I wish I could tell you that I have always been good at self-care, have always managed symptoms of burnout gracefully and have been fine in a general sense. To say that would be lying and would further perpetuate the myth that therapists have their shit together. The journey that got me to where I am started way way back, but just for shits and giggles let’s go back to summer 2020.
It was June 2020 (which isn’t that far from when I wrote this in August 2020 and edited it in September). This was in the “middle” of the COVID-19 pandemic, I had been working from home for 3 months. I was in the most healthy and happy relationship of my life. I had a few awesome close friends. I was making good money, had time off (that I seldom took). I was in therapy and had worked through a fair bit of my own trauma. I had hobbies. I had a career I was objectively good at. I was knowledgeable, well read, and had good experience. All before I turned 30. I was also depressed, anxious, often triggered, down on myself, exhausted, passively suicidal, physically unwell… I dreaded doing anything related to my job. Worst of all, and I hate to say this, I didn’t care about my clients… I honestly couldn’t care anymore. The fucks to give were all gone, the proverbial well had dried out months ago. I felt helpless and hopeless about clients, about humanity. But… I was a strong social worker, and I just kept going, day to day, doing everything over and over and over. And over…
One day I had a client crying on the phone all I could think was, “Jesus. Fucking. Christ. You’re sad, I get it. Join the club, life sucks. Just shut up and do something about it.” I paused, disgusted, scared and frustrated with myself, “What the hell is wrong with me?! That’s not how I am supposed to think about this! I am not that person; I am supposed to care! Why don’t I care?!” Since I was in the middle of the session, I had to contain that all and pull my shit together and finish the appointment. Once it was done and I hung up the phone, I stared into space and tried to process what was happening to me. It felt like I started to wake up to what was happening to me; I started to see that I was beginning to make mistakes and only just catching them before it turned into a big deal. I wasn’t offering my best services. I was on autopilot.
I did what any good social worker does, I talked to my clinical supervisor. I told them bluntly and with vulnerability, what was happening and how I felt. I was very honest and open, hoping for some validation, some empathy, care. What I got was a “lecture” about what I already knew. They regurgitated everything I had already read and researched, but not even in an educated way or with any thoroughness. It was almost offensive how poorly it was delivered.
Anyways. There I was feeling all the things, not getting much, if any, help with them. Knowing that I had to do something, I worked on why I must have been feeling that way, how it had happened, what had gotten me to that point. I read articles and books, talked to my colleagues and friends. I knew in theory how to work on my symptoms, and what to do. I still have this treatment plan in my head (like I said, I am writing this awfully close to when this all happened, so I am not indeed out of the proverbial woods just yet). I just couldn’t do it. No one had ever taught me how to do the internal work I would need to do as a therapist, no one had told me what to expect internally. I realized I had gone into this work, eyes closed tight and here I was seeing the reality of this work, what it had done to me, and what I had done to myself several years in. I started clearly seeing the wear and tear it has had on my psyche, my emotions, on me as a person.
Let’s take a few steps back. To be clear. How I got to this point was not completely the fault of “the field”. Like I alluded to earlier, I have my own baggage and trauma which has heavily influenced what makes me, me. This has also played a big role in WHY I chose this work.
The following section is from a personal journal entry in December 2019.
It has always been my job to help others. Even as a young child I was a natural at making myself small, having fewer needs, being independent in order to be less of a burden. I learned that in order to earn my keep, be worthy of anything, I needed to do something for someone. What came naturally as a deeply sensitive person was helping, listening, and feeling for others. I got so good at it that I made a career out of it.
I learned so many basic counseling and social work skills within the first ten years of life that when I finally got into graduate school I was made in the shade. I was a natural, it came easily. I think the assumption is that when a grown adult goes into a graduate program, they have a more or less well-rounded, healthy set of skills upon which to build. I didn’t have that, this was a huge issue moving forward. I knew how to handle living with this set of skills on a small scale, with friends and family. NOT as a professional. The problem was that I was not well balanced or well-rounded as a person and I was so good at “social working” that I just jumped in eager to help, to fill a purpose. I didn’t have a whole other set of skills that are needed in the field like setting boundaries, self-advocacy, self-care, etc. that are expected when you are an adult.
What happened was that I jumped into this disaster of human misery thinking that I was made in the shade, I have been doing this my whole life, but had no protective gear. It’s a whole different ball game to provide mental health care full time for 8 or more hours a day; it’s nothing like being the friend everyone talks to. You are in a fucking ecological disaster. Some people have protective gear, they have the boundaries, they can advocate for themselves, they have a healthy sense of self or whatever. But there I was without boots, a jacket, or whatever else you might fucking need in a god damn disaster zone. Of course I got infections in the cuts one will inevitably get, of course I was coming home covered in goop and never really being able to get it all out from my hair and under my fingernails. I never learned otherwise, and no one prepared me.
I started realizing going to and graduating from school was like I had researched and learned about everything I could about some sort of ecological, environmental disaster (think BP oil spill, Chernobyl, poisonous lakes). I knew about the local and global ecosystem, I learned about the plants, the animals, I learned about why it was a travesty. I was ready to go into the disaster zone to make a difference. However, nowhere in my education did someone adequately impress upon me the absolute necessity for practical tools like waders, gloves, a hat, sunscreen, bug spray; anything to protect me from the very real hazards of the job in the disaster. School gave me shovels, trowels, clippers, hoses, tools to work on the problem, and they probably
assumed I already had a jacket, boots, wader, gloves, and goggles and further assumed that work places provided sunscreen, bug spray, maybe even a hat. Looking back now, at the beginning it’s like I was wearing a tank top, shorts, canvas tennis shoes and maybe a wind breaker, in a fucking poisonous lake.
Other’s told me to take care of myself, make me a priority, saying, “You can’t pour from an empty cup”. But I didn’t see many other people doing it either. I was arrogant, I thought I was strong enough to not need it. Only weak people need gloves and goggles. I thought if I just cared and cared and worked and worked to help, to fix people, the swamp would clear.
*woosh, pan camera back to Summer 2020* There I was, wounded, sick, malnourished (whatever metaphor you want to put here) and I had to get out. I started to wake up in this seemingly never-ending series of ecological disasters, not caring that people were crying and struggling, and all I could think about was that they just needed to get the fuck over it. I was lost so far in the polluted lake with no real exit strategy. I had not planned for this. I had placed a bet on myself that I could hack it, that I would be fine. The only way was for me to get out—a med evac. I had to *gasp* take a leave of absence.
There are so many things that got me to that point. Some are system wide; some are part of the system of where I work. Some are from my own internal workings, negative core beliefs, negative thinking patterns, faulty assumptions. Some of the things existed before I started this work and weirdly make me good at this.
I don’t know how much of me sharing my story of lack of adequate self-care, of what my burn out was/is like helps anyone. I guess I am just hoping it makes it real for someone so that they avoid the mistakes I made. I guess it comes down to me wanting to go back and fix myself; if I can prevent what happened to me in someone else, then it feels like I heal myself. This is fundamentally flawed and part of why I have such bad burn out. Also, I don’t want to be one of those people that says, “Don’t do what I did” or worse, “Do as I say not as I do” so I avoided saying anything. But this is also part of my burn out—being afraid to say anything, being afraid of my own voice, denying that I even have one at all, not believing that I have anything valuable to say at all. I also know, a lot of what I have to say is said by countless other people in what may be more eloquent ways. But I come back to the point…I have a voice, maybe someone would benefit from hearing it.
This is as much for myself as it is for other people. I want to live a life I am proud of, one that I don’t need a vacation from, one where I am genuine, authentic and real; so I am learning to use my voice even when it feels awkward. I am learning to use my voice to stand up for myself and others even when what I think and feel is invalidated by people in power.
I know that what I am about to talk about is something you already know, and I know you will say to yourself, “Yeah, I know. I will.” And you might think, “That won’t be a problem for me.” But it will. Maybe you will be able to do some self-reflection about it quickly afterwards, hopefully before the full throws of burn out grab you, you make a change.
I wish I had known early on that you absolutely cannot care for others in a healthy, sustainable way if you do not take care of yourself first, if you do not have clearly defined internal and external boundaries that you regularly enforce and that are supported by those around you. I know you know this. We tell others this all the time. But us therapists/counselors/social workers have a nasty habit (not everyone, but I have yet to encounter a mental health provider that doesn’t or hasn’t struggled with this at some point…I have a lot of thoughts about this to discuss later) of giving sound advice and suggestions and somehow thinking we don’t have to follow it. It’s classic, it really is.
We all experience stress, exposure to the everyday hazards of this work differently. My experience will not be yours. All I know is that what I have been through is unremarkably common, and yet, I feel like it is not shared as widely and as thoroughly as I believe it should. Ignoring not only the issue of burnout, but the lack of adequate education about it and self-care, we put ourselves, our clients, and the field in jeopardy. It is irresponsible, reckless, arrogant and short sighted.
As far as an answer to “Now what Sara? What are we supposed to do?” I have no real satisfying, thoughtful, profound answer. What I do now is this:
Journal entry from December 2019
The funny thing is that when things get bad, I know there isn’t anything anyone can say or do to make it any better. There isn’t always anything you can do or say to yourself that makes it better. Sometimes, all that can be done is to sit through it however you can despite how excruciating it can be. Sometimes, just knowing you aren’t alone and that someone has been there or knowing that someone somewhere cares even just a little makes all the difference.
If I can be that person, that voice for someone somewhere, I will have done my job. I know what it is like to be there, in the trenches of your mind with thoughts like bombs and feelings like mustard gas trying to kill you. It’s exhausting and excruciating fighting with and within yourself every day. I suppose in war, part of what might make things more tolerable is having your comrades, your platoon mates or whatever, there fighting with you; knowing you aren’t in that hell alone. Dealing with mental illness, trauma, oppression, with life, is no less of a significant widespread battle. How awful is it that we all feel incredibly alone even when everyone is fighting the same or similar battle?” We are all fighting something, and hearing someone say, “Hey! Yeah, me too! How do you fight off the suicidal thoughts at work??” can make all the difference.
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