So, Now What?

07- Fear of Not Doing Enough… Developing Unshakeable Assurance

• angela tam

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Fear of Not Doing Enough and Developing an Unshakeable Assurance

 

The biggest threat to your feeling of not doing enough to help your client’s suffering isn’t your client. It’s YOU. 

 

If you are so afraid of the feeling therapist guilt, that you:

1)        Go over your allotted time for each session

2)        Over explain why time is up to soften the blow

3)        Extend the session beyond what is sustainable

4)        Ignore bathroom breaks/skipping lunch breaks

5)        Try to fix and patch things up before the end of session

 

Let’s be clear.. you’re not being kind, considerate, or generous. You’re slowly killing your therapeutic practice. Your guilt is getting in the way of you practicing your healing gifts fully. You are taking yourself out before you even get a chance for anyone to show any backlash. 

 

The first step to disarming therapist guilt or inadequacies?

 

Deepen your relationship to your worst fear if the scariest thing happened. 

 

What if your client was so mad at you for ending the session on time? What if your client perceived that you were a selfish and cold person?

 

Let me show you how to do that. Do the courageous work when you put yourself out there and take care of your needs. Prioritize your health. Stick to your boundaries of ending the sessions on time. Tune in and find out!

Come follow me on instagram @heyangelatam and subscribe to my newsletter here. Looking forward to adventuring with you!

Angela Tam:

Hey, this is Angela Tam. I'm back again with the "so Now what? Podcast. Thank you so much for tuning in and I can't wait to dive in with you about this topic.

Angela Tam:

This series is devoted to my mental health clinicians and practitioners and adjacent folks that are healers that are finding yourself feeling there's always this guilt of not doing enough or fear of not doing enough. Maybe you're finding yourself going over time in your sessions and having a hard time wrapping up the sessions, and maybe you feel this impending doom or guilt around ending your session or this anxiety around oh my gosh, this session is almost up and my client is crying still and I somehow have to leave them in a better place than they were coming in. Or you're over explaining and over processing the ending, explaining why it's time to end the session to soften the blow. Or maybe you're extending the session beyond what is sustainable, telling yourself that this is just going to happen once, it's not going to happen again. Or you're just not signaling that the time is ending until the last possible second, so the session ends abruptly and you're just going to peel the band-aid off and just tell the client that you really have to go. Or you ignore your bathroom breaks, skip lunch breaks or dinner breaks and you run late for the next client session. Maybe you try to overfill the end with comfort or try to fix it before time is up and try to help them to be in a good place, even if it means skipping your lunch, even if it means going overtime, and maybe you tell yourself I'm just going to schedule more buffer time in between my sessions so that I give myself the leeway to wrap up and go overtime, and at least I would plan to go overtime versus accidentally go overtime. Is this you? Is this something that you're really struggling with at this season? I just want to let you know that I get it.

Angela Tam:

I have been in private practice for so long for almost 13 years at this point. I do have ADHD, so I do have time blindness and I get lost in my sessions and hyper-focused in my sessions. And that is the positive aspect of having ADHD. Is that 50 minutes in a session feels like five minutes. Most of the time I don't keep track of time very well. I used to not keep track of time really well and I would just fly through my sessions and towards the end I'd be shocked that my session is over and I would have to drop the ball and drop the news that the session was ending like a bomb and really watched a client crumble before me and, anticipating that the client might crumble, my anxiety around this would really just eat me up and it would take up a lot of bandwidth of worry, anxiety just eating away in the mental, real state of my mind.

Angela Tam:

I really wanted to be likable. I really want to be helpful. I did not want to cause more distress in people's lives. They're coming to me so that they can have some of the distress alleviated, but instead distress alleviated, but instead it's my anxiety is causing me to worry that maybe I am causing them more distress because I'm ending the session or because I left them in a worse place than they were before they started with me, and my fear is that I would be perceived as someone who's cold-hearted and just someone who's just so by the books and stick to my boundaries and, just as a result, cold and leaving people hanging and selfish. If people would be left in limbo constantly and having sessions end abruptly, then maybe my fear is that people would see me for who I truly am, this selfish person who doesn't care, who's apathetic to other people's struggles and just can move on at the drop of a hat because time is up and I just have to go to the next session.

Angela Tam:

That is one of the worst fears that I sat with early on in my practice, and I really was always scared that if I did this enough, my clients would eventually leave me because they thought I wasn't a good enough caregiver, that I was re-traumatizing them and causing them to have unnecessary suffering and I would just then just be paralyzed and collapse with shame. So why even bother? So I just had the Sunday scaries a lot around my practice days. I didn't work every day early on my career because I had a young child to take care of at that time, but when I did go in for my practice days I would be so anxious, especially around the end of my meetings, and just wondering oh my gosh, how do I wrap up, how do I keep this to the 50-minute allotment so I don't burn out? So what happened in that time and how did I get from there to here?

Angela Tam:

That time? I was really burnt out because I was caring for my young kid. I was really mindful at that time, as a young parent, to count the number of times my kid was crying and if it was a day that they didn't break down, I would feel so good about myself. Oh, I did a good job, angela. I anticipated their needs and I was on top of it. And you know what? My kid didn't cry. I just felt so good about myself. And days that they did cry, I just felt so terrible. I was like, oh, I just could have done better to prevent them from breaking down and I could have stayed on top of it and they just wouldn't feel that way. And I realized how much parallel there was in my private life as to my public life.

Angela Tam:

I find myself tiptoeing and trying to see how much I could get away with taking care of myself while still taking care of my kids. So I just thought can I take this shower? Can I feed myself? Can I go on a walk with my friend and leave my kid with my mother-in-law? Can I do this and that and the other? And would it be pushing the boundaries of what my kid can handle in terms of their separation anxiety?

Angela Tam:

Ultimately, what I found myself doing is I put my needs below the needs and care of my clients and my kids. Because I could. I felt like this I don't know survivor's guilt around it Like I had the privilege to do it. I have the privilege to take a shower later, or I have the privilege to not spend time with my friends and maybe just take care of my kids, or in my clients in my therapy client relationships. I have the privilege of going over time. I have the privilege of charging my clients. In my therapy client relationships. I have the privilege of going over time. I have the privilege of charging my clients less because my husband was full-time working at that time and was a breadwinner of our family, or I had the privilege of not suffering as much as my clients were suffering.

Angela Tam:

I thought I could give a little bit of myself so that, because I could, I had the privilege of being able to do so, the financial stability to do, and I was paralyzed with the fear of not being a good enough caregiver as a result and I put my physical needs below my kids and my clients' needs and found my health deteriorating as well as my mental well-being, and I really saw this as a client and kid problem. I just thought, ugh, if only my kid was less sensitive. Or, oh, if this is a circumstantial thing. If I just fix my schedule, if I just added buffers, I just don't have enough time or I just don't have enough energy. If I could just sleep more, if I could just give more, I wouldn't have this issue. And that is just not the case.

Angela Tam:

The fear of not being good enough and deprioritizing your needs is not something that happens with a client. It starts with ourselves. We are afraid, ultimately, that we are not good enough for ourselves and that fear is maybe not felt or conscious, but is a result of this critical dialogue inside that says you are not good for anyone, you are not worthy of love and care and basic human right of rest, but you need to earn it and you need to make sure everyone else is okay before you take care of yourself. And you should deprioritize yourself as a form of care for others. But in fact and I know if we were to sit in our more rational brains that deprioritization is a form of self-harm.

Angela Tam:

It's a form of self-sabotage is a form of self-harm is a form of self-sabotage. And when you allow your sessions to spill over and disregard your health and really disregard the next client's time, the impact is that you are enacting self-harm. You're programming yourself to believe that your worth is less than your client's and you're harming yourself when you try to soften the blow and over-explain yourself. You're trying to shield yourself from the shame that might come from your client's potential backlash for ending the session. You are slowly killing your creative and compassionate gifts of being therapeutic. When you stay small and don't tend to your needs, you're saying to your client and to yourself I am not important, and that is self-harm. That is a form of self-harm that results in self-harming behaviors over time and they look really innocent because they're socially rewarded.

Angela Tam:

We're seen as people who are selfless or are so generous, but really, at the shadow side of things, we are slowly killing ourselves, slowly harming ourselves when we have this continuous behavior of putting ourselves last, of putting ourselves last. Why does this happen? Why does this happen in the first place? And I'm going to break this down from an IFS perspective, internal family systems perspective. Some of you might know this already, but I'm just going to get really specific about how this shows up in general. So why does this fear come up of us not being good enough?

Angela Tam:

And then the behavior of running over sessions and then deprioritizing our own needs in order to prioritize the comfort and safety of our clients' needs or, in my case, my kids' needs happens when we are blended, and the term blended is literally what it sounds like. You're being hijacked by a feeling and you're blended with that feeling. And so blending happens when a part of you and this is the idea behind internal family systems is you're made up of a bunch of parts of yourself and those different parts of you have feelings, have beliefs, have value systems and they operate independently of you. Most times they hijack you and cause you to do the work of self-defense for you. So it hijacks you when it senses that it is unsafe. And the result of being blended with a part is that a part or a tendency takes over, along with its behaviors and its principles and its feelings. It hijacks the switchboard of your consciousness, so it doesn't even cause you to realize that it's being hijacked, and now it's causing you to consciously and unconsciously believe that you are the feeling. You are fusing yourself to the feeling You're adopting the feeling. That feeling and the beliefs, tendencies and behaviors feel like truth. They're not just a feeling, they're like truth and they are you. They're like it causes when it's hijacking you, causes you to believe that you are the feeling, you are the part, instead of noticing that the guilty part of you is being activated. Then the therapist therapist or you feel like I am, that I'm that feeling, I'm failing and I'm failing my client and if I prioritize my own well-being, I'm just going to be a failure.

Angela Tam:

And blending happens as a result of your parts feeling threatened, vulnerable or triggered and it reminds them of a past pain. So the part says, if I take over, I could keep us safe and control and connected. So let me break that down even further. How it happens. How it happens is something external is being triggered. So let's say time is running out. So you're noticing the clock shifting and someone is looking disappointed or someone is being like looking crushed, and they don't even know that the time is running out. They just seem crushed. And this part of you notices that the time is running out and you're noticing okay, this part is stepping forward. Maybe you're not noticing the part is stepping forward, but this part steps forward and tries to lead and flood your system with the feeling of guilt and creates a loss of objective perspective, which is okay. I need to end because my session is coming up. That's objective and the client will be okay if I end. They might be crushed but they'll eventually find the resources to go back to equilibrium.

Angela Tam:

And it causes this person, causes you to think that this problem is urgent. This problem is true and if you don't do something about it it's your fault. And then the part can drive you to action to avoid the pain at all costs. So it causes you to extend the meeting time over, explain towards the end or rescue. And the mentality when you're blended is that this story feels real, everything feels immediate and high stakes and there's urgency involved and there's identity takeover. This feeling is not a feeling, it's me. And this part uses past burdens to interpret the present. So if this client is disappointed, that means that I'm repeating my parents' neglect.

Angela Tam:

How do you unblend and step into your more authentic self? First, if you are blended and spiraling in your feelings and feeling not good enough and you have to move into your next session, recognizing that this part is a part, and that is really the first part of the work. You might not have the consciousness to sit there and notice that this part is a part, but as you're doing this work you might start to come to that realization quicker. You might start to come to that realization quicker when you're noticing, oh, my chest is tightening up or my arm is tingly or whatever, and that is an indication that I'm feeling guilty. Sometimes that work of connecting your body experiences to a part is also helpful and working with a practitioner is really helpful for that.

Angela Tam:

Second is externalizing the part and noticing okay, this is one of the many voices that are coming up to help and recognizing that the feeling that they're trying to cause you to feel is for a protective reason, and that part is not you, but a voice that's working to help you bring you to safety, but a voice that's working to help you bring you to safety. And sometimes externalizing that part is tricky because some people like to use a parts map to externalize their part, like just to draw like a map of their parts or some people and this is what I've recommended to some people before is to create like an altar of your parts so that you could see what parts are there. And an altar for your parts would mean like dedicating a space to your house and then writing down messages that parts would tell you and putting the message in an altar so that you could see. Okay, this is like basically a map of my parts and sitting on an altar external to my body, and that helps us to externalize it. Third is try to see if you can access some groundedness and anchoring to help you gain some resourcing, to find steadiness. So sometimes that means humming a song, looking outside the window, drinking some water, taking a few deep breaths to gain a little capacity to recognize that you are in the middle of a storm, an inner emotional storm. Fourth, see if you could access your higher self, and this might take some practice. So some people like to go on Spotify to access a song list that helps them to tap into their inner power or to their inner voice, to their gentle nurturer. Some people like to do this by making a collage because they're more visual, and putting that collage right next to their computer and so they can access their higher self, so they can get into that inner calm. Some people like to keep some things that their inner voice might say to them, the higher self might say to them, in their back pocket and take it out whenever they feel under-resourced and some of those things that people might say.

Angela Tam:

I can leave our meeting and trust that my client's inner resources will help them do their week. I'm not my client's only resource. They have ancestors, spiritual guides that may or may not be known to them, that are looking out for them. I'm a part of the collective fabric of my client's well-being. There are other people, known or unknown, that are looking out for them. Client's moods or states of being my inherent value is not dependent on whether or not I was helpful. If my client is disappointed that we have to end the session, it's okay. I can hold space for their disappointment during our next session.

Angela Tam:

Fifth, see if your higher self can send some compassion to your guilty parts, and this is sometimes difficult, but sometimes I like to tell people to pretend that their parts or in this case, the guilty parts or their inadequate parts is a small child, and sometimes putting a picture of your childhood self or some other random child on your desktop might be helpful. And picture that child telling you that they're feeling so guilty for ending the session early and not being helpful. And picture that child telling you that they're feeling so guilty for ending the session early and not being helpful, and see how much easier it is to potentially send this little child's compassion, and that would be something that you can do in proxy to your parts, and sometimes it's easy to send this child's compassion versus your part's compassion because you don't really have a face to that part.

Angela Tam:

Seven, notice that there's an underlying painful feeling beneath every avoidance behavior, and this fear is different for everyone and sometimes different for different circumstances, and so this underlying feeling of pain is the result of what happens when the protective behavior such as the protective behavior of trying to not to extend the session or people pleasing or over explaining around session ending is something that you're trying to avoid. The pain is something you're trying to avoid, but this protective behavior is not allowing you to avoid. Maybe it doesn't work and maybe you feel even more crushed or even more guilty towards the end. Usually, if the protective behavior fails, that's when you feel this underlying pain. And so notice sometimes when you're trying to end the session on time but there is backlash from the client and then you feel like a shitty therapist. So just notice that feeling of what happens when your protective strategy fails.

Angela Tam:

So in this case, when and if there's backlash from the client around the session failing, notice what you feel, notice the bad feeling underneath and tend to that feeling of pain in a compassionate, kind way where you're witnessing some of the stories that it's carrying historically, because all stories, all pain, has a charge Sometimes there's an intergenerational charge and sometimes there's a personal charge to it and tending to that, being curious about what kind of stories it has, will tell you what is informing the current behavior and actually will diffuse future protective behaviors, because then those protective behaviors don't feel like they need to work so hard to protect you from feeling this painful feeling, if that makes sense.

Angela Tam:

Anyways, I hope this is helpful and let me know if you have any questions and let me know if this resonates with you, and I'll look forward to seeing you next time for more work on how to work with your fears, your worst fears as a therapist, and what behaviors maladaptive behaviors we tend to have in our practices as we're tending to our clients. I'll talk to you really soon. Thank you so much for tuning in. Bye.