Before You Burn Out – CBT for the Therapist: An Interview with Dr. John Ludgate
Do you ever wonder about how your therapist does it? If you are a therapist, do you ever have a day when it takes everything in you not to reach over and slap your patient silly? Or raise a white flag in defeat?
Occasionally people ask me, “How do you listen to peoples’ problems all day long without becoming depressed yourself?” The answer is the same for whatever the job is: we need to pay attention to balance. I do my best to balance the hours I dedicate to work, for family time, and for just plain old time off and play.
But to be perfectly honest, there are those days when I find myself severely stressed out. It could be I’ve over-booked myself too many days in a row, or had a series of challenging sessions or maybe just one person I wonder if I’m really helping.
On those days, before I decide to chuck it all and go work for Mary Kay, I remind myself of what Dr. John Ludgate, of the Cognitive-Behavioral Therapy Center of Western North Carolina, wrote. He says turnabout is fair play and invites the therapist to use the CBT techniques they share with their patients on themselves.
Whether we are new to the profession or seasoned, in private practice or in a not-for-profit setting, sometimes the therapist’s thinking could use a tune up to help them feel better about their work. That’s why I am happy that Dr. Ludgate agreed to be interviewed on this subject, one he describes as being close to his heart:
EWN: Dr. Ludgate, in looking over the material you gave the attendees of your workshop, “Advancing Your CBT Skills”, I was pleasantly surprised to see “Common Negative Thoughts” and “Dysfunctional Beliefs” written specifically for therapists. Reading those pages for the first time I thought, “Wow, other therapists have these thoughts?” It was a revelation. When did you start looking into how therapists could use CBT for themselves?
Dr. Ludgate: Probably about 20 years ago when I realized how my own thoughts were getting in the way of doing effective CBT and also causing distress (anxiety, frustration etc). This was confirmed when I started supervising novice CBT practitioners who had these same issues and also as I realized just how little our training equips us for this part of our job!
EWN: Is there something about therapists that makes them particularly vulnerable to critical self-judgment?
Dr. Lugate: Absolutely. Therapists have been found to be very idealistic, have very high standards for themselves and have a very strong need to help others. All of which are great characteristics but they can set us up, too, if they are held too absolutely, and just like our clients, we fail to reality test our assumptions and beliefs.
EWN: What has been your experience using this approach yourself or with your students/supervisees?
Dr. Ludgate: CBT is reflective and I believe it should be if it has any merit. CBT has helped me a lot professionally and personally. From students\supervisees it has elicited a very positive response as they have not had anything like this before and should have to deal with the challenges we all face and not get burnt out. There are no texts on CBT for therapists (I am trying to develop a workbook), no workshops, it is a sadly neglected area which we ought to be giving attention to in training, in supervision, in agency support groups and at conferences.
EWN: Is there anything else that you would suggest for the therapist to keep a healthy balance in their approach to their work?
Dr. Ludgate: Yes, practice what we preach. Cut off from work at defined times, don’t have unrealistic expectations of yourself or your clients. Don’t take it home with you. Balance recreation and self care with work demands. Find healthy stress relievers and basically do all the things we encourage our clients to do, especially check out our own thinking when upset and recognize distortions, erroneous conclusions and come up with more balanced adaptive thinking which promotes better therapy and reduces our stress and frustration.