From the time you were in graduate school, your instructors and supervisors have likely emphasized the importance of self-care. Burnout is a real risk in the world of counseling and psychotherapy, and you have to be able to take care of yourself in order to avoid it.
These messages come from a good place. But they ignore reality for many therapists, especially those early in their careers. And those messages often come with dangerous assumptions and a dark undercurrent: If you’re having a hard time, it’s your own fault.
Feeling tired? Do more
Perhaps the most dangerous assumption that comes with many messages about therapist self-care is the idea that taking additional time for self-care is even a realistic option. A few years ago, a study examined California family therapists and clinical social workers who had dropped out of the licensure process before even reaching their clinical exams. That study found that every month that the person spent as primary caregiver for a child while also registered as a prelicensed therapist reduced the chance that the person would ever reach licensure. Simply put, they had too much on their plates to finish their required experience hours in time.
Many of the common suggestions about self-care presume that the therapist or counselor has extra hours in their day just waiting to be filled with a new activity. In reality, many sacrifice social time, sleep, and other areas of normal functioning in order to attend to their work and family obligations as best they can. Maintaining a balance of work, family, and play — often suggested as a key component of self-care — certainly would be ideal, as I imagine most mental health professionals would agree. But it is simply unrealistic for many therapists, especially those early in their careers. That extra hour we are supposed to carve out for play — is that to come at the expense of an hour of paying work, an hour of already-limited sleep, or an hour of taking care of children?
Self-care comes at a cost
It is also common for messages about self-care to ignore many therapists’ financial reality. Most of us have to pay for food, housing, and other costs of life. Many recent graduates also have to manage a staggering amount of debt. Remember that the minimum degree necessary to become a therapist costs five times as much as it did 30 years ago, in inflation-adjusted dollars.
Here at Ben Caldwell Labs, we share the anger many therapists feel about financial exploitation in the workplace. Some training sites actually charge you to work there. Many therapists work in unpaid jobs that legally should be paid. Employers sometimes won’t even tell you what a job would pay until late in the application process. (That actually harms employers and applicants alike, which is part of why California law now prohibits withholding pay information from job applicants in any field.)
Yet messages of self-care often suggest taking time off from work, or starting expensive leisure activities. Many therapists simply can’t afford either. The financial struggles involved in becoming a therapist are glazed over, or not mentioned at all.
What “self-care” often really means
Perhaps most troubling is the undercurrent of a lot of self-care discussion. When therapists are told that their stress and burnout comes from inadequate self-care, rather than the very real inadequacies and injustices involved in a lot of mental health work, we are told that our stress is our own fault. We are told that working in a difficult job with severely mentally ill clients and low pay would be more survivable if we just worked a little harder. In this way, encouraging self-care can equal shifting the blame for a deeply broken system onto those doing their best to work within it.
Look, if you’re stressed, and you can afford a few days off, or your sleep patterns could be better, or there’s something else in your life that you can reasonably fix, by all means, do it. Our work is tough. Vicarious trauma is a real thing. And we do have a responsibility to do what we can to bring our best selves into work each day. When we can’t do that, we need to back off from client care.
But if someone blames you for the stresses caused by our excessive requirements for mental health training, or those caused by your own employer’s policies and practices, they’re out of line. People in positions of power need to be working to make the system better, not blaming you for the suffering you experience within it.
Self-care is great for those who can afford it. Those who can’t shouldn’t be told that their lack of self-care is the problem. The problems in this field are so much bigger than what self-care alone can resolve.
Originally published April 2, 2018. Republished April 9, 2019.