“At least it’s not cancer.”

Courtesy Emma JaegleI was working in a residential treatment center for teens. It was a typical mid-week day, and I was supervising “school time,” a period where clients are able to work on their treatment assignments and homework from their schools back home. Often during this hour, the primary therapists would pull the clients for individual sessions. I happened to know that today was the day that Nicole* was going to be given her diagnosis of depression, and I was prepared to help her process her emotions should she need coaching after her return from session. Sure enough, Nicole returned from her therapist’s office with a solemn look on her face. When she sat down away from her peers, I walked over to her and asked, “How did it go?”

She let out a sigh, “Well, I found out my diagnosis.”

I nodded. “I see. What’s that like for you?”

“I guess it’s better to know what’s going on and have an explanation for everything. At least it’s not like I have cancer!”

That comment gave me pause. I thought: But I have cancer.

Self-care can’t — and shouldn’t — always mean time away

Therapists are human. Most of us join this profession because we have gotten through our own traumas, making us strong to help others. We’re not expected to be immune from all mortal experiences that our clients go through, and our work can be a constant reminder of our scars. In those moments when we experience our own complications in life, we are expected to seek out our own counseling or take a hiatus from our work. But how realistic is that?

When we go through our own problems, we tend to be even busier sorting our lives out, having doctor appointments, communicating with friends and family, planning funerals, and otherwise doing whatever it takes to deal with the obstacles in front of us. Taking the additional time and money to seek our own therapy adds obligations at a time when adding obligations is hardest. If we listened to our own advice, we would make the time to take care of ourselves. But it is undoubtedly easier said than done.

When it comes to taking a hiatus from work, is it practical? When learning that we have a diagnosis that entails a long recovery process, do we simply take a week off to gather our thoughts and return “all better?” When we suffer the loss of a loved one, do we take a few days off, only to return to our clients expressing their frustrations about their own loved ones? When we are going through a divorce, do we refer our couple clients out?

Our clients trust us to be there for them, and we need to work in order to make ends meet. We have bills to pay too, and mental health careers are unfortunately low paying, compared to other professions. When considering whether to take time off, we may find ourselves asking whether there will be new clients when we return to replace those that we may lose in our absence. The answer to that question can influence whether we take time off at all, and if so, how much. Our emotional needs can only be one part of the equation.

Work to do

In my case, my work was very flexible, allowing me to take off however long I needed for myself. Time off for self-care is a nice concept, and this was certainly generous of my employer. But I also needed to financially support myself and my impending medical bills. I ended up taking a few weeks off to have my surgery, and a month later, a week to complete preventative radiation. Work was an active effort to keep my own problems at bay while helping my clients with their latest issues, however seemingly small in my perspective at the time.

Nicole obviously meant no harm with her comment, and objectively, she was right. Her diagnosis was, relative to cancer, easily treatable. She was simply trying to say “it could be worse,” which is a functional-enough way of dealing with bad-but-not-tragic news. She ultimately was put on appropriate medication and moved back to her home, where she continued outpatient therapy.

I’m happy to say that I no longer have cancer. Like much of what we encounter in life, this experience has made me more empathetic with clients struggling through life’s unexpected events. That empathy includes a newfound understanding of clients who don’t want to put their own emotional needs first, who even cancel or reschedule sessions in times of heightened stress. Because there’s work to do. And bills to pay. And sometimes pulling yourself together enough to do the work, and pay the bills, is better self-care than taking time off to fall apart.

* Her name and other details have been changed to protect confidentiality.