Therapist Burnout & Recovery
We are in a severe mental health crisis in the United States. Since the pandemic, therapists in our community across the country share in feeling overwhelmed and exhausted. The increase in the demand for care, intensity of need, and compassion fatigue is contributing to therapist burnout. I, like many other therapists, struggle with both wanting to provide the support my clients need and feeling overwhelmed by trauma. When we bend our boundaries to meet the needs of our community, something must give. Predictably, currently over half of psychotherapists are currently experiencing burnout (Journal of Clinical Psychology).
Burnout, a term first coined by Freudenberger, has three elements: emotional exhaustion, decrease in empathy/compassion, and a decreased sense of accomplishment. Therapist burnout is heavily influenced by two powerful factors: vicarious trauma and distress.
Vicarious Trauma
“Trauma is by its nature an excess of what we can manage or bear.” Laura Kahn
Vicarious trauma, also known as compassion fatigue, occurs when therapists are traumatized by sitting with survivors in their pain and embodying their stories of abuse and trauma. Some symptoms of vicarious trauma include intrusive thoughts and images related to the client’s disclosures, avoidant responses, somatic disturbances, emotional swings, and feelings of dread (Pearlman and Saakvitne, 1995). Vicarious trauma when unprocessed can often lead to traumatic stress responses.
If you are a therapist and feeling defensive reading this, I want to share that feeling burnout is not shameful. It is simply impossible to sit in the distress and pain of our clients and not be affected by it. Thankfully, there is a path forward for healing clinical burnout.
1. Self-loving care. As clinicians we need to mindfully create rituals for self-loving care. The practice of self-care is something that we commit to in order to fully show up for ourselves and for our clients. Some warning signs of burnout may include celebrating a cancellation, counting down the minutes during a session, feeling resentful of a client needing extra support, or an overall decrease in empathy or compassion. If you notice these warning signs, see it as an invitation to get curious about your mental health needs and to make room for self-loving care.
2. Connect with your community. We do not heal in isolation; we heal in community. Reach out for group supervision and consultation. Ask for support and connection. One of the bravest moves you can make is to vulnerably ask for help when you need it.
3. Manage your own boundaries. Be realistic about what a sustainable caseload looks like for you. Maybe you need an hour break every three sessions or find that your empathy capacity decreases after session twenty. Before you agree to a work request, check in with yourself. Will you feel resentful about doing the task? Are you only saying yes because you’re fearful of their disappointment or frustration in response to a boundary? Can you set a gentle boundary in order to put your emotional wellbeing and safety first?
4. Sustainability. Prioritize your wellbeing and emotional needs. How do you need to reprioritize your life so that a vacation isn’t needed to recharge? How can you make more time caring for yourself so that each new stress feels manageable?
