Part 1 – A Letter to Therapists: Burnout and the Hands-on Approach to your Salvation
A therapist falsely assumes that it is their privilege to sit in the passenger seat while their client drives. It is this false assumption that leaves therapists feeling like they slammed into the same walls as their client after a session.
Burnout is a thing in the lives of therapists. It specifically is a glaring problem when many therapists follow the same “HR Pamphlet” advice that they often find themselves providing to their clients. Read a book, take a walk, practice work-life balance, etc. While taking care of ourselves is important, even a highly balanced therapist will still find themselves falling into burnout regularly.
I remember a young trainee therapist that I was supervising telling me that the content of her therapy sessions was so distressing that she was unable to sleep. She assured me that she knew what to do and went on to tell me that she was running on the treadmill every night after she got off work. “THAT’S NOT HOW THAT WORKS!” I exclaimed.
So let me tell you how I believe burnout “works”
Our emotional minds are a beautiful and miserable animal. Old wiring creates random results that no longer fit for any current situation and at the same time can create something life-affirming (“It’s a double rainbow!”). The old wiring is awesome in that it monitors situations for responsiveness to the emotional energy it controls and will offer an ebb and flow of that energy to best create an impact. This means that the anger that I show my neighbor about their untrimmed hedges will continue until my neighbor gets out his clippers. Throughout this process, the ebb and flow of anger is monitored to determine if it is creating the desired change in the hedges. When the old wiring recognizes that anger is not getting those hedges trimmed, the old wiring dwindles down the useless energy. This way, we can divert that energy to something more useful, and return to monitoring the hedges situation to see if a new energy would be more impactful. A side note to this paragraph is that unexpressed “helpful” emotional energy may toggle the ebb and flow of the anger to create action (i.e., low anger then a sudden burst of high anger). Complete shutdown of this emotional response (i.e., I cannot go get my sword and horse and challenge my neighbor in a duel) may cause the “technically” useful energy to linger beyond the moment that it is trying to impact.
Let’s break that last paragraph down a bit. Our limbic system creates emotional energy to impact our lives (surviving, connecting, etc.) and if we have an emotion about something and the emotional response does not create desired effects, then the limbic system starts to turn off the emotional response. Lacking emotion towards something that previously had been “emotion filled” often feels almost “numb.” Our cognitions will also report a lack of interest, thoughts of defeat, and dissatisfaction. This systematic shutting down of energy directed towards a goal is the overall experience of burnout. (As a trauma therapist, I am compelled to note that this does not apply to trauma as much as you would think because the limbic system believes that the chaotic emotional responses following trauma ARE creating a desired effect which would be keeping us alive even if we are tormented by them.)
So, what was my old intern doing when she was running on the treadmill every night after having the emotional exhaustion of her daily sessions? She was trying to trick her brain into thinking that running was the action that was going to “release” her emotions, almost like she was trying to milk a dairy cow’s full udder. Unless this nightly running creates a change in her client’s issues, the milk will refill the utter just like her emotional load will continue to need to be released. An example of this would be having been involved in a car accident and having a perpetual fear response. Scream therapy may help release some of the fear-based energy in the body but if the screaming does not tap into the originally stored and locked away memory of the car accident, then the client will report feeling better in the moment only to have the udder refill with fear by the following morning… or the drive home from the scream therapy session.
In the following parts of this blog, I will address burnout as it uniquely relates to therapists and two primary issues causing burnout for therapists as well as their practical solutions.
By Jason Temple, LMFT