Self Care as the Most Important Work, with Alison Crosthwait

Topics covered:  Self care as healing and as a process of "becoming;"  signs that we are in need of self care (as tuning in);  Alison's path to becoming a therapist, her current view and practice of self care, and ideas for implementing a self care practice. Length:  51 min, 35 sec.

Class Notes

About Alison

Alison Crosthwait is a psychotherapist and writer based in Toronto.  

She writes weekly at on the topics of "therapy and life, and the intersection of those things."


Alison’s story of self-care (Quotes from Alison)

  • Practicing during difficulties and losses—it’s the worst job in the world when you’re going through your own hard day.

  • Forming while I have lost. Grappling with questions in order to keep practicing.

  • Self care has become the foundation of my life and fundamental value.

  • On the eve of the U. S. election, the words “self-care is devotion” came to me. Something shifted for me and prepared me to address the surprise [of the election]. It was like, every moment, everything that we do is our act of devotion. Every moment, how we act.

What is self care?

  • Self care is such a big topic—in many ways it’s the story of our life

  • Self care is actually our own healing in whatever form that that takes

  • The healing of the therapist is what allows the therapist to do the work

  • Self care is an active process that never ends; it’s dynamic—just as clients' needs are changing all the time, our needs are changing all the time.

  • In order to be who we are in the world to our families, to our clients, to ourselves—self care is the core of it.

  • This is the thing! It is the issue! We need healing, because we are in pain of some kind, and in order to be with ourselves, moment to moment, we have to experience that pain. Self-care as expanding from relaxation to held container ways of being with the things we have experienced and with the person that we are as a result.

"I started in therapy when working as a trader in the stock market, stressed out of my mind.  Self care started as ‘come down; relax;’ get to know how I feel.  What I’ve come to understand about self care, and what helps me do the work now:  The extension of this work is work for our planet, work for children; it’s work for the people who don’t have what we are so fortunate to have.  It’s the path towards caring for everybody.  And so, as a result, this is actually very subversive work.  It is hard work, because if we actually have our own feelings and our own selves, we will make our own choices, and the whole world is not set up for this type of agency.  We are up against our culture in doing this work in a particular way, and there is great meaning to it."

Evidence of self-care


  • Presence for me is the marker as to how is my self care. Presence to myself and presence to my clients. Ultimately, the relationship that we have with our clients is the prime determinant of their success and our success. This is about HOW we are with them, not what we do.

  • Can we listen to our clients?

  • Our we present enough to listen to our clients.

  • We are trying to understand the whole person. Sometimes, I'm getting the gist of it, and I just can’t land. A sign of needed self care is not having the resources to follow the micro-moments of our clients' stories.

Welcoming difference

  • Can we hold our own wounds and prejudices as ours, and allow them (clients) to have theirs?

  • Can we be different and still care?

An evidence of self-care is being able to do this.

Allowing influence

  • Do we allow our clients to move us?

  • Anytime we are using theory to distance ourselves from our clients it's an indication that I’ve got a lot of feelings. Theory is very helpful, we need it, but if I’m always thinking of their character disorder, I have to ask myself, what’s happening over here (with me)?

Taking care of ourselves:  Can we have compassion with ourselves?

  • “If you were your own therapist, what would you say to you right now?”

  • “This is all part of the learning, and all part of being human.”

What does self care look like?

  • Self care as finding ourselves, our inner resources, our vitality, our aliveness. It’s not only restoring, so that we can go back into battle.

  • Self care is finding a way to live alongside suffering. There is so much suffering in the world, I’m living with it, we’re all living with it. The question is “How?”

Signs that we need to "tune in," and practice self care

When we feel: 

  • contempt

  • judgment

  • boredom

  • irritation

  • fear

these can be important signals in our clinical work when related to a particular client.  These feelings contain information; we must allow ourselves our feelings, because they are telling us important things.  This is how they feel, they just can’t show it to you.  

From Ili:  As an aside, in my graduate work, a professor told us that if we feel something "in the room," someone present (a client) is likely feeling the same thing.  This has stuck with me and has helped me be aware of my feelings in session, and learn how to use them therapeutically. 

Additional signs:

  • boredom

  • irritation

  • tired

  • overwhelmed

  • distractibility (jumpy mind)

  • reactivity

  • when we lose our ability to reflect

  • irritated and sharp in our personal lives

  • busyness

Busyness is an illness.

We all have huge demands on our time—dealing with that dilemma directly is important.  When we are constantly responding, then there is “nobody at home.”  Then, at the end of the day, we have just responded; we haven’t brought ourselves.  Busyness can be used as an excuse.  I’m too busy--then the way that you’ve worked your life is not in line with your values.

Sometimes, we have to sacrifice things that we really want, because of things that are happening in our lives.  We may have other dreams, but we must consciously work with these conflicts and values.

(See the end of the recording for more on busyness).

Practicing self care

  • We can live purposefully, because self care is a practice. It does require vigilance, but it gets easier with practice.

  • The work of healing, the work of coming to ourselves, takes time. For a time, constant vigilance is required, but then it becomes a part of you.

  • We need to be CEOs of our own lives.

Alison's practice

What Alison does for self care—the intentionality of how she puts this together is what she mosts wants to convey, not the actual structure/practices.  Follow your intuition in order to develop your own program.  

Consistent (daily and weekly) practices

  • Extremely long days on Tuesdays, Wednesdays, and Thursdays in private practice. Mondays and Fridays are reserved for writing, reading, studying, supervising, and personal therapy. Thursday night, after a long day at work, Alison has a massage—a process for releasing feelings from the week.

  • Spends at least 25 minutes each day with herself, with a set of practices that change, but involve some form of breathing, reflecting, praying--it depends. This is a daily practice.

  • "Woo Woo" Warning! Alison cleanses the energy in her office, in order to release the work done in the her therapy room during the week.

Practices that she goes in and out of:

  • Continuum ( body movement process that involves breath, sound, movement, and permeability between us and the other.

  • Proprioceptive writing (Linda Trichter Metcalf)--a practice of writing your own thoughts.  Listen to what you hear, write it down, and be ready to ask the question, “What do I mean by?”  The freedom of having our own thoughts (subversive, exciting, and transformational).  When I’m allowed my own thoughts, when I’m allowed to think what I think, then all of a sudden, I can let other people, because I’m not so tight.

  • Personal therapy.  Every therapist should be in their own therapy of some kind.  We carry a lot, so we need to do that.

  • Made a change to live on a farm, and drives there on Thursday evenings.  Environment, and what we surround ourselves with matters.  "It’s not just things and time blocks."

How to get started, and miscellaneous tips

  • One small step. Don’t let self care become a burden that induces guilt and the "shoulds.” Listen to your own response to these ideas, and being with one thing that resonates with you.

  • How Alison moved from the stock market to being a therapist. “I always knew the stock market wasn’t for me.” I knew that I couldn’t keep up the pace, if that makes sense.

  • Self care really is the way in which we follow what we know.

  • Busyness is no the enemy, it is not “wrong.” She is not suggesting that we should all have a quiet schedule. The question is “how are we?” How are we in our soul?

  • Diet, supplements, and exercise. Proper attention to nutrition.


From Alison:

  • The Good Therapists: Weekly blog article is released at 7 AM EST on Tuesdays; therapy and life and the intersection of those things.

  • Free mini course delivered by e-mail. A course to help you make more progress in your therapy; it includes worksheets, prompts, mp3s, etc.

  • Alison is developing experiential workshops. Coming soon!

Additional resources mentioned

BONUS:  Alison also contributed to the Family Therapy Basics blog.  She and I chatted about four signs it's time to reflect on your wellness and take a look at your self care practices.  Read the blog article (there's also a brief Youtube video) here.


The Good Therapists