That Time a Client Made Me Cry.

I was somewhere between Marrickville and Petersham when I started crying in my car. 

I had just finished my second session with Kyle: a dad with a masters degree whose life had been completely derailed by a bipolar episode and several months of hospitalisation. 

On that day, Kyle and I met at a cafe to speak about what we could work on together. He hadn’t been out of hospital for long - less than three months - but he really wanted to be doing something because he knew that volunteering, even one day a week, was going to keep him healthy. 

On paper, Kyle sounds like a dream client. He was super motivated. Kind. Collaborative. Intelligent. 

He was like a unicorn, if unicorns could take out income protection policies. 

The kind of client who (1) I knew I could help and (2) actually wanted it.

And this is exactly the reason why I found myself crying inside my beat-up Mazda 3 after our session.

Because it wasn’t fair. 

It wasn’t fair that severe mental illness had robbed Kyle of 5 years of his life - his marriage, his kids, his job, his health.

It wasn’t right that someone who hadn’t done anything wrong spent the next 3 years trying to find a balance between medications and treatment that did the job without making him feel like a zombie with tremors.

It was wrong that Kyle went from having a successful career to being a patient in a psych ward. 

It wasn’t fair. 

Being a health professional requires you to face the harsh realities of life and cruel tricks that fate likes to play on us:

The injustices, the mistreatments, the follies of our healthcare and compensation systems.

Many of our clients are people who were in the wrong place at the wrong time, people who fell through the cracks, people who just got a raw deal and are suddenly facing a life they didn’t plan for. 

As a case manager, it’s all too easy to become the person who shoulders that burden for your clients. 

As a rehab counsellor in my twenties, who has lived a privileged and, let’s be honest, a very sheltered life, I have always been confronted by the hardships my clients face. Sometimes that burden and sadness can culminate in the driver's seat of your car as you drive back to work after a session. 

Sometimes that burden is more insidious.

It can be a feeling of heaviness in your chest and in your heart that becomes hard to shake. Maybe your feet start to move a little more slowly as you get ready for work in the morning and prepare for the day ahead. Maybe it feels like that fiery passion you had for helping people just doesn’t burn so bright any more. 

That’s how empathy burnout feels. 

There are so many things you can do to look after yourself when you start to feel this way. You’re already doing well if you can recognise empathy burnout for what it is and notice when you start to slip into this place. 

And yes, in the short term at least, taking breaks (even, dare I say it, a holiday or two) and making time for self-care will always give you a boost. 

But there is a fundamental shift in our thinking that we all need to make if we want to beat this thing - because shouldering the burden for our clients has never helped anyone, ever (source: science). 

I keep a little post-it note in my notebook to remind me of this every day: 

I didn’t get my client into this, and I definitely can’t get them out of it. But I can choose to walk beside them and help, and they can choose to say yes.

It seems almost too obvious to see it written there - but it’s true. How often do we expect ourselves to be The Fixer of All That is Broken and make all the bad stuff go away? To help, to make it better and BE REALLY MAD about how unfair everything is? (Uh - I hope it’s not just me here?)

Imagine if, before every session, you reminded yourself that while you don’t have the power to fix things, you have something even more incredible: the opportunity to offer your client support and guidance while they take back control of their life - if they choose to accept it? 

...(Big fat emphasis on the choice element here, guys.)

 

P.S. Kyle is a fake name. Client confidentiality is kind of a big deal. 

My Crisis of Meaning (And What to Do When You Hit Yours)

Most Rehab Counsellors choose this career because they want to help people, pure and simple. 

So it makes sense that most of us go into this role with some pretty lofty expectations about what it means to be a Rehab Counsellor.

  • We want to help people find meaning. 
  • We want to help people get their lives back. 
  • We want to help people overcome adversity and do the stuff that matters. 

I actually think that these high expectations are what set so many Rehab Counsellors up to crash and burn. 

Burnout and turnover rates are pretty high in this industry - but is it our own fault?

Do we have unrealistic expectations about what this job really entails, and the difference we can make? 

Well... Yes. But also no. 

Let me explain. 

I present to you: The Roller Coaster Curve 

The roller coaster curve maps out my first year of being a rehab counsellor almost to a tee. 

Early on, we’ve got Uninformed Optimism. You’ll be in this stage if you:

  • Are considering becoming a rehab counsellor
  • Are studying to become one
  • Have just started your first job

At this point, everything about Rehab Counselling is AWESOME. You’re being sold ideas of helping people, collaborative work, creative problem solving and helping people reconnect with meaning and purpose. 

Everything Is AWESOME!!! in the Uninformed Optimism Stage.

It’s sunshine, puppy dogs, and total ignorant bliss. Good times. 

Our rollercoaster then chugs along to Stage 2: Informed Pessimism. 

Informed pessimism happens when you’ve been around the block a couple of times. 

  • Maybe you’ve had a client who had no desire to get better or treated you with disrespect.
  • Maybe you’ve had an experience at uni that left you underwhelmed.
  • Maybe you’ve become bogged down by unnecessary paperwork and red-tape that leaves you feeling frustrated and completely restricted

At this point, you’re feeling a little (or very) jaded.

Disillusioned, maybe, but still hopeful and ready to press on. 

And then…. comes the tipping point. 

Stage 3: The crisis of meaning. 

My crisis of meaning happened after a few months into my first job as a Rehab Counsellor. I was working with clients with really serious health issues and what felt like a lack of support and skills to actually help them. 

I was doubting myself, doubting my choices, and I dreaded going to work every day. I was ready to throw in the towel. 

The thing about the crisis of meaning is that it happens to nearly every Rehab Counsellor who cares about their job and wants to help people.

Why?

  1. Your studies will not and cannot prepare you for what it’s like to have a real, live complex and confusing human being in front of you. 
  2. Add on those lofty expectations we spoke about earlier - like changing people’s lives and helping them find meaning and purpose - and it’s no wonder we find ourselves in a crisis. 

I’m not saying this to scare you or deter you - I’m saying this so that you know that you’re not crazy if you’ve ever felt this way too. 

And I’m saying it so that you can give yourself a break and put down your superhero cape for a minute. 

Not every client who comes to you will be a good fit. And not every client will be receptive to your desire to help. 

You can’t change everyone’s life - but the impact you can make in this job is still so, so real. 

For every client who has been a total nightmare to work with, there’s been another who has thanked me for how I helped them. 

For every time that I wanted to smack my head into a wall out of frustration, there have been times when I’ve been floored by the amazing, intelligent and hardworking people I’ve encountered in this job. 

Your crisis of meaning will still probably come - but whether you crash and burn or pull through is up to you. 

The people who crash and burn forget that every job has it’s sucky moments.

Even people like Mark Manson, who makes a living out of writing awesome things every day, feel this way:

“I am living my dream job…. and I still hate about 30% of it. Some days more.”

So… what are we to do? Do we give up on the idea of helping people?

Nooooooooooo. Please don’t do that. 

But what if we stopped expecting so much of ourselves? 

I think Paul Jarvis is on to something here: 

“I think what’s better is that we just find a place where we can make a difference. And, making a difference is fairly easy. First, you just have to leave things better than you found them. Second, you have to leave yourself better than when you started.”

I really want to emphasise the second part. Making a difference isn’t about running yourself into the ground - and you absolutely, completely, and totally have the power to decide whether you’re going to let this happen. 

Much of it is about the mind shift involved in seeing yourself as a facilitator rather than an expert.

It’s also about being able to clarify expectations and vouch for yourself, like we explore in the Survival Guide

And if you’re in a crisis of meaning right now (or maybe just feeling a little bit grumpy today), here are some questions to ask yourself: 

  • How can I look after myself today?
  • What can I do that excites me?
  • What small win can I tick off by the end of the day? (cleaning your desk TOTALLY counts, by the way.)

You might like to check out something I’ve written earlier about self-care, too. 

And remember that you’re not the only one who has felt this way. In fact, there’s a whole heap of us behind the scenes reading the Able-Minded newsletter, which you can sign up for at the end of this post.

OK, over to you:

How do you look after yourself when you’ve had a bad day (or week, or month)? 

 
 

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Feature image by J. Nathan Matias is licensed under CC by 2.0.

Newsflash: You're a Rehab Counsellor, Not a Wizard

Hey Able-Minded people. 

I have been in a season of busyness lately (you too?). The good news is that I'm feeling mighty fresh after a week of holidays in the gorgeous hunter valley... and I got to channel my inner amateur photographer for a few days:

 

Australia's latest and most worrisome organised crime syndicate. #followtheleader #huntervalley

A photo posted by Natalie Taylor (@ablemindedrc) on

 

Back on topic... preparing for holidays was one of the most stressful things I've had to do this year (a first-world problem if there ever was one, but stay with me here).

It was probably the first time I've been important enough to worry about what will happen while I'm gone, and much to my team's amusement/frustration I was definitely not on my A-Game as I tried to get things in order before my leave.

But here's what happened:

  • I had a meeting with my boss where she gave me the time I needed to talk through what I was working on, what I could delegate and what could wait until I got back.
  • She gave me permission to be a bit stressed out, helped me make sense of why I was feeling the way I did and reassured me that everything would be fine while I was gone as long as I prioritised the important things before I left.
  • My teammate called me to ask, "What can I help you with so that you can leave on time today?" (and I immediately collapsed into a puddle of gratitude).
  • My entire team wished me a safe and happy week off. I know I will be missed but I also know that my team will look after things while I'm gone. 

This past week, I felt so connected to my team. I had permission to be human (while still being held accountable to the stuff that matters), I felt important and I felt like a valued part of a community of people who really care about me.

So what I'm really trying to say is... 

I feel safe at work.

Many of our clients aren't as fortunate. 

Often, they're unwell as a result of the stress they've dealt with at work, and for those who aren't, many are reluctant to return to workplace where they don't feel valued, supported, understood.... and safe.

Layer on top of that a heaping of suspicion towards third-parties (including us) and fear around loss of benefits... and you've got a client who is suddenly feeling very threatened and very unsafe. 

So what does this mean for us? 

We need to take Rehabilitation out of the vacuum. We simply cannot do this alone.

Talking about capacity and medical certificates just isn't going to cut it. 

People are not inspired to return to work because a piece of paper tells them that it's okay to start working again.

People go back to work because they feel safe, that they belong and that they matter.

From Simon Sinek: 

This is what I mean by feeling safe: "I love the people I work with, I love where I work, I enjoy going there". [The imbalance happens when]: "I feel safe at home, but I don't feel safe at work". 

It's time for us to have bigger conversations about going back to work. 

Workplaces, employers, insurers and treating health professionals all have a crucial role to play in recovery and return to work.

The most troubling thing about our current processes is that they often exacerbate the uncertainty and lack of control that a person experiences after they become unwell or injured. 

And even if we're doing everything in our power to help our clients feel empowered to make choices and decisions, to regain some sense of safety in their lives, rehab is still bigger than us. 

It's not just our actions that matter. 

I've been in so many situations where I've been too scared to speak up and say that pushing a "return to work" with a certain employer just isn't going to work because my client and their employer have a poor relationship and a lack of trust.

Then there are other times where a client is so suspicious of their insurer's motives (and mine, too) that they become paralysed and completely stuck. 

I was afraid that this would signal my failure as a rehabilitation consultant - because I couldn't make things work out. 

Rehab is bigger than just our clients. 

If we want our clients to take personal responsibility, then we need to do the same. And we need to ask that everyone else involved take responsibility for their role in this process as well. 

Please just keep in mind... 

Rehab Counsellors Aren't Wizards!

Newsflash: You're a Rehab Counsellor, Not a Wizard!

Newsflash: You're a Rehab Counsellor, Not a Wizard!

If you're in a situation like the one I've described - feeling like you're stuck between a rock and hard place, and feeling like you're failing because you just can't seem to make things stick - I want to let you know that you can't do this alone. And you're not a failure because it didn't work out. 

Even the world's best Rehabilitation Counsellor, with master-level persuasion and negotiation skills, can't make a "return to work" happen if everyone else doesn't want to come to the party.

With that said, please don't go hide under a rock and assume that you're powerless. 

Because we need you.

We need you to speak up and help us change the conversation about what recovery and return to work look like and the role that everyone can play in this process. 

We need you to speak about what we can offer as Rehabilitation Counsellors, as well as what we can't fix on our own. 

We need you to clarify expectations with everyone up front and be clear on who is responsible for what, as well as the type of outcome that is realistic given the timeframe and resources you've been given. 

Sometimes, I think that people mistake us for wizards dressed up as normal people. 

(It's because most people don't really know what a Rehab Counsellor does in the first place.)

You can be the quiet voice of disruption that helps people understand that they, too, have a role to play in recovery and return to work. 

You don't have to do this alone, but you can be part of the conversation that makes things better. 

Take this idea out for a spin...

Try out this diagnostic next time you feel like you're stalling - does your client feel safe?

We all seek out safety... so what is your client currently doing to create a feeling of safety for themselves? 

Start there. 

Have you had a similar experience to the one I've described above? Connect with me in the comments below - I'd love to hear from you. 

 

Feature image by Steve Rotman is licensed under CC by 2.0.

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You're Too Young To Be a Rehab Counsellor

I’ve often felt like I’m too young for this job.

What could a person in their twenties have to offer someone who’s two, three decades older?
Don’t you need life experience to be a decent Rehab Counsellor?
And seriously, what could a twenty-something possibly know that all the other experts haven’t already tried?

There’s that word… expert. 

Rehab and return to work management is like an expert’s playground.

You’ve got doctors, specialists, psychologists and stumpologists (OK - I made that one up), every other –ologist you could think of…. plus anybody else with an opinion. That means friends, families, benevolent co-workers, bosses, managers and that guy two doors down who slipped at work and got a massive payout. How’d he do that?

We put a lot of faith in experts. Our clients trust and hope that one day, some expert will finally find the missing piece of the puzzle that puts them back together again.

By the time they come to us, our clients are no strangers to the “expert opinion”.

And yet, none of those expert opinions have helped them get unstuck.

If expertise was all it took, your client wouldn’t be sitting in front of you, saying (or thinking) something along the lines of:

“Let’s see what you’ve got that I haven’t already tried yet.”

And I know the feeling of terror that comes with those clients who just make you want to throw your hands in the air and say, "yep – I seriously have no idea what to do now."

Aren’t you supposed to have a plan? Well…

Whose Expertise Is It Anyway?

I’ve worked myself into the ground trying to come up with The Answer  to my clients’ problems. I’d agonise over transferable skills, analyse possible job options and bang my head against a wall trying to discuss the benefits of work with my clients and their doctors.

Nothing moved forward. Nobody cared.

To my clients, I became just another person with an opinion who let them down because I couldn’t fix them, right the wrongs of the system and give them their old life back.

The last thing your client needs in their life is another expert. They have plenty. 

It’s all too easy to fall into the trap of feeling like you need to have all of the answers for your clients, and this feeling is especially pronounced when you’re a new graduate and you feel like you have none of the answers.

Experience is important, expertise is needed, but you already have the most important expert right there in the room.

It’s your client.

And you don’t need 28 years of experience plus a doctorate to start asking them some better questions.

Seriously, It’s Not About You

I often still catch myself feeling like an idiot because I don’t know what to do yet, what to recommend or what the plan should be. I get caught up in a trope I know all too well:

“You’re too inexperienced, you don’t know anything, you’re a big fraud and everybody knows it.”

It’s times like this when I thank my brain for that story (broken record that it is) and remind myself that seriously. it. is. not. about. you.

The experience that is crucial, and the experience that is mostly ignored, belongs to our clients.

Only they can answer questions like:

  • What’s missing here?
  • What’s working and what isn’t?
  • Where do you feel stuck?
  • What do you wish people knew about you?
  • What matters to you and how can we do more of that?

And those are just a couple.  You need exactly zero years of experience to be curious.  It doesn’t cost anything to listen, hear and seek understanding.

And you’ll be one of the few people who do.  Our clients are sick of being told what to do by experts who don’t get it and don’t listen.

Our real expertise lies in being able to help our clients draw on their own experience, their own expertise, to start making choices about where they want to go next.

I’ve been playing with this idea of shared expertise for a little while now.  And what’s an idea worth if you can’t turn it into a venn diagram?

Shared Expertise and The Sweet Spot

Shared Expertise in Rehabilitation Counselling. There's beauty in not having all the answers. Ⓒ Able-Minded 2016.

Shared Expertise in Rehabilitation Counselling. There's beauty in not having all the answers. Ⓒ Able-Minded 2016.

Thinking about sharing expertise has been a revelation for me. Our expertise as health professionals only becomes relevant and useful through the lens of our clients’ experience, their values and their unique insight into their own lives.

Asking big and powerful questions helps us find the sweet spot, where we can exchange expertise with our clients, back and forth, to move towards an outcome that is meaningful and valuable to them.

If we’re lucky, we might even stumble across a big, hairy audacious goal that catapults us and our clients forward.

Every meeting you have with your client in which you are the expert is a missed opportunity. 

Being the expert is boring.

The question-askers get to have some fun.  First of all, a question-asker doesn’t run themself ragged trying to solve someone else’s problems. They don’t have to shoulder the burden of having all the answers and engineering a plan for someone else’s recovery.

Question-askers get to be curious. They get to be humble. They aren’t plagued by the insecurity of not knowing it all because that means they get to work with their client to figure it out. Question-askers build partnerships and get out of the driver's seat so that their client can take back the wheel.

I think I’m OK with riding shotgun for now. Are you? 

 

Let's Celebrate the Beauty in Not Knowing It All:

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Further reading: Michelle Loch at Rewired Leadership has been instrumental in my learning around what it means to be a facilitator for my clients rather than expert. If you want to have more powerful conversations with your clients, please consider one of her programs.

Feature image by Melpomene/shutterstock.com

 

#SlowDownSunday: The Stress-Free Job

Welcome back to #SlowDownSunday! As we wrap up the weekend and move into a new week, I want to use this time to slow down and reflect on what made it onto our radars in the last 7 days.

This week? Lets talk about stress:

A post from the New York Times popped into my newsfeed this morning: In Desperate Pursuit of the Zero-Stress Job.

It got me thinking about how many of our clients (and their treating health professionals) believe that the only job they can succeed in is one without:

  • pressure
  • deadlines
  • anxiety-provoking situations
  • times of stress

I’m not sure that this job exists. 

And I’m not sure that a life without stress and anxiety exists either. 

I don’t say this to diminish the havoc that stress and anxiety can wreak on a person’s life. And I’m not suggesting that we encourage people to pursue unnecessary stress in their life or work.

But when we set a goal to completely avoid something that is a side effect of being, well, alive, I think we might be creating some problems. 

So why are we so afraid of stress?

It makes sense that stress is something we'd rather avoid. Stress sucks. And we've all read the articles and been told by our doctors about the health effects of prolonged stress. Our adrenal glands just weren't built to be on high-alert around the clock. 

But stress-free living has a dark-side.

The Yerkes-Dodson Law tells us that people need a baseline level of stress in order to perform effectively. Zero stress doesn't necessarily mean that we'll function better, or that we're able to navigate life more effectively. 

In the pursuit of the stress-free life, we also have to say no to the things in life that are innately difficult, yet rewarding and meaningful.

When we talk about a stress-free life, we are also talking about a life that is devoid of human connection.

We are talking about a life with no new experiences or environments, one without opportunities to learn and grow and develop ourselves, to pursue meaning and purpose and the things we really care about. 

The stress free life comes at a cost. 

This reminds me of something Russ Harris says often in his teachings: 

"Don't set goals that a dead person can do better than you."

I don't know about you, but a goal like "avoid being stressed or anxious" is something that a dead person would totally kick my butt at. 

So my question to people who feel that their lives, and their choices, are at the mercy of stress and anxiety is this: no one but you can decide your limit. But… 

Is there something valuable enough that you could make room for some anxiety and stress in order to have it? 

As Rehabilitation Counsellors we are in a unique position to ask this question of our clients. What if we could work with our clients to:

  • Minimise unnecessary stress through suitable job choices and accommodations;
  • Help people develop the resilience and strategies to effectively manage and respond to the stress that cannot be avoided;
  • Identify the things that are worth pursuing as part of a rich and multidimensional life, even if that means stress and anxiety come along for the ride;
  • Talk about whether working could help them achieve the things they value, and empower people to do more of what matters.

So what do you think: Is the stress-free life one worth living? 

Oh, and one last thing…. what was on your radar this week? 

Image credit: The images in this post by Bernard Goldbach and Franklin Ramos are licensed under CC by 2.0.

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