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  • Márcia Fervienza

On The Costs and Rewards of Being a Mental Health Professional

Even though most of the work done by counselors, coaches, psychologists and social workers are research-based and behavior-oriented, I wanted to let you know that what we really work with is invisible. Our approach to a student or patient is through self-report and observed behaviors, and even though both are good tools as hints into the unconscious and into every person's inner pain, they are also subject to different interpretations and abstract. We don’t really know what is the reason behind a person's negative or self-destructive behavior and we don't know much about our patient's life beyond what they tell us. But their report of what is going on is also pervaded by their own filters and lenses with which they see the world. Furthermore, when someone tells you "this is what bothers me", can they be 100% sure that that is the problem? Hardly ever!

Then, based on what we see and hear, we make inferences, create correlations and connections. We take into account what we know (past history), what they tell us and what they do. We try to learn more with our ears, eyes, minds and hearts and we try to come up with an effective approach and intervention that is more likely than others to work for that particular patient, based on elements that are fleeing and subjective.

But the bottom line is that we are dealing with the invisible. We try to understand and solve that which is not concrete, physical, touchable. We try to connect with people that usually are connection-avoidant, who are afraid of letting go of control and who are extremely resistant to letting you in. Some of them have been hurt in the past when they allowed others to know them; others never even had the opportunity to connect, so they don’t know how to do it or what that is all about. They don’t know, and we are usually scared of the unknown.

But we try. We observe behaviors, we try to assess levels of inner peace, improvement in their sense of self-efficacy, their personal satisfaction, we look for any increase (or decrease) of compassion towards others. We observe our patients after we make an intervention in hopes of seeing something better, something new (a break in an old pattern of behavior, a new way of approaching and relating to others, more coherence between thoughts and actions, etc.).

When we see improvements, we are overflowed with happiness. But improvement can be short-lived: old behaviors can be easily triggered in the face of certain threats or challenges, and change can come in ebbs and flows. Growth and improvement is anything but linear. It can happen in gradual steps, but more often than not it shows as one step ahead, two steps back, until it becomes more habitual, familiar, and common place (or safe) for the patient.

Growth and improvement take time, and have different meanings for different individuals. Therefore, it is equally hard to measure. There is no standard scale with items to check off when it comes to personal development, because (as the name says) the development is personal. Although there is certain milestones that are expected in terms of behavior and functioning, what is a meaningful life for each person varies so much. As each person starts treatment at a different developmental level, each person has different goals for their lives.

Thus, coaching and counseling is completely customizable and customized for each patient. It involves as much technique and training as it does sensibility – to find the right approach that will work for that client, but won’t scare them off or push them too hard, beyond their level of readiness to embark on their inner exploration.

And the ending of each of our days is different: some times we are overflowing with happiness for noticing even small changes in the people we work with; others (and more often than not) we are drained, because we feel our clients' pain and suffering very deeply. We care. It would be impossible to do this work if we didn't care.

Witnessing people’s pains and regressions isn’t an easy path to choose in life. But because each negative pattern that is broken, each limiting belief that is overcome is so rewarding, we keep on doing what we do. For our love, compassion and belief that it is possible to be better, happier and live a fuller life.

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