Overcoming Regrets: A Key to Clinician Resilience

As a clinician, do you have any regrets? If so, how have you coped with such feelings? It’s probably impossible to do dedicated work in the addiction field without experiencing any regrets—whether related to clients, families or co-workers.

For example, an addiction counselor whom I know well recently confided regretting not being tougher with family members, whereas another long-term colleague reported, “My main regret is that I didn’t realize soon enough that some of my clients needed a team approach. I waited too long staying with one-to-one sessions.”

Have your regrets lately increased, diminished, or remained the same? Mounting research shows that your answer may significantly affect your mental and physical health—as well as your resilience in combating burnout.

For today, psychologists view regret as an important phenomenon, broader than and different from guilt. They are converging on the notion that what we regret, how often we do so, and with what intensity all make a difference. These findings make intuitive sense, for not everyone is fixated on past mistakes or missed opportunities in life, while some people can't ever seem to let go.

Researchers draw a big distinction between regrets over actions and those involving inaction. It seems that regrets over actions evoke mainly “hot” emotions such as anger (“How could I have been so stupid to have bought that car?”). But regrets over inaction typically elicit feelings of wistfulness (“What if I had moved to Los Angeles with Amanda that summer instead of staying at home?”) or despair (“Why didn’t I go to law school when I had the chance? I’ve wasted my life selling insurance.”) Evidence also shows that people experience more regret over their actions in the short term, but as they age, this attitude reverses, and regrets of inaction become more salient.

These discoveries may be particularly relevant to addiction counselors, who sometimes find themselves fixating on what they could have done differently to prevent client relapses or worse. Early in my career, I experienced this distress when a 28-year-old woman I had counseled in a hospital setting died of an overdose two months after discharge.

Three tips for clinicians

How can you reduce your work-related regrets? Recent psychological research suggests three effective methods:

1. Find a mentor. When I began my clinical career in South Florida, I was lucky to learn the ropes from a highly successful psychiatrist with a warm, personable demeanor. He had a wonderful, self-deprecating sense of humor and was also a family man with four children. More than any specific therapeutic technique, I learned from him the importance of balancing work with loving relationships—and the power of jokes and quips to reduce stress.

Years later, when writing Alfred Adler’s biography, I discovered Adler had pioneered the use of humor in therapeutic relationships (specifically, in helping clients see their problems from a broader, more hopeful perspective). In seeking a mentor, look for clinical experience, empathy and the ability to self-disclose easily.

2. Join a peer supervision group. Because mentors are often older figures trained in an earlier time, you’ll also benefit from regularly sharing ideas and experiences with peers, those with a similar level of expertise. This task isn’t difficult if you work in a rehab center or hospital with many colleagues, but in small clinical settings you’ll need to take the initiative to create your own group.

In this regard, a good role model is Sigmund Freud, for as a struggling, solo practitioner feeling professionally isolated, he invited a few colleagues via postcard to join him for lively discussions at his office every Wednesday night. This tiny group eventually blossomed into the worldwide psychoanalytic movement.

To provide necessary structure to your meetings, it is useful to choose a specific topic and leader in advance each week.

3. Practice expressive writing. If you don’t already keep a daily journal, now is the time to begin. Decades ago, Abraham Maslow urged his students to gain self-awareness by journaling—especially to express their feelings about personal events. Maslow emphasized that this must become as habitual as brushing one’s teeth.

In the context of this article, it’s essential to write about your regrets, those of both action and inaction. Keep the focus on your feelings. Don’t intellectualize. As the great British writer Katherine Mansfield said, “Regret is an appalling waste of energy. ...You can’t get it into shape; you can’t build on it. It’s only good for wallowing.”

Edward Hoffman, PhD, is an adjunct psychology professor at Yeshiva University and a licensed psychologist based in New York City. His books include biographies of Alfred Adler and Abraham Maslow, and he most recently co-authored, with William C. Compton, PhD, Positive Psychology: The Science of Happiness and Flourishing (Sage Publications). The author thanks Paul Palnik and Kirk Schneider, PhD, for their contributions to this article.