Learning arenas for professional development: Retrospective accounts of senior psychotherapists

Copyright 2001 by the American Psychological Association, Inc. 0735-7028/01/$5.00 DOI: 10.1037//0735-7028.32.2.181 Professional Psychology: Research and Practice 2001, Vol. 32, No. 2, 181-187 Learning Arenas for Professional Development: Retrospective Accounts of Senior Psychotherapists Michael H. R0nnestad Thomas M. Skovholt University of Oslo University of Minnesota What can senior practitioners teach other practitioners about learning arenas for professional development? Four primary learning arenas were identified after a qualitative inquiry of 12 psychotherapists, averaging 74 years in age. The 4 learning arenas are early life experience, cumulative professional experience, interaction with professional elders, and experiences in adult personal life. The results indicate that profound experiences in any of these primary arenas can radically affect the professional work of the practitioner. To develop optimally, the practitioner needs to continually process and reflect on experiences in both personal and professional life domains. What lessons can senior psychotherapists teach other practitioners about their development throughout the professional life span? By answering this question, individual therapists may be able to create a developmental milieu that can facilitate development and prevent burnout and resignation. Also, educators may be better able to structure training programs so that competence can be enhanced and a foundation can be made for optimal postgraduate functioning. To practice psychotherapy can be deeply meaningful and rewarding for the therapist (Guy, 1987; Skovholt & R0nnestad, 1992). Although therapists are generally happy, healthy, and content with their work (Radeke & Mahoney, 2000), they also encounter considerable challenges when interacting with clients (Kihlburg, Nathan, & Thoreson, 1986; Mahoney, 1997; Schwebel, Schoener, & Skorina, 1994). Challenges, strains, and burdens inherent in therapeutic work need to be recognized, understood, and mastered if therapists are to develop optimally and maintain a positive morale in their work (Orlinsky, Ambuehl, et al., 1999, Orlinsky, R0nnestad, et al., 1999). Many factors impact the ability of therapists to function well. In one study, Schwebel and Coster (1998) ranked items regarding both well-functioning and impairment. The following were highly ranked items when both parameters were combined; self- awareness and self-monitoring, personal values, preserving balance between personal and professional lives, relationships with family, personal therapy, vacations, relationship with friends, professional identity, and mentors. There is a need to better understand the dynamics of how factors such as these influence professional functioning and development. We may get a distilled view of what makes a difference for professional development by asking senior therapists about what has impacted their professional lives. Senior Therapist Project Twelve senior therapists from a large (N = 100) qualitative study of therapist development (Skovholt & R0nnestad, 1995) were reinterviewed 11 years after the first round of data collection in 1986-1987. This subsample had a mean age of 74 years (Mdn = 75; Mode = 74), ranging from 61 to 84 years old. The mean number of years of postdoctoral experience was 37.6 (Mdn = 37.5; Mode = 41), ranging from 25 to 56 years. All were licensed psychologists. Five of the 12 had a diplomate in either clinical or counseling psychology. Six had received degrees in clinical psychology, 4 in counseling psychology, 1 in school psychology, and 1 in human development. Nine were men and 3 were women; all were Caucasian U.S. citizens. They had received their PhDs from six different universities throughout the country. All worked, or had worked, in either a primary or secondary position as a practitioner. An attempt was made to contact all 20 in the original senior sample group. Three had died, 1 was disabled, and we were unable to locate 4 of them. All the practitioners were contacted by the authors and asked to participate in a qualitative research interview similar to the one they had engaged in 11 years earlier. All agreed to participate. The interviews were conducted by either one or both of us (the two authors). All interviews were audiotaped, followed the structured format of 23 questions, and lasted between 1.5-2 hr. The 12 transcribed interviews served as the database for the qualitative analysis. The data analysis was similar to the one used in the original 6-year study (Skovholt & R0nnestad, 1995), which consisted of a qualitative, inductive method of inquiry (Hoshmand, MICHAEL H. R0NNESTAD received his PhD in counseling psychology from the University of Missouri—Columbia. He is professor of clinical psychology at the Department of Psychology, University of Oslo, Oslo, Norway. His professional interests include clinical supervision, the professional development of psychotherapists, and psychotherapy research. THOMAS M. SKOVHOLT received his PhD in counseling psychology from the University of Missouri—Columbia. He is professor of educational psychology at the University of Minnesota. His professional interests include counselor and therapist development, burnout prevention, and clinical supervision. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Michael H. R0nnestad, Department of Psychology, University of Oslo, P.O. Box 1039, Blindern, 0317 Oslo, Norway. Electronic mail may be sent to helge.ronnestad@psykologi.uio.no. 181 182 R0NNESTAD AND SKOVHOLT 1989; Patton, 1990) and an adaptation of the "constant comparative method of analyses" (Glaser & Strauss, 1967). The data processing consisted of the following two phases: Phase 1, in which we (the authors) individually read the transcriptions, then selected and highlighted sections of meaning, and Phase 2, in which we jointly selected and organized content into domains reflecting sources of influence for professional development. Content was not selected unless there was strong accord between us. We repeatedly checked descriptions against the data to ensure the validity of constructions. Four major themes emerged from the data. All themes are interpersonally anchored and are alike in that way, yet different in other ways, such as being influences at different phases of the life span. The four themes, labeled primary learning arenas, are the profound impact of early life experience (Primary Learning Arena 1), the profound cumulative influence of professional experience (Primary Learning Arena 2), the profound influence of professional elders (Primary Learning Arena 3), and the profound personal experiences in adult life (Primary Learning Arena 4). Primary Learning Arena 1: Profound Impact of Early Life Experience In these interviews, we saw the influence of early life (childhood, adolescence, family, parents) on various aspects of professional life and functioning. Eight of the 12 senior therapists that we interviewed made reference to how early experiences had impacted them as professionals. We were surprised to learn that, for 6 of those 8, the stories were primarily negative. The main family themes were abandonment, demanding achievement orientation in the family of origin, rigid and restraining child-rearing practices, conditional love from parents, and growing up in a family with a rule of no emotions. These experiences were seen as influencing professional life and functioning in various ways, such as selection of work role and theoretical orientation, therapeutic style and focus, attitude toward colleagues, experienced hardships, and ways of coping in practice. One senior participant conveyed that she had grown up in a very demanding and achievement-oriented environment, one with exceptionally high standards of performance. She explained, I have always had performance anxiety. I have always had it; no matter when I start or what I do, I am always concerned with how it will go ... it is a damn nuisance . . . it is always there, and I know it . . . it is a thing that keeps me careful about what I do ... I like what I do, look forward to what I do, and yet every time I am working with somebody, I am watching the clock and saying, "Only 20 more minutes of it" . . . am I going to be able to do the work? Some senior practitioners explicitly stated that interaction with their parents had impacted choice of professional role and their conception of "how therapy worked." The experiences seemed to fall into one of two categories: either negative experiences that elicited a counterreaction or positive experiences that were seen as formative and were typically reported to have a modeling and guiding quality. Some senior therapists told us that the influence of the family of origin manifested itself in indirect ways. One example is that interchange with parents impacted selection of mentors. When talking about the struggle to find and learn a method (of therapy) that worked, one male practitioner described how important it was for him to receive positive feedback and encouragement from professional elders. He said, From my parents, I got a lot of pretty instrumental encouragement. It was not genuine support for me as a human being. It was pressure to keep up the family reputation, so the people who became mentors for me and who really turned me on were people who were really encouraging and said, "Hey, that is a good idea and come join us, be part of the team," or, "Here is something that I think you will enjoy." Without sharing with us the specifics of an early childhood trauma that she referred to, one female practitioner told us that this trauma had impacted her attitude toward work in the sense that she took early retirement. She said, I think I survived those years without any ill effects on my day-to-day functioning as a professional. .. but I think because of my increasing cynicism over the years, I was motivated to end my career early. .. . My early retirement from practice and from the profession was a function of personal experiences, but I don't think early experiences impacted me while in practice. We were also informed how childhood experiences could impact choice of theoretical framework. Having felt rigid childrearing practices, one male practitioner strongly resisted discipleship or therapeutic approaches that were closed to reformation. His attitude toward theory reflects the upbringing practice of his early years. When talking about his efforts to become a transactional analysis therapist, and his opposition to it, he said, But I also saw it as being a very rigid system . .. and this is my personality more than my professional training. I have always been very resistant to rigid classification systems, probably growing out of my own early childhood experiences. At times, we were struck by how directly and intensely early experiences limited later therapist functioning. One male therapist described a family environment in which both parents had actively turned off difficult emotions and were resolute about action and decision making being more important than the reflection and processing of experiences. It was a very rationally oriented family. We saw a continuity between this and his approach to therapy and also to his seeming limits as a therapist. He had chosen an approach to therapy that was an intellectual, verbal, advice-giving, and rational combination of Skinner and Ellis. Talking about the potential impact of family background on therapist functioning, he said, Something that sticks in my mind was a couple that came in ... and got into a violent argument, violent, not physically but just use of words and yelling at each other and so on. And I found it very hard to tolerate. Earlier, he described his family as having an overly optimistic attitude, one in which "you gloss over conflicts." About the couple verbally fighting, he said, "And I really could hardly stand it, when it went on and on and on." When talking about how he deals with boredom in therapy, he conveyed that, instead of processing it, he changes the subject: "If it goes on too long, I change the subject. I try to assume responsibility for the course of the therapy. If it becomes boring for me, I try to strike some interest into it." SENIOR PRACTITIONERS In addition to the explicit link between early experiences and later functioning made by this practitioner himself, we also saw a connection between this therapist's desire for challenges on a constant basis and his perception of his mother. He explained, I have put myself in probably the greatest variety of situations that I could without being fearful or intimidated. .. . My mother was always like that; she was always adventuresome. . . . I keep finding things I want to get into that I don't know enough about yet. That is the way my mother was. Only 2 of the senior therapists mentioned explicitly how positive childhood and parental experiences were directly and positively related to later professional functioning. Both made reference to how parents became models for them of "how therapy works." One female practitioner made explicit mention of how the love of her mother became her therapy model—"therapy as love." Another female practitioner described, I think . . . [therapy] works first of all because a trusting relationship develops. I think it may be more important than all the other things people tend to do, but then I have always kind of thought that. I think it works when the person feels enough trust to talk about things in a way that they can hear themselves and get a little distance at the same time that they are close to it. When asked where this view came from, she answered, I suppose maybe it came from my parents. I never doubted that what they did was for my best interest. I am sure about [my understanding of] my parents and also what therapy is all about. In some ways, I never did really fit that into any of the theories and patterns that I was thrown into in professional training. We were surprised to learn that so many of the senior therapists reported being adversely influenced (directly or indirectly) by early life experiences. None of the therapists that reported an early background with some adversity told us about how this had positively impacted the quality of their professional work. However, there were reports of indirect positive consequences. One, who had grown up in a very poor family, told us of a drive to avoid poverty. He had chosen a professional role and context that provided much material wealth. As indicated, another said that because of conditional acceptance from his parents, he developed a sensitivity and appreciation for genuine collegia! support, which turned out to be quite positive for him. However, the general flavor of the reports was that negative early experiences continued to exert a negative influence as adults. We want to draw conclusions cautiously because we did not systematically inquire into all that needs consideration; however, our findings on early experiences appear contrary to the perspective of the "wounded healer" (Henry, 1966). Early wounds are not necessarily healed and seem to find their expression also in later professional years. Exactly how these influences played out in multiple work roles seemed clear to us sometimes and unclear other times. Primary Learning Arena 2: Profound Cumulative Influence of Professional Experience We were told about the impact of extensive professional experience on professional work. It was difficult to differentiate this impact from that of the aging process. We are reminded of 183 Watzlawick, Beavin, and Jackson (1969), who argued that how one punctuates and organizes event sequences is arbitrary in the final analysis. As a context of what the senior therapists told us, we want to convey that some of them experienced distress, sadness, and worry about declining physical health, reduced energy, limitations in activities and accomplishments, tiredness, and concerns due to care-taking responsibilities for their spouses. Some objected to the glamorization of old age, such as one male therapist who said, "And then later on the energy declines . . . I think the golden age is not best by any means. As far as I can tell, being old and wise is not better than being young and innocent and energetic." In general, however, the therapists reported high life satisfaction. This included contentment and gratitude for a career as a therapist and also for living a rewarding private life in their senior years. There were many reports of the positive effects of the human aging process on professional life, specifically on conceptions of the professional self and therapist attitude. The participants reported a decline of pervasive anxiety as they gained more experience. One male therapist said, "I have become a lot more secure. In recent years if somebody would strongly confront me, I would be much more able to say something that was more understanding, than to just become tense about it." This sense of security seems to come from a complex cluster of differentiation of responsibility, clarity of work role, and sense of therapeutic competence. These highly experienced therapists were telling us that, during their last years of working, they were working in a way and using a style that suited them. One female participant expressed it this way: "I think I question myself less about what I am doing compared to some ideal, some norm." During the interviews, we were generally impressed by the sense of confidence and assurance with which the senior therapists expressed themselves. When asked about brevity in her answers, one participant replied, Maybe it is more like I say what I say and people can take it or leave it. I don't have to make sure that the person has to see exactly what I saw. I think there is more confidence, but there is also a sense that everybody is not going to see things the same way anyway, and that is ok ... As a woman, I was enculturated in a period where I was taught to please others and that sort of thing was a crucial part of existence. So it has taken a long time to lay that aside. As a metaphor for her professional development over the years, she conveyed, I think about starting out on a walk. We have a very narrow path that you had to follow, and you watch your step so you don't fall off the edge. There is no edge to hold on to ... but now, at age 78, it is like walking in a wide world that has forests, deserts, rivers, oceans, and mountains, and it is like you go into it with your hiking boots and there is lots of grass, and you can sort of walk around in it without fear, and everything is more comfortable. The intertwining of the aging process and cumulative professional experience impacted therapeutic attitude. One male practitioner expressed it this way: "I think that I am much more mellow. I don't have a great urgency to fix somebody . . . I don't feel an urgency about 'having to make the therapy work'." Another male therapist said, "Maybe I became a little more patient as I went along and realized that it was not my job to solve the problems so much as to help the person evaluate alternatives." Another said, 184 R0NNESTAD AND SKOVHOLT "As I got older, I learned that clients often did not want me to say anything .. . they just wanted me to listen and go through it with them." The participants told us that with experience came more tolerance and that they were more patient and more empathic toward their clients. One therapist said, I think in some ways getting older and finding my intellectual, physical, and emotional powers declining is probably what has made me a little more empathic with clients. I am a little more responsive and a little more likely to give my clients time and a place to operate. Primary Learning Arena 3: Profound Influence of Professional Elders In these interviews, as well as the ones 11 years earlier, we heard powerful, passionate, and appreciative descriptions of professional elders. The actual interchange happened years earlier in the lives of these now senior therapists. However, the profound internalized influence continues in a very active way. Observing and interacting with respected and trusted seniors appears to be an integral part of being a student and a practicing professional therapist. For some, the importance of the senior therapist's impact had a mentor quality. There was a strong, positive psychological investment in the positive influential quality of the senior. Now, at mean age 74, a general theme for these senior therapists is the internalizations of professional elders. When asked about mentors, one female therapist said, I don't have them any more, honey . . . I always had mentors, and wonderful mentors . .. and they were always there, these wonderful men. . . . I am sure I have internalized these mentors. . . . I often speak of Kurt as in the present rather than in the past even though it was decades ago. One of the male participants described many strong mentoring relationships. Recalling one graduate school mentor, he said, I recall any number of instances in which he invited me to sit in [therapy] as a mouse in the corner during sessions, and consequently, immediately after those sessions, I could ask questions that were very pertinent and alive, and he would respond. I observed a master therapist, and sometimes he would bring me up to date on a case that he was dealing with. The general picture emerging from the interviews is that our participants had positive, influential professional elders. The impact of these people, in time, becomes what we have labeled the profound internalized influence of professional elders. Primary Learning Arena 4: Profound Personal Experiences in Adult Life Our participants told us how adult experiences had impacted them professionally. Only one of the practitioners we interviewed did not make this connection. The general picture was one of being influenced by both positive and adverse aspects of life. Since the mean age of the senior therapists was 74, they were gleaning from a long period of time, covering portions of 7 decades. Most influential was the quality of the primary relationship with the practitioner's spouse. These experiences ranged from extremely negative to extremely positive. One male practitioner talked about how marriage disruption had caused unfavorable career moves. He said, My personal life has probably had a lot of negative impact.... I have been divorced three times . . . the first two of those led me to make career decisions based on what was going on in my personal life, and in retrospect they were both bad decisions. Conversely, we were informed how a caring marriage had contributed strongly to professional self-confidence and assurance. One female practitioner described a rigid religious upbringing and a similar environment in graduate school. She told us, I used to be able to open my mouth and talk about anything under the sun, and I think that what I had to say was as worthwhile as anybody else. By the time I finished graduate school, it was like I had to look at what I was saying through about 17 pair of eyes before I could decide it was all right. Regarding self-criticism, she said, I think my husband is probably the most important influence in my life. He is extremely supportive. He really starts objecting if I start putting myself down one way or the other. It is an old bad habit of mine, and he stops it for me, and it is so positive that he does it. We were struck by how confident and assured this therapist came across in the interview. Present family can have an effect on the therapist in various ways. One male practitioner informed us, My spouse had an emotional disorder and was hospitalized many times. .. . What did I learn? I learned how to be tolerant of somebody who was ill. I watched my kids learn a lot about accepting . . . I learned a lot about being a good psychologist. I learned a lot about being a person. In the beginning, I was just so judgmental of my spouse.. . . Also, one of my children had a learning disability . . . that was hard too. . . . I was an achiever and a striver in my work so how could he have a learning disability. . . . I was extremely successful in my practice, and when that happens, it is easy to think you are something special. When difficult things happened in my family, it was painful, but it was good too, for perspective. Three of the therapists that we interviewed were widowed. They reported immediate distressing reactions to their spouse's death. They also described long-term positive consequences regarding increased competence in their work. One female therapist said, I lost my husband not too many years ago, and I adored him. And having work was the one thing that kept me sane. I sort of felt that in this room [referring to her office], I was still the same person. Outside I wasn't anymore. And I have had a lot more widows come to me; people would send them to me and I seemed to understand them. Hearing the intense loss-of-spouse grief accounts from the senior participants affected us personally. We also received reports of how their own grieving had made them better at empathicaHy connecting to the experiences of clients. For one practitioner, the intense flood of grief emotions was a transforming life event that dramatically changed him from being a rationally oriented therapist. He conveyed, For a long time, I was very avoidant of negative feelings and did not want them expressed in the office, and when I saw them coming, I 185 SENIOR PRACTITIONERS signaled that "we don't talk about that," and I think over time I have just become more accepting and better able to tolerate somebody else's negative feelings. I think I still have a tendency to try to optimize or persuade, but I am better at accepting the negative feelings. . . . I think one of the things that sort of shifted me out of the rational, cognitive, behavioral perspective was when my first wife passed away . . . I was pretty rational and cognitive and nonemotional and a good behaviorist. And then when she died, it all fell apart and I really got in touch with a lot of feelings . . . it opened up all sorts of things that I wasn't aware of ... feelings, emotions, vulnerabilities, strengths. And it had a tremendous impact on me and in my work. His new marriage to a woman who had a strong influence served as a second transforming event for this practitioner. The loss of one spouse, followed by the presence of another, combined to cause a large change in therapist identity and professional self-concept. He told us, And my second wife . . . was not totally pleased to be married to a raving behaviorist . . . she has put in a lot of stuff, a lot of "affected oriented ideas" that shifted me and made it easy for me to make the kind of changes that I have done. There are a lot of influences from her. We want to convey in more detail the story of an 84-year-old therapist. She illustrated how both her relationship with her mother and grief from the loss of her husband and daughter had an impact on her professional outlook and functioning. She said, "Within a two year period, 30 years ago, I lost both my husband and my only daughter, and I went into a very tough depression after such a slug. .. . which was very very difficult." This participant's commentary and reflections touched us deeply. She said the intensity of her grief was greater for her husband who was there every day than for her adult daughter who had moved to another state. She gave a detailed account of her recovery process concerning the death of her beloved husband: Oh, I did all kinds of things to recover . . . I would go back to every place that we have been together, and once I got back to the doctor's office where I had to take him every week, . . . and the tears were running down my cheeks, and the nurse was saying, "Oh . . . what is happening? Can I help you?" I said, "No. . . . I am just on a pilgrimage of pain." I found that if I went once, I could go a second time.. . . There were so many places where we had been, to restaurants, to the * laundry ... you see that once you face i t . . . and a lot of people won't do that. . . you just have to face i t . . . I can talk about it now, because I walked into the eye of the storm, and I was determined to recover. I would go to the library every week and hunt for something to help me ... you have to give yourself time. It took 18 months before I could feel like eating or drawing breath or anything. You have to tuck the lost person away somewhere, some place in your heart—it is really in your head—to come to a place where it no longer hurts . .. that is the big recovery. When you can remember without pain, you are w e l l . . . . I prayed for peace and purpose, and I eventually got the peace . . . and I sure got the purpose 'cause I had lots of clients. They came to me without advertising. I did help many, many people and eventually I had so many clients. With intense gratitude, she spoke of the care that she received from one of her professors: "He led me through some of the toughest times after my spouse died, and I am forever in debt to him, and I learned a lot about being a psychologist by being on the other side of the table." This female practitioner informed us of the positive consequences of grieving. She gave examples of how clients appreciated her work. She said, And then I realized somewhere along the way, it was just an example of my own life. I had recovered from my grief; I could show that it could be done, because the worst thing about grief is that you feel it forever. People would say, give it time . . . there was not enough time . . . I could not live long enough. . . . I was very desolate. She emphasized the power of modeling in therapeutic work with grieving clients. She said, "I was a living example that you can recover . . . I had started a new life making progress . . . and these clients who came to me, who were very discouraged, could see that it could be done, that you can recover." She continued to share her experiences: I had one client who wouldn't take her wedding ring off, and it had been going on for a year, and she was in such a desolate condition, and I said, "I want you to go home today and take off your wedding ring and put it in the drawer and leave it there. Start to make a break," and she called me back and said, "I did it." Sharing my experience with my clients is of great importance; I really knew what they were going through, because I had been there . . . and look at me now; I am fine . . . I get so disgusted sometimes when I watch TV and see people sobbing and sobbing over the fact that dear ones died 20 years ago, and I think, "Come off it; it's time you quit crying." I can talk freely about my spouse and child. I don't shed tears now. The interview with this senior practitioner is a clear example of the direct impact of both child and adult personal life on professional functioning. In addition to modeling, important components in her therapy model with grieving clients included the following elements: The clients must face the pain; therapists must share their experiences; and therapists should be caring, directive, and encouraging and convey (a) that change takes time, (b) that the length the client needs varies, but (c) that there is a limit to how much time it should take. Her model of change was clearly influenced by her own grieving but also by her relationship to her mother. She explained, I just marvel to this day of the vastness of her capacity to love . . . never did any of her children (and there were lots of them) feel that there was any partiality. . . . we were all so important to her ... such stamina, strength, bravery and courage .. . she endowed us all with her values. . . . From my mother, I got one very positive theory in all my work with people. I didn't change dramatically over time .. . "God is love." I believed there was a bit of God in every human being . . . I always treated a client with the intent of searching for the "piece of God in him." Individual Differences in Reflective Awareness All participants shared generously with us their reflections on the topic of the investigation. There was naturally some variability in therapists' ability or willingness to reflect on and share their experiences with us. The variability can be attributed to differences in the working relationship that we were able to establish, although it was our impression that we had established reasonably good working relationships with the participants. Our previous findings (R0nnestad & Skovholt, 1991; Skovholt & R0nnestad, 1995) suggested that for optimal development to occur, therapists need to (a) 186 R0NNESTAD AND SKOVHOLT maintain an awareness of the infinite complexities of therapeutic work, (b) continuously reflect upon the challenges and difficulties that they encounter, and (c) resist premature closure—a defensive and distortion-causing process that exists in therapists who are unable to balance the assimilation and accommodation processes when encountering difficulties and challenges in therapeutic work. The findings of the current study suggest implications that are congruent with, but go beyond, the above three recommendations. Practical Implications * Specifically, we want to highlight three major implications from this study. The first concerns the need to be aware of the variety of opportunities for professional development that the practitioner continuously encounters. The second highlights the significance of processing and reflecting experiences in all life domains in order to grow professionally. The third is that being a psychotherapist can be a viable and rewarding career in the mature professional years. We will present and expand on these implications in the following sections. Implication 1: For Practitioners, Professional Growth Is Impacted by Experiences and Events in Both Their Professional and Personal Lives Education for the practitioner never stops. Opportunities to develop "are everywhere and anywhere." Although the common use of the term commencement means "the end," the dictionary meaning is "the beginning." Our participants told us how the years after graduation were very rich in educating them, not only about professional issues but also about human life. Consequently, a more sophisticated and more nuanced conception of professional education is that it needs to be conceptualized within both a professional and human-life-cycle perspective. In addition to ongoing personal and professional life influences, our participants told us how much they were influenced by early childhood experiences. Regarding the impact of early life, our results point to the need for students and practitioners to continually process and reflect upon the ways that childhood experiences may impact professional functioning and development. Our participants told us that even in later professional years, when it would be easy to assume that professional training and extensive professional experience had strongly modified or erased early impact, the early years continued to exert an influence. Mentoring relationships are important because of their longterm implications: Mentors and other professional elders impact the professional life of practitioners forever! The senior participants told us how, even at the mean age of 74, their own professional elders were still influential. On the issue of mentoring, we would like to highlight two practical implications. First, we strongly agree that students and practitioners should actively explore the professional environment to find good mentors while respecting potential mentors' own needs and limits. Second, we suggest that the learning environment of professional training be structured in such a way that it facilitates the establishment of mentoring relationships. Because optimal mentoring relationships are contingent on a match between junior and senior, small programs, with a limited number of faculty and supervisors, may be limited. They do not allow students to interact with many seniors, thus providing fewer opportunities for good matches. Students need to actively explore to find mentors who can provide a good match. The learning environment of the student needs to provide the student with direct contact with and observation of several senior practitioners. The implication is also that training programs should not be rigidly structured. Ideally, they should be flexible in terms of providing for and allowing students to engage professionally with numerous professionals. The balance between (a) the program providing supervisor continuity should be assessed against (b) the need for variation in exposure to seniors. Implication 2: The Processing of Profound Experience Is Important for a High Level of Competence The classic saying that one can have 20 years of experience or 1 year of experience 20 times captures the challenge of transforming experience into wisdom. To make this transformation, it is incumbent that practitioners reflect and process the potentially rich experiences that personal and professional life provides. This can occur individually, in a dyad, or in a group context. The classic method is individual focused therapy, supervision, or consultation. Well-regarded group contexts are peer-group supervision and seminars on practitioner topics. The contemporary American work environment for therapists offers seduction away from this processing and this reflection because of the fast pace and multiple demands to be productive. We caution practitioners against the paradox of running so fast that they get nowhere, which is a way of saying that unprocessed experience does not lead to wisdom. It seems that a key to age being valuable for a therapist is the active use of processing and reflection. Since a central theme addressed by psychotherapists is loss, it is incumbent that they, to be competent, optimally process their own personal life losses. When they do that, they become even more valuable and competent for their clients. Our respondents told of processing their own losses and, as a result of doing their own psychological work, becoming more in demand as practitioners in the later decades. We cannot emphasize enough that, to develop optimally, practitioners need to continually reflect on both their personal and professional experiences. Early life experiences, adult personal experiences, and client experiences need to be continually adi dressed and processed. The fact that personal life is an important arena for professional development is both evident and overlooked. It is evident in the almost universal support for personal therapy as valuable in the formation and growth of therapists. Although there is no general professional expectation to reenter personal therapy in adult years, many do so. Also, structural aspects of work may represent obstacles for reflection. High workload is one stress factor that makes reflection difficult. Personal therapy is endorsed by most therapists and many training programs. Nevertheless, it seems that training programs need to provide more extensive structures for reflection and processing of early life experiences than now seems to be the case. Discussion groups, seminars, personal therapy, and supervision are arenas for such processing. It goes beyond the scope of this article to address issues relating to the differentiation between personal therapy and supervision. Treatment models influence not only how therapists think and what they do, but they also influence the difficulties and challenges that practitioners expect to encounter in their professional work. We would like to convey, however, that both SENIOR PRACTITIONERS supervisors and those receiving supervision should be open to discussing the possible and manifest implications of practitioners' early life experiences on the actual interchange between therapist and client. Our results imply that training programs may be enhanced by supplementing traditional course work, supervised practice, and personal therapy (the triad of training) with seminars focusing on the interface between personal and professional development issues. (We know that some institutions have done so.) Processing personal life issues within the educational system raises a number of questions regarding the content and definition of professional and personal issues (i.e., what is professional and what is personal) and how to regulate these boundaries. We suggest that such seminars be run by practitioners at practicum and internship sites. An advantage to this approach is that practitioners are not part of the power structure of the training program. Implication 3: The Profession of Psychotherapy Is a Highly Viable Avenue for Psychologists in the Senior Years One of the important practical implications of our study is the viability of therapy as a career field in the later adult years. With increased experience, heightened personal and professional confidence, greater creativity, and less anxiety, our participants—in their 60s, 70s, and 80s—offered strong endorsement for the viability of this career in the later decades. This is a strong contrast to the notion of employee obsolescence in the later decades. Since the cycle of technological innovation is so short, a person's knowledge base within a technological realm can quickly decline. The problem is so severe that we now have many laws against age discrimination in employment. The career field of therapy is a great contrast to this effect. 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