In therapy, there is an imaginary fourth wall that allows the client to be seen and heard while the therapist guides and supports from the side. The professional standard has always been to only disclose what you as a provider are going through once you have worked through it, and only for the patient’s healing and growth and not your own need to reveal your story.
In spring of 2020, I sat through Zoom session after Zoom session with my clients, nodding along about my anxiety and fear about the lockdown. Of course, you are wiping down all your groceries, so am I! As the pandemic has progressed there is no way we as providers can escape self-disclosure. Certainly, I save all my deepest fears and concerns with my own support systems, but the wall that was once there no longer exists. In many ways, this seems to be reassuring to patients, that they are not alone, and that of course their own therapist struggles. How I have coped with many things during this time become the practices I recommend to my clients.
It is both refreshing and frightening to be so transparent with my clients. Why? Because it completely flies in the face of the stern warning about self-disclosure that we learned from our own professors. While being here for my clients, I have had to put aside that voice, while also asking myself “is this of benefit to share with my client? Is it for me or them?” This alone could be causing many of us emotional exhaustion.
Burnout is defined as the physical symptoms of compassion fatigue, including but not limited to fatigue, depression, avoidance of work. According to Dr. Hudman-Stamm, the researcher behind compassion fatigue, it is the physical component that accompanies vicarious trauma.
Before the pandemic, my circle of counseling colleagues and I would meet to consult about current patient problems. These meetings are often relieving and productive as we are sharing about patient concerns to be better at our jobs. Consultation among counseling colleagues is recommended to help us with our career longevity, as well as our need to remain objective with our clients. Lately, when we meet, we talk about how exhausted we are. Isn’t it more exhausting to meet over Zoom? How are you coping with this? Yes, I see fewer clients in a day. Yes, it is harder to say no to a new patient referral. No, I don’t know anyone taking new patients. Yes, I will see that one client in person because I can’t get a good enough read on how they are really doing over Zoom. No, I won’t see families over Zoom, there is too much that I am missing to get a good clinical picture. Are you sleeping okay?
We therapists are burned out. But here’s the thing: when we name something, we tame it. Before the holidays, one of my long-time clients asked me how I was doing. I told her the truth, that I was exhausted. Did I expect her to therapize me? Of course not. I said, I am exhausted, and I can still be here to listen to you. And I am without guilt or shame, I am taking three weeks off. And no, it won’t completely take away the burnout, but I receive so much satisfaction from helping my clients, that it will help fuel my own healing, so long as I am honest with you, and taking the time to resource myself, I can keep showing up for the people that I serve. This is called compassion satisfaction, and it is what counselors feel when they receive feedback that they are truly helping their clients. The research shows that this alone helps counselor’s fend off the physical and psychological symptoms of compassion fatigue.
If you are a therapist, when you do consult with colleagues, please take the time to share with them what you are doing well in your sessions. This will help you keep your brain wired for the compassion satisfaction that you need to keep going. And if you have neglected to go to consultation, start again. Research shows that this is one of the most important aspects of reducing isolation in our field. And take care of yourself. Seriously a bubble bath is nice but what are your attitudes, activities, and actions beyond the bubble bath that you are doing on a regular basis? This would be a great topic to keep on your consult agenda. And maybe you are doing all these things, and here is your reminder.
So, what can you do as the patient knowing that your own therapist is likely burned out? First of all, if you question that your therapist is not taking care of themselves, ask them to do so. It will mean a lot to them to hear that you care. However, if they don’t say something like “I have my own resources thank you for asking,” and you feel like your counselor is not listening, it is okay for you to take care of yourself by finding other supports. By and large, the therapists I know are doing everything that they can to stay healthy enough to work with you. Why do I recommend yoga? Because it helps me with my own pandemic anxiety. Why have I been sending out pamphlets about sleep hygiene? Because I too have struggled with sleep during this stressful world event. Do I know the best places to get the vaccine, or avoid overcrowded shopping? I do, and I will share this and more with you. Because you are who I got into this business for, and I want us both to survive this and have a future of thriving.
If you are my client, be assured that I am putting my own oxygen mask on first.
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Thank you for reading, and warm wishes to you and yours!