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Is it ok, as a practitioner, to have a bad day?
We fully accept that our clients have their ups and downs; we rely on the disclosure of such things and actively work the details of these peaks and troughs into our sessions.
But is it equally acceptable for us to respond honestly when our clients, as they regularly do, ask “How are you?”
On one hand, it’s important that our clients see their worker as an example of strength and dependability. We should present a face that is ‘well’ and ‘able to deal with problems’; after all, we are hoping to engender these skills in our clients.
On the other hand, perhaps we should let our clients see us as fallible and human. Isn’t it levelling to realise that even professionals have problems and sometimes things get us down? Doesn’t this show that we can relate to our clients far more?
Would you prefer a financial adviser who occasionally struggles to make ends meet? Or one who drives a Porsche and is never short of cash to flash?
Which one would you trust more?
Hmmmm – how interesting. I keep going one way then the other. Part of me we would like to say that it is important for practitioners to be human BUT a potentially bigger part of me wants the conusmate professional.
Off to mull this over -….
Great question and not always easy to answer.
In a therapeutic setting, I generally keep a boundary around this. It is not appropriate for me to move out of my professional role and show my own suffering or struggles to vulnerable clients. Caretaking clients will want to take care of me and these are generally the ones who will test out how I am.
Of course we are not robots or brick walls either and I certainly let clients know how I feel in a session with them if that’s appropriate. “I feel sad when you say that” or “I’m confused by what you are saying”. There are many ways to appear human, indicate empathy and show that we are challenged by life at times too.
I don’t tell them I’m having a bad day because that is not going to help them, and although I might think it will help me, it will just confuse things and in fact potentially abuse the therapeutic relationship.
Now about my day…
i think you’re both right about the importance of maintaining boundaries. but sometimes boundaries can become barriers.
there’s undoubtedly a big difference between saying, “I had a rough night last night, don’t feel too good,” and pouring your heart out to a client who may then feel responsible for your feelings.
i don’t think there is a definitive “right answer” to this, just as I don’t think that there is a hard and fast rule around disclosing past drug use on the practitioners part. i believe it’s down to the individual workers to best judge how to manage what they share with their clients.
Have mulled and I think it may be down to reading what the ‘patient’ (thanks Ollie) needs on that day. I know on good days I really like having the sense of closeness that comes from shared recognition of fallability.
On bad days what I want is for someone to focus on ‘me’ and for them to almost remove themselves from the equation.
It’s a bit like parents I suppose – you want to be mates but you also want them to be mum and dad when needed.
oh dear. is “client” not de rigeur anymore? i’m not a doctor so i struggle to call the people who see me “patients”…
Thats a really interesting topic.Ive found its best to leave your own problems outside of sessions.From experience clients are focused on their own thoughts and come into a session pre-armed and to bring additional thoughts to their agenda is not helpful.
Give yourself time to reflect on any personal difficulties your going through and seek supervision or a friendly empathic ear to confide in.If its burnout take some time out maybe a holiday to reavaluate and recharge the batteries.
The humaness of being human is due to the nature of working in addictions transference takes place that can lie in our sub-concious which may mean a trivial personal matter may seem more than what it is.This is not meant to minimise real problems and if they are not dealt with a possiblity may arise were one ends up loosing focus in sessions or inappropriatelly giving angry feedback when our own thoughts are triggered.
Its down to our own personal responsibilty to decide how as a professional to improve and your blog has done exactly that it will help us all look at our beliefs and attitudes and how we approach clents.
Graham – see Ollie’s blog on ‘The power of language – treatment and recovery, do we create the barriers’ if you haven’t had a peek anyway. There’s a fair bit there about barriers and terminology potentially being one of them.
i have read ollie’s blog..it’s very thought-provoking.
i’ve left him a comment
Brilliant question Graham. Hmmm! I think it’s essential that our ‘clients’ see us as ‘human’ – but that despite our ups and downs, we can still be dependable, relied upon, stable and so on. I think it can sometimes be a good modelling exercise when people can see how others react to difficult situations or off days without using! On the other hand, there needs to be proper boundaries to ensure that we don’t get in the habit of discussing personal matters, using off days as an excuse not to do our jobs properly, or to lean on clients for support etc.
I think this also depends upon what capacity in which we are seeing our clients, for example, a therapeutic session vs a cuppa and cigarette and someone asks, ‘I heard you’ve been ill, how are you?’ Will mull…
p.s. Everyone – good points!
i think you’ve made the most persuasive argument there Sarah. that it’s a good modelling exercise and can demonstrate how people cope with difficulties without substance use.
I usually think it’s better to err on the side of being human. Patient’s view us in a variety of ways, but it is in those moments of surprise, when we step out of the scripted roles, that real change takes place. A patient can forgive us our mistakes provided we learn from them, but can they ever repair the the feeling that something about who they are or the way that they express themselves was a misstep?
That doesn’t mean we shouldn’t examine our motives. When I chose to self-disclose I try to always keep the therapeutic relationship, particularly the patient’s interest in mind. If owning a feeling or error doesn’t further therapeutic goals, then it is self-serving and I have hijacked my patient’s session.
The implicit goal of therapy with addicts is to help them accept responsibility for their actions (and sometimes feelings), if by stepping out of the inherently lopsided therapeutic relationship I can demonstrate moderately successful coping strategies, then I have done my client a service.
It is almost a question that is impossible to argue. There are two conflicting ethical issues here,
1: It is important to portray a positive image to your clients, without being too corny, to be a source of hope and inspiration.
2: It is equally important, if not more so, to be genuine and true to yourself.
So the question is how do you resolve this conflict?
Well, from my perspective, people will know if you are putting on some kind of act. Maybe it’s best to answer the question as honestly as possible without displaying a destructive “what’s the****ing point” attitude.
I hope this makes sense
matt
