken away and suddenly you were stuck with your feelings and nowhere to go,” says Anne. “So you were forced to face your traumas.” The indirect impact: longer queues at counsellors’ clinics.

Seeking help

It can be an exhausting routine (most therapists this writer spoke to admitted to seeing four to five or perhaps more patients a day), but there has perhaps never been a more crucial time for mental health practitioners to take care of their own sanity. From small but important steps like practising mindfulness, keeping the therapy space separate from other activities, exercising and dieting to seeking counselling for themselves, healing oneself has become a top priority for many.

As Anne says, “I have been taught to jump into my client’s shoes and walk along with them. But when they leave, I jump out. If I

worry about their problems, I am going to burn out and won’t be able to do my job. You have to teach yourself not to worry, there is no other way.”

The most important self-care mechanism reiterated by all experts is the need to have a mentor or support system. The concept of ‘coaching the coach’ might sound odd for a layperson but it’s the supervision by a superior or a trusted peer that acts as a shield to protect a therapist from getting overwhelmed by the barrage of negative energy he or she is exposed to. “I attend regular clinical supervision with a senior psychologist and additional peer supervision groups to help me reflect on the work I do with clients. Secondly, like all clinical psychologists, I am required to attend training each year to help refresh my skills and keep up to date on the latest developments. I have learnt to be self-reflective and therefore I regularly ‘check in’ with myself to understand how I am and what I might need to look after myself,” says Catherine. Anne adds she meets her therapist once a month, even if there is nothing dramatic to discuss. “I just talk to her and let it all out! I also surround myself with well-balanced, non-judgmental friends who do not drain my energy. I don’t surround myself with friends who may need me as a therapist.”

For Lee, a relaxing bath soaking with Epsom salts works as a great natural detox. “Of course, I know how to energetically cleanse my own aura and ground my energies well. Before I start any day, I always put my energies in a visual white ball of protection which benefits me as I go through my day so the perceived ‘burn out’ is not as bad as one would choose to imagine,” he says.

Tania concurs. From religiously practising her own self-care routine that includes meditating, listening to music or an audio book, showering after an intense session and walking the dog, to keeping in constant touch with her family and friends and taking frequent breaks, she doesn’t miss a beat when it comes to protecting her space. Then, there is the all-important step of having a professional support system. “Frankly, I wouldn’t go to a therapist who doesn’t seek therapy herself. That’s the reason I work on myself every single day,” says Tania.

Drawing the lines

Above all, being mentally strong requires another skill — the ability to say ‘No’, and maintain strict boundaries. Kanchan cites the importance of proper scheduling. “Once a coaching session is over, I absorb it for some time. Instead of focusing on the pain and thinking of the negative aspects, I think of the positives for at least 20 minutes. But if I feel I have taken on too many clients who feel burdened by pain, I ensure to not stretch myself with sessions. It’s okay to reschedule and say no.”

Given the immersive and personal nature of the relationship as well as the fragile emotions being tackled, it can be easy to get emotionally swayed but that’s where a therapist needs to ensure he or she is not part of the story. “I personally do not get attached because I have learnt to be friendly, lighthearted, empathetic, and endearing but not get attached. It is very essential to bring fun and happiness into each session,” says Lee.

Ultimately what matters most for a therapist is that their clients need them to be their best version of themselves to be able to truly make a difference. And seeking support for themselves is just the way to pay it forward. As Lee concludes, “We need help and guidance from time to time. We are all human, none of us are perfect.”

(Lekha is an editor and journalist based in India)