Imagine this: you’re on a plane, and the oxygen masks suddenly drop. The instructions are clear – put your mask on first before assisting others. I often use this analogy with clients. Take care of yourself first. Funnily enough, I rarely practise this myself.
Have you ever felt a similar tug between prioritising your clients and yourself? For a profession built on empathy and helping, neglecting our own needs can become second nature. I’m often caught between encouraging clients to prioritise self-care while struggling with my own. It’s a paradox, isn’t it? And in this push-and-pull, guilt —the unwelcome companion—lurks in the background.
So, how do we identify the presence of guilt and manage it? Here is my handy “5 situation checklist” to identify how guilt creeps into my work and ways in which I try to address it:
- The Therapist’s Paradox
Taking time off as a therapist can feel impossible. When I step away, the burden of the clients’ well-being lingers, making me feel more remorseful than restful. I remember the first time I cancelled sessions for a family emergency; as I hit send on that email, guilt washed over me like a tidal wave. ‘You’re abandoning them, leaving them in limbo.’ Ironically, many of my clients echo these feelings when they reschedule—they worry about being a burden or letting me down! It’s a common struggle. Lately, I’ve been making more time to do maintenance checks and engage in self-care— journaling and taking long walks—which has been a game changer. Instead of viewing time off as a weakness, I now see it as essential to being the best therapist. I’m just refuelling my empathy tank! - Ethical Dilemmas
Speaking of empathy, guilt often surfaces not only when my tank is low but also when turbulence hits, and that happens when value differences emerge. This was my challenge when working with a woman grappling with infidelity. My own values tugged at me in sessions. I felt a constant battle between empathy and my internal biases. Soon after, guilt waltzed into the room. While I tried listening without judgment, my feelings sometimes leaked through. Simply recognising this was a turning point. After all, isn’t self-awareness every therapist’s secret weapon? Processing my guilt meant digging deep. Supervision proved to be just the place. I differentiated between my values and my client’s experiences, remembering that my role was to support and understand, not impose. Acknowledging my emotions didn’t diminish my ability to help; it enriched our relationship. Personal experiences have space in the therapy room. How could they not? Isn’t that what countertransference is? A delicate dance between my client’s psyche and my own. - The Burden of Progress
Guilt extends to more than just my internal experience in sessions. It takes a strong hold when clients don’t “progress” overtly. When a client appears stuck, I almost feel like a gardener who cares for a plant only to see it wither. One of my client’s struggled with low mood for weeks on end. We made little progress towards their goals. The byproduct? I questioned my competence and battled the guilt of not facilitating progress. Here, a reminder that progress is not solely the therapist’s responsibility goes a long way. I cannot wave a magic wand and solve all client issues. By shifting focus on process rather than progress, I try to address the guilt I unknowingly overloaded into my system. - Emotional Roller Coasters
Therapy can be quite the emotional rollercoaster, not just for clients but for therapists as well. We navigate a whirlwind of emotions—joy, sadness, anger, and frustration— together. Etched in memory is one particular session where a client narrated a frustrating situation, and suddenly, it felt like I was riding an intense wave of irritation. Once the frustrations passed, guilt tapped on my shoulders. ‘How could you feel mad during the session?!’ My antidote to this guilt is allowing myself to feel whatever comes up. After that session, I reflected on the roots of my emotional responses and their impact on our alliance. When feelings are too painful for the client, they can be unconsciously projected onto the therapist! So, I allow my here-and-now reactions to inform my understanding of clients’ emotional landscapes and lean into the therapy rollercoaster! - The Ghosts of the Past
When I recognise parallels between my client and my experiences, it’s a stark reminder of my challenges. Just recently, I had a client who was struggling with boundary setting. It triggered memories of my own difficulties in saying ‘No.’ I felt guilty that this would cloud objectivity. Discussing my feelings in therapy and supervision helped me process my experiences. As we tell our clients, seeking support is a sign of strength, not weakness.
Guilt is an intricate experience that can significantly impact the therapeutic process. But it also has the power to facilitate deeper insights. By focusing on here-and-now dynamics, we can harness this power of transference and countertransference to foster deeper connections. It often pays to engage meaningfully with guilt. If we dodge our own complex feelings – like guilt – how can we help clients address theirs? To help clients process guilt, we first need to do the same ourselves. We’re here to support others, yet we forget to care for ourselves. Just like the aeroplane safety briefing tells us. You’re no use to others if you’re out of oxygen… Or in the therapy world- if your tank is empty!