The Human in the Helper: I’ve had it happen twice

Caitlin loves her job and it shows. She works with youth involved in the juvenile justice system and has loved that system for over 15 years. It’s a career choice not many colleagues would commit to, especially when working with a population that assumes greater risks of loss, compassion fatigue, and vicarious trauma. Even though she finds her work rewarding, Caitlin has also experienced every Adverse Psychological Event (APE) known within our field, including the not often talked about ones, like client violence directed towards others. “I had two clients murder people in the community.”

Caitlin is willing to share her story to help others while also acknowledging how difficult it can be. “I had four deaths in an 18 month span,” she recalls. For her two clients who killed people, these tragedies happened after they had closed out of services. “The support I received around this happening was different because they weren’t active clients.” Caitlin reflected on how the support was minimal in supervision and consultation because of the clients not being active on her caseload. She named how it felt like leadership was relieved to not have to staff these cases, and redirected her to focus on her current caseload of at-risk kids. She heard messages like, ‘It sucks that that happened. What are you doing for your current suicidal kids?’

Although Caitlin understood the focus of leadership on current clients, this messaging didn’t help her healing process as a person. She found herself questioning if she’d done enough for her clients. If there was something she missed. And then there was the grief. “I was surprised that I felt so much grief for the kids who engaged in violence. I thought things must have been pretty bad for them to do this.” Caitlin’s compassion confused colleagues, who did not hold compassion for her former clients at all, instead labeling them murderers and engaging in black and white thinking. “They are still traumatized kids,” Caitlin named.

A trauma lens helps Caitlin remain in this work with her clients, as well as her abundant compassion for what her clients have been through.  Even so, the losses still took a toll on her. She felt acute symptoms of grief in the first month, with flare ups anytime she saw her former clients in the news for their trials or sentencing. She had recurring nightmares with her clients in them. “They were always calling out for help. Someone had to help them.” What helped Caitlin most was having one colleague who understood what she was going through, because they worked with the same population. “One time I came into her office and cried,” Caitlin shared. “My mentor said, ‘Caitlin, you are working with people through some of the darkest moments of their lives. That doesn’t always mean they come out of the darkness by following your light.’”

Caitlin reflects on the importance of having a colleague or mentor who can hold this heaviness with us. Someone who aligns with our beliefs and gives us space to heal. Someone who supports the ugly cries and the dark humor. Someone who reinforces we aren’t alone. She also encourages colleagues to do their own psychological first aid, making sure to eat, sleep, and move their bodies. “You will want to freeze. Honor all your feelings. You will experience every stage of grief.” Caitlin doesn’t have any plans to pivot from this population because she operates from a belief that what we do as mental health professionals still matters. “For every horrible thing that happens, there are 10-20 that don’t end up that way. Those horrible things are still the minority.” Caitlin’s story provides a beacon of hope in light of something that feels so heavy and so powerless. We feel honored to be able to share her messages here.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: I was too busy to feel anything

Keiko is pursuing her doctorate in social work. When she’s not serving mothers and women in her private practice, she enjoys spending time with her two children. Although Keiko has big goals for herself, they were accelerated after her diagnosis with breast cancer in her late 30s. She shared how she and her doctor caught it at an early stage, but it was happening at the same time she’d joined a group practice and was building her caseload. “How do I deal with this?” Keiko reflected, “there’s no good time to have cancer.”

Keiko understood that as a small business owner, she couldn’t take time off or slow down without the risk of lost income. “I think I was in shock at first, then I was too busy to feel anything.” She recalls how she focused on making each doctor appointment and continuing to work. “I had to wait 1.5 months to get answers on what my treatment was going to be.”

After that stressful waiting period, Keiko was told she would undergo radiation and hormone treatments, but not chemotherapy. She elected to not tell her clients what was going on, especially as she was still unclear of the outcomes. “I didn’t want to worry them or have them caregive me as the result, “ she shared. Keiko also recognized some survivor’s guilt in her experience. “I didn’t go through the same process (chemo) as them, I can’t be glad in front of them.”

What helped Keiko most was doing her own therapy work with an oncology psychotherapist. “Cancer is weird, it was nice to work with someone who understands it.” She was grateful to connect with peers and cancer survivors as well, who continue to give her hope for her future.  Keiko has spent time reflecting on her priorities. “I want to see my children graduate, get married, and live happy lives.” So she evaluated her next steps and decided to pursue a doctorate in social work. “We think cancer equals death, and that’s not true.” Keiko is hopeful that her story will inspire others to fight cancer and pursue their passions. “It’s almost like having cancer can make us think, ‘let’s do this,’ giving us permission to do the things we want to do.”

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: You can't make someone live for you

Shannon isn’t a stranger to grief. She lost her brother to addiction in 2008 and has dedicated her career to helping clients through trauma and substance healing as a social worker and addictions counselor. As she was preparing to expand her family, her dad approached her to share that he was ready to die. “My dad was suffering from a lot of health issues. He’d been unhealthy most of his life.” Shannon’s dad had received permission from his doctor for Medical Aid in Dying, a year-long process that requires two physicians to sign off to receive the medication, which a patient then administers to themselves in order to remain fully in control of the process of dying.

Of course Shannon was devastated and overwhelmed at hearing her dad’s decision, although he had been speaking to wanting to die for over a decade. “I was six months pregnant when he called me up to tell me,” she remembered. “I asked him to wait until after my son was born. I explained postpartum and the impact this grief would have on me and the family, and he agreed to wait.” But Shannon didn’t immediately feel at ease. Instead she and her sister went through a rollercoaster of emotions, alternating who would hold hope and conviction to try something new to save his life, while the other named how it was inevitable that their dad would die because he wanted it to be so. “We looked at medication changes, a new psychiatrist, psilocybin, but nothing changed his mind.”

Shannon recalled how her dad’s biggest worry was that she was going to ask him to continue to delay his death date. He said there was never a good time to die, and she had to ultimately agree. However, Shannon and her sister had an opportunity to weigh in on his death date and be present for his end of life journey. “It was so sad and special to be there. It meant everything to him that we were there.” Shannon was six weeks postpartum when her dad died, and she vividly remembers him dying and her going into another room to pump breastmilk for her baby. “It was so strange. I think I was in shock for months.”

Shannon went right back to work days later, and after six months, a new wave of grief hit Shannon as she realized he was truly gone. “I recognized that I was missing him and that I had to live the rest of my life without him.” The experience has impacted her both personally and professionally in how she engages others around death and dying. “Now I see it is not our responsibility to keep someone alive. It was his body, it was his life.” Shannon hopes that fellow therapists will work further to understand the difference between Medical Aid in Dying and suicide. “My dad wasn’t afraid of dying. He was ready.”

Therapists, out of feelings of responsibility, often struggle to hold their own fears in check when faced with a client who is thinking about death. How do we strive for neutrality, holding space for client experiences from a place of compassion for their pain and suffering? Shannon has found the stories of Near-Death Experiences influential in her ability to connect with others on a human level regarding dying, to fully see what people are experiencing including her dad. “I realized that no amount of time would be enough with him. Two months, six months, a year. It was really eye-opening and helped me move towards acceptance of not trying to demand one more day, one more day. That was a huge turning point in my thinking.” Shannon was able to show up for her dad, even in her own grief. “Dying isn’t the worst thing that can happen, suffering is worse.”

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: I don't blame him

Rose is no stranger to grief. She’s experienced several losses in her lifetime and even specializes in death as a counselor. Helping others navigate loss fuels her professional purpose, and yet she recognizes it’s a whole different experience to go through a significant loss yourself. “My daughter Layla was killed on her skateboard in the crosswalk.” This tragedy catapulted Rose into a shock response. “Everything comes to a halt, until you come out of it or ask for help.”

Rose began her quest for receiving help by reaching out to other therapists. “I knew I needed to process what happened.” She reflected on how others had problematic, and oftentimes hurtful responses to grief. Messages of grief being messy and an urge to get through it as fast as possible. An alarming message of hurry up and get over it. Rose understands grief differently. “Pushing grief down or attempting to get over it leads to it expressing in other ways, most often as flare ups.” She spoke to how buying something at the grocery store can leave a person in tears when they realize their loved one enjoyed that food. Or seeing someone spiral out when hearing food ordered at a restaurant in the exact same way as the person who’s died. 

Rose recognizes that her grief is hers to process in ways that feel right to her. “I couldn’t find a therapist who wanted to help me with this. Several of them said it was too heavy.” So she pivoted into doing her own work individually, and with the help of a close friend willing to be her witness. “Find yourself a friend who can hear it. They don’t need to understand your experience or give advice, they just have to acknowledge they received it.” For Rose, this meant sharing what was coming up for her in text messages to her friend to prevent a flare up. It helped her stay grounded in the most difficult moments after Layla’s death.

Another piece of Rose’s healing process was giving herself a break from her grief. “I told myself that I was going to set it aside to work from 10-2 every day. Then I’d fall apart at 215.” This allowed Rose the opportunity to rest her brain, embrace meaning with her clients, and take a break from the grief of losing Layla. It gave her a sense of power and control in a powerless situation. Rose encourages others to find a counselor who doesn’t take on their symptoms as the client. She explained how it allows the professional to hold space for the work without taking on the emotions associated with the loss. “It’s mine to handle,” she shared, “I’ve got to find hope in the hurt.”

Rose also emphasized how she wants to think of Layla and talk about her every day. “I want to live in the love of her, not the loss. Just because she’s gone, doesn’t mean our love is gone.” Rose embodies this by seeing different perspectives of loss with tons of compassion. “Things happen to everyone involved. I just had to change my glasses to see things from their perspective.” Rose shared how the person who hit Layla in the crosswalk was a peer at school. “I don’t blame him, I could see that it was an accident. Layla wouldn’t have wanted him to stop his life because this happened.” Rose recounts how she took this young man’s hand and walked with him into the crosswalk, so he could truly understand how he couldn’t have seen Layla crossing that day. It’s the gift she gave him in a situation that was awful for so many. “A whole school was affected,” Rose reflected.

Now Rose is even more determined to help others with their grief. She wants clients and community members to feel empowered to take their time and try things until they find what’s right for them. She named that not everyone is going to go through the five stages of grief, and not in any particular order if they do. Rose wants to normalize the grief journey and feels called to  create support since her own journey of seeking support had been so challenging. She’s channeling her experience into her client work, wanting others to feel free of the clutches of grief. “I want to help others find hope in the hurt. Layla’s love fuels everything I do.”

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: You don’t have to be a rockstar clinician every day

Tim has a calming presence for both his clients in private practice and for his students as a dedicated professor. He’s known for giving students and supervisees grace, affirming that perfectionism isn’t the goal of their learning. Tim says this philosophy comes from his own lived experience with difficult choices, specifically decisions involving his therapy business and his home life in an effort to find balance during moments of grief and loss. “My dad had cancer and was placed on hospice. I was gone from home for three months,” he describes. Thankfully, Tim had already moved his practice to 100% telehealth months earlier when the COVID-19 pandemic had shut everything down, which allowed him to see his clients remotely from another state. “Going to work was a nice break from what was happening with my dad. It was nice to feel in control of something, to remove myself for a break and go to work.”

Although Tim was able to see clients remotely, he made the choice to refer several newer clients to colleagues, knowing he couldn’t give them his best during that difficult time. “I’m grateful for my network, to make this handoff to other specialists that could serve the clients best.” He also worked with several colleagues to take his clients for a month for bereavement after his dad’s passing. “It was really hard. I wish I’d focused on my coping and how difficult it was to see him decline. I wish I had taken off a little sooner.” Tim describes a struggle with wanting to be there for his clients while also taking care of himself. “I don’t think clients got my best at the end. Yet I tell others, including my students, that you don’t have to be a rockstar clinician every day.”

Coping during his loss involved remaining connected to his wife who had stayed at home. “I wanted to call her everyday but not use her to vent every day.” Tim has ideas for fellow therapists who are going through a significant loss. “Use your rolodex. Call a friend and vent. Don’t isolate.” He shared how calling a new friend each night helped him through, without putting too much pressure on his wife as his primary support. “Therapists are used to being the listeners so they don’t always ask for help, which can lead to burnout.”

Tim also talked about the risks of burnout coming from the loss of income when having to reduce a caseload or close business temporarily. “I wish I’d known about business insurance that would pay for when we can’t work.” He named the importance of having some money for emergencies, which echoes some of my work as a Financial Therapist. Most importantly, Tim reflected on the boundaries he needed with clients to avoid burnout. “Clients knew what was going on, but I was very careful to keep the hour focused on them.” He says this is important because he works with a lot of middle-aged clients who have significant responsibilities. When they tried to focus on Tim, he’d reassure and redirect clients by saying, “this is your hour where you don’t have to care for someone else.” 

Tim’s practice is healthy and rewarding today. He and his wife are making plans with the intention of taking time off to travel each year and he continues to teach and supervisee therapists-in-training. When asked what his key takeaway has been from his experience of pausing his business in support of his dad and for grief and loss healing, he said “if you can do this, you can do anything.” His thoughts sound in alignment with post-traumatic growth, which makes sense for folks who experience such a life-changing event like this one.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Power of Ritual in Healing

As a long-time bereavement counselor I have had the privilege of working alongside clients whose grieving is both complicated and intense. Even as we together tease out the knots and kinks that make relationships tangled and messy, we also focus on the beauty, the memories, and the pain. Whether it is the individual flow of mourning or grief that is heightened by society’s focus on anniversaries or holidays, using rituals and ceremonies to move through the grief is something I encourage all therapists – and clients – to be open to.

What causes us to tear up over a favorite song or poem that reminds us of our loved one? Our body provides us with a natural healing outlet for our grief when we are confronted with memories that trigger our emotions. Not everyone sheds tears easily or willingly after a loss, but the process of grieving can allow us the opportunity to work through this physical pain.

What can we do to encourage our own healing in way that is both respectful of the death and mindful of our life? Memorials and rituals are excellent ways to personalize the life of the person who has died. While many traditions encourage the sending of flowers or food to the bereaved family immediately after the death, there are other, longer-term gifts, memorials, or rituals that can carry forward the meaningful life that is no longer on this earth. 

In our Western culture, many have found solace in placing a tombstone where they can visit the deceased on a regular basis. We have also begun seeing additional options for creating a living memorial. Purchasing park benches, planting trees, buying a brick at a museum walkway, making donations to a cause that inspired your loved one are all options that are lasting reminders. But beyond the public shows of support, there are smaller daily or weekly things that can help keep the conversation open in your heart. Finding a place or creating a time for “sacred space” is a way of elevating the emptiness to a different level within your consciousness. 

Individualizing the loss

Consider a theme that resonates with you and the person who is gone: nature, sports, travel, music, food. Think about how you remember that person. Create a process or memorial that embodies that idea. Spend some time thinking about what feels authentic and what you feel comfortable with. Begin your journey when you feel ready.

• Perhaps nature is a theme. Collect small rocks from your hikes or nature walks that you keep in a spot in the garden or in a glass jar. Allow yourself the freedom to know your loved one was with you as you enjoyed nature and that you are respecting his or her presence by bringing it home.

• Hobbies can offer us a way to connect. Be mindful of the time you spend allowing your emotions to be present while you garden, bowl, or cook. Make a decision to incorporate your loved one in the process – cook his favorite meal once a month, print her name on your bowling bag or plant their special flowers annually. 

• If you are so inclined, take on an activity that you dedicate to do as an internal connection with your loved one. Take an art class, begin blogging, volunteer to read in an elementary school. Embrace the feeling of doing the activity together in your heart.

• Meditate or spend a portion of time each day in a safe spot for you to grieve and remember. Read a favorite poem, look at photos, or play a special song and let yourself cry or laugh.

What I have found is most effective in soothing the grief is to work with clients to discover what makes them connect with the soul of their loved one. It matters not at all that others don’t “get” it – it can be an inside joke. One woman felt comforted going to the golf course where her father used to play; another donated her husband’s clothes to a shelter where he had volunteered; another family whose young child died collected donations to enhance the playground at his school. And for those whose memories were bitter, I’ve suggested planting herbs or vegetables whose sharp quality can ultimately become something valuable. Making meaning of their life and honoring that which feels good and familiar is the key.

Grief and the (many) holidays

Being in a vulnerable state during the holidays can cause anxiety and depression. While those around you are celebrating and enjoying what they have, you may be feeling the loss of what you no longer have. The rule for observing a holiday is: trust your gut. If you don’t feel able or celebrate with others, don’t – you are allowed to say NO. Change it up. Have Thanksgiving with a neighbor, go away for the week, volunteer at a shelter for Christmas, have another family member host the Easter or Passover dinner.    

While seeing the trappings of public holidays can cause pain, there are other more personal observances that no one may be aware of or choose to remember, and the same principle of ritual can help. Whether you share these moments with others who can support you or you gain strength from the intimacy of privately remembering, know that your journey is unique and unless your activities are taking you out of living, you should feel comfort in your rituals.

• Create a special memorial cup that celebrates your loved one, and use it only on holidays, anniversaries or birthdays. 

• Offer a toast or a blessing or a prayer with those you love.

• Visit the gravesite or a spot sacred to you in the weeks prior to a remembrance date.

• Buy an ornament or decoration that acknowledges the loss and display it .

• Wear an item of clothing or jewelry that brings to mind your loved one; keeping a physical reminder can be comforting.

• Buy or make a card and write loving thoughts on an anniversary; keep it as long as you wish.

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Guest post written by Tia Amdurer, LPC, NCC

Tia Amdurer, LPC, NCC, has her private practice, Heartfelt Healing Counseling, in Lakewood, CO, where works with individuals healing from grief, loss, abuse, low self-esteem and family of origin issues. She is the author of Take My Hand: The Caregiver’s Journey (www.TakeMyHandJourney.com ). www.HeartfeltHealingCounseling.com

Holding Space for Horror, Hurt, and Healing

Have you ever felt the sensation of déjà vu? The gut feeling that you’ve been here before and thus can’t escape this surreal feeling, like you’re floating, your stomach is full of rocks, and there’s a ringing in your ears? For many of us, February 14, 2018 was a day of déjà vu in its worst form, reliving the trauma and horror of another mass shooting.

For me personally, the sudden anger, sadness, grief, and avoidance that came to the surface were the very same that I experienced after the Aurora Theater Shooting on July 20, 2012.  For others, it felt like Columbine on April 20, 1999.  Many people around the world are affected by the loss and violence surrounding a mass shooting and so many of us want answers. As therapists, we hold space for the questions and the grief, providing a safe environment for processing of loss, fear, and desire to understand. As trauma therapists in particular, we encourage clients to explore fears and needs in order to feel heard, and possibly, to begin the healing process again. And yet there are days we struggle with balance, the effort of holding space for others as well as holding space for ourselves.  If we are completely honest, it may even feel easier to hold space for others rather than think and feel our own emotions.

Professionally, it didn’t occur to me that Aurora would stay with me in my practice, year after year. July 2012 was supposed to be a month of celebration as our cohort had graduated and were seeking our first jobs as therapists. We had bonded in role plays, through projects, on adventures, and with humor. Survived internships, passed exams, and grew as individuals. Aurora would prove to impact the cohort quite rapidly when we found out four of our own peers were present and involved in the violence that took place. It took all day to get answers about their safety, and when we finally did receive word, we came together to grieve the loss of one of our own and trauma to three others. You may know him as the hero who took a bullet for the woman he loved, shielding her from the chaos in the theater. His actions show his character and the person he was in this world. There is so much I could say, but know that he was loved by many and brought humor and lively spirit to otherwise heavy work. We grieved together over the weeks that followed, knowing the impact would go beyond our cohort and be felt around the world.  Before we could blink, the cohort was scattering rapidly, almost like a driving force was pushing us away from one another, and away from the reminders of what we’d lost. It became easier to avoid and attend to others, to embrace their pain and needs for healing by throwing ourselves into the therapeutic work, perhaps hoping to heal ourselves in the process.

And yet with each new tragedy, full of images, horror, and tears, we are transported back to our own dark times. Perhaps triggered to the point of needing breaks, tracking our own emotions, and holding boundaries with our clients to stay present in their grief. Grappling with whether to share our pain with clients out of connection and compassion or decide to lock it away for another, more private time.

Whatever direction you decide in your own grief, know that your efforts to help others through connection and compassion go a long way in recovering from these tragedies. Let us be gentle with ourselves as we are with our clients. Let us acknowledge the hurt and remain open to the healing. Let us recognize the avoidance of pain and the safety needed to face it. And let us hold space when words cannot capture what is felt rather than said.  Only when being true to ourselves and embracing vulnerability can we truly support healing.

In loving memory of Alexander C. Teves