Setting up and maintaining a private practice – establishing a safe and reliable referral network, finding the right premises and clinical support and building a good reputation – takes much time and effort, especially when CPD, supervision and accreditation obligations are added to the mix. It’s hardly surprising that these factors, along with the personal demands of the work itself, can lead some counsellors to avoid or ignore the further requirements of a natural mid-career crisis.
This state is not in itself pathological; rather it represents a staging post in the counsellor’s mature career, where big questions need to be asked and dealt with if clinical performance, personal fulfilment, even your own mental health, is not to be put at risk. Having achieved professional success and allowed yourself some years to savour it while developing your expertise, you now find yourself somewhat weary, the work feeling a bit repetitive perhaps, less inspiring. What to do?
A quick note of caution: sometimes this flatness denotes the downplaying, even to yourself, of what amounts to exhaustion. You may still rely on paid employment, so struggle on, but with ever declining commitment. It’s important to distinguish between these two states. Burnout needs swift attention. Many refuse to take leave or a sabbatical, to delegate or go sick if necessary, due to financial pressures; or resulting from injured pride at the inability to live up to their own expectations. For some, work and the gratitude of clients is their only solace for impaired family/personal relationships they feel unable to alter. Some skilled counsel can enable such a sufferer to find practical and psychological ways round or through burnout, but this lies beyond the scope of this article.
So, how does the perfectly normal mid-career crisis manifest? Roughly halfway through a counselling life, a re-evaluation occurs, as the well-established practitioner recognises the professional plateau they currently occupy. By now, you have probably done your share of supervision, further training and conference attending, alongside your routine clinical work. What next? Stay a safe pair of hands, a good all-rounder? Branch out boldly and retrain in another therapeutic discipline? Make a sideways move into coaching or mediation? Become a trainer? Forget counselling for the time being and take a refreshing sabbatical to paint or write? Set up a counselling consortium or business? Now that you have proved yourself, could you work fewer hours with less stress? Or (finances permitting) retire altogether and do that travelling at last? These are all perfectly legitimate directions to take when facing that mid-career crossroads. But I’m going to suggest another alternative, more nebulous, but deeply rewarding. Instead of turning to the outside world for future career sustenance, you can teach yourself how to use what is inside you for the benefit of your client. A whole new dimension to your work will open up.
Case example: John
John, in mid career, was an established and dedicated practitioner. He requested a few private supervision sessions with me. Qualified in integrative and CBT disciplines, he had written several theoretical papers, taught part time on a reputable training course and had run his own practice for many years. ‘I don’t want to discuss my clients with you,’ he said. ‘I know all that. I just want to know how to be with them. Obviously I don’t offer them a gin and tonic or show them my holiday photos, but neither do I want to seem cold and distant. Yet if I get too close, I might seem unprofessional and lose their confidence, or even give them the idea I want a personal friendship. After all these years, I still sort of wriggle and hesitate, unsure of how I should act.’
John was looking outwards, to me, for the ‘right answer’. I suggested he look inward. When face to face with a distressed client in a quiet, potentially intimate setting, John, without consciously deciding it, took refuge in knowledge, techniques and ideology. As the client’s story emerged, he fitted the material into a theoretical framework, deployed carefully timed and worded interventions learned in both his trainings, then looked up the literature as soon as he got home to check what advice and information the integrative and CBT orthodoxy would provide. The trouble was that his training, counselling ideology and intellect were all being (ab)used as a defence mechanism against an anxiety and insecurity that was occasioned by his unhelpfully pressing need to ‘help’, and to be seen as good at the job. He could not tolerate the idea that he might, for a time, not know what to do, say or feel, as he listened to a story that so far made no sense to him. Rushing to his ideological bibles while relying on familiar formulations, or those suggested by his supervisor, was first aid for himself rather than the client. He was compelled to do and could not be.
Supervision, personal therapy and a lot of reading are all essential counselling tools. But no matter how wise, empathic and non-judgmental the counsellor appears to be, their secret self remains (comprising all the parts they rarely talk or even think about). This self always affects the counselling process. John’s inability to tolerate his temporary ignorance or impotence in the session was occasioned by his secret self’s terror of being seen by the client, and by himself, as incompetent or even useless. It hampered his capacity to truly listen, consult, converse, ponder, bear with and eventually understand the client. (Our quick look at his family and marital history revealed how such fears of inadequacy and an over-determined sense of responsibility for others had arisen and become entrenched.)
The practitioner’s role is to understand and enlighten the client, but in order to do so, they need to be enlightened about themselves. Their private ‘hang ups’ should not, like John’s, interfere with an easy distance between the therapy couple. Paradoxically though – and providing they are fully aware of them when they are triggered by the client’s narrative – the self’s secrets can be a great help. For example, a client constantly irritates you, which does not fit with your view of yourself as a compassionate practitioner. But accepting your irritation as part of the session’s material, rather than guiltily banishing it, you can now ask yourself whether the client has touched on an old wound of yours, and so better use restraint when reacting. Or does he irritate everybody? Is it just those in authority perhaps, or those he regards as inferior to him? Is it some kind of defence: rejecting others before they reject him? Where does rubbing folk up the wrong way feature in his family life and relationships? Thus, your own feelings and thoughts, particularly the negative ones, if you dare acknowledge them, can rapidly enhance the counselling endeavour.
Even when John’s secret self was at rest, and nothing charged was occurring, he still didn’t know how to conduct himself. I asked him what was wrong with authenticity, ‘being yourself’ – minus the gin and tonics of course. The neutral, so-called ‘professional attitude’ can seriously restrict the growth of a mutually transparent, reality-based relationship that enables the client to trust and confide. The client needs to know whom they are talking to. The counsellor has a unique sense of humour (but takes the client very seriously); they have their idiosyncratic gestures (that never overwhelm the client), their special way of sitting, smiling, puzzling over things, choice of language: in short, their own personality. They are accessible. Look at the room they have provided; however un-intrusive, it speaks volumes about them, even though their private life is not on their shared agenda – the client’s paying for a service after all. Still, the client may become curious and develop fantasies about the counsellor. If they trust the counsellor sufficiently to volunteer these, joint insight into the client’s relational functioning will be deepened.
Put yourself in the client’s shoes
Would you feel helped by the following: a Holy Hollis, Earnest Ellis, Snuggly Sam, Sort-it-all Sasha or Mother/Father Sugar? These are stereotypical performances unconsciously manufactured to put the counsellor at ease, not the client. Holy Hollis speaks in hushed, reverential tones; the atmosphere can best be described as churchy. The client would not dare to giggle, swear, share a joke with or tease this type of counsellor. But they feel safe to them, priestly. They make a steeple of their hands, nod wisely all the time, as if they know, so they put up with it.
Earnest Ellis is deadly serious too, but more anxious inside. Rather than restful like Holy Hollis, Earnest Ellis bears a sweat upon their brow until they find the right intervention to make. They have read everything and attended every workshop. They really want to do well. Their self-doubt so impels them to be compensatorily perfect that the client, amazed and grateful for all this concentrated attention, helps them out by automatically agreeing with whatever they utter. They are helping the helper, not themselves (story of their life?).
Mother/Father Sugar has to be loved. They pour the affection, encouragement, affirmation for which they so long onto every client. They wrap them in cotton wool and rob them of their right to learn and grow through their suffering. Mollycoddled, the client’s pain is left in Mummy/Daddy’s safe lap. They go away happier after each session, but no wiser. They have been infantilised to meet their counsellor’s need to be needed.
Snuggly Sam is a real pal, an older sibling: ‘I’m on your side, we’re in this together.’ They are an incurable optimist and drip feed denial techniques/attitudes into their client: every cloud has a silver lining; take stock of all your good points; think positive; give yourself treats. They dispense sound advice and reassurance – no digging into all that messy stuff. (Are they having trouble inspecting their own messy stuff?) The client is fine – until the sessions have to stop and they are bereft.
Sort-it Sasha is kind, but has a similar blind spot, of which they are totally unaware. Pain, loss and anxiety can be reported on and talked about by their client until doomsday, but must never be re-experienced in the counselling room – it’s too raw and upsetting. Such things are sorted, explained, labelled and generally tidied up, often along with recommended reading. The client now knows what’s bothering them but doesn’t feel much better. Knowledge alone is insufficient for healing to happen.
Comment and discussion
The counsellor’s self-monitored emotional involvement in the process is conspicuously absent from all these examples. Instead, it is their defence mechanisms and their own denied needs, way out of conscious awareness, which dominate the proceedings. These take up much of the available interpersonal space, successfully squeezing out the counsellor’s fears but also the room to work more deeply with the client. Hopefully, they will gradually become aware of the limited results, start to doubt themself and/or their philosophy, and find the courage to face their mid-career crisis.
The crisis frequently commences with an awareness of personal fatigue, a nagging, nameless discontent. This maybe mixed with cynicism about the ever-increasing bureaucratisation of the profession, the palpable threat of malpractice suits, the impossibility of meeting client expectations – preferably by yesterday – the ‘new’ theories and techniques that turn out to be a rehash of the old. CPD feels like a treadmill rather than an opportunity. However, this low period in what until now has seemed a satisfying and interesting job can also be construed as a time of creative depression, a wake-up call. Can that discontent be reworked into something more fruitful for both the counsellor and client without the counsellor always having to look outward for more professional stimulation and validation? For hasn’t that hectic world of achievement and recognition already been conquered? So is there anywhere left to go?
Summary
If the answer to this is ‘yes, turn inward’, what are the basic characteristics of the post mid-career counsellor who dares to do just that, who safely escorts their secret self into the counselling room, not just their professional and public one? Whatever your original or current ideological persuasion, you genuinely engage with the client, allowing your true personality to show, not via a role or attitude that is considered ‘proper’. As you both talk, you monitor, moment to moment, how the client uses you and the shared situation to do and be all those things that may have contributed to their relationship problems in the first place. You pay careful attention to your emotional reactions to this ‘being made use of’. What part of your subjective response to their treatment of you is your own ‘stuff’, and what is valuable data to assist you to understand how they must relate to others, and, in early formative years, must have been related to?
Are you unintentionally responding in a way that might encourage a blind re-enactment of, rather than an understanding of, their earlier conflicts? In other words, are they leading you to respond as did other significant persons in their past, and you are obliging them without realising it? It is all too easy to be entrapped by these reenactments if both internal worlds are not admissable: if you cannot keep an eye on your own as well as the client’s, pausing frequently to ask yourself: ‘What the heck am I doing?’ The dangers of closing off your secret self to yourself should never be forgotten. You risk cueing your client to re-enact with you your own unresolved interpersonal dramas, which is not the purpose of counselling at all.
Unlike John, the counsellor is sufficiently aware of their secret self in the session to note and circumvent the temptations of their idiosyncratic defence mechanisms. At the same time, they are confident enough to make intuitive interventions that are daring leaps into the dark: they may contravene the counsellor’s training ideology, the established literature, and the sometimes overly rigid rules of safety we all take for granted. The trusting alliance they have built with the client through their genuine, rather than role-based, behaviour, will see them through should they make a mistake – a mistake they can talk about openly. No one can show them when and where to leap, for, experientially speaking, no one has been where they have been.
The post mid-career crisis counsellor is on their own, independent of their therapeutic ‘family’, of books, theories and supervisors. They have become the kind of counsellor who, when asked, can only describe their ‘school of thought’ by using their own name (‘I am a Mary/Mark Smith counsellor’). This is not professional narcissism, but what in Jungian terms would be called professional individuation. They have emerged from their mid-career crisis to fulfil their deepest and truest potential as a counsellor through inviting the client inside them into the sessions.
Wyn Bramley is semi-retired and runs a small private practice in rural Oxfordshire. In her last public post she set up and directed the master’s programme in Psychodynamic Studies at Oxford University. She worked for many years in universities and the NHS, both in London and Oxford. She is a couple therapist, group analyst and the author of several books and papers, including The mature psychotherapist: beyond training and ideology (Free Association Books, 2017) and The broad spectrum psychotherapist (Free Association Books, 1996).