Practice in Action: Ethical Self-Care

In our latest Psyched to Practice episode, we explore the often-overlooked topic of self-care for helping professionals. They delve into why self-care is more than just a feel-good concept—it’s an ethical responsibility that directly impacts our ability to serve others. Paul and Ray reflect on how the pandemic reshaped the conversation around self-care, highlighting the tension between the need to care for ourselves and the demand to support others. They discuss how burnout, compassion fatigue, and even poor decision-making can emerge when self-care is neglected. The hosts emphasize that self-care isn’t just a one-time action but a lifestyle, requiring ongoing reflection and deliberate effort. They also discuss practical strategies for integrating self-care into daily routines, from taking short, intentional breaks to embracing hobbies that bring joy and energy. Learn how shifting the mindset around self-care can transform it from a perceived luxury to a professional necessity, helping you maintain resilience and provide the best care possible for your clients. Tune in to this episode to learn how to make self-care a sustainable part of your life and practice, and why taking care of yourself is the key to helping others. 

To hear more and stay up to date with Paul Wagner, MS, LPC and Ray Christner, Psy.D., NCSP, ABPP visit our website at:

http://www.psychedtopractice.com

Please follow the link below to access all of our hosting sites.

https://www.buzzsprout.com/2007098/share

“Be well, and stay psyched”

#mentalhealth #podcast #psychology #psychedtopractice #counseling #socialwork #MentalHealthAwareness #ClinicalPractice #mentalhealth #podcast

Transcript

Hey everyone, welcome to the Psyched to Practice podcast. Your one stop for practical and useful clinical information. Masterful insights from experts in the field and a guide to Daily Living. I'm Ray Christner. And with me Paul Wagner and how we're kind of running a little of a theme, I think, here, where today we're going to maybe connect the dots on two past episodes that really kind of address some of these self care principles, but really kind of talking about our ethical responsibility as clinicians regarding self care and you know, for being in the helping profession, it's so frequently that those individuals are the ones that are experiencing the burnout or are having difficulty with implementing you know, the mindfulness and the self care pieces. And so how we can really recognize. Is the significance and importance of that, because we might feel like we're doing a service for others by thinking that one one more person in or kind of, you know, working through our lunch, but recognizing the toll that it takes. And, you know, as we advocate for others, we really just need to be mindful and know it's a theme. We've been talking about remodeling, what good self-care looks like and really how we can implement it in our day to day. Yeah, and I think is helping professionals. Sometimes he'd say to me, We're the worst at it. But you know, we do, we do struggle, I think, with it. And I think there's a maybe a historical kind of piece to it. I think, you know, there's always talk about self-care, but I'm not sure that historically in helping professions, we really put it out there as a necessity. And I think one of the reasons tying it to ethics is we know that when we take care of ourselves, we're going to help other people better. And, you know, we've all heard the the metaphor of being on an airplane and the oxygen mask comes down and, you know, you put it on your self before, you know, helping others. But I don't know that we always have have done that. And so I think that COVID maybe change the mindset a little bit. I mean, I think since that's happened, I've I've read much more and heard much more about really why it's so important that we do it. And I think tying it to ethics or is an important way to look at it and you know, so like When you're bringing up COVID, the conversation I have frequently is, you know, it changed everything and it really forced me to have to stop. And, you know, whether it's creating stillness or creating engagement in my home and. That's true for so many individuals. However, again, some of those in the helping profession, that was when they were at their busiest. And so there's this kind of dynamic where we, I think, got a lot more exposure kind of in the general population. And it's now more in this case. And, you know, we're tending to it more. But there's also this pressure that says, you know, and we're needing these individuals to be there and, you know, essential workers in this piece. So it's kind of a catch 22 there of where to practice self care. But we also, you know, when do we have the time. Yeah and and I think that it's you know, it definitely recognized it in covered but I think the the interesting part it really hasn't changed. I mean the need and the the kind of demand that we place on ourselves that's kind of continued so know so I mean I guess as were you know were saying self care maybe. Maybe we got to figure out how do we define it. So like when you when you refer to self-care and what your definition and. Really like, I would say up until maybe some of our recent interviews, I really had to stop and reframe what I was what I was labeling as that, because initially self-care was just an act and it's it's, you know, taking a vacation, it's, you know, stopping and, you know, getting a massage or getting that cup of coffee. And it's it's a singular act that was kind of providing care for myself. And, you know, certainly after the conversation with Chris Grammer and talking about that self-compassion, I think we connected that in that episode where, you know, self-care is the action, but self-compassion is the mindset. And I think, you know, it's really trying to blend both of those aspects together. And it's not just a singular act of self-care, but it's a kind of a lifestyle. And it's fine to say, how do I nurture myself so I can be that provider for others? And it's not only in those times of crisis when the oxygen mask is there, but, you know, how am I ensuring that I'm staying healthy How am I ensuring that I'm staying, you know, aware and that I'm able to provide that best service and best care for those that that I'm working with. So I think much more it's changed from an action to, you know, a lifestyle. Yeah. I think that's a great a great point. And it really I think has evolved for me as well professionally and personally, I guess over the you know, I'd say probably the last 20 years for me, you know, I think early in my profession it was just, you know, workaholic, nonstop. And I think sometimes I get into that now. But but it's a it's different. It's a different kind of approach. But, you know, when I do find it, you know, I think one thing I put in place is the idea that it has to be deliberate, you know, deliberate action like and and the other pieces, you know you mentioned. But like you just go on vacation or we do something. And I and I've done that my whole career. But I think as as it's evolved for me, self care has really taken on a kind of a number of different factors in life. So, you know, really focusing on what am I doing physically, you know, whether that's eating healthy, maybe that's just making sure I'm eating lunch, you know, those types of things. It's, you know, mentally or emotionally and spiritually. Like there's a there's a kind of different components that I think we have to sort of pull together for self-care that it's not just not just about taking a day off. It's, you know, again, it's it's that nurturing and kind of feeding all of these aspects of our life. And, you know, as you're saying, like those various domains, I can't help but think back to an episode. And I know it's one I think that we've kind of rereleased recently the case conceptualization. And in that episode you mentioned how there's a trend in psychology. It's like we're identifying the issue first. And so it's, you know, I have a person who has this diagnosis and this concern and then we're talking about strengths and then we're talking about other components of their lives. And, you know, how we can at times do a disservice by just looking at the issue. And we really need to kind of tailor self-care, I think to each individual person. It can't just be, you know, I do this, this, this and this because someone told me to do it. It has to really be a good fit for us and it has to be dynamic and meet us where we're at. So when you're talking about that intentional piece or and creating space for it, I think it needs to be not only okay, it's tailored for me in general, but it needs to be tailored for me and what's occurring for me. And in this moment, yeah, I mean, I think it's great. And I, you know, I think when we talk about strategies, we'll even get into that maybe even a little bit more detail. But yeah, I just had a situation just, just today I was talking to a just a friend of mine and I don't know how we got talking about just relaxing. And I said, Oh, you know, to relax. I've been doing a lot of writing and he's like, Oh, what are you writing? And I'm like, Oh, like working on a couple new books and some things, and he's like, That's work. And I said, Yeah, I mean, it is, but for me. That cognitive exercise of ratings actually very rejuvenating. Like it gives me a lot of passion and I love it. And it was interesting because in and I'm probably being harsher on him than I should, but there was a judgment there. There was a like, that's not relaxing if you spell kayaking or you should be out, you know, doing these other things. And, you know, I think your comment about it being so, you know, personalized, I mean, what works for one person and what rejuvenates them and creates more passionate them? I think it's very different than than another person. And it really is about finding what is your ideal self-care. And it really that's a great, great point that we should stay focused on. So. And you know, as we're going through and you know, you mentioned earlier, it's like self-care care isn't a new concept in especially when we're talking about, you know, the various kind of psychology related fields, like it's something that's written in our ethical code. And so, you know, for us to be able to practice ethically, self care is a part of that. And yet so often it's it's missed. And so I also think that there's a part of it that said, it's like, hey, I'm not going to skip over my C's because there's a, you know, I don't want that license, you know. And so in that same way, we can't just take self-care for granted. And I don't want to phone in self care in, you know, in this life. So being able to view it as now, you know, in a positive pressure way, an obligation that allows us to practice ethically in practice, you know, and to the best of our ability. Yeah. And with, you know, with the idea of ethics, when you kind of hit on this, pretty much every ethical code for every mental health profession has at least one, if not two. Provisions about self-care now may not always be, you know, highlighted in red and flashing that as self-care, but they're definitely in there. So your APA kind of words it in in this idea of striving to be aware of the effects of our physical and mental health on our ability to work. You know, any W for social workers kind of a similar way but really talks about monitoring performance and warning warning against practicing impaired, which we talk about later on I think probably one of the ones I like the best ethically I think was ACA, the American Counseling Association. They actually do call it out. They you know, they basically say counselors need to engage in self-care activities. You know, I mentioned for me, it's these different variables. They also do that. They talk about emotional, physical, mental or spiritual well-being. And then the National Association of School Psychologists, same thing. Nass has this idea of work related activities and paying attention to personal factors that may interfere with performance. So, you know, really across the gamut, they're there. They're called out. Now, is it the one we focus on the most? No, you're right. Most people focus on continuing ed credits. Yeah, that's that's the big one. But yeah, I mean, it it's so important that they're in there and I and I, I actually think we're going to probably see more and better language as, as these get revised, mainly because of, you know, what Chris Girma and others have talked about as this idea of burnout. So yeah, it's the self-care that really is going to help prevent that. And let us, I think, practice well and you know. I think self care suffers from good intentions, especially in the helping field where, you know, again, it is it's trying to just get one more thing done because it that, you know, we kind of strive for this idea of productivity or this, you know, I need to help the most people or I need to get the most done for it to feel worthwhile and for me to, you know, create a sense of purpose. And certainly there's an element of that, like, I want that to be something, but I don't want it to be everything. And, you know, in the same way, if I were having a surgery, I don't want, you know, my surgeon to be someone who is exhausted and who, you know, he's like, oh, you know how you get to one more? You know, that way this person doesn't have to wait another week. Like, you know, I've already done three surgeries and I've been up for 20 hours, but. Yeah, I know. Let's, let's put one more. It's like, I think it'd be okay. I was waiting. Like, I want someone when they're going to be, you know, at their best or at least performing in that optimum range. And so if we can view it in that perspective, it's almost doing a disservice by not engaging in this. And I think really that that's where these ethical principles are really coming from and saying, you know, we don't want to be an impaired clinician. And, you know, we say that and at least my immediate thought goes to like, Oh, well, I'm not using substances while I'm practicing so and I'm not impaired by impairment can look so different and so diverse. And again, it's what then if an impairment keeps us from being in that optimal state and if we can think of it in that way, that we have to really kind of be mindful and watch out for that. Yeah, I mean, I, I, I think you're right. I mean, I think this idea of performing optimally and, you know. I think when we when we burn out and we don't have self-care, we start practicing in a good enough mode instead of an optimal mode. And that really, you know, that's not how I want to practice. You know, that's not what I want. And I don't think, I think anyone really does like, but. Sometimes we get in our own ways because sometimes we burn out because we're trying to help so much and we're not taking care of our self-care because yeah, we're going to add that other appointment late at night or early in the morning. And, and sometimes we have to, I mean, that's, that's, that's the nature of the beast. But there's also a boundary of being able to say no and not because of an unwillingness to do it. But we may not be at our best. We may, you know, like you said, with surgery, you know, you don't want your surgeon to be dozing off in the middle and nor do we want to do that in therapy. You know, I I've. For a number of years have reviewed ethics cases in Pennsylvania for the state board. And you have a number that you know that the ethical issues came about, not necessarily because the person was just this terrible clinician, but many times was a result of bad judgment that came from being burned out. Maybe someone who took shortcuts on notes, maybe someone who, you know, just wasn't attentive in session because they were exhausted. So, you know, when we when we think of how this connects to that that ethic piece, I think we always have to change our view that self-care really is a professional responsibility, but that's really what it is And that's that's how we have to do it. And, you know, doing it isn't making us selfish. It doesn't make us self-indulgent. It's not making us narcissistic. It really is what's going to keep us at our best. So when we when we changed the mindset from it being us being selfish to really an ethics necessity, I think then we can view it differently and we're going to make I think better choices with it. Yeah. And you know, looking at those different reasons for it, like, you know, there's this. Elf judgment and a sense of being selfish. And then there's at times these external factors as well. And so I know, you know, at least when I was working in community based mental health, like there was this push that said, hey, we need to, you know, see as many individuals as possible. And again, I think good intention, however, you know, the execution is going to then, you know, suffer as a result of it. And so we have individuals who are practicing and or who are trying to serve others. And. If the thought is like, I don't have time for self care and you know what, we'll come back to that a little bit in a bit more detail and expand on like, you know, self care doesn't maybe take as much time as we think it does. But in that same way, like trying to make sure that we're not putting ourselves intentionally or unintentionally, you know, in an environment that's going to demand more than we're able to give because then, you know, we were needing to make a change in the same way that, you know, I think just about any mental health professional would encourage, you know, the clients that they work with to assess and, you know, review that and then making an informed decision. We also have to do the same and it might feel again, we're being selfish in doing that, but we're again, we're actually performing at a better in a better life when we're doing that self-care like that when we do that self-reflection. Yeah, it's I mean, it's a kind of maybe going off what you're saying, you know, really, there are these, I think, common barriers or pitfalls. Maybe we'll call them to self care and the system itself can do that to us. You know, I mean, and again, maybe I think that's what happened after COVID. You know, I remember, gosh, when when that happened, I remember sleeping in my office to try to get things rolling because we were moving to telehealth at that point, which we weren't ready for, you know, and it was, you know, it set itself from the beginning is kind of this this stressful time. But, you know, so our system can do that. You know, we're trying to get as many people in. We know there's long wait lists, you know, and in some ways trying to reduce people's pain. But it's some sometimes results in kind of a negative. So yeah, I think I think that's a great one. You know, it's interesting with that systemic, you know, I was reading an article. That that used the term the myth of invulnerability. And I thought it was very interesting, and that was a great term. And Amy, I'm going to probably butcher these names, but it's Amy Rochat and some are all Bull Lorig, and they did an article in Current Psychology a couple years ago. But the myth of invulnerability, essentially, they they basically said that it's one of the reasons why we neglect self care, because we think we teach it to other people. We somehow think that we're invulnerable. So the effects of not doing what we were telling people to do. And I think that's interesting because, I mean, I know some of the best therapists say, no, they're really bad at using that their own strategies. And so, yeah, that idea of a myth of involuntary ability that we somehow think we're immune to it because we're so skilled in the technique. And the reality is we're just not. Yeah. And you know, I'm probably opening up a can of worms that we can certainly derail and I think probably, you know, future episode material. But I don't know if it's been in an episode or not, but in the conversations that we have is looking at, you know, we're at an age, you know, kind of culturally where there is such an awareness and such a focus on mental health. Yet why are we still in a mental health crisis? You know, as we're seeing these advancements, shouldn't we be seeing then a reduction and improvements and it's just really not happening? And why is that? And, you know, I think that's a part of it. Just because we know it doesn't mean we're doing it doesn't mean we're doing it well. And, you know, even as we're, you know, working with our clients like. I know one of the most challenging things is, you know, to inform them and to share the information. And they can have they can recite it back beautifully. They can talk about and be creative with how they are going to do it. But then the time comes to do it and it's like, I don't have time. I'm just going to and we have to challenge those pieces. And so really when we're saying it's a change in lifestyle, it really is from that core piece of we're needing to slow down and take the time for it doesn't have to be a ton of time, but it has to be an intentional time effort. Yeah, I agree. And it is something where, you know, it's attending to it and you know, whether it's, you know, an intentional or purposeful, you really have to make that decision and make it a part of our lives. Now, you know, and I think there's there's a lot of different pieces. I mean, I think that, you know, the other piece that goes along with that is, you know, air paradox. So idea. And Chris Gerber, I think maybe better than anybody. But, you know, this this idea that we don't develop. We're not good at developing self-compassion or compassion for ourselves. We're compassionate the but we don't do that as good with our own lives. So I think Chris and his that whole, you know, kind of mindful self-compassion model really looks at that, I think, in great detail. And. It's interesting because, you know, we would think that, you know, being in the helping profession now, we implement these pieces in a practical way. And yet there's other professions out there where it's a requirement and it's built into their day. And so, you know, pilots and truck drivers, they're given restrictions on how much they can do because after a certain point, they're not going to be optimal. And, you know, certainly there's a safety component there. There's a safety component here with us. It's it's different, but it is a safety piece. And again, if we are, you know, missing information or if we're, you know, we're not we don't have that mental acuity to kind of read the tone or read what's not being said in the moment. There can be some drastic things that happen. And so, again, it's not a scare tactic because again, it's not meant to be this pressure, but it's meant to be this invitation to say, how do we change things and really, you know, have them make more meaningful impact. And self care is one of those that certainly we need to change the language and the rhetoric around it and how it's being practiced. Yeah, I'm glad you mentioned about other professions. Like, you know, my dad was a truck driver. That's what he did by profession. And yeah, I remember he, you know, he was only allowed to drive so much and he had to log it in. And, you know, if he got pulled over, they pulled his log and, you know, they checked it. Like if he was driving too much, that that could be a fine for him or his company. And it was just the nature of what they did. And, you know, and I know for some that's frustrating because they can only drive so much. And there are sometimes people are paid by the load or whatever it is. And I think, you know, we're not much different. You know, I mean, I think people in in especially those in private practice, you know, they're income driven by how many people they can they can see. And, you know, there's all of these things. But yeah, I guess, you know, I think our conversation is going to challenge the professional organizations out there. But, you know, I wonder, why haven't we done that as a profession? Why haven't we said, hey, maybe we need to put some guardrails up to say there should be a balance or at least some some guidelines to say, think about this. You know, how how are you going to perform optimally? Because, I mean, I know some people that, you know, gosh, they're seeing an outrageous number of of individuals. And sometimes I think they believe they're doing well with it. And maybe they are in many cases. And I know for myself, like I like long days, that's kind of how I work. And then I take, you know, more time off at other times. But, you know, I know my boundary like I do now at times, like. I would add one more person on on certain days. They're not going to get the the the same level of care for me or attentiveness as it would if I would add them on on a day that I only had four or five appointments scheduled. So, you know, self-awareness is a piece of it. But I do wonder why our professional organizations haven't at least maybe provided some suggestion. And it's so interesting that like. At first positions that I held working in, you know. I worked at Wal-Mart. You know, it was one of my not my first job, but it was one that, you know, during during my undergraduate. And I had to take, you know, 215 minute breaks and I had to take, you know, 30 minute lunch. Right. And it was required, like, you know, that I would get in trouble if I didn't go and take that time. And, you know, sometimes it was you're in the middle of doing something and it's not ideal because you're going to put it all back and you have to get it all back out. And but really that's like that's mandated self-care. And so, you know, there are positions even, you know, very common ones out there that like they're practicing this. And I don't know that we're necessarily taking full advantage of it when we're in those positions, but it's creating the space for it. And we as individuals need to match that. And being able to then step into it and saying, okay, the space is there. How do I fill it in? How do I fill it for myself in this intentional way? Yeah. And you know, I think it's interesting here we've mentioned about COVID and, you know, how that's kind of led into some of this. But, you know, it's interesting to say I don't know how this is going to pan out. But, you know, we I know there's some research that's out there, but there's a lot of people move to four day workweeks and working these long days. But but they also don't want to work super late at night. So they work these long days and they skip their lunch or they skip those 15 minute breaks. And we're now compacting all of this time into a very short kind of space. And and I wonder about that. I mean, I've I've thought about it for myself. I've thought about it for, you know, you know, other people that I've I've worked with. It's one of those things that sound really good and we believe it. It's helpful. But I also don't know because I think the more I've seen people move into some of that, the more stressed out people are. Like the three long days, long weekend days. Isn't the same kind of recovery as we get when we recover in small chunks. Like you mentioned, about 15 minute breaks. Like I remember my first one of my first jobs was working in retail and it was like they were strict about it. Like when you took your break, like you had to go to like the break room or you had to leave the facility like that's what you did. And it wasn't an option. They didn't want you talking to other people like you had to go. Like if somebody else wasn't in the break room, you didn't do it. And I have to say, it was a little bit of a simpler life then. You know, it was like I mean, I appreciated that time. I appreciated the fact of sitting down. I remember eating lunch in a lunchroom like that was part of it. And then we get, I think, into professions where maybe we take shortcuts around that. And, you know, again, I think for myself, I've changed that over time. Like, you know, I'm much better about for lunch. I actually sit down and go, would I leave my office? I sit in a different room. I actually eat. And really it's much more intentional throughout my day. I know when I'm going to have some time that might only be five or 10 minutes and we can kind of talk about that with interventions. But again, intentional kind of time and I think we may be losing that as people want to get home earlier at night. They want to work these four day work weeks. So they they work these long days without really thinking about those breaks intentionally as maybe as much as we should. Yeah. And, you know, in a much different context. But it reminds me of a conversation we had a while ago where we were talking about quality versus quantity. And I think the comparison was, you know, both McDonald's and Ruth Chris are billion dollar companies, but which one do we want to be at? And, you know, I cannot but think about that in terms of like, you know, we can, you know, take all of this time and like condense it into, you know, four day workweeks where it's, you know, one after the next, after the next, after the next. But does that really allow for the quality to occur? Right. And. Ruth Krauss is pretty good. So, like, I know that's where I'd rather rather be. Get my meal. Yeah. And it's, and maybe there's an in-between, you know, I think maybe there's. Yeah. And I think maybe there's a way of. You know, again I. Despite the fact of what may be how it came out. I do pretty much work a four day workweek. But I do know on those four days, I'm going to work late. And so I'm here at my office, usually an hour before my my first appointment. I forced myself to take an hour in the middle of the day, and then I have two half hour blocks now in my my schedule that I take between appointments. So essentially, I have 2 hours during my day where there's not client time they are for me to just kind of reset. But by adding those 2 hours, instead of getting out of here at 5:00 on until 7:00, you know, I'm out a little bit later. But by the four days you are important to me. And staying later and giving myself those breaks through the day. I function a lot better. My last appointment. I'm still pretty fresh, believe it or not. And it's not a difficult thing. If I tried to pack that. And we all know how therapy works, right? Like, sometimes they just don't end at the 45 minute mark. You know, they do it right. We'll have those days where we're running late for every appointment. And, you know, it's just the nature of the business. And then we don't even get that 5 minutes. Like one person leaves, somebody else comes in. So, again, I think if we're doing that, maybe that's some things that people need to think about is what is that like for you? Is that four days, really? Are you exhausted at the end of four days? I can say now that I build breaks into my day as fresh Thursday as I am, you know, on Monday I feel pretty good. I mean, in fact, we record the podcast after we're done on on Thursday nights a lot of times. Yeah. So it's, you know, and that's not an added burden because of the steps taken through through the day and through the week. So yeah, I think something just for people to maybe think through and you know, going back to this. Allard mindset like, you know, as we're talking about these like, you know, overall concept of like what it looks like and how to frame it. I think it's so important to recognize, again, the dynamic pieces of it. And, you know, if there's a day where it feels like, yeah, I can go back to back and it's an honest assessment, okay? But we have to make sure we're doing that where we're like we're doing this honest assessments of ourselves because there's going to be a time when it's not. But if we don't take the time to stop, we're just then putting ourselves at a deficit and then we're trying to recover from that deficit. And it's this constant, like a cat and mouse game. And so, you know, taking the time to really just check in with ourselves and that can be, you know, under a minute, you know, in terms of like, okay, okay, like, you know, let me pause and just kind of think like, okay, how do I feel like that went, you know, how am I just feeling like, you know, am I retired, you know, and what's happening here and being able to really giving ourselves a bit of that guidance session, a session versus, you know, it starts and it we're just getting caught up in the maelstrom of the day and feeling at the end of it like we just, you know, got hit by a tornado. Yeah. Yeah. You know, it's interesting, I. Several years ago, I had to see a medical specialist. And I'll never forget this. I mean, it's actually like something that's not always on my memory. And then you kind of said something that kind of cued me. But I have this appointment with this physician, and I go in, I'm sitting in the bathroom and he knocks on the door and he comes in and it's the first time I've ever had this happen, but I thought it was brilliant. And he said, Hey, listen, I hate to do this to you. Would you happen to have 10 minutes that you could wait for me to come back? I've been running back to back, and I just need to just pause for a second. I just want to grab a quick snack and make sure I'm kind of present when you and I are talking and I feel like I'm not going to be able to do that at the moment. And I was like, Oh yeah, like, you know, go ahead. And like, you know, gosh, I haven't I think I even joke I haven't even use the bathroom yet. And he's like, now, like sometimes that happens. And in my world he's like, you know, you're okay. And yeah, that's great. So I sat there, probably played something on my phone or he did whatever, but I thought, Wow, what an amazing strength. He had to have to say that, you know, to come in and recognize it and, you know, and rather than just letting me sit in the room, the fact that he came in and said, hey, here's what's going on, just want to make you aware. I appreciated it. And, you know, again, being somebody who I think is fairly compassionate and yeah, absolutely. Like, go ahead. And you what? He came back and it was just a great appointment. And I you know, it may have been great even if he didn't do that break, but, you know, the fact of his awareness to actually say it, to call it out and not to be embarrassed by it and just said, hey, you know, I just want to make sure, you know, if you're 10 minutes late, it's not going to be an inconvenience for you. And, you know, maybe if maybe it would have been and he would have just sat there. But I'm going to guess most of the people that would have been in that room that he would have done that with would have given him some grace. Yeah. And, you know, as you're saying that I'm trying to play both roles in my head where, you know, hearing that I view that as such a if the strength and like the self awareness and I can't but wonder like, you know, if I'm in that, if I were to do that, I feel like I feel guilty you know, and you know, there was that initial thought of like, okay, you know, how would I feel? And, you know, letting someone know that and what a difference where, you know, we both are agreeing like. We view that as such a positive thing. Right. And again, you know, even in the therapy session or promoting these things, such a positive thing. And yet when we're taking those same actions, guilt or feeling, you know, I'm doing a disservice or I'm being selfish. And again, that's that reframing process that needs to happen. And we need to be aware and catching ourselves and challenging and saying, no, I can. And that's the self-compassion I think that Chris was talking about. Right. You know, and certainly. Yeah. Just changing. Changing the dialog that's going on there. Yeah. And I think the interesting part is, you know, so as, as a patient and being in that role, my perception was he was a better doctor. Like, I mean, at the end, like, that's the real interesting part. Like I remember going like and this guy, like, he's kind of got it going on. Like, he's, he's, you know, and I trusted him more. I like all of these things that kind of came from that perception I had. But you're right. Time to turn it to guilt that somehow we're inconveniencing someone. And again, he was, you know, said, hey, if, you know, you have somewhere to be, like you don't have 10 minutes. Listen, I'll see you now, but. And it was almost like his his kind of strength in asking permission and saying, hey, are you okay with this? Again, it was you know, I'm not sure. Even if I was in a hurry, I would have said, yeah, I think I have been like, oh, no, me like, listen, like we've all been there like use take a break. Like it's not going to be 10 minutes isn't that much. And honestly, it probably wasn't even 10 minutes, but it reset him. And, you know, again, something good that maybe we need to think about that it's okay to do. Yeah. And most people are going to understand it and you know, it it kind of takes this action. I mean, it's a very personalized actually has the word self in it, you know self care. Yeah. But it makes it collaborative in a, you know, at least in the way that he approached that. And, you know, how do we give ourselves that permission and you know, so frequently, if we can have it, serve others in a way, it can then give ourselves that permission. And so, you know, I can't help but wonder for him if informing you of that, there's this permission that I'm going to be giving you a better level of awareness and a better level of care. So. That's the permission I need for me to take that time. And yeah, being able to go through that, seeing how, you know, this individual, I can certainly also be collaborative there. Oh, yeah, absolutely. And again, it's you know, we we all, I think can understand and maybe we just need to look at it on ourselves, you know, it's you know, so let's let's maybe before we talk about interventions, let's kind of just wrap up this. So what are the risks when we don't do that? When we're not doing well, when we're not we're not really doing self-care. What what are some of the you know, we talked about, you know, maybe it would result in us just doing good enough care rather than optimal care. But when it goes wrong, what are what are some of the things that you that come to mind for you? You know, and I think it's almost it's a. And a sliding scale, or they can really be compounding pieces where, you know, in the very beginning of poor self care, I think it's just, you know, kind of a lack of lack of maintenance. And so it might be, again, we're skipping lunch and maybe we're feeling a bit more tired. So, you know, it's, you know, we step back and say, okay, well, like, what's the big deal with that? But in the same way, I don't know if my I'm getting a low tire warning on my my tire from you know, I don't know that I want to go a long, long trip with, you know, why don't I stop and take care of it? And so in this way, like, how do we kind of look, look and listen to these warning signals that we're giving ourselves? If it's my stomach is kind of like clenching, if I'm feeling myself, like, yawning or, you know, physically, I'm just kind of feeling like. Magnet. Okay, like that's information. Those are signals. Let's attend to them. But I think they can certainly then start to grow into into relationship distress and into, you know, maybe having less time or spending with those that we care about. So we're not getting that remote revitalization. You know, we're then maybe not engaging in the activities that, you know, can really, you know, bring engagement or bring excitement, you know, and. It just ends up feeling like, okay, we're now entering into some of those burnout territories. And then burnout is, you know, what we have when we have poor self-care. But I think it goes even beyond that. And I'm curious, kind of in those early stages, is there anything that comes to mind for you before? Like, there's more severe ones. But yeah, I think that I think you really kind of hit on, I think in relationships and I even view it as not only relationships with others like our friends and our family and, you know, but even the relationship we have with our. Yeah. Again, you you're doing doing cases that involved ethics, you know, reading things where they were like, you know, their face was disconnected or they fell asleep during our session or, you know, like, wow, you kind of read that and go like, you know, people are aware of our alertness and our connection in therapy. So, you know, we affect those relationships. But then as you kind of said, you know, if we're not playing with our kids or spending time with our our spouses or significant others, or maybe we are they're but we're falling asleep because we're so exhausted. And and I've done that before and still probably will do it again. Like we get to those points. But, but they become so recurrent that it, you know, it start impacting and then, you know, as we all know, then that creates another level of stress in our lives, right? Then our relationships are becoming dysfunctional and then maybe that we bring that into to work. So there's this like whole cycle. Yeah. And then you burn out, you know, mentioning that. I mean we've said that a few times. I think that's one of the ones where that's when we really start going, Hmm. Something's not right here. Yeah. Maybe we're not liking our job that come into work's a hard thing. Yeah, I was reading a Facebook post and a group. You know, it was me. It was like, I cry my whole way home from work and cry on my way to work. Wow. Like that? Yeah, that. That's like, wow, that's burnout, right? We were hit to that that point. And, you know, gosh, I hope through this this kind of conversation, maybe we're going to catch some of those things, because I think these these little three, which are are kind of a lesser ones than what we're going to go into. They're hard enough. And, you know, same with anything. Like, if we don't give something here, it's not going to thrive. And I think from there, we can invite in enough. Maybe we lose our resilience. And so resilience in a variety of ways. So we can lose. There is kind of our physical like immunity, resilience. Like, you know, we we see that, you know, as we're, you know, sleep deprived, as we're not meaning in our basic needs, we're likely to get sick, which means we're more likely to then, you know, have to after crash and, you know, or we work through the sickness. And so then like we're just dragging it out even more so and as well as like, you know, we're in the mental health field. We hear a lot of really, really hard things. And I think there can be that resilience of experiencing vicarious trauma. And so certainly, you know, right, serious trauma can occur when individuals have the best of self-care, but we're we're increasing our risk of it. And I think that's something to certainly be aware of. And then on the other end of that, I think also compassion fatigue can be another piece of that where, you know, instead of it being, you know, hitting so hard and like we're carrying it with us. Anything? No, I. So what? You know, your partner just passed away. So what? Like, you know, you just like. And you're not saying it out loud, but our pair of verbals are nonverbals, because, remember, you know, words matter, but it's not the words that matter the most. And, you know, so the way we're expressing this, this interaction with those that are sitting across from us so important and, you know, if they're feeling that lack of compassion, what are they there for? Yeah, it's yeah, I think it's you know. It's a good thing for us to use as maybe a little self monitoring tool as well. And I think maybe I've said this in another episode at some point, you know, the rule of thumb for me has always been when I don't sit with people and feel something, it's probably the time for me to end my career like. I think that's time where maybe I'll kind of wind myself down if I ever get to that point. But, you know, both good emotions and bad emotion, you know, I mean, there's yeah, we do. We listen to hard things and and when, you know, and I do, I feel when people tell me things, I feel it like it's, you know, there's a there's a reaction. And I think that's a good thing. I mean, I think that's just therapists, you know, that's that's what we should be doing. It helps us kind of understand and and it really makes me know that I'm alert. It makes me know that I'm aware. I'm not just going through the motions of techniques. And when we stop doing that, maybe that's a marker where we kind of go, wait a second. You know, I'm hearing these hard things and it's, you know. Don't feel anything, but we need to pay attention to those things. You know, doing this 28 years, I've heard tough things and it's just as hard today for me as it is that that was my first year. It's again, it's that I think that I think it's a good self-monitoring. We don't want it to be that traumatization piece but. Being aware of it and and feeling it and being there, I think that sometimes minimizes it. Also, like I, you know, where we we don't experience that traumatic piece of it, you know, and with these things, I think, you know, kind of the rest of these risks, I think with self kind of self care or lack thereof are really a result of those first few we mentioned. Like when we when we start doing those, then it starts creating. Problems in our actions. Yeah. You know, so, you know, things like you start making errors in judgment or, you know, you become impaired in our confidence, which we never want to get, you know, get to that point. But that's part of it. Or maybe we're not meeting our obligations, whether that be ethically or legally. And worst scenario is that our our inaction in self care results in actions that harms that. Maybe we we really aren't there for someone. And and again, this is not it not to fear people, but there are people that can then get licensure violations or something legal or even harm for the therapist themselves. Like it gets to that point. So, you know, making sure we're we're really kind of attending and monitoring all of these things. And you know, I think that last one in particular because that and, you know, I can't help but think about, you know, when you mentioned the myths of invulnerability, how that can really resonate for for clinicians in the mental health field for the idea of harm to self. And, you know, there can be passive and active, you know, and neglecting health, you know, could we be inviting in other pieces or are we delaying now really important surgeries or even health maintenance things that are going on, you know, reading ulcers or even I believe in Chris's episode, he talked about working with a social worker who is engaging in self-mutilation. And, you know, just because there's this lack of compassion and care that's being given and how that can be something that, you know, we can we can suffer from. And so not just assuming that we're we're impervious to it, we need to recognize, you know, we are. And vulnerable. We are vulnerable. And, you know, vulnerability is. Good thing, you know, we strive for vulnerability and communication and connectedness as a driver of vulnerability and recognizing our own self-care and addressing it. Yeah. Yeah. I mean, absolutely. You know, and it kind of takes me back to where, you know, we did the episode about it. You know, it's okay not to be okay. And which for me was just a really kind of powerful kind of episode. And, you know, it it makes me think about, you know, making sure we're asking that to colleagues and and asking that idea to ourselves, like, you know, you know, really paying attention. You know, the reality is, is mental health professionals do get to a point of self-harm and and even suicide, you know, that, you know, there's there's been a number of people that I'm aware of in the field that have gotten to that point. And, you know, so making sure that, you know, we are asking our colleagues where they're at and and maybe help guiding them to self-care. You know, I think sometimes it's you know. It's easy to just walk by people in the hallway, but to just, you know, pause for a second and just check in. You know, it's something we always have to keep in mind. And and then maybe, you know, helping get people to to pay attention to the self care. So and, you know, so there are the risks. And so I want to make sure to also talking about, you know, what are the strategies and, you know, as this reminder, this is not a manual for self-care. It is a personal piece. But, you know, being able to look at like what are some potential techniques and how do we adapt it and make it our own. But we need some sort of foundational piece. And, you know, one of the most effective ways that we can engage in self care is first engaging in that self reflection. And we're kind of pausing, creating that intentional time and space to check in on where we're at. But again, if it's, you know, mentally, physically, emotionally or spiritually, where am I at and am I okay with where I'm at? Like, it's not just like, oh, you know, this is this is this. It's what does that mean? Yeah. Yeah, I agree. And I mean, I think that's that's where, you know, the whole mindful self-compassion really is such a great concept because I think it does that does really help us engage in that self-reflection and really kind of pausing. And yeah, I think sometimes we think that self care is this big thing. Like there's this like, you know, ah, taken many days off and long vacations and that those are all good things. And you know, I, I love a good vacation. That's a, that's a wonderful thing. But I think the piece I, I hope people hear is that it's the small moments. It's the it's the really that pausing on purpose. During the day. Check in with yourself and to take a break. But to be reflective about it, you know, I say I kind of have some times in my day now that I purposely have some breaks and know when I hit that, I usually. Pause for a second and just kind of go, okay, where I'm at, like, you know, this was a rough morning and I had really kind of some tough cases. You know, maybe I need to then do something that is, you know, much more intentional. Maybe I'm going to engage in something like. Some relaxation or I'm just going to watch her. Really? Ridiculous TikTok video. And that's going to make me laugh. You know, I think that we have to reflect and not you know, we don't really need an hour to reset or a half hour to reset. Sometimes a good 5 minutes is is more powerful than those longer breaks. And, you know, like I believe in the executive functioning episode, we talked about the Pomodoro technique and, you know, example like that idea of that's what it's structured off of and you know, it's five minute breaks up until a longer period of like this longer break time. But we're not just working straight through. We need some of that time to pause. And, you know, whether it's taking care of bodily function, you'll go get a glass of water or use the bathroom or if it's, you know, just kind of closing our eyes and just kind of taking a moment for ourselves. I love that you brought up the, you know, the ridiculous tick tock, because, like, I think humor is such a great way of warding off or, you know, warding off self-care or warding off of burnout and just yeah, those, I guess, early risk signs that we were talking about and, you know, finding things that we can laugh at and especially like not just chuckle but like know how good it feels to have a deep belly laugh and then, you know, laughing until we cry, so to speak. And, you know, I recently had an experience of that where me and my friends lives were pretty busy. My one of my best friends, you know, just had just had his first child. So, you know, it's just such a busy life. And for the first time, I got to go over and, you know, I got to meet his son. And we were then just kind of, you know, talking. We're throwing a Frisbee around and just it just things happen and we end up just laughing and laughing and laughing. And it's just like those moments that can just feel so restorative and sure. You know, had I not made the time to go and visit, then I'm not experiencing that. I'm feeling an even greater sense of disconnect. So pausing to recognize, okay, it's been a while and I have an opportunity, let me see that. But if I don't pause to recognize that one day, you might miss it. Yeah. No, it's. Yeah, and I think humor's great. I mean, I think humor in those small doses are good. I think also sometimes humor in our sessions can be really useful. I think there's there's some boundaries we keep with it, but, you know, it can lighten sometimes the situation, which I think can be done very appropriately. And yeah, I mean, it's yeah. So it can be those little things. But you know, I think when we think about self-care, it really is, you know, I guess thinking in regular intervals, I'm glad you brought up Pomodoro. I think that's a great example. You know, there's a reason why Pomodoro techniques work. You know, it really is those little resets and maybe, you know, it's not a 25 minute and then a five minute break that we need for self-care, but there is a ratio that we should pay attention to. You know, for me I find it's kind of like at about the two hour mark, taking a little 5 minutes is probably a good thing. But it really it's I think it's kind of self dependent, you know, in addition to humor. Another thing I would kind of add and there's little breaks music, I think music's another great one that, you know, we don't think of it as a strategy. I, I wish I could remember the, the researchers name because I just read this article this morning but just cannot can't bring it up in my head. But they were talking about the fact that when we listen to music, we love it in in effects our endorphins and we actually get a dopamine burst to our frontal lobe like they're actually researching music and they're doing this as a combination in music therapy and neuroscience and kind of looking at, you know, maybe we need to apply a different way in music therapy that there's there's, you know, there's a piece to it that the right kind of music at the right moment gives us this this just boost and we feel good and know I get that like, you know, come on. We all have right? We're in a car. Certain song comes on the radio and we just feel good for that. 5 minutes, right? Yeah. Just so again, like, you know, so for me, I have a little playlist. I have some songs that I know are just going to be kind of a boost for me. And, you know, I'm trying to remember the documentary I was watching at some point. They were discussing the importance of music in film and how, you know, changing the background music changes the tone and, you know, just the mood. Yeah, they had some silly examples, you know, taking some horror movies and, you know, it's the same exact scene. They're not cutting it, but they change the. Background music is like a montage and all of a sudden it goes from like this terrifying experience to this ridiculous one or, you know, going from, you know, again, like this conflict to action to changing the music. And now it's a romance and like what's good. And so it's it's has such an impact and it can really just direct ourselves. And so whether it's to create change or to create awareness, I think music is a great addition to that list. Yeah, absolutely. And again, something we can implement really simple doesn't have to be, you know, something that takes forever. It's just a nice, nice little kind of adjustment, you know, the other kind of thing. And there are some obvious ones out there, but maybe to call out, maybe some that maybe people don't think about. The other thing I would say is. What I would want a tournament, a leisurely diversion, where what are the things that we divert our stress to that we just enjoy doing? So maybe that's a technical way to say what are our hobbies? You know, what do we like to do? You know, I I've shared it with Paul many times, know cooking's mine. Like cooking's the thing that is it completely changes how I feel. And it's a years ago I owned a restaurant and I used to leave work and I would go there and start working in the kitchen and be like, You've been working all day. Why are you doing this? I was like, Oh, it's like great. Like, it's just like, it's such an energizing thing. I still do it, you know, when I have when when I need my breaks, you know, I have a my process is kind of very long when I do it. But, you know, I'll take a day where I'll go like, hey, I need to really just reset myself and I'll get up at 5:00, 530 in the morning and start going to farmer's markets and finding what products are out there. And as I go through it, starting to create in my head what I want to make. And then that turns into me going home and prepping and then cooking and then, you know, hopefully as as a family, we're then all sitting down and then that creates some connection, you know, and some, some other pieces. So it's this whole process that's a part of my leisure activities that that day I will say every day that I do it, I just feel great. And for some people that might sound like that's a lot of work to put into it yet, but it diverts my mind from it. It really kind of refocuses me. Do you have something for you that you do something similar and like, I'm kind of torn between two because they really blend together. But I love setting these like little. I have an idea in my head and I want to see if I can make it happen. And I really enjoy being outdoors and especially with camping. And so there was this book I have I have this hedgehog. And if I'm going camping, you know, I it's the setup piece of it that I don't like. So, you know, my wife would probably disagree with how you how enjoyable it is, but I spent, you know, a couple months just kind of trying to create this, like, okay, I want to have something that's just going to stay here and I can throw it on the back of my vehicle. And then I have, you know, the vast majority of my packing done and it's organized in a way. And so it was really kind of starting off with like I was like, okay, I have a spare toolbox sitting down here that, you know, has some rolling casters and they're taking it off, finding ways of making it work and being creative with it. So parts of it were disassembling it. Parts of it were, you know, I'm like, okay, it's hot. I want to be outside. So I'm going to turn this cooler into, you know, I got a battery powered fan and now I'm turning it into an air conditioning and researching it. And so, you know, if I had salt to the ice and now it's going to get turned into a slurry and it's going to be much colder and stuff. So it's just kind of like this, like excitement and being creative and expressive in that way. And so, you know, whether it's kind of tinkering and messing around with something or being out in nature, I think those are two that really just I can get lost in it. Yeah. And I mean and I think there's, there's so many different ways, whether people like traveling or just driving around or going to watch a concert or playing a musical instrument themselves. Like there's a bunch of ways we can we can get into it, but it really is a good reset for us and something we have to focus on. That also, I think broadens us all a little bit culturally when we do do those things, that's when I have and then if you have any others, we all kind of add on here. But, you know, I'm going to kind of, I guess, create kind of aa2 ends of a spectrum. And I think the other thing we have think of is paying attention to our our need for connection and our need for solitude. And I think those two things work together. And I think for self care connections so meaningful it, you know, whether it's with family or hanging out with friends or whatever, you know, in any way that we're connecting with others. I think we also have to recognize that it is okay for us to sometimes just spend some time alone and, you know, maybe only by ourselves somewhere or maybe just can go sit in a movie theater and not talk to anyone, whatever it might be. It's okay to just be with yourself sometimes and and be present with yourself. I mean, I think that's probably the time I have the best reflection when I do that. Yeah, but we need both. It really is creating this, this idea of balancing both parts of that our lives and being in social professions. We need that that sometimes close the door and be present with ourselves. And, you know, that's that spectrum there is so important because it's the intentional connections we care about and we have to make that. An evacuee. We're going to be there with ourselves. And so we can start to connect with ourselves. But creating those opportunities and not just going, you know, check next, check next. And there's one more that I wanted to throw in there. And it's being able to recognize accomplishments because it can be so easy. The kind of, you know, getting into that, you know, next routine, it's okay, this is done, this has done, this is done. But to really stop and giving ourselves some praise, giving ourself like I'm proud of what we've done and it doesn't have to be an end product. It can be a part of the process. And you know, it each deal that we're talking about task chunking like now let's not stop and celebrate at the end. We need intervals, you know, we need to be able to kind of really pause and I can't help but remember a year ago, Shawn Te, who was the he's the instructor for insanity workouts, if anyone's familiar with that program. He's very physically fit guy. And I was listening to an interview he had and he was in South Africa with his husband and they were going to go and they had kind of scheduled with a guide to go and climb a mountain. And he was kind of sharing his story and he's like, Oh, you know, I'm fit. I thought, you know, it's going to be good. And it was challenging and and just kind of like constantly looking up the mountain and starting to feel tired, starting to feel worn out. And the guide was then touring like, hey, there's a, you know, here's a bit of a flat area. We're going to stop and take a break. And he's like, No where, you know, we're not at the top. Let's just keep going, let's keep pushing and then got to where we're stopping and we're taking this break. And he he talked about how when he got to that space, it was the first time he turned around and he saw what he had accomplished. Because, you know, there's the mountain that's, you know, he still hasn't conquered. But you talked about how that view from that point was. You know, eventually that was far more gratifying than even being at the top of the mountain and pausing and looking at the accomplishments of what we've done instead of just the grind of getting to the end. I think that's brilliant. I mean, I think we don't do that enough. I mean, it's you know, it's always how do we push forward? And it's okay to look back for a second. You know, how we got there. I think it's a just a great example and and something that we need to do more and more. I mean, I, you know, I, I think I never did it to the level of course he did it. But, you know, had to have had times in my life that I have done that. And I it has been it's been powerful. Whether it's you know, maybe I was writing something and it wasn't quite done, but gosh, I had all this and back dissertation comes to mind that or even just being in college like I remember like, you know, getting to a point in graduate school where it was like. Don, you know, like Windsor's. And then you look back and go, Oh, my gosh, like I accomplished all of these steps. You know? So, yeah, there's so many ways I think we can do that's a great, great example to have. And, you know, there are so many other things out there. I mean, I wish we could just kind of. Do a whole kind of couple of hours on all the different ways. But I think just keep in mind, it's it's okay to learn how to play well and to do things that are fun, whether they're 5 minutes or climbing a mountain. It doesn't you know, it doesn't matter. It's you just need to be purposeful with them. I think this is kind of really important. I guess as we kind of wrap up, let me just just kind of summary summarize a little bit what you know. What is self-care and. What's not self-care. You know, like, let's kind of, you know, put it like for me for the the not so care. One of the things I have is that it's it's not a checklist. It's not a to do list. And please don't just make it another thing you have to do and really kind of think of it in a different way that this isn't something you something you just have to check off every day. And, you know, I guess to the things that it is, I think it's. It's not the action, it's the lifestyle change, and it's intentional space where we choose to stop. And whether that's savoring, whether that's reflecting, whether that's, you know, laughing, but it's creating that space for ourselves and making it a pattern that can't be sporadic. It can't just be, you know, when we're struggling. It's going to be best served when we're maintaining it. So, you know, make a maintained lifestyle change. And, you know, again, we've talked to some great authors who have talked about this. You know, you know, Chris Grammer for with mind, for self-compassion, for burnout, will kick in, for mindfulness, for life. And, you know, with the right resources and great books that just kind of like break down. And again, they're giving kind of these strategies of how to implement these pieces. But, you know, you can't make it your own and just make sure that we're not just doing it like a one and done or sporadic. But that's right. It's sustainable, it's deliberate. You know, all of those things, you know, which I think is important. And, you know, the. Doing this. It makes us not only better at what we do, but it also really makes us start enjoying it more. And I think that's that's really the the key. And, you know, it's approaching it again, not out of you're doing this for personal reasons, you're doing it for your ethical responsibility. E Yeah. So I'm going to kind of get a little cutesy and I want to end with a quote. I actually, it was funny. I was when we were preparing for this, I was like, Oh my gosh. Like, there's a quote that I have sitting in my office that actually is something that's in one of Maya Angelou's books, which was great. I can't think which book I pulled it from, but I think it's going to kind of summarize everything. And she she basically says, My mission is in life is not merely to survive, but to thrive and to do so with some passion, some compassion, some humor and some style. Maybe that's self-care. And and she said, well. With that. We hope you enjoy this episode. Please check back in in two weeks. But until then, be well. A site. The information contained in this podcast and on the site. The practice website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, educational or medical advice, diagnosis or treatment. Please note that no professional patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host guest and listeners of this podcast. If you need the qualified advice of a mental health professional or practitioner, please contact services in your area. Similarly, if you need supervision on clinical matters, please locate a supervisor with experience to fit your professional needs.