In the last few years, I found myself working with an addictions counselor who was very vocal and direct. I was new to the field, yet I felt strongly that her approaches were not always therapeutic, and sometimes not professional— too much self-disclosure or inappropriate topics under discussion. During our group, I allowed the clinician in me to be swallowed up by her dominating presence. I felt at a loss for how to redirect the group, and I stayed quiet because I worried that I would be even less effective. I would come out of group seething, but felt helpless to do anything. I was crippled by self-doubt. During this time, my self-efficacy as a new clinician plummeted, making work I used to feel somewhat comfortable with even harder. I felt down and ineffective, and I dreaded going into work. I felt tired, and slept more though it never felt like enough. (I have learned that I experience stress physically first, meaning I may feel exhausted and sick before I can tell that I feel overwhelmed emotionally and cognitively.)
I coped ineffectively by blaming my co-clinician, instead of acknowledging how frustrated I was with myself for not interjecting more in group or suggesting that we facilitate groups individually, alternating hours. I stood still, treading water, instead of taking action to get additional supervision or wisdom about the situation, instead of taking additional time to plan topics for group so that I would have a clearer way to contribute. Due to fatigue, I also let basics of self-care go, eating less nutritiously, exercising less, engaging with my own interests less. It was a difficult time. The difficult thing about depressive symptoms is that you do indeed feel down, but then you also self-select behaviors that are detrimental to your sense of self and your mood. Of course, interventions such as behavioral activation are built on this principle.
Now I believe I would handle this situation differently. I have better supervision in place, I would re-involve myself more regularly with my own therapy, and I might consider psych medication to help with my mood. I also have a little more willingness now to take risks in the group treatment setting in which I work. I am more comfortable working with my group without a co-facilitator. Now I don’t always wait for anxiety to pass before trying out a skill or teaching something new. What I do is not always perfect, but I make myself ACT anyway because this is how I learn, because it is my job to model tolerance of discomfort, and because my job demands that I be proactive.