In the course of my practice as a therapist I am frequently asked a variation of the following question by those seeking to enter the counseling field: “How do I know if I’m too damaged/broken/messed up/traumatized to be an effective counselor?” My immediate response is always how encouraged I am that they are even asking this question, as it reveals a necessary level of self-awareness and humility which are two essential qualities for being an effective therapist. (It is the people to whom the question does not even occur that I actually worry about). While graduate level programs in counseling are supposed to serve a gatekeeping function to weed out students who may need to delay or re-consider entering the profession, and licensing boards are further tasked with protecting the public from counselors who knowingly or unknowingly harm rather than help their clients, aspiring as well as established counselors may want to consider the following factors in assessing their readiness/continued suitability to offer mental health services to others:
1. Personal Therapy
One cannot understand the unique experience of being a client unless one has actually been a client. We are not objective enough to rationally and realistically observe ourselves and the impact our experiences, particularly those early in our childhood, have had on our growth and development. The vulnerability of sitting in a waiting room after having filled out paperwork asking intrusive questions of a very personal nature, to see a stranger we have never met yet will hear our deepest, darkest, most shame-filled utterances is an experience we need to keep fresh in our memories in order to meet our clients in that exposed, tender, sacred space with gentleness and respect for the tremendous risk these people are taking by even walking through our doors. The most effective therapists I know have an established relationship with their own counselor that they check in with at regular intervals, whether that means weekly, monthly, quarterly or yearly, depending on what they together determine is an appropriate level of support at any given time.
2. Understand your Attachment Style
Whether you practice counseling from an attachment perspective or not, your attachment style, or the way you relate to yourself and others, is heavily influenced and shaped by your earliest interactions with your caregivers in infancy, and will have a tremendous impact on how you respond (or react) to your clients. If you have an insecure attachment pattern that you have not recognized and done some work on understanding how it might influence your interactions with others (see point #1), you may get triggered by certain clients who activate coping strategies you developed earlier in life to keep yourself safe. Whether you lean towards an entangled, dismissive or disorganized attachment pattern, the goal is to continue working towards an earned secure attachment from which you can relate to yourself and others from a centered, compassionate, grounded, non-reactive stance. An excellent article on this topic is pasted below:
3. Understand the Concepts of Transference and Counter-Transference
Transference is when a client projects his or her feelings and perceptions onto the therapist, and counter-transference is when the therapist does this back onto the client. Both occurrences are inevitable in the counseling process, but it is the therapist’s responsibility to recognize when this is happening (see point #1) and bring the transference dynamic to the client’s awareness to explore how this unconscious process is affecting his or her relationships outside of the counseling office while managing the counter-transference dynamic so that it doesn’t sabotage the therapeutic process.
4. Be Trauma-Informed
This applies both to yourself and your clients. Experiencing any type of trauma (and some would argue, who hasn’t?) does not disqualify a person from entering the counseling field, in fact, personal suffering can deepen our appreciation of and capacity for empathy for our client’s suffering. We do not have to have experienced exactly the same types of trauma our clients have in order to have a baseline of understanding for how they have been impacted, as we generally share similar neurobiological wiring and responses to fear and pain as humans. How our brains developed, and our personalities were shaped, however, will depend a great deal on the type of environment we come from (beginning in the womb), as well as our basic personality type, heredity, access to support, and ongoing life experiences. Having a coherent narrative of your life up until this point, especially about your childhood experiences, is essential to having an organized attachment style and the ability to contain your own trauma material when necessary to work effectively with a client (see point #1).
5. Know when to Refer
There may be clients you refer to other professionals when their particular presenting issue is potentially triggering for you or their issues are outside of your scope of expertise. We cannot be the “right fit” for all the clients seeking our services. With the explosion of research and new information emerging daily about the origins and best treatment practices for mental disorders, it is increasingly difficult to be a generalist in the counseling field any longer. Our responsibility as therapists is to make sure each client gets the best help possible, and this may require referring to a colleague who specializes in that particular area. There are also times when we simply cannot contain our own trauma material sufficiently to remain effective with particular client populations. After my most recent assault, I stopped taking referrals for new clients presenting with this issue, and was careful to seek peer consultation for clients with assault histories already on my caseload to deal with the inevitable triggers and counter-transference that surfaced during sessions to minimize the impact on my ability to continue to do good work. Of course, I sought personal therapy as well (see point #1).
6. Practice Effective Self-Care
While therapists often preach self-care to their clients, they are notoriously poor at practicing this themselves. I added the word “effective” because self-care can seem like an oxymoron as it is not always relaxing and soothing; it can be very hard work at times (going to the gym or the dentist come to mind). Generally the four areas I explore with clients are (1) Nutrition (2) Movement (3) Sleep and (4) Stress Management. I challenge therapists to have a self-care plan in each of these areas. (If self care is a challenge, see point #1).
7. Seek Support
The counseling profession can be extremely isolating. Even in a group practice or agency setting, counselors usually work alone in offices, spending hours each day listening to trauma-filled stories of people in extreme pain. Due to confidentiality constraints, counselors cannot share the content of these stories or any other identifying information with others. Supervision, mentorship, and consultation are all effective ways to seek support and input from colleagues in the field who can objectively offer guidance for difficult cases and validation when we feel overwhelmed or stuck. We may also seek support from our own personal counselor (see point #1).
8. Pursue a Solid Education
While a capacity for empathy and a desire to help others are certainly necessary qualifiers for anyone interested in becoming a therapist, wishing to do good and being qualified to do so are very different things. While effective therapists tend to have good intuition and discernment, these alone do not prepare a person to be a skilled counselor. There is a body of knowledge, including information about human growth and development, theories about personality development and how people change, ethics and laws governing the profession, etc. that provides a solid foundation for a would-be counselor to learn and integrate into their own personal style of providing therapy. Most graduate programs require their students to participate in their own personal counseling (see point #1).
The desire to become a therapist is often borne out of a personal experience with trauma that we wish to help others avoid or overcome. It is imperative that we not seek to heal ourselves by trying to help others heal. We need to have done significant work on our own issues before we presume to help others with theirs. This does not mean that we need to be “perfectly” healed. Some of our issues may remain a struggle for a lifetime. I believe the standard for therapists is “sufficient recovery” which means that our issues do not interfere with but actually inform and inspire our work with others.