Practicing psychotherapy is undoubtedly fulfilling and gratifying but there are times when we as therapists might feel distressed or experience feelings of emotional discomfort despite its many rewards. Let me just take a crack at this professional conundrum and write about how burnout is prevalent and affects many of us and include tips and strategies that could help prevent burnout in therapists. I know we are conditioned as therapists that have an unending reservoir of endurance and compassion, as therapists we are masters of relationships, self-care and whatnot.
But alas, we are not immune to burnout which is defined as a “state of physical, emotional and mental exhaustion caused by long-term involvement in emotionally demanding situations” (Figley, 1995, p.11). After all, it’s not always easy to “walk the talk”.
Therapists might feel emotionally exhausted and lonely because of the chronic work-related stress along with the tendency to help as many individuals as possible. As therapists, we are more vulnerable to psychosocial stressors, which if persistent will lead to burnout. Burnout, first coined by Freudenberger in 1975, comprises 3 components, namely emotional exhaustion, depersonalization (loss of one’s empathy, caring, and compassion), and a reduced sense of accomplishment.
Each of these components falls into a continuum and we may experience unpredictable expanses of each component at different times during one’s career. We as therapists need to keep track of these components for our emotional and mental well-being to avoid feeling burned out. While prevention is better when we experience burnout, we should stop and reassess our current scenario and make the changes needed to get us back on track. One of the early signs of burnout involve increased work effort coupled with minimal or no increase in productivity. In some cases, the output of work may fall. Concomitant with the fatigue seen in early burnout is “distancing behaviours.” (Freudenberger, 1979).
Burnout can also be manifested in verbal withdrawal from patients, rigid behaviour or going by-the-book attitude, displacement of self-anger in patients, along with some other affective, cognitive, physical, behavioural and motivational manifestations like low mood, emotional exhaustion, guilt, low self-esteem, dizziness, hyperactivity, etc.
One might tend to confuse burnout with stress, but stress is a contributing factor in burnout. In simple words, not a lot of stress but too much of stress leads to burnout. Stress is essential for burnout but it is not necessary that every time stress would lead to burnout. Stress is not a disorder like burnout, every one of us has experienced stress in our lives. One thing that I would like to add as a psychologist is that stress leads to anxiety and physical consequences whereas burnout leads to depression and emotional consequences generally. We as therapists struggle to admit that we are emotionally exhausted and tend to feel guilty about taking a break from helping our patients. It seems awful to leave our patients unattended and our needs seem pale in comparison to theirs.
Even with an awareness of compassion fatigue and the impact of vicarious trauma, we as therapists tend to shrug off the idea of burnout and think it won’t happen to us. After all, we are sacrificing our self-care for the greater cause. There can be shame in admitting that we are experiencing compassion fatigue, but we are humans, and we are not protected from stress just because we have therapeutic skills,’ says Dr Linda Dubrow-Marshall, BACP-accredited counsellor and lecturer in psychology at the University of Salford. Admitting this depicts that we can address these issues.’ Anyway, our profession is an emotionally demanding one, and burnout is an increasing concern in the mental health field and should be addressed as much. Ironically, the mental health field has paid relatively little attention to the health and well-being of its workers. But when we realise we are in the throes of burnout, it is good to acknowledge and talk to someone we can confide in or a colleague who is going through a similar phase or has experienced burnout and has overcome it.
Support Groups and Self-Care
Self-care and support groups are very important for therapists because of the nature of our work. Proactively engaging oneself in self-care activities like meditation, journaling, spirituality, and taking a break will help prevent the challenges usually faced in our profession, although self-care is an ongoing endeavour. The practice of self-care by therapists should be an ethical imperative. Self-reflection and self-assessment should also be incorporated into our self-care strategy. Also supporting a strong network of family and friends is very important.
In my honest opinion, we should seek therapy for ourselves before we delve into the profession as therapists ourselves and avoid transference in therapy. Plus the way we choose to respond to distressing situations is pivotal in avoiding emotional fatigue along with good preventive steps and coping strategies to minimize its deleterious effects. Being self-aware is vital and catering to any warning signs that show in our self-care regime is a pivotal factor, for example feeling bored in a therapy session, waiting for the session to end, etc. The bottom line is therapists should know how to stay balanced and centred in both their personal and professional lives.
There will be times when patients can be demanding, we might have a constant worry about our progress as our field is constantly evolving. We must make self-care a priority and nurture both our brain and heart as it is our valuable resource in our line of work. Being resilient is also vital as therapists and having an emotional reserve, otherwise, therapist as a profession is gratifying. It is also pivotal to how we respond to the experience of extreme stress and what coping strategies and preventive steps we take to minimize its deleterious effects. Obviously whatever I have mentioned is not exhaustive, it is just to give you an idea of ways to cope better.
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