Helping the Helpers: Fierce Self-Compassion and Social Justice in the Therapy Room
Rebecca McKinney, pluralistic counsellor and lecturer in counselling at Edinburgh College, https://www.counselling-directory.org.uk/counsellors/rebecca-mckinney
‘These kids need someone to champion them,’ says my client, who works with vulnerable children, ‘Who else is going to do this? There are never enough hours in the week, so I work all weekend. That’s just what I do.’
As a counsellor living and working in Midlothian, just south of Edinburgh, I have heard variations of this story countless times. Our area is home to a high number of public and third sector ‘key’ workers: nurses, teachers, police, local government, and charity staff. They are the helpers, the people who dedicate their careers to trying to improve the lives of others, and they make up the largest part of my client base. Often, they seek out therapy when stress, anxiety, depression, or what I tend to see as existential sadness have hit overwhelming levels, sometimes following a diagnosis from the GP and/or being signed off work.
In our initial sessions, clients who work in these helping roles may not immediately identify work-related stress as a key issue. They may come with personal challenges: relationship issues, grief or loss, physical illnesses, or emotional states that they are struggling to understand and regulate. ‘I love my job,’ they will often say, waving away my curiosity about work. However, as the therapy unfolds, attention inevitably comes back to work and the strain of managing ever-growing demand with what seems like ever-dwindling resource, and how this impacts their relationships and their personal wellbeing.
Although helpers may genuinely love their jobs, the current reality of life in the public and third sectors is that workloads are unsustainable, stressful roles are often not well supported, budgets have been eroded by government-led austerity for over a decade and pay has not kept pace with inflation. The communities that my clients serve are badly affected by growing levels of poverty and inequality, which places all public services under intense strain. A young teacher tells me she has to buy food for Primary 1 pupils who are sent to school hungry. A charity advice worker describes her distress at telling a family in extreme financial hardship that there is nothing more she can do for them. An occupational therapist pours out her frustration about being unable to get an elderly patient out of the hospital because it will take weeks, if not months, to get a care package in place for them. A support worker comes to counselling with a black eye, having been punched by a service user. In my clients’ stories I hear love and dedication, and trauma. This trauma may be caused by singular events (i.e., being assaulted on the job) but more often accumulates with a sense of powerlessness that creeps in over years. It is this trauma I most often see leading to the fight/flight of anxiety and overwork, or the freeze of depression and burnout.
Through practice-based observation, I have witnessed some common, interwoven threads in my work with people in the helping professions. For so many of these clients, being a person who helps others is a fundamental part of their own self-concept. Helping may be integral to their value bases and, at an existential level, to their feelings of purpose. This is often linked to conditions of worth which emphasise the selflessness of helping, frequently inherited from parents and grandparents in similar occupations. They may feel that making a vocation of helping others is a noble pursuit, but it takes on a more problematic aspect when it comes attached to certain unforgiving beliefs, for instance, ‘My needs are less important than others’; ‘If I take care of myself first, I am a bad person’; ‘If I say no to the overtime (paid or unpaid), if I take sick leave, if I stay home or leave early to look after my child, if I don’t work over the weekend, if I can’t keep up my heroic efforts day in day out… then I am not only a bad nurse/teacher/other but a failed human being’. The gendered aspects of this work are of course significant, and worthy of a separate discussion in their own right; not all of my clients in these occupations are women, but most of them are.
The fallout for clients’ non-working lives and mental health can be devastating. The core beliefs that clients carry into their work also impact them at home, where they also bear the burden of care-giving and emotional labour. Much of my therapeutic work with people in helping occupations gravitates toward examining and challenging core beliefs and conditions of worth that lead to unsustainable levels of selflessness, establishing healthier boundaries, and generally recognising that none of us can run for very long on an empty tank. Compassion abounds in these clients, but much less so for themselves than for others. We work on cultivating what Kristin Neff calls fierce self-compassion. Neff says:
Fierce self-compassion…tends to involve protecting, providing for, and motivating ourselves. Sometimes we need to stand tall and say no, draw boundaries, or fight injustice. Or we may need to say yes to ourselves, to do what’s needed to be happy rather than subordinating our needs to those of others.
Politics inevitably creep into the therapy room as we make space to discuss this, but in this case the personal and the political are inseparable. Many helpers shoulder a sense of personal liability for structural failures. Everyone in the public and third sectors is profoundly aware what the austerity agenda has done to their services, but this awareness doesn’t dispel the guilt about letting vulnerable beneficiaries down. Corporate management, with Government sitting above it, has learned to exploit value-driven workers to a merciless degree, leaving our public services teetering precariously on their backs. Recent strikes across the public sector indicate just how weary public sector workers’ backs are becoming.
I am fully aware of the political subtext as I challenge my clients to care for themselves with as much dedication they do for their own beneficiaries. Holding space for clients to recognise and respect both their own needs and their own limitations—through fierce self-compassion, for example—becomes a joint struggle for social justice. Counselling can make an impact, for the relatively small numbers of people who are able to access it in a meaningful way, but I’m also keenly aware of the limitations of our discipline. More widespread change must happen at societal level, with community action, policy and governance. Fundamentally, it requires all of us to remember something our ancestors knew: that caring for each other is the responsibility of everyone, not just the professionals.
Acknowledgements
Photo by Ehimetalor Akhere Unuabona on Unsplash
