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Caring for self while caring for others

July 1, 2010
by David J. Powell, PhD
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Heed the signs of trauma exposure, and take steps to assume personal control

You can only go halfway into the darkest forest; then you're coming out the other side.
- Chinese proverb

Caring for others is hard work. Being exposed to others' trauma opens us to our pain. It is important for caregivers to be good stewards of themselves. The Webster's II New Riverside University Dictionary defines stewardship as “the careful and responsible management of something entrusted to one's care.” As counselors, we're entrusted with people's stories and, at times, their lives. This is an incredible honor and a tremendous responsibility. In counseling, we create space for and honor clients' hardship and pain. To be a good steward of this privilege is to remember the sacredness of this relationship, to maintain the highest ethical practices, to act with integrity, and to honor our responsibility.

Stewardship of our relationship with clients is not just a good idea you hear about at a conference. It is a daily practice, tending to others' and our pain, suffering and trauma experiences. It entails learning to stay present in our counseling, no matter how difficult the stories we hear might be. It means slowing down what we hear from clients in order to be curious about what is happening within ourselves. It is paying attention on purpose, in the present moment.

Counseling involves listening non-judgmentally, suspending our assumptions and biases, and simply being present to another. To be an effective counselor, we need to pay attention to our intention. It doesn't mean putting on a happy face. Instead, we need to embrace the paradox that if you are to be effective as a counselor and experience joy in what you do, you can't afford to close yourself off to the experience of pain.

There are many barriers in our daily lives that get in the way of this attentiveness. Some barriers are personal, some societal, and others institutional. Ever say to yourself, “When my boss leaves, I'll feel much better,” or “When we get more funding, things will run more smoothly,” or “If I can attend this conference, I'll learn how to be a better counselor.”

One of the most profound influences on our personal stewardship is who we are as individuals-our own history of pain and suffering. Yes, some organizations foster pain when they ration services, operate bureaucratically and focus primarily on the bottom line. Societal forces influence our self-care; these include systematic oppression, racism, ageism, sexism, ethnocentrism, elitism, or heterosexism. Some organizational or societal issues can and should be addressed to seek change; others require regular recitation of the Serenity Prayer, accepting that which we cannot change.

‘I'm OK, but I worry about her’

Most of us do not realize how really tired and burned out we are until we hit the wall, becoming apathetic to clients. But what does the wall look like before we hit it?

For some, the elaborate structure we build around our hearts resembles a fortress. We build a moat, we add sharks in the water, we create new weapons to defend ourselves from the pain of clients, and we build higher and stronger defense walls. When we finally hit the wall, we find ourselves locked inside a protective fortress of indifference and apathy (“Who cares? What can I do to change this? I've got to get a better job”). What we did to survive destroys us. The key is rather paradoxical: We need to dismantle the walls, melt down the weapons of our heart and open ourselves to the pain of others.

Does any of this sound like something you at times experience? Here are 13 signs of trauma exposure.

  1. “I so often feel helpless and hopeless. Why am I getting out of bed today? Why am I bothering to go to work, other than because I need the money?”

  2. “I can never do enough.” This leads to a sense of internalized inadequacy.

  3. “When I get to work, I feel I have to be hyper-vigilant and attend to everything.”

  4. “I don't have any original thoughts anymore. I'm bored with what I'm doing. I can't remember the last time I felt creative.”

  5. “The first word out of my mouth lately is ‘no.’ I love the Mom I am treating but I hate the Dad. I always knew the new effort would be a disaster.”

  6. “I came home last night and thought, as my daughter told me about her hard day at school, ‘You think you've got problems. You should hear the stories of the kids I saw today.’ I wanted to say to a client, ‘You should be grateful for what you have, in comparison with other patients here.’” Nothing ever seems to engage your empathy.

  7. “I can't remember a time when I wasn't tired. My body seems to be keeping score. Been there, done that.”

  8. “I want to just turn off the phone and not talk to anyone when I go home-and many times during the day. I pray it will snow today and the agency will be closed (and I live in Miami!). My favorite day of the week is when I don't have to go to work.”

  9. “I deserve better pay, a safer work environment, more respect from my boss, and greater resources.” This is a sense of persecution, of “them vs. us.”

  10. “I feel guilty because I can leave at the end of the day and go to a safe home.”

  11. “I'm not an angry person. Everything is fine at work.” And then the conversation over the water cooler becomes cynical and angry about “them” (whoever the “them” may be).

  12. “I feel emotionally asleep. I can't empathize anymore. I feel numb to pain. I don't have any ‘oh my’ moments anymore. My children say I don't play with them anymore. I don't laugh or sing now.”

  13. “Who else will do it if I'm not here? I cannot leave; they rely on me.”