It is a common belief within the mental health field that a psychotherapist's competence is often compromised when they work with clients who share the very same problem that they have, but are neither aware of nor motivated to work on. Early in my career, I came to the conclusion that in order to become a truly empathetic, competent and integrity-based psychotherapist, I would need to resolve my own propensity to be attracted to emotional manipulators. I would need to practice the very same standard of mental and emotional health as I promoted in my professional practice. My commitment to resolve my personal issues, which includes my codependent propensity, is the basis and inspiration for this chapter.
The "Golden Rule" may be one of the most universally accepted axioms in the world. The modern version, "Do unto others as you would have them do unto you," speaks to the importance of reciprocity and mutuality in relationships, as well as the need to avoid double standards. It is an ethical and moral imperative that is beautiful in its simplicity, universality and applicability. The Golden Rule has a long history dating back to 1780 BC in ancient Babylon [1]. Five religious references to the Golden Rule include:
•The Bible/Old Testament -- Leviticus 19:18: "You shall not take vengeance or bear a grudge against your kinsfolk. Love your neighbor as yourself: I am the LORD."
•Rabbi Hillel (fl. 30 BC - 10 AD): "That which is unpleasant to you, do not to your neighbor. That is the whole law and the rest but it's exposition."
•The Second Testament -- Luke 6:31: "And as ye would that men should do to you, do ye also to them likewise."
•Confucius: "What you do not wish for yourself, do not do to other." (Riegel, 2012)
•Hinduism: "One should never do that to another which one regards as injurious to one's own self." Brihaspati, Mahabharata (Anusasana Parva, Section CXIII, Verse 8)
If the Golden Rule was adapted to the helping professions, I believe it would go something like this: "Do unto yourself as you would expect others to do unto themselves." The "Golden Rule" of the helping professions speaks to the necessity for all helping professionals to apply the advice or direction we give to others to ourselves. It is an ethical mandate for us helping professionals to "practice what we preach."
As people who are entrusted with so much responsibility, professional helpers should conduct themselves according to a standard that prohibits them from providing services that they themselves need. Moreover, these professionals should not provide a service if their own unaddressed or untreated condition blocks their capacity to effectively help their clients. Just like the original Golden Rule, the Golden Rule of the Helping Professions emphasizes the need to avoid hypocrisy or double standards in the manner in which helping professionals provide professional services. Asking clients or patients to follow advice that the professional helper has no intention of practicing themselves, e.g., get help for alcoholism or treatment for our sexual abuse trauma, puts clear and definite constraints on their capabilities and the quality of services they provide. The "Golden Rule of the Helping Professions" is indeed a moral and ethical mandate.
This author ascribes to the conventional belief that all therapists should periodically participate in their own therapy throughout their careers. A blog entitled "Therapist, Heal Thyself" speaks to the importance of self-care for psychotherapists.
I need to be able to sort out my own personal issues from those of my patient and that is very difficult without having done work in therapy. Just as I cannot see my own back without a mirror, so too I cannot see my shadow and blind spots without benefit of the mirror of therapy. It is not a function of how happy one's childhood was because none of us come to adulthood without issues, without shadow. It is matter of the major importance of self-education, the kind that can only come, I believe, through the process of engaging in self-exploration with a good therapist. -- (Cheryl Fuller, www.jung-at-heart.com, 2007)
I believe that the Golden Rule for the Helping Professions is the cornerstone of competency for all helping professionals, especially psychotherapists. Having familiarity with the client/patient's experience or knowing what it's like to be "on the other side of the couch" or "the other side of the stethoscope" creates higher levels of empathy and consequently higher levels of professionalism. It is particularly helpful in developing higher degrees of compassion, understanding and empathy for the clients/patients we serve, while also increasing our awareness and understanding of their feelings of vulnerability, anxiety or fear. The Golden Rule for the Helping Professions brings us to "talking the talk while walking the walk" or as Benjamin Franklin once said, "Well done is better than well said."
The genesis of the idea for the Golden Rule of the Helping Professions can be traced back to my first week of graduate school at Boston University in the fall of 1987. During our orientation, our lead professor, James Day, Ph.D., asked the group of nervous graduate school newbies to raise their hands if we had ever been in psychotherapy. Naturally, of course, my hand shot up! While proudly displaying my openness to psychotherapy, I looked around and was surprised that only about 20 percent of my classmates had similarly participated in psychotherapy. Dr. Day was also surprised. I will never forget what he said: "How can you expect to enter into a career field in which you are entrusted to affect and change someone else's life, if you have not, yourself, experienced the process?" He continued with, "I promise you, by the time this program is over, you will need therapy ... and if you still don't think you do, it doesn't matter, it's a requirement!" He was right; we all needed some extra help that year!
It is my belief that for us helpers to be effective, responsive and impactful to our own clients, we should seek to recognize and confront our own emotional and psychological limitations. According to Carl Goldberg, author of On Being a Psychotherapist (1991):
The journey in the quest for healing and problem resolution can only happen when both the therapist and the clients share the same willingness for increased awareness and understanding of their own identity.
Based on anecdotal evidence and this author's 2.5 decades of professional experience, it seems that a significant proportion of professional helpers had a parent who was narcissistic or an emotional manipulator. More specifically, it seems that many helping professionals are involved in personal and romantic relationships in which they are caretakers or codependents to a narcissistic partner. It is the presumption of this author that when we professional helpers were children, we learned to cope with our narcissistic parent by developing a pleasing, helpful and accommodating persona. Having developed a high tolerance for frustration, endless patience, effective listening and problem-solving skills while learning to squelch our own feelings, helped us not only survive our childhoods but also created a foundation for adult codependency. It is well known that psychotherapists (professional helpers) were cast at a young age into the role of helper or nurturer in their families. It is then logical to presume that professional helpers, especially psychotherapists, are drawn to a career that matches their unique world view, personality and psychological needs [2].
Given that many professional helpers did not have ideal childhoods (some psychologically healthy families), psychotherapy is highly recommended, if not required. Taking the time to sort out the impact of one's childhood experiences, especially if they were traumatic, is an essential component of professional and emotional development. Professional helpers are no different from the clients they provide services to, as both share a need for emotional health as well as personal and relational stability. Professional helpers who seek services for their own psychological/personal issues increase the potential for positive outcomes with their clients. It is commonly accepted by most psychotherapists, that first-hand experience with the psychotherapy process not only may solve the therapist's problem or issue, but also creates deeper levels of empathy and compassion for their own clients.
Therapists seeking their own type of services, especially psychotherapy, is neither new nor unusual. According to 20 years of research, 84 percent of all psychotherapists have reportedly sought psychotherapy (Norcross & Evans, 2009). The propensity to be on both sides of the couch can be traced back to Sigmund Freud, who wrote, "Every analyst ought periodically ... to enter analysis once more, at intervals of, say, five years, and without any feeling of shame in doing so" (Freud, 1937/1963, pp. 267-268). After all, our professional qualities of empathy, patience, calmness and compassion are closely tied to our current mental health.
Because codependency is a common problem among mental health and healthcare professionals, it is critical that these professionals seek psychotherapy services early in their career.
Ideally, this should occur at the student level, because the insight that is gained will enable potential caregivers to recognize both the positive and negative aspects of their codependent behaviors and the effect that these may have on their personal and professional interactions (Clark & Stoffel, 1992, p. 823).
Therefore, it becomes incumbent upon all those in the helping professions, who were most likely children of emotional manipulators, to pursue their own journey of personal and emotional healing. Without practicing what we preach, we would be negligent and careless in our duties.
What follows expands on the Golden Rule for the Helping Professions:
•If you share the same problem as your client, your abilities and effectiveness may be compromised.
•Our mental health and our professional capabilities are intertwined.
•Our personal growth will almost always advance our professional capabilities.
•Like an oil change, every mental health and most helping professionals should seek psychotherapy at specific and necessary intervals.
•"Practice what you preach." Promoting physical and mental health in others requires you to follow your own advice or direction.
•Be a role model to your patients/clients; let them know you take care of yourself.
•We must examine our own reactions and judgments, as they are likely to represent what we do and do not like about ourselves.
•Intuitive abilities come from an unconscious experience of positive mental health.
•Your job may make you feel good, but it won't sustain you emotionally.
•Leave your work at the office.
•Learn to play and have fun when you are not working. You have a difficult job and life is short.
The Golden Rule of the Helping Professions should, therefore, remind all professional helpers and healers to do for themselves what they expect their clients to do with them. Practicing what you preach makes all the difference in establishing a remarkable career.
Other references:
1. Bond, Kenneth (1998), Religious Beliefs as a Basis for Ethical Decision Making in the Workplace, Humboldt State University, retrieved 10 July 2010, "...Code of Hammurabi (1780 BC). I used a translation by LW King with Commentary by Charles F. Horne (1915).
2. Roe, A. (1964). Personality structure and occupational behavior. In H. Borow (Ed.), Man in a world at work. Boston: Houghton Mifflin.