Experiencing loss is an inevitable part of life, and counselors are trained to help others overcome these emotionally difficult events. But what do counselors do to process their own personal grief — and how can they ensure that their grieving does not impede on the therapeutic process of clients?
Eric W Cowan, a counseling professor at James Madison University and author of Ariadne’s Thread: Case Studies in the Therapeutic Relationship, says self-care is key. Cowan, a member of the American Counseling Association as well as the Virginia Counselors Association, told Counseling Today that counselors must constantly manage their emotional well-being, especially when suffering a personal loss, to ensure that they can successfully provide therapy to clients.

Do you believe counselor self-care has become more important within the profession over the years? If so, how?

My impression is that there has been a growing awareness that counselor self-care is central to providing effective counseling — at least we seem to talk about it more. The real question is, does this awareness translate into counselors creating for themselves the kind of balance in life that enables them to tend to their own mental health needs, especially in times of personal challenge or crisis? Are counselors being mindful that they must provide for themselves the kinds of self-enhancing experiences that they wish for their clients?

This takes a kind of discipline because counselors are subject to the same barrage of impersonal demands of a complex culture as everyone else. At the same time, counselors are subject to a whole set of very personal demands inherent in the intimate counseling process. Learning what it is you need to stay balanced and self-aware becomes very important.

 Why is counselor self-care important?

Counselors have a unique challenge compared with other professions because the counselor functions as the very instrument through which he or she strives to be helpful and effective. Conceivably, a surgeon, an accountant or a car mechanic can be effective regardless of what is going on in his or her inner world or outer life — it is an easier job to partition that out from the task at hand. The counselor’s inner world of thoughts, emotions and interpersonal sensitivity are, however, the very tools he or she must utilize to be effective.

The counselor whose inner life is in turmoil or greatly out of balance is not only in danger of being less useful to the client, but also of importing his or her unmet emotional or spiritual needs into the relationship with the client. These countertransference enactments hinder the client’s ability to use the counselor to foster therapeutic growth. More insidiously, for some clients this dynamic with the counselor may reenact old traumas in which the client’s own developmental needs became subservient to an implicit demand to prioritize the needs of caregivers in crisis.

As counselors, we can also tend to build up a kind of psychic charge that has to do with this deep involvement in others’ emotional turmoil. This has to be discharged or expressed in some way, or you carry around all this tension and wonder why you are yelling at the dog.

When a counselor is suffering a loss in their family, what self-care steps should they take?

Robert Haas has a poem that begins with something like, “All the new thinking is about loss. In this it resembles all the old thinking.” I love that line because it reminds us that the experience of loss and the challenge of responding to great loss is inherent to loving others. We need to learn to live alongside loss because it is the rule and not the exception.

Counselors, especially, must learn to live with this idea because so much of what we do is to help clients move through great loss and attending grief. Of course, counselors do this by helping clients make room for grief in their inner life — to honor its place and give it a voice. Only then can a profound loss be taken in, accepted and ultimately incorporated.

When grief and loss come to the counselor, it challenges the counselor to this heightened level of attention and self-acceptance. The process may take up more space in the counselor’s thoughts and feelings than they would like, especially because counselors often imagine that they always have to “keep it together” and be a model of perfect mental health. The paradox is that by failing to fully honor a personal loss, the counselor’s grief may not move and transform, and transformation from a loss of something “outer” to something that you are able to hold within is where it’s at. That’s what you are after.

Being “out of balance” because one is not attending to pressing demands from within is different from the temporary imbalance and dislocation of attending to and honoring one’s profound feelings of loss.

How can counselors tell if their grief is hindering their ability to practice?

When counselors carry unresolved grief from old losses or when they are in a process of mourning from a recent loss, they are especially susceptible to problematic enactments with their clients. Most often this would show up as a loss of optimal therapeutic stance.

For instance, imagine that the client’s tears or expressions of grief elicit from the counselor not only a disciplined empathic resonance but also the counselor’s tears or expressions of grief in response. The client may begin to attenuate or even to hide his or her emotional responses. In other words, the client begins to adjust his or her expression of affect to accommodate the counselor’s ability to stay emotionally intact. This loss of the counselor’s ability to provide an adequate “holding environment” for the client’s affect is a sure sign that the counselor needs to attend to pressing emotional needs.

Less obvious is when counselors find they are compromised in their ability to be fully present with the client in the here and now because of distractions from upwelling emotions not related to the therapeutic session. At that point, it is a disservice to the client to try to tough it out, and you’ve got to do something to attend to yourself.

Is the way that counselors handle grief different, or do we all mourn the same way?

For counselors, it is tough to have to go through life always having to cultivate one’s self-reflective awareness. Garrison Keillor remarked that sometimes “you just have to stand up to reality and deny it,” but as appealing as this sometimes sounds, this is not really an option for someone who has committed to the counseling profession.

If counselors handle their grief differently, it is because they have come to the realization that each developmental task, each loss or transformation, involves a kind of death to an old self and the birth of a new and expanded self. Whether this death and reconstitution is in response to a loss of some person or a letting go and birth of something new from within, a new phase of personal development, it always involves some level of acceptance of loss and pain.

Perhaps it’s this letting go and not grasping to hold onto something familiar that ultimately fosters greater awareness. It’s that whole idea in Eastern philosophy that everything is in a state of flux, of passing, of impermanence and transformation. The counselor does not feel less pain in loss but is, perhaps, more likely to accept it as direct experience, less likely to turn that pain into neurotic suffering. That’s the attending part, I think. Not the frantic effort to avoid inevitable pain, but more an enhanced ability to carry it willingly and mindfully.

Should counselors use past experiences to help clients get through their own grief?

It is tempting for counselors, in an effort to create rapport with clients who are experiencing a profound loss, to reference their own losses and grief experiences, especially if they resemble the circumstances of the client’s loss. The intent is to communicate that “you can get through this as I have,” and “I have been there so you can relate to me.”

The danger in the counselor’s referencing his or her personal experiences of loss and grief is that it tends to take up emotional space that rightly belongs to the client. The client is temporarily obligated to understand the counselor’s profound experience of loss. The client may begin to wonder if his or her own expression of loss is hurtful or damaging to the counselor. In the worst-case scenario, the client may find that his or her loss cannot compete with the counselor’s or that the client feels a need to make the counselor feel better.

Counselors do use their past experiences to help clients get through their grief but not ordinarily by relating to the client the specific incidences or content of the counselor’s experiences. Rather the counselor’s experiences of loss inform the process and pathos of his or her empathy for the client’s specific losses.

What can counselors learn from experiencing a deep loss?

This experience of a deep loss strips us of trivialities. For a period we seem consumed in pain but also have a deeper sense of the profound and important. If the loss is tragic, as the death of someone we love by accident or suicide, then the loss may be shattering and it will take much attention and effort to directly grieve rather than become depressed.

But, sometimes, the experience of loss can awaken us to an enhanced and deeper awareness, what Martin Buber called the “infinite ethos of the moment.” Then we are more fully present to our existence and its potentialities, even though, or perhaps because, we see how fragile it is. Ideally, the loss allows us to participate more deeply in our relations with others. Or perhaps we experience what Buddhists refer to as impermanence, leading to a new openness to the flow of our existence, to letting go. The process of saying “Yes!” to life, open armed, even in the face of great pain or loss.

That’s the thing — you want to toss in the towel, but you still have to find a way to say “yes” to counter that nihilistic or fear-based impulse. This is what most of our clients are struggling to regain, and if the counselor can do it, then he or she can help others to do it as well.

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For more on this subject, read Counseling Today’s September Feature, Attending to countertransference.