I'm worried about the therapists but I know they can save themselves
“I’m worried about the therapists” is the title of a blog post bopping around the internet. Friends are forwarding it to me and I’ve seen it posted on at least two counseling and therapist Facebook groups I frequent. I have a lot of reactions to this blog post. First, a sadness that therapists, and so many other helpers on the front lines, are struggling right now. Second, a call to action and a wish to help. Because I’ve been there too and it took me almost a decade to craft a life that sustains and fulfills the hard work I do. Finally, I feel really freaking frustrated that the things I learned over the past decade aren’t more widely available. I hate that sometimes we think self-care is exercise and sleep. It’s so much bigger. It is a way of life.
My own experience with burnout
Not a mug shot - just me burnt out
I spent much of my twenties barreling into therapy rooms with a full heart and white knuckled endurance. I loved my clients and had no idea how to care for myself so I could keep doing what I loved. My template for relating to suffering was ‘hold it or fix it’ and those seasons of being a therapist it felt as though the suffering was endlessly poured into me. I tried my best. I did the things I knew. I exercised the hell out of my body, I slept 9 hours a night, I had a strong social support network and started meditation. I thought I was the freaking valedictorian of self-care. Little did I know.
Those years were marked by classic burn out signs. My evening alcohol intake climbed. I made strong old-fashioneds and giggled over a pint glass full of port. Violent nightmares scared me awake. I scanned for jumpers while biking over the Golden Gate Bridge. When I was mugged down the street from the hospital, it felt inevitable. I thought “Of course, there’s violence everywhere. I’m lucky I wasn’t shot or raped.” I reported to work straight from the cop car, slinking home only after my boss kicked me out of the hospital.
Inevitably, in almost predictable annual cycles, I would reach an exhaustion point. I would do a yearlong sprint of clinical care, burn out, then run back to a desk job, doing research or policy work related to trauma. I tried to do what I loved from a safer distance. I told myself I must not be meant to do this work. Clearly, I couldn’t take it, wasn’t good at leaving the job in the hospital. Rumi says, “Never give from the depths of your well. But from your overflow.” But I didn’t know that. I didn’t understand how to care for this soul and spirit, dedicated to doing good in the world. I didn’t understand there are tools and skills to show up this great mission-driven work.
There is lots of hope for helpers experiencing burnout
This series of posts are intended as a simple blue print of what science and my personal experience have taught me are helpful to know and practice so you can do the work you love in a way that is sustaining and sustainable. This first blog post is a list of what I wish I had known back then, when I was fried to a crisp and blaming myself.
To all the therapists and other invisible front line workers who are deteriorating behind the scenes, there is another way, a way to fall in love with your work again. There is a way to do our heart’s work without breaking our own heart in the process. There is a way to do sacred, good, hard work that sits with tragedy (not alone with white knuckles) but with and in celebration of all of humanity.
What I wish I had known in the midst of my own burnout
I wish I had known the signs of burnout like disrupted eating and sleeping, not feeling like myself, feeling chronically ineffective, hopeless, and like my work didn’t make a difference. (You can assess your own level of compassion satisfaction, fatigue, and burnout here.)
I wish I had known that my own secondary trauma stress symptoms (nightmares, vigilance, ruminating on work at home) were a risk of the work I did but could be addressed with connection, professional support, and new skills. I just needed to learn skills, I didn’t need to leave the profession.
I wish I had known that my exceptional strengths and values that make me a great therapist are inexorably linked to parallel vulnerabilities like not prioritizing my own personal well being, not acknowledging my own suffering, and having strong reactions to work or impacts that fall below my high personal standards. If I had understood that these vulnerabilities were just part of the package, I would have more compassionately understood the need to make plans to protect myself, like self-care guardrails. (Special thanks to Dr Patricia Watson for the ideas illustrated in the table below.)
