Holding you, holding me: Throwing light on Therapists’ burnout
We have all been overwhelmed and personally challenged in the year 2020. Hearing the same conversations repeatedly over news and social media or having a personal setback is starting to feel like a mind numbing experience altogether. What’s unsurprising is that this is a collective feeling. With the rise in the number of coronavirus cases, there is also a rise in the number of individuals, families and support systems that are exposed to psychological distress.
While the frontline workers are overstretched and have been working tirelessly to save lives, allied or non medical mental health professionals form the invisible backbone of the health system. And they’re slowly burning out.
In the last few months, psychotherapists and counsellors are working extra hours and also lowering there service fees to make mental healthcare more accessible. They’re overworked and drained with constant demands from both work as well as their personal lives. Because guess what? they’re in this pandemic too! According to ‘helpguide.org’ “Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands.”
With everyone forced to be at home or confined in physical spaces for long periods of time, two things have happened.
1) Emotional issues that were previously ignored have now become unavoidable
2) The ongoing stress , anxiety and grief because of the pandemic has longed to a see certain end
At a time like this, burnouts are real for a therapist and how! Unlike other professions, mental health work needs you to immerse yourself in the subjective world of your client. The process of insight oriented therapy models, for example, need you to act as a container for your client’s feelings and stay in the emotional chaos together. There is honestly no backing down from this. This coupled with hours of screen time leads to exhaustion (emotional, physical and digital) when life is happening for your therapist too.
I have a private practice and I try my best to keep checking in with myself and how I’m doing. I have to admit though, during this pandemic, I’ve felt more burned out than usual. Its the queues from body that act as indicators. It could take form of me feeling unwell, having headaches from too much screen time, being overburdened with admin work or just feeling emotionally unavailable to myself. When I notice I’m unable to make time for things that nourish me and keep me mentally healthy, I know it’s a red flag. Life hasn’t stopped for me and I’ve had my own personal setbacks too. Everything feels like a constant hustle, even my breaks. I have longed for more breathing space between sessions, a relaxed lunch , space to grieve or time with my friends & family. I have often felt like I’m doing myself a disservice when I allow myself only boundaried timelines to feel things. I think what I find hard is to balance the commitment I feel towards my clients and myself. After all, I’m in this pandemic too.
To offer more perspective, my colleagues Rhea Gandhi and Siddhi Dugar join me in sharing what burnout feels like for them.
Mumbai based psychotherapist Rhea Gandhi says; “I recognise that I am approaching burnout when I become frustrated that my clients don’t see my humanness. My human capacity for exhaustion. That they can’t always see, it’s not them that drain me.
In so many ways, with each client we lie in a cocoon, building a home, a safe comforting warmth. The outside world fades out of this space, our relationship becomes the only real thing we hold on to. They bring in their stories, share their pain, trauma and laughter. I attune to their needs, their desires, their darkness. For that hour, I’m only theirs and that’s how they know me. Our relationship is deeply intimate, real and alive. If they’ve only met me in a cocoon, the phantasy of me staying there until they return is natural. But really when they leave, the background that had faded away slowly becomes my reality. The cacophony of daily life, the drudgery of chores and the everyday conflict, unexpected life events, my own ‘stuff’ — they come into focus. In reality, my personal life continues simultaneously, along with my work with my clients. And believe me, there is plenty that goes on outside of our relationship that drains me — I’m human.
There is a lot that happens in the time and space that pass between sessions. The human condition, unfortunately, doesn’t escape the therapist. In fact, we deal in the human condition. That’s where we get our hands dirty. We deep dive into emotional worlds, sit with existential angst and bear the emptiness and loneliness of reality. We sit with the not-knowing, search for meaning and generate hope. And we do this for both ourselves and our clients. Immersing ourselves into the human condition is our fulfilment. Then why can’t the side-effects of being human show up on us? After all, we really are the most vulnerable.”
Delhi based psychotherapist Siddhi Dugar shares her thoughts on burnout by using the metaphor of oxygen masks. She says;
“…If there is a loss of cabin pressure, the panels above your seat will open, and oxygen masks will drop down. Be sure to adjust your own mask before helping others.
During this pandemic, work has immensely increased mainly triggered because of the anxiety and uncertainty that dawned upon us. It has been a ‘shit-show’ as one of my client very aptly describes it. People have reached out to me from different parts of the world; my contact details were contagiously spreading as well. More people needed a therapist and just like myself, overnight, even my colleagues found themselves overbooked. While I have been extremely happy by the openness to seek help for mental health, I have also been overwhelmed by the response. I have held the guilt and stress of having a waiting-list, extending my work hours and even days, accepting lower fee work, accommodating SOS requests, flooded inbox messages, directing others to the right resource and holding friends and family’s expectations to psycho-educate a way out of this dreadful period.
Amidst all of this, few times there were moments and phases where I started to resent my work that was once giving me satisfaction. I silently prayed for no client requests and deeply wished for an escape for myself. This was odd. My work is my passion that has driven me yet I find myself unable to even start the day, often zoning out, losing sense of time, finding it difficult to keep a track of my sessions and majorly depending on reminders and alarms to get myself to appointments, and sometimes even messing up my admin-related work like double booking a slot. I felt stuck; finding it difficult to move forward as if there was a mental block; a blank space that I couldn’t look past. Even though I had increased supervision and personal support to help me hold my clients’ anxieties as well as mine, I felt paralysed.
I was burned out! The helper in me dived in this wave without a life-jacket. In all my super-ness, I’m still a human. I’m only able to work in the deep meaningful psychological connection with my clients but I was slowly disconnecting with myself. The shift to virtual mode of work was only increasing the gap. There has to be breaks and boundaries to safe guard my authenticity as a practitioner. The most basic reminder that mental health professionals often forget is that our sanity and mental peace is equally important. Holding and containing, facilitating change, helping people sail through these difficult times is a huge responsibility and self-gratifying, but I can’t be efficient in doing so if I’m mentally, physically and emotionally drained. How can I help others if I can’t help myself?
I need to breathe first.”
In conclusion, I’d like to say that if you’re a therapist and have resonated with what we’ve shared so far, know that you’re not alone. You’re human and your limitations need space too.
About the authors
Smiti Srivastava
Smiti Srivastava is a COSCA (Counselling and Psychotherapy Scotland) qualified psychotherapist trained at the University of Edinburgh. She currently has a virtual clinic and practices psychodynamic & insight oriented therapy .
Rhea Gandhi
Rhea Gandhi is a psychodynamic and person-centred psychotherapist trained at the University of Edinburgh based in Mumbai. She is visiting faculty at St. Xavier’s College, Postgraduate Department of Psychology and the Chairperson of the Indian Chapter of the International Attachment Network.
Siddhi Dugar
Siddhi is an integrative psychotherapist trained both in person-centred and psychodynamic approach from the University of Edinburgh. She has her private practice in New Delhi and also offers online sessions.
