As a counselor, you probably have a few “go-to” therapy metaphors that you use in sessions. For example, the “airplane oxygen mask” metaphor is a powerful analogy that demonstrates the significance of meeting your own needs before attempting to help others.
Another example of a therapy metaphor is the “rearview mirror” analogy. If you’re driving, and your entire concentration is on what’s behind you, you’ll crash. Good drivers, in contrast, focus ahead, but also regularly check the rearview mirror. The “rearview mirror” metaphor effectively illustrates how recovery from drugs and alcohol requires learning from, but not dwelling on, past mistakes and regrets.
Powerful Therapy Metaphors: Analogies in Counseling
The following is a list of helpful therapy metaphors and analogies for growth, self-care, emotions, addiction, grief, counseling, and life.
Forming a new habit is like carving a path in the jungle. You trod through the undergrowth and take the same route over and over again, until a clear path is formed. Meanwhile, older pathways become overgrown and wild, disappearing from sight with unuse.
A habit forms the way water carves a new stream or river.
You can’t see the grass growing, but after a week or so, you can see that the lawn needs mowing.
You can’t pour from an empty cup.
Mind the “check engine” light in your car. It indicates that something is wrong; if you ignore it, the problem will likely become worse. The longer you ignore internal cues, the greater the damage to your “car.”
A plant requires the right amount of water, sunlight, and fertilizer to grow and thrive.
You are a battery that needs to be recharged every so often.
Metaphors for Emotions
Our emotions are like a thermometer in the window. You can see clouds or rain or sun, but without a thermometer, you won’t know if it’s 90 degrees or 17 below. Emotions impact how you experience the outside world.
Life is like a heart monitor; there are ups and downs. If it goes flat, you’re dead.
The more you bottle up your emotions, the more likely you are to explode.
Repressing anger is like stuffing trash in a garbage can. Eventually, it’s going to spill over if you don’t take out the trash.
When you resent someone, it’s like drinking poison and expecting them to die.
Anxiety is a hungry monster that gets bigger when you feed it.
Worrying is like riding a stationary bike; you can peddle as hard as you can, but you’ll never get anywhere.
Therapy Metaphors for Addiction
Addiction is a disease of the soul.
When you’re in active addiction, you’re a shadow of yourself.
Addiction is like being in a toxic relationship. It’s all-consuming, lust-worthy, and even thrilling at times… but at the cost of your health and well-being. You have to break up in order to move on with your life.
Addiction is like a tornado, ravaging everything in its path. After the storm, it’s time to rebuild. It won’t look exactly the way it did before the tornado hit… but there’s potential for things to be even better.
Addiction is like other chronic health conditions in that there’s no cure, but it’s 100% manageable with treatment and lifestyle changes.
The longer you sit and stare at a plate of cookies, the more likely you are to give in to temptation. Set yourself up for success by avoiding triggers when possible.
If you hang out in a barber shop long enough you’ll end up getting a haircut.
Temptation is like a muscle that grows weaker with use until it finally gives out.
Living life without drugs or alcohol is like any skill; you first learn how to do it and then you have to practice. You may slip up, but don’t give up; learn from your mistakes. You can’t excel at anything without practice.
Cravings are like waves; ride them out until the wave recedes.
Attempting to save someone from drowning is dangerous. In their frantic efforts for oxygen, they’ll claw over and push the person trying to help underwater. This is an unconscious survival instinct. When your loved one is in active addiction, they’ll fight anyone and anything that gets in their way of a gulp of air.
Metaphors for Grief
Grief is a deep wound that takes time to heal. The wound is raw and painful, but will eventually scab over, although leaving behind a permanent scar.
Every person you lose takes a little piece of you with them.
Metaphors for Counseling
Going to therapy is akin to filling your toolbox with tools.
In a car, your therapist is a passenger in the front seat, but you’re behind the wheel. A passenger offers assistance with reading the map and providing directions, but it’s up to you to choose the turns you’ll take, and ultimately, the destination.
A counselor doesn’t provide the answers, but offers the tools to find them.
Going to therapy is like going to the gym; you may feel sore and you won’t see immediate effects, but the long-term results are gratifying and well-worth the investment.
Therapy Metaphors for Life
Problems in life are like bad smells; you can attempt to mask them or cover them up, but you have to remove the source before they can truly go away.
You can’t choose the canvas or paint in life, but you decide the picture you’ll paint.
Your life is a book with many chapters and pages. Every day is a new page. You write your own story.
Life is like a “choose your own adventure” book. You make decisions, but you can’t always predict the outcome.
Sometimes you’re dealt a really sh**** hand. How are you going to play your cards?
The only difference between a rut and a grave are the dimensions.
Self-care is not a luxury; it’s necessary for survival when your loved one has a substance use disorder. By taking care of yourself, you gain the energy and patience to cope with your problems. Self-care promotes wellness and emotional intelligence; it puts you in a better space to interact with your loved one. Strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers.
When your loved one has a substance use disorder (SUD), it can be overwhelming, distressing, and all-consuming. When we’re stressed, we forget to practice basic self-care, which in turn makes us even less equipped to cope with the emotional chaos addiction generates. This post is about self-care strategies for when your loved one has an addiction.
(Side note: I strongly recommend reading Beyond Addiction if your loved one has an SUD or if you work in the field. This book will increase your understanding of addiction and teach you how to cope with and positively impact your loved one’s SUD by using a motivational approach. This is one of the best resources I’ve come across, especially for family members/significant others.)
Based on the premise that your actions affect your loved one’s motivation, taking care of yourself is not only modeling healthy behaviors, it’s putting you in a better space to interact with your loved one. Chronic stress and worry make it difficult to practice self-care. Self-care may even seem selfish.
However, by taking care of yourself and thus reducing suffering, you gain the energy and patience to cope with your problems (and feel better too). Furthermore, you reduce the level of pain and tension in your relationships with others, including your loved one with a SUD.
Self-care strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers. Therapy and/or support groups are additional options.
“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.”
Self-Care Strategies When Your Loved One Has an Addiction
The definition of resilience is “the capacity to recover quickly from difficulties” (Oxford Dictionary). Doctors Foote, Wilkens, and Kosanke wrote that having resilience is a way to “systematically reduce your vulnerability to bad moods, lost tempers, and meltdowns.”
While you cannot “mood-proof” yourself entirely, resilience helps when facing life’s challenges, setbacks, and disappointments. To maintain resilience, one must practice at least the most basic self care practices, which are as follows:
Self-care is not something you can push in to the future. Don’t wait until you have more time or fewer obligations. Self-care is not a luxury; it’s a necessity. The authors of Beyond Addiction pointed out that self-care is something you have control over when other parts of your life are out of control. If you find it challenging to implement self-care practices, tap into your motivations, problem-solve, get support, and most of all, be patient and kind with yourself.
“Taking care of yourself is the most powerful way to begin to take care of others.”
On tolerance, Doctors Foote, Wilkens, and Kosanke suggested that it is “acceptance over time, and it is a cornerstone of self-care.” Tolerance is not an inherent characteristic; it is a skill. And like most skills, it requires practice. However, it’s wholly worth the effort as it reduces suffering. By not tolerating the things you cannot change (such as a loved one’s SUD), you’re fighting reality and adding to the anguish.
Self-care strategies and techniques for distress tolerance include distracting yourself, relaxing, self-soothing, taking a break, and creating positive experiences. (The following skills are also taught in dialectical behavior therapy (DBT), an evidence-based practice that combines cognitive behavioral therapy techniques and mindfulness. For additional resources, visit The Linehan Institute or Behavioral Tech.)
Switch the focus of your thoughts. The possibilities are endless; for you, this could mean reading a magazine, calling a friend, walking the dog, etc. The authors of Beyond Addiction suggested making a list of ideas for changing your thoughts (and keeping it handy).
Switch the focus of your emotions. Steer your emotions in a happier direction by watching corgi puppies on YouTube, reading an inspirational poem, or viewing funny Facebook memes. The writers of Beyond Addiction suggested bookmarking sites in your Internet browser that you know will cheer you up.
Switch the focus of your senses. This could mean taking a hot shower, jumping into a cold pool, holding an ice cube in your hand, walking from a dark room to one that’s brightly lit, looking at bright colors, listening to loud rock music, etc. Also, simply walking away from a distressing situation may help.
Do something generous. Donate to your favorite charity, pass out sandwiches to the homeless, visit a nursing home and spend time with the residents, express genuine thanks to cashier or server, etc. By redirecting attention away from yourself (and directing energy toward positive goals), you’ll feel better. In Beyond Addiction, it’s noted that this skill is especially helpful for individuals who tend to ruminate. Also, it’s important to brainstorm activities that are accessible in the moment (i.e. texting a friend to let them know you’re thinking about them) that don’t take multiple steps (such as volunteering).
“Body tells mind tells body…” Relaxing your body helps to relax your mind. It also focuses your thoughts on relaxing (instead of your loved one’s addiction). What helps you to relax? Yoga? A hot bath? Mindful meditation? (I recommend doing a mindful body scan; it’s simple and effective, even for the tensest of the tense, i.e. me.)
In Beyond Addiction, self-soothing is described as “making a gentle, comforting appeal to any of your five senses.” A hot beverage. Nature sounds. A cozy blanket. A scenic painting. Essential oils. A cool breeze. A warm compress. A massage. Your favorite song. Find what works for you, make a list, and utilize as needed. Seemingly small self-care strategies can make a big difference in your life by creating comfort and reducing out-of-control emotions.
Take A Break
“Taking a break” doesn’t mean giving up; it’s a timeout for when you’re emotionally exhausted and is one of the best self-care strategies you can have. Learn to recognize when you need to step away from a situation or from your own thoughts. Find a way to shift your focus to something pleasant (i.e. a romantic movie, a nature walk, a day trip to the beach, playing golf for a few hours, traveling to a different country, etc.)
Create a Positive Experience
Doctors Foote, Wilkens, and Kosanke refer to this as “making it better,” not in the sense that you’re fixing the problem (or your loved one), but that you’re making the moment better by transforming a negative moment into a positive one. Suggested self-care strategies for creating a positive experience include the following:
Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
Meditate or pray. As explained in Beyond Addiction, “meditation or pray is another word for – and effective channel to – awareness and acceptance. Either one can open doors to different states of mind and act as an emotional or spiritual salve in trying moments.”
Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
Find meaning. The authors of Beyond Addiction wrote, “Suffering can make people more compassionate toward others. Having lived through pain, sometimes people are better able to appreciate moments of peace and joy.” Suffering can also inspire meaningful action. What can you do to find meaning?
Borrow some perspective. How do your problems look from a different viewpoint? Ask a trusted friend. You may find that your perspective is causing more harm than good.
Perspective is “an understanding of a situation and your reactions to it that allows you to step back and keep your options open… [it’s] seeing patterns, options, and a path forward” (Beyond Addiction).
When Trish married Dave nearly 20 years ago, he rarely drank: maybe an occasional beer over the weekend or a glass of wine at dinner. After their fist daughter was born, his drinking increased to a few beers most nights. Dave said it helped him relax and manage the stress of being a new parent.
By the time their second daughter was born several years later, his drinking had progressed to a six-pack of beer every evening (and more on weekends). Currently, Dave drinks at least a 12-pack of beer on weeknights; if it’s the weekend, his drinking starts Friday after work and doesn’t stop until late Sunday night.
Dave no longer helps Trish with household chores or yardwork as he did early in their marriage. He rarely dines with the family and won’t assist with the cooking/cleanup; he typically eats in front of the TV. Dave occasionally engages with his daughters, but Trish can’t recall the last time they went on a family outing, and it’s been years since they went on a date.
Dave struggles to get out of bed in the mornings and is frequently late to work; Trish is worried he’ll get fired. They frequently argue about this. Dave is irritable much of the time, or angry. Most nights, he doesn’t move from his armchair (except to get another beer) until he passes out with the television blaring.
Trish is frustrated; she believes Dave is lazy and lacks self-control. When she nags about his drinking, he promises he’ll cut back, but never follows through. Trish thinks he’s not trying hard enough. She can’t understand why he’d choose booze over her and the kids; sometimes she wonders if it’s because she’s not good enough… maybe he would stop if she was thinner or funnier or more interesting? At times she feels helpless and hopeless and others, mad and resentful; she frequently yells at Dave. She wonders if things are ever going to change.
A different perspective would be to recognize that Dave has an alcohol use disorder. He feels ill most of the time, which affects his mood, energy level, and motivation. He wants to cut back, but fails when he tries, which leads to guilt and shame. To feel better, he drinks. It’s a self-destructive cycle.
If Trish understood this, she could learn to not take his drinking personally or question herself. Her current reactions, nagging and yelling, only increase defensiveness and harm Dave’s sense of self-worth. Alternative options for Trish might include learning more about addiction and the reasons Dave drinks, bolstering his confidence, and/or creating a supportive and loving environment to enhance motivation.
In recovery language, a “trigger” is anything (person, place, or thing) that prompts a person with SUD to drink or use; it activates certain parts of the brain associated with use. For instance, seeing a commercial for beer could be triggering for a person with an alcohol use disorder.
You have triggers too. For example, if your loved one is in recovery for heroin, and you notice that a bottle of opioid painkillers is missing from the medicine cabinet, it could trigger a flood of emotions: fear, that your loved one relapsed; sadness, when you remember the agony addiction brings; hopelessness, that they’ll never recover. It’s crucial to recognize what triggers you and have a plan to cope when it happens. Being aware of your triggers is a self-care strategy.
Therapy and Support Groups
Lastly, self-care strategies such as therapy and/or support groups can be a valuable addition to your self-care regime. Seeing a therapist can strengthen your resilience and distress tolerance skills. Therapy may provide an additional avenue for perspective.
(Side note: A good therapist is supportive and will provide you with tools for effective problem-solving and communication, coping with grief and loss, building self-esteem, making difficult choices, managing stress, overcoming obstacles, improving social skills/emotional intelligence, and better understanding yourself. A good therapist empowers you. A bad therapist, on the other hand, will offer advice and/or tell you what to do, disempowering you.)
Regarding support groups, there are many options for family members, friends, and significant others with a loved one who has a SUD, including Al-Anon, Nar-Anon, and Families Anonymous. Support groups provide the opportunity to share in a safe space and to receive feedback, suggestions, and/or encouragement from others who relate.
“I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival.”
In sum, self-care is not optional; it’s essential for surviving the addiction of a loved one. Self-care enhances both overall wellness and your ability to help your loved one; in order words, take responsibility for your health and happiness by taking care of yourself. Commit to engaging in at least one or two of the self-care strategies you learned about in this post.
“I gave up on having a future. And I was strangely okay with it.”
From Survival to Endurance to Fulfillment: How I Found Meaning in Life
Without delving too deep into my past, I can tell you that my late teens and early to mid 20’s were not the best of times. They were dark. Lonely. Depressing. I was living a life of chaos and hopelessness. At one point, I didn’t think I was going to survive; I gave up on having a future. And I was strangely okay with it.
My turning point was a spiritual awakening of sorts. A
near-death experience led to a realization that I didn’t want to die; and it
was either die or change my life. I picked change.
What helped me to live again (and ultimately find fulfillment and meaning in life)? You might guess family or a relationship or God. But at the time, I wasn’t close with my family, I didn’t have any significant relationships/friendships, and God wasn’t a part of my life.
It was the following that helped me with finding meaning and becoming the person I am today:
Having not a single shred of self-esteem, I went to see a counselor. She created a safe space and then uplifted me, making me feel worthwhile. She normalized what I was going through; I felt less alone. She affirmed me for positive choices I made. She initiated the mending of my fragile self. I gradually gained confidence, not only in myself, but in the idea that I could live a better life as I started finding meaning.
She loved me unconditionally… and she depended on me fully. I knew that if I died, she would never understand why I left her. I couldn’t bear that idea; I wouldn’t do that to her.
She played a huge role in my recovery. I sometimes think she saved me. She was instrumental in finding meaning in life.
I’ve always known I have potential. I’m smart and creative and determined. But that potential died somewhere along the way in young adulthood. In moments of clarity, I mourned my lost potential. I wanted to be better and to do better with my life. I was meant, maybe not for great things, but for better things than living out of my car, broke and friendless. When I decided to live, my potential reawakened; it became a driving force – a bright, glowing beacon that revitalized and inspired me.
“You have to forgive yourself.”
I couldn’t bear to tell my therapist about some of the things I’d done. I was ashamed; late at night, lying in bed, I would think about the past. I’d feel sick to my stomach – then, an unpleasant head rush heart racing not able to get enough air… (That’s the feeling of shame seeping from your mind into your being.)
My therapist didn’t push me to share; instead, she said, “You have to forgive yourself.” It became my mantra, quietly uttered in the dark. I would repeat, “I forgive myself, I forgive myself, I forgive myself…” until I internalized it. (That being said, it didn’t happen overnight… it took weeks, months, years. But all was set in motion with that one simple statement.)
I went back to school and was able to fully immerse myself in my studies. As a naturally curious person, learning is a sort of fuel for me. The more I learn, the thirstier I become. My classes provided me with not only knowledge, but with a spark that generated purpose.
While in school, I discovered a new passion; I fell in love with research. (#nerd) I thrived in my research/statistics class; my undergraduate study was even published in a national journal. It felt good to be passionate about something again; it stirred up (from the dust) long-forgotten loves, like reading and writing – passions I thought I’d left behind in childhood.
A Meaningful Career
After finishing college and starting graduate school, I became a counselor… finding meaning in helping others. My first job in the field was tough, heart-breaking at times, and deeply fulfilling. It solidified what my education had started to shape – I no longer needed to survive or endure life; I found my purpose and a meaning in life.
Where can you find the help you need? While there are plenty of resources out there for mental health and recovery, they’re not always easy to find… or affordable. (Plus, the Internet is full of scams!) This article is a starting point for getting help when you aren’t sure where to turn. This post offers practical guidelines; all of the resources in this article are trustworthy and reliable… and will point you in the right direction.
This post is not comprehensive; rather, it is a starting point for getting the help you need. There are plenty of resources out there for mental health and recovery, but it is not always easy (or affordable) to find help. The resources in this post are trustworthy and reliable… and will point you in the right direction so you can find help.
If you need treatment for mental distress or substance use, but are not sure how to find it…
If you have insurance, check your insurer’s website.
For substance use and mental health disorders, you can access the SAMHSA treatment locator. You can find buprenorphine treatment (medication-assisted treatment for opioid addiction) through SAMHSA as well.
Consider using Mental Health America’s interactive tool, Where to Get Help. NeedyMeds.org also has a locator to help you find low-cost mental health and substance abuse clinics.
At campus counseling centers, grad students sometimes offer free or low-cost services.
You could look into community mental health centers or local churches (pastoral counseling).
In some areas, you may be able to find pro bono counseling services. (Google “pro bono counseling” or “free therapy.”) You may also be able to connect with a peer specialist or counselor (for free) instead of seeing a licensed therapist.
As an alternative to individual counseling, you could attend a support group (self-help) or therapy group; check hospitals, churches, and community centers. The DBSA peer-lead support group locator tool will help you find local support groups. Meetup.com may also have support group options.
Additional alternatives: Consider online forums or communities. Watch or read self-help materials. Buy a workbook (such as The Cognitive Behavioral Workbook for Depression: A Step-By-Step Program) from amazon.com. Download a therapy app.
Lastly, you could attend a free workshop or class at a local church, the library, a college or university, a community agency, or a hospital.
If you’re under 18 and need help, but your parents will not let you see a counselor (or “do not believe in therapy”)…
Some, but not all, states require parental consent for adolescents to participate in therapy. Start by looking up the laws in your state. You may be able to see a treatment provider without consent from a legal guardian. If your state is one that mandates consent, consider scheduling an appointment with your school counselor. In many schools, school counseling is considered a regular educational service and does not require parental consent.
Alternatively, you could join an online forum or group. (Mental Health America offers an online community with over 1 million users and NAMI offers OK2Talk, an online community for adolescents and young adults.)
Lastly, consider talking with your pastor or a trusted teacher, reading self-help materials, downloading a therapy app, journaling, meditation or relaxation techniques, exercising, or therapy podcasts/videos.
If a loved one or friend says they are going to kill themselves, but refuses help…
Call 911. If you are with that person, stay with them until help arrives.
Explore Learn to Cope, a peer-led support network for families coping with the addiction of a loved one. Alternatively, you could attend Al-Anon or Nar-Anon.
Keep in mind that it’s almost impossible to help someone who doesn’t want it. You can’t control your loved one or force them into treatment. Instead, find a way to accept that there’s no logic to addiction; it’s a complex brain disorder and no amount of pleading, arguing, or “guilting” will change that.
If a friend or family member overdoses on heroin or other opioid…
You can receive free training to administer naloxone, which reverses an opioid overdose. Take an online training course at Get Naloxone Now. You can purchase naloxone OTC in most states at CVS or Walgreens.
In addition to talking to your doctor about medication, the patch, and/or nicotine gum, visit Smoke Free, Be Tobacco Free, or Quit.com for resources, tools, and tips.
Call a smoking cessation hotline (like 1-800-QUIT-NOW) or live chat with a specialist, such as LiveHelp (National Cancer Institute).
Download a free app (like QuitNow! or Smoke Free) or sign up for a free texting program, like SmokefreeTXT, for extra support.
Attend an online workshop or participate in a smoking cessation course; your insurance provider may offer one or you may find classes at a local hospital or community center. You could also contact your EAP for additional resources.
If your therapist is making unwanted sexual remarks/advances…
Contact the licensing board to file a complaint. Each state has a different licensing board. Additionally, contact the therapist’s professional association (i.e. American Counseling Association, American Psychological Association, etc.) Provide your name, address, and telephone number (unless filing anonymously). Identify the practitioner you are reporting by his or her full name and license type. Provide a detailed summary of your concerns. Attach copies (not originals) of documents relating to your concerns, if applicable.
Are you in therapy or have you sought counseling in the past? Are you currently practicing as a therapist or counselor? This article explores what makes a therapist effective (or not).
What Are the Characteristics of an Effective Therapist?
The American Counseling Association (ACA) established a code of professional ethics and values as a guide in practicing as an effective therapist. The ACA’s mission is “to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.”
Professional values include the following:
enhancing human development throughout the life span
honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts
promoting social justice
safeguarding the integrity of the counselor–client relationship
practicing in a competent and ethical manner
Ethics include autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity.
The ACA outlines professional values and ethics, but for the purpose of this article, I wanted to learn about current perceptions and views. Also, how do counselors exemplify the code in their practices? Using social media (Reddit and Quora) as a survey tool, I reached out to mental health professionals and therapy participants; I also browsed through older threads and posts on the topic.
I read about traits (like active listening and compassion) that are important to both therapy participants and clinicians. Additionally, I learned about negative experiences, which was disheartening. So what makes a good (or bad) clinician?
An effective therapist is someone who…
Is kind and compassionate
Puts a lot of thought into what they say
Educates their clients (coping skills, symptoms, stress management, etc.)
Reflects and validates feelings
Understands human behavior and mental disorders
Sets and adheres to healthy boundaries
Is genuine (and genuinely cares for their clients)
Has a wide range of techniques and a variety of tools
Is humble (and gives advice sparingly)
Creates a safe place for healing
Is knowledgeable (evidence-based practices, current research, etc.) and intelligent
Possesses emotional intelligence
Experiences and conveys empathy
Has a sense of humor
Recognizes and values other perspectives
Interestingly, a few responders took into account a therapist’s personal values and views (not just how they conduct themselves in a session). As a counselor, this resonated. For example, a therapist can’t be genuine if they’re empathetic with their clients, but rude or nasty otherwise. Being a counselor means fully embracing the code of conduct. Consider how it would feel to discover your therapist treats restaurant staff poorly or gets hammered and then drives. It would likely leave a bad taste in your mouth. A good clinician is a role-model. Furthermore, it’s important for a counselor to be emotionally stable and self-aware, which is something I’ll explore shortly.
Regarding professional development, it was noted by Lazar_Milgram (Reddit user) that a counselor must commit to “relearning,” meaning re-reading text books, literature, and research to prevent it from fading. As humans, we forget things. We need to go back to the original source of knowledge now and again. It’s not enough to go to grad school; a counselor must commit to a lifelong education. Along those lines, Lazara_Milgram reported that an effective counselor re-visits his/her failures. If we were unable to help a client for one reason or another, it’s worth it to review their file and our records, consult, and then learn from our mistakes.
On self-awareness, Reddit user Valirony, a marriage and family therapist, shared it’s important for a therapist to be aware of “[his/her] own existing issues and [be] either well-processed on those fronts and/or very capable of compartmentalizing the baggage that is less well-processed.”
To expand on this, consider the experience of emotional anguish. An empathetic person who has experienced a personal tragedy may consequently feel a desire to ease suffering in others. Naturally, they’re drawn to the counseling profession; but if their wounds haven’t healed, they lack the capacity to help their clients.
Sadly, some counselors enter the profession seeking to “fix” others as an attempt to compensate for being unable to face their own issues. In contrast, an effective therapist recognizes his/her limitations as a counselor, especially in the face of personal tragedy. They recognize when it’s their own “stuff” (and not the client) triggering a reaction. They leave the past where it belongs and carry little to no emotional baggage. This allows them to be fully present and engaged.
Valirony (Reddit user) also discussed constructive criticism. It’s essential for the effective therapist to remain open to constructive feedback in order to grow. Valirony explained, “I see a lot of defensiveness in some of my colleagues during consultation; I’m no saint and I feel defensive here and there, but I always take a look at that defensiveness for whatever it is in me that I need to change.” Defensiveness is a clue that something’s not right. On constructive feedback, Reddit user Lazar_Milgram suggested, “Embrace criticism – every criticism is a 50/50 package of perceptual information about you. 50% tells something about you and 50% tells something about client.” Providing it’s thoughtful and well-presented, criticism can inspire insight or provide a new way of looking at something.
Ann Veilleux, a private-practice psychotherapist and Quora user, identified emotional intelligence as a trait for effectiveness. “Intelligence comes to mind first, emotional intelligence certainly, a curiosity and interest in people [as] more [than] machines or plants.” Emotional intelligence is innate; it can’t be developed the way a skill can. Furthermore, a good clinician is curious, but their interest is attached to the well-being of their clients. Veilleux pointed out that an effective therapist must possess interest and ability – not one or the other – in order to sustain the level of investment therapy demands. It’s the “interest and ability to have intimate relationships with many people at the same time and not to tire of that.”
The Therapeutic Relationship
With regard to the client-counselor dynamic, an effective therapist recognizes that the relationship is central to the therapeutic process; it’s the key to healing and growth. A client must trust the counselor before they feel safe enough to share their pain or humiliation or guilt. Traits like warmth, humor, and transparency foster an honest and caring relationship. Counseling skills are important, but can only go so far without a trusting relationship.
To promote a supportive relationship, Reddit user RedYNWA suggested that counselors practice empathy without being overly emotional. RedYNWA described how they felt when their therapist cried in session. “I believe my topic brought up something personal for her. The minute she cried. I stopped talking, and changed the topic. I felt she was unable to hold my topic, and I felt a responsibility to ease her distress. It changed our relationship, I felt like the therapist, and it restricted my ability to divulge deep emotions. It was unintentional on her side. However, it destroyed the therapeutic relationship.”
In the above situation, a counselor’s emotional reactivity upset the balance of the therapeutic relationship. Unintentionally, the therapist sent a strong message. The message was that she was too fragile to hear her client’s pain. If the therapist can’t be strong, how can the client? A counselor who breaks that easily can’t be a source of unwavering support. It’s the client’s job to cry; the therapist’s job is to remain calm, to maintain a safe environment, and to instill hope.
I am acquainted with therapists (colleagues and former peers) who occasionally cry in sessions. Sometimes, it’s an instinctive reaction to hearing the horrors clients have gone through; the discrimination, the trauma, the abuse, and worse. There was a time I cried while facilitating a group, but it wasn’t related to anything being said. That morning, I had learned a former client died by suicide. He shot himself in the head. He was only 22. I felt vulnerable and self-conscious about crying in front of my clients. Later, my supervisor helped me to understand that crying can make a therapist seem more human and authentic, which has the potential to strengthen the counseling relationship while conveying empathy.
Some clients will feel closer to a therapist who cries; others will feel uncomfortable. There’s no right or wrong. Quora user Philippe Gross, Assistant Professor of Psychology at University of Hawaii, pointed out that even with all the right qualities, a therapist will not be a good fit with every client. When this happens, Gross stated that “an effective therapist should be able to recognize this soon and refer the client to a more appropriate therapist.”
One Reddit user and professional counselor, ForeverJung, touched on the importance of not getting caught up in their clients’ pain to the point it becomes their own (also known as vicarious trauma). It’s having “the ability to care deeply and then shut it off,” which can be difficult, especially for new counselors. ForeverJung also shared that an effective counselor must be able to listen, while at the same time “synthesizing data,” and then provide a constructive response that the client will be able to make sense of.
Redddit user blueybluel shared about a therapist they described as absolutely wonderful. “She was incredibly empathetic and patient with me, almost to a fault I felt like sometimes. But it really helped me a lot with my self-hatred, self sabotage and suicidal thoughts because for the first time ever, I was regularly associating with a person who was so soft with me. She genuinely thought I was a great person just the way I was, and that I didn’t have to accomplish and be perfect all the time just to have worth and to deserve to live.”
Similarly, Gatopajama (Reddit user) described positive interactions with their current therapist, who shares their odd sense of humor. “[My therapist] is serious when the topic calls for it, but usually a session with her feels very comfortable and laid back, like having coffee with a girlfriend. She also shares a little bit about herself sometimes (not in an inappropriate or TMI way) — it makes me feel like I’m talking to a real person and not a human psychology textbook. Plus, she’s got a gigantic bowl of moonsand in her office. Sometimes I plop that thing on my lap and play with it the whole hour to keep my hands busy if I’m trying to talk about something difficult.”
What are the Traits or Characteristics of an Ineffective Therapist?
While some traits (such as having a gigantic bowl of moonsand!) positively impact the counseling process, others contribute to nonproductive (or even harmful) therapy. When I elicited feedback on effectiveness, I learned about some horribly ineffective and disturbing practices.
An incompetent clinician lacks self-awareness and insight in addition to the required knowledge and skill. They may have entered the field for all the wrong reasons. They’re rigid and closed to new ways of thinking. Most importantly, they don’t listen to their clients. Ssdgmok, a Reddit user, described a bad clinician as “someone who talks about themselves each session, poor listening and ‘giving advice.’” Contrary to popular belief, a counselor’s role is not to advise the client. A therapist is more like a collaborative partner who leads the client to their own insights while providing the tools for change.
To give a personal example of a therapist who talked too much (although not about herself) and didn’t listen, I’ll use myself – but in the role of the client, not the clinician. I was in my late teens and it was one of my first experiences seeing a counselor (a middle-aged woman). The therapist had apparently just finished a session with a young woman who had attempted suicide. And the therapist proceeded to tell me all about it. Meanwhile, I was bursting with pain and self-doubt; and the therapist continued to talk about the client who had just left her office. She went on and on about how she couldn’t believe “that little girl” swallowed an entire bottle of Tylenol. It was like she didn’t hear a word I said, and I left feeling even worse. (Luckily, that experience didn’t poison my view of the profession or dissuade me from entering the field a decade later.)
A Reddit user shared about expressing thoughts of suicide to their therapist
Jwaggin “Therapist: Are you suicidal Me: Yea… Therapist: You hate your mom? Me: uhhh no Therapist:Well if you kill yourself your mom would be very hurt Me: uhhh ok (thanks for the guilt)”
If this happened, it’s clear that the therapist lacked not only empathy, but a basic understanding of mental illness. An effective therapist never shames or “guilts” a client. The client is already in pain (which is what brought them to therapy in the first place). Also, when a client says they’re suicidal, it’s the therapist’s responsibility to explore this with the client while ensuring the client’s safety. An effective therapist helps the client to identify what (if anything) would prevent them from killing themselves; the clinician won’t admonish the client for their hopelessness. To do so would be demeaning, with a disregard to human dignity.
Reddit user blueybluel shared, “When I told [the therapist] all my struggles, she seemed empathetic, but then got on this weird shtick of telling me to do homework of writing down things I like about myself, in an aggressive, demanding, pull yourself up by your bootstraps kind of way, and said, “Can you do that for me? By next week?” I canceled the next appointment and never saw her again.”
There’s no room for aggression in this profession. A good therapist is gentle; they don’t give orders. Instead, they explore, listen, and ask questions. It’s a respectful partnership between client and counselor.
After tragically losing their infant son, a Reddit user sought therapy
wonder-maker “I explained my situation about having lost my infant son in a tragic household accident. She asked me to wait a moment, got up, walked to the front desk, came back with a sticky note from the receptionist and told me to come back and see a different therapist at a later date, then refused to make eye contact with me. The next therapist said to my face ‘Boohoo, your kid died, get over it.'”
In the above example, the first therapist was a woman in her early 40s and the second was a male in his 60s. I’m disturbed by what happened to wonder-maker (Reddit user); and I’m horrified that these “helpers” are out there providing counseling services. The female therapist’s reaction could be explained by lack of experience or skill; alternatively, hearing about the accident could have triggered her (which is why self-awareness is so important). However, there is no excuse or explanation for what the male clinician said. You don’t have to be a therapist to feel empathy or compassion (but you do have to be a jerk to tell a grieving parent to “get over” the loss of a child).
In summary, there are many things that positively impact a counselor’s effectiveness, while opposite traits are related to incompetent practice. An effective counselor is an active listener, expresses empathy and compassion, and is genuine and transparent. They promote healing and self-exploration. The therapeutic relationship is also important. An effective clinician creates a safe environment for building trust while providing support. Additionally, to be effective, a therapist must commit to a lifelong pursuit of knowledge to learn new techniques and evidence-based practices, to understand how scientific developments will change the counseling profession, and to keep up-to-date on relevant research.
In contrast, a therapist who is uncaring, uninterested, and who doesn’t listen will never be effective. A counselor who constantly advises their clients or who shames their clients is incompetent and unethical. Furthermore, the absence of emotional intelligence greatly impacts a clinician’s counseling abilities.
Regarding personal values and lifestyle choices, there’s a gray area. Can a therapist who gossips or who abuses sleeping pills provide effective services? What about a marriage counselor who cheats on his wife? While a few therapy participants and mental health professionals emphasized the importance of a therapist’s personal integrity, most responders viewed effectiveness in the context of therapy alone.
Lastly, therapy participants who reported unproductive or even damaging experiences received services from therapists who did not adhere to the ACA code. Conversely, positive and effective experiences were related to ACA values.