In Defense of Underperformance: A Trauma Worker’s Argument for Staying Alive

During my final semester as an undergraduate student, I was rushed to the hospital in an ambulance with what doctors thought was a pulmonary embolism.

I had woken up that morning feeling under the weather, as I had for a few weeks, except this morning, I couldn’t get my heart rate to slow down to a normal speed.

At urgent care, things escalated quickly- there were hushed voices, an EKG, IVs dripping saline into my arm, and nurses wheeling me into an ambulance headed to the ER.

After plenty of blood work, questions, and another EKG, the doctors ruled out not only a pulmonary embolism, but just about every other malady that could have been behind my 185 beats/min resting heart rate.

The doctor sat next to me, puzzled. Finally, he looked up from his clipboard and asked, “What’s your lifestyle like? Are you a student? Do you work?”

Now, at the time, I had a full course load; I was finishing up two separate degrees. I had an internship at my school’s sexual assault center, which had me in the office 16 hours a week. I was also on-call, either answering a hotline or going to the hospital to work with sexual violence survivors in person, at least 24 hours a week. I was also working part-time helping a professor do data entry and coding for his research. My second job was facilitating peer-led workshops on violence prevention to freshman students. I picked up a few shifts at an art museum weekly, as a third job supplement. Passionate about spending my “free time” volunteering, I was also a coordinator and mentor for a youth program, and ran an arts group at a local subsidized housing unit for seniors.

I explained all of this to the doctor. He nodded and stood up to leave.

“You’ve got to quit some things. That’s why this is happening. Go home and rest.”

Nothing was wrong with my heart. At the age of 22, I was very rapidly and effectively working myself to death.

The curse of an empathic heart

It will come as no surprise to any of my loved ones reading this that I spent the rest of that day agonizing over the idea of quitting something. Everything was important. My heart was in all of it. I couldn’t quit. But I couldn’t not quit, or I could quite literally die. Something had to give- doctor’s orders.

It strikes me as troubling, but not at all surprising, that it took a trip to the ER to get me to take inventory of my limits, my health, and my compulsion to overperform. Overperformance is a chronic pest that takes hold of those in possession of both an empathic heart and an anxious mind. It has a sneaky, evasive way of presenting itself as “just how you are”- when in reality, overperformance is a direct outcome of a vicious amalgamation of socialization and circumstance. It’s cure very well may be, perhaps unsurprisingly, underperformance.

This is not an essay on why underperforming is a strategic middle finger to the capitalist machine, but it could be. Perhaps another time. It isn’t an essay on secondary trauma either, but I’m sure that will come. It is an essay to affirm, mostly for myself but hopefully for others, and especially for other trauma workers, that a life in which we are not bleeding ourselves to death with productivity is still a life of worth.

“If I don’t do it, no one will.”

Laura van Dernoot Lipsky writes in her (incredibly helpful) book Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others of the sense of grandiosity that trauma workers are prone to feeling:

“Many people get hooked on involvement in others’ lives: solving their problems, becoming a powerful figure for them, getting increasingly attached to the feeling of being needed and useful…I have found that this form of grandiosity often keeps people in their work much longer than is perhaps best for them. You think, ‘who else will do it if i’m not here?”

As I lay in my bed after returning from the hospital, I weighed each job against one another to try to select which one I should quit. For every role I held, save for the art museum position, which is the job that ultimately drew the short straw, I always came back to the damaging conclusion that I couldn’t quit, because no one else would do the hard work. Who on earth would willingly volunteer their time working at a rape crisis center?

Couple this problematic martyr-esque line of thinking with the messages I got from friends and family (“Oh wow, I could never do that” or “That work just isn’t for everyone”) and soon enough, I felt an obligation to push myself past my limits to prove that I was the one for the job- ta da! Here I am! I’ve got grounding techniques and reflective listening skills and I am ready to use them!

Not only does this set someone up for exhaustion, but it sets them up for developing a self worth that hinges on being able to do emotionally challenging work while being generally unaffected by it. In turn, this leads to further overperformance- you turn into someone with something to prove. It’s a vicious cycle.

Don’t forget….oppression!

I would be remiss not to follow up with these more accurate statements- “If women don’t do it, no one will” or “If survivors don’t do it, no one will”. Because quite frankly, if survivors of sexual violence, which we know are mostly women, stopped doing trauma work, stopped picking up the crisis line, stopped working at rape crisis centers, stopped sitting with survivors of sexual violence in the ER, stopped working at domestic violence shelters, stopped making safety plans with women being abused….what would the movement to end gender-based violence look like? Would there be one?

Spoiler- no, I do not think there would be one. Power is not given up willingly. In my time as a trauma worker in various organizations and in various roles, I have never experienced a swell of men jumping at the chance to put an end to gender-based violence. I’ve been in plenty of rooms filled to the brim with women working tirelessly to end their own oppression- but rarely, if ever, have I been in a room of men working tirelessly to give up their own power. (Because, remember, there are plenty of survivors who are men- but the vast majority of the time, the perpetrators are still men.)

And for me, that’s the hardest part of doing trauma work. There is always more of it to do, and there are never enough people choosing to do it. I look around the room at work and see a handful of brave, overworked women taking on the world. How could I possibly step down? How could I choose not to do trauma work? So I do it. Until my heart gives out. It’s almost (almost) poetic.

Handing over the fork

Deep down, there’s a part of me that still believes that everything will be okay if I just keep working at it. If I throw everything I have into my work, less people will get hurt. In reality, I am the one who ends up aching emotionally, mentally, spiritually, and physically, when I refuse to stop over performing.

What overperformance leads to is a deterioration of and disconnection from the body and the mind. Because frankly, all of those inspiring messages about late nights spent working on your craft, those messages about putting your blood, sweat, and tears into your passion, are not for trauma workers. Maybe they aren’t for anyone.

Ultimately, the goal, at least for me, is equilibrium- feeling in touch enough with my limits and boundaries to let my efforts ebb and flow. But that is a lofty goal and it will take practice. So, for now, it is by no means an understatement to declare that actively choosing to underperform is an act of resistance against damaging learned behaviors, and is indeed an act of survival.

While it may seem obvious to some that rest is necessary to live, and that rest is okay, this does not always connect with trauma workers who chronically overperform. The irony, of course, is that my idea of what constitutes underperfomance is almost certainly an objectively adequate amount of effort. But still, I have to start somewhere.

So, am I taking myself up on this? Am I being prescriptively lazy sometimes? Well…I’m learning. When my heart starts racing, I pause and consider when was the last time I took a nap. I take days off to do nothing but watch TV and cook myself dinner. I ask for help…sometimes.

I’m learning that if I don’t do it, then I don’t do it. Someone will pick up the slack, or maybe no one will, but either way, the important thing is that I’m not putting myself in the hospital. I’m learning that more often than not, someone will pick up the slack if I let them.

On a day I felt particularly overwhelmed, my partner, who is very fond of metaphors, texted me, “You have a lot on your plate. We’re willing to help, but you have to hand us a fork.”

Underperforming is throwing up your hands, dropping the cutlery, and letting someone else cut up the food for once. I am learning what my forks are. I am learning how to hand them to others and take a goddamn nap, and it is saving my life.

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