As I sit in my bed trying to figure out what to write about, I recognize I am breaking all the sleep hygiene rules I tell my clients about.
1) Laptop in bed. Exposure to screens is not suitable for sleep and our sleep hormones. AT ALL. The fact that I have trained in Cognitive Behavioral Therapy for Insomnia and several Nightmare protocols makes it worse that I am participating in this behavior. Please don't show this to my old patients at Fort Cavazos. My previous patients would give me such a hard time since I used to teach this as part of a group PTSD protocol.
2) Work-life boundaries. Those need to get better. But my back hurts - maybe from the stress I hold from hearing trauma all day, or this is what the late 30s start to look like - and creating a private practice is not for the faint of heart.
I then roll my eyes because I catch myself participating in unhelpful thinking patterns. It is the worst when you do this for a living sometimes. I then recognize that this blog post does not need to be perfect. It just needs to be genuine and authentic.
Therapeutic rapport and authenticity are sometimes lost in our field amongst filing claims, treatment plans, writing notes, furthering training, making ends meet, etc. We can get lost in the day-to-day stressors. When starting our business, we can also make ourselves appeal to everyone, even if it drains our energy. Practicing therapy requires authenticity in the room. Authenticity bolsters the therapeutic relationship and furthers the connection so treatment can be done. Without a therapeutic relationship, the achievement of therapy goals halts. I have found that many professionals get too in their head or try to follow a specific protocol to the letter instead of going with their clinical judgment and their felt sense.
I would encourage everyone to do these five things to enhance clinical relationships with their clients:
Do your work.
You must go to therapy if you are in the mental health field. You especially need to go to treatment if you specialize in something you have also been personally impacted by. We are responsible for acknowledging if we are experiencing countertransference during the session.
Be honest about how you can help someone.
I say this as a trauma therapist, Certified EMDR therapist, and EMDR Consultant-in-Training. I will consistently see people who say they treat trauma; however, their conceptualization of "trauma" and the modalities they have trained do not lend to evidence-based treatment in treating that trauma. Speaking about trauma does not qualify you to treat it. That may seem rough, but that is why I have not taken on couples. Can I work with couples? Yes. Could I do an okay job? Sure. However, I haven't received Gottman, Emotional Focused Therapy, or any other treatments that would benefit couples therapeutically. Knowing who YOUR client is will be paramount when connecting with them in the room. This knowledge will also empower you in your practice to further your passions and fuel your momentum forward. Sitting with a client that drains your energy impacts your ability to participate in relationships with other clients, friends, and family.
Put your pen down. Be in the now.
While fresh out of graduate school at NYU, I worked at a level I trauma center in the Bronx. I worked on the Women and Children's health team. On my first day on the job, one of my colleagues told me, you better CYA (cover your a**) because a woman just threw her baby across the parkway last week upon discharge from L&D. Needless to say, I wrote every single detail down on my bedside assessments. A short staff and a hectic environment also made it necessary to remember important information and ensure a safe discharge for mom and baby. However, I recognized that I was missing what was RIGHT in front of me when writing things down. It could be body language, a wince of pain, a shift of moisture in the eyes, words, breath patterns, etc. That is essential when connecting with our clients. Be in the now with the client. Hold their space. Put the pen down.
Listen to your body.
Listening to my body was never taught to me in graduate school. It was about self-care and how not to burn out. But let's be honest: taking a bath once a week is not a solution. Our body sends us signals all day, but we are on autopilot, on the grind, barely peeing between clients, and do not listen. Listening to our bodies is of absolute importance.
Look at what gives your body energy in sessions and what takes energy away. If there are cases with high countertransference, put those at a time of the day when you can best focus. Considering the order and amount of your caseload will allow you to stay energized for the remainder of the clients and, more importantly - your loved ones. For instance, I can't see anyone with MDD symptoms after lunch. Their energy brings my post-lunch nap energy down, making it hard to focus, ultimately impacting the therapeutic relationship. I put someone who is traumatized or has high anxiety. I know without a doubt that those cases fuel me and give me energy.
Seek consultation from trusted colleagues.
It is not enough to get consultation during your supervision years. We willingly accept one of the most important responsibilities that one can have. People are coming to us at their most vulnerable, sharing their demons with us and praying that we can help them through the darkest times of their lives. As Spiderman says, "With great power comes great responsibility." We must continue to grow. We must challenge ourselves. We must not think we are the smartest in the room because of life/professional experiences. Continuing to invest in consultation with peers or other colleagues is critical to ensure that we continue connecting with our clients, others, and ourselves.
To be authentic with clients, we must first be genuine with ourselves.
With care & bravery,
Maria B. Wiggins, LCSW-S, ADS
Certified EMDR Therapist and EMDR Consultant-in-Training