This is the final part of our series on dealing with difficult clients.
Complicated clients look to us to help with their terrible suffering from anxiety or OCD, which is often combined with other problems.
In Part II, I considered ways to broaden the help and support for your complicated clients.
In this final Blog on this topic, consider the importance of you as the clinician taking excellent care of yourself and finding colleagues for support as you deal with this level of suffering and distress.
Wellness
While you are working with clients who are difficult, make sure you keep up your own wellness plan – eat healthy food, exercise, and get enough sleep. Be sure to use healthy coping strategies like yoga, mindfulness, hobbies or sports. Think about how you are going to manage to keep the stress of a particular session at work and not let it drag into your personal life. Try doing mindfulness mediation for 5 minutes before you leave work. Spend a minuets grounding yourself and focusing on your breathing and noticing how your body feels. Tense? Where are you holding your stress? Then work on just allowing your thoughts about your client to come and go without judgment. You could then try giving yourself a message like “I am basically doing a good job.” Your goal is not to struggle with this thought, but just to have it as a touchstone. Finish your 5 minutes with a few deep breaths before returning to the present and the journey home.
Support
Cultivate relationships with other professionals who can offer you support when you feel overwhelmed by a client. I wrote a note to a college after a difficult exposure session with a client didn’t go well, and just writing the note I realized several reasons I was especially upset about this situation:
It was an exhausting day, and I have been beating myself up. However, I realize that part of the problem was my client was sick last week, ran out of her Prozac, and just went back on yesterday, so today was probably an extra bad anxiety day for her. I also realize the reason I feel so upset myself is that I care about her and it’s hard to watch her suffer like that and then watch her give in when she was really through the hardest part.
My friend wrote back:
“I am sorry for both of you! That is an exhausting and challenging process. The silver lining is that you have made me feel so much better. I hate struggling with clients and often wonder….what would another therapist do to change the outcome? I think this is hard work, and anxiety is a formidable opponent. Is there anyway for her to practice being in a place that she can’t get out of and then do an imaginal exposure?”
This thoughtful, supportive response allowed me to accept my own sadness and frustration. Having recognized that, I was able to move back into my work with other clients and my personal life until our next session. It meant I was ready to support this client in her own sadness and frustration when we met the following week. Also, this email reaffirmed my alliance with my client, collaborating together to work to break the spell anxiety had on her. I also had a new exposure ready for my client, so we were able together to take the difficult exposure in stride and continue our work to get her to live a full, rich life without the anxiety bully limiting her.
Your work with your clients is important. They need you. Remember to put on your own oxygen mask first so that you are in good mental shape to help your difficult clients heal.
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