Recognizing and Preventing Burnout: A Guide for Helping Professionals
In 2019 the WHO described burnout as "the syndrome that results from chronic workplace stress than has not been successfully managed." You may have heard burnout also referred to as compassion fatigue, secondary trauma, or vicarious trauma, and it is estimated that it occurs in 50% of clinicians. This is a serious issue in the health care field, and for all helping professionals, that has been intensified during last year of the covid-19 pandemic. Today we are witnessing many new clinicians experiencing burnout before they have even been in the field for very long.
So what does burnout look like, and how can it be prevented?
Thank so so much to Chris Perez and Denver Wellness Digest for the interview!
Understanding Burnout with a Trauma Lens
Many people think about trauma as one large, impactful event. Complex trauma refers to multiple traumatic events that build up and have a compounding effect over time. These events maybe be big ones (Trauma with a capital "T"), or might be smaller ones that are not recognized immediately as trauma. This includes things like ongoing emotional abuse or gaslighting, microagressions, and high stress work environments. This slow build of stress over time can be harder to notice, but can have just as big of an impact as single event traumas, and can lead to Post Traumatic Stress Disorder. Clinician burnout can be viewed as a build up of complex trauma, a high level of stress that burns the candle at both ends until the system collapses. It can be hard to see it coming, so it's important to keep an eye on signs and symptoms of burnout before it gets out of hand.
The Problem with "Pushing Through"
Many people have a tendency to push through stress, but this is based on the idea that the period of stress is brief and that rest can be enjoyed when the stressful event ends. This might work well if you are having one intense week, but when the stress is ongoing for weeks, months, and years, you can not wait for the "other side" to arrive before you rest a recuperate. "Pushing through" doesn't work as a long term solution. There needs to be another approach.
Signs and Symptoms of Burnout
I encountered my first experience of burnout in the last semester of my masters degree when I was working and seeing clients as an intern therapist, writing my masters paper, and navigating the sudden onset of the covid-19 pandemic. It was an intense and overwhelming time, and it was my own therapist who pointed out to me that I was experiencing burnout. Realizing that this was true, I sat down and wrote a list of all the symptoms I was experiencing so that I would have it for future reference. This was my personal experience, but many of these items align with known burnout symptoms. Today, I use this list as a personal check-in tool to assess my level of stress and how well I'm coping.
Preventing Burnout by Tuning-in to the Body
It's vital to pay attention to our bodies and how our bodies are responding to stress. Cultivating self-awareness of both our physical health and how emotions, stress, and trauma are impacting the body helps us recognize signs of burnout sooner as well as gives as avenues to address it. Listening to our bodies can help us create supports on day-to-day, week-to-week, and year-to-year levels.
Burnout is a Systemic Problem
The truth is self-care and burnout is not all on you as an individual. No amount of self-care is going to rejuvenate you if you are working 80 hour weeks with high intensity clients every week of the year. Our health care system is fundamentally set up in a way that is not supportive for providers. It's important to examine what stressors are happening in your work environment, your hours, and the demands placed on you by external forces. Be realistic about what is in your control and what is not in your control. You are not going to change the whole system in a day, but you might be able to identify some places for advocacy. Ask yourself: what are the wiggly pieces in this system that might be changeable and would improve things for me and my co-workers?
Build Your Social Support System
The difference between trauma survivors who develop PTSD and those who don't is a matter of support. It's not about inner strength, and it's not about the intensity of the trauma. Research shows that having support while working through a traumatic experience makes all the difference. As helpers, we must also have social support. Family, friends, and colleagues will all play difference and vital roles in our well being. Mentors and supervisors are important for support in work and career path. Friends who in you field can be beautiful connections who will understand your struggles intimately. Friends who are not in your field can be beautiful connections who will keep you alive to other aspects of life. I also highly recommend therapy for all care providers so that you have a professional to turn to and support you through stress and vicarious trauma.
Seek Out Support Before You Need It
Working with a trauma therapist to address stress, vicarious trauma, and burnout is an often under utilized resource for providers. Often when people come to therapy, they are already far along the path to burnout. But like any health issue, it is much easier to address and correct if it is caught earlier in the process. Remember that an ounce of prevention is worth a pound of cure.
If you are experiencing the signs of burnout, or want to prevent those signs from appearing, working with a trauma therapist can be a vital part of your plan for resilience building. If you would like support in this process please reach out for a free consultation.
How Setting Boundaries is Actually Good for Your Partner (despite it feeling like the opposite)
Take a moment to imagine two people:
The first person has a good sense of themselves and seems to really enjoy and value your relationship with them. Your interactions feel mutual and balanced. They are good at communicating what they do and don’t want. You never have to guess how they are feeling, or where they stand on an issue. Because they are honest about their feelings, you know that the joy and connection you have with them is genuine.
The second person also seems to really enjoy and value your relationship, yet there is also a vague sense of distance between you. They are really nice, helpful, and reliable, always willing to say ‘yes’ and show up for you, but the relationship is unbalanced. They aren’t honest about their feelings so you’re never really sure where you stand with them or if their smile is genuine or placating. There are clearly negative feelings and resentments brewing under the surface, but since they never share this or ask for anything, you have no way to address it.
Which person would you rather be in a relationship with?
“I don’t want to let my partner down when they need me. I’m afraid they’ll feel hurt and rejected.”
“I’m afraid my partner will be mad if I set a boundary. Getting into fights will damage our relationship.”
What’s missing from these common fears is an understanding of how clarity and communication of your wants and needs actually improves things for your partner. Take another look at the two examples above. Would you rather be with someone whose emotions are genuine, or who wears a positive mask even when they aren’t ok? Would you rather have a partner help you because they want to, or because they feel obligated to? Would you rather know when your partner is angry, or have them silently seething and building resentment towards you? Would you rather be with someone who is good at taking care of themselves, or who gives so much that they burn out and become tired and irritable.
Boundaries might seem like they will disrupt or end a relationship, but in actuality boundaries are all about maintaining relationships. Setting a boundary shows that you are invested in the relationship and you want it to go well in the long term. Communicating your honest feelings and needs shows that you trust your partner and are willing to be vulnerable with them. Saying ‘no’ demonstrates that your ‘yes’ is genuine and meaningful. Taking care of yourself in this way also gives your partner permission to take care of themselves in ways that they need.
And yes, it is possible and even likely that practicing honesty and boundary setting will create some conflict or hurt feelings. That is also ok! It is not possible to go through life without ever upsetting another person, and this is actually another opportunity for growth and connection. Working through conflict is incredibly bonding, and many people report feeling closer to their partners or friends after having resolved an argument. Working through conflict or hurt feelings is another way to show that you care, and you’re invested in the relationship in a deep and meaningful way.
The next time you feel the fear around setting a boundary, I invite you to reframe the situation and ask yourself not only what your own needs and feelings are, but also what kind of partner you want to be, and how your communication will benefit you, your partner and your relationship as a whole.
As a somatic counselor and dance/movement therapist, I guide clients in connecting to their bodies as a way of deepening their self-understanding of desires and needs. If you're having trouble communicating and setting boundaries in your relationships, please reach out for a free consultation.