Managing expectations and internal pressure helps us help clients.
KEY POINTS
Burnout is a growing problem across all sectors of the economy, especially healthcare.
More than half of nurses and physicians and almost a third of students and residents reported symptoms of burnout.
Therapists can better serve patients by taking good care of themselves.
Burnout is a growing problem across society, highlighted by the stress and disruption brought on by the COVID-19 pandemic. A 2021 survey from Indeed found that 67 percent of U.S. workers believe burnout has worsened during the health crisis. In that same study, just over half of respondents, 52 percent, said they themselves feel burned out, up from 43 percent who said the same in a pre-pandemic survey. Reasons cited for burnout included working longer hours, difficulty separating work and home life, and concerns over finances and health.
The numbers are even worse in healthcare, where up to 54 percent of nurses and physicians and around 60 percent of students and residents report symptoms of burnout.
And the consequences go beyond simply feeling exhausted or anxious over one’s job. According to the Mayo Clinic, burnout can lead or contribute to fatigue, insomnia, alcohol or substance misuse, heart disease, type 2 diabetes, and high blood pressure, among other issues.
I have a chance to see some of the factors that contribute to this problem up close in the substance abuse rehabilitation field. Like other workers in healthcare, we’ve faced the burdens of coronavirus safety protocols and necessary changes to treatment because of those protocols, as well as a more challenging caseload, with higher levels of mental health disorders among clients.
Less talked about, however, is the internal pressure health care workers put on themselves to see their patients improve. While the situations we deal with are sometimes quite literally matters of life and death, holding oneself to unrealistic expectations can trigger burnout and make workers less effective in their roles, impairing treatment for others who desperately need it.
The problem with having unrealistic expectations is that providers eventually lose the ability to be present. They become overly fixated on the past or anxious about the future, benefiting no one when the presence of mind is a necessity.
How to control unrealistic expectations and internal pressure
There is a concept known as the “self of the therapist,” which recognizes that who we are as people ultimately plays a role in the kind of care we’re able to provide. It holds that therapists should be emotionally healthy themselves to the best help clients, and that therapists would benefit from working on and resolving their own personal problems.
This philosophy might best be summed up as: You can’t give what you don’t have. Giving expertise, support, and guidance from a place of emotional well-being and abundance is more effective than trying to help a client toward a goal you yourself have not reached.
But how do we build up the self of the therapist?
To start, individuals in the healthcare field need to recognize that they are not superhuman. We have needs, feelings, and troubles like everyone, and they need to be addressed and worked on. We need to care for ourselves the way we would provide for our clients. This could take the form of engaging in a quiet practice like yoga or meditation, making sure we’re eating healthy foods regularly, getting enough sleep, and participating in activities that bring joy, such as spending time with friends and family.
We also have to recognize the needs and feelings of others in a clinical context. This means that we share responsibility for a client’s outcome not only with the client but with our colleagues and others involved. Instead of working independently and out of sync, a truly integrative approach does indeed take a whole village, whether it’s family members, referents, primary providers, schools, teachers, or peer groups. When a truly collaborative treatment team and community is formed, the burden is shared, and it holds everyone involved accountable for working toward a positive outcome.
It's also important to fully integrate and understand the things we learn from our experiences. If we are not spending time to digest and come to terms with things, we’ll end up leaping from task to task, never really learning, and falling victim to the frenetic pace of clinical workloads.
In therapy, we talk about the importance of processing or deeply thinking through an issue to learn from it and improve. The same process applies to the people giving guidance and support; to make progress, we have to integrate the new information we gain from our clients and cases.
Setting aside time to think about the problems we’ve encountered in our personal lives, and how we’ve navigated and overcome them, nourishes us and makes us more resilient to burnout in our professional lives.
Self-Care
We live in a time when work schedules and the normal routines of daily life have been turned upside down by the COVID-19 pandemic. Burnout, already a growing problem before the health crisis, is now front and center in a way it has rarely been before.
Health care workers are battling the pandemic and its fallout while also dealing with an epidemic of burnout in its own ranks. This is immensely worrying for anyone who comes into contact with or relies on our healthcare system, essentially everyone. We can start to turn the tide in this battle, however, if health care workers are given the space to care for themselves as they would their patients. It benefits everyone to remember that we can’t give what we don’t have.
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