Burnout and Boundaries

 

Keeping myself healthy while dealing with other people’s problems all day is a challenge.  I have to balance keeping a professional distance while expressing genuine empathy.  I need to help my patient feel felt while not falling into despair with them.  Have I cried in session before?  Yes.  Have some of my patients been mad that I didn’t cry with them?  Yes.  I am dealing with so many different personalities and needs in my office and balancing what it best for each person takes constant vigilance.

Sometimes I am personally affected by my patients, I think about them at home and their problems keep me up at night.  This is one sign for me that I need help to figure out why something is bothering me and do my own personal work on that.  I believe we have an ethical responsibility as therapists to pay attention to our alarm bells and then address those alarms.

Its honestly the hardest (and most costly) part of my job.  More accurately, I choose to make it a hard part of my job because I feel its of the utmost value.  Also, I focus a lot on it when I’m training other novice therapists.

There are a couple routes a psychotherapist, or any professional working with people, can take to manage emotional boundaries and prevent burnout.

First, I could turn myself off emotionally and risk being seen as “cold” by my patients and lose the ability to “tune into” the subtleties of their communication.  Dan Siegal says that this “tuning into” helping the patient “feel felt” is the most important skill a therapist has, so I’d prefer not to go this route.

Second, I could continue to provide empathy, mirroring of emotions and helping my patients “feel felt”, but then I am at risk of burnout.

Is there a third option?  Can I offer the second option but still keep myself healthy emotionally?  I think so.  If I can mindfully monitor my burnout level, practice self-care, make sure I have a third party keeping an eye on me and make changes when needed.  If I do all this, I can continue to work in a way that is effective and ethical and still stay emotionally healthy for the people in my personal life.

There are a lot of burnout tests online, but here’s one I took and liked, Online Burnout Test (from mindtools.com).

Everyone is at risk of burnout from their life.  Symptoms of burnout look very similar to depression–irritability, problems with sleep, problems with appetite, hopelessness, fatigue, thinking about personal life at work (or vice versa), inability to see the positive, more negative coping behaviors.  Yes, sometimes we need a new job.  But, more often than not, we need to take a vacation, get some perspective and come back to the same life empowered to to make changes.

All professionals that work with people need to keep in mind emotional boundaries and burnout.  Accountants out there, how are you doing in this area during tax season.  My heart goes out to you!!  Read on for some of my unique strategies for preventing professional burnout.

Fortunately, long ago, I realized the importance of therapists having their own therapist.  I have been going to mine monthly for years now.  Whether I think I need it or not, she helps keep me on track and is essential for preventing burnout.  We talk about transference, counter-transference and making tough choices professionally and personally, when necessary, to stay healthy.

I believe we need to become a “forever student” in the areas we struggle in.  The topic of boundaries is my area of constant study.  I am always reading books and listening to podcasts on this topic.  This month I am paying for an experiential workshop on boundaries.  Merle Yost is an EMDR Consultant, author, retired private practice therapist and now trainer.  I met with him as part of my EMDR Certification and still am benefiting mentally from the boundary exercise I did with him.  He does a one-day workshop with a small class that helps anyone who is human (and interacts with humans) to learn how to keep from getting drained from other people’s negative energy.   Merle isn’t going to give you a list of to-do’s, he is going to walk us through visualizations and insight-oriented techniques that will change the way we approach people and listen to our internal “boundary violation warning signs”.  I know I will walk away with practical tools I desperately need.  If you want to know more, read Merle’s article and check out his website.

I also value business consulting from another more experienced professionals in my field.  I love getting a second set of eyes and ears on my concerns.  I pay for hourly sessions as needed and make sure to get this informally through lunch dates with colleagues.

All of these are in addition to my already rigorous self-care routine.  Church, prayer, exercise, taking supplements, trying to eat healthy, working part-time, guarding my off hours with my life, good skin care, good dental care, working with a naturopath, keeping emotionally draining people out of my personal life, trying to be present with my kids, entertainment that is fun, volunteering, being relaxed about housework, meeting regularly with friends and a quite, meditative morning routine.

Despite all this, from time to time, I still get too close to burnout.  Yet, I learn so much about myself and grow immensely from these difficult times.  What are some of your strategies for protecting emotional boundaries and preventing burnout?