The shame of burnout

Burnout hurts. "Burnout won’t happen to me, though. I look after myself. Or will it?"

When I experienced burnout, combined with vicarious trauma, it was a horrible experience. And it wasn’t even a surprise, in some ways. What was a surprise was the depths that I found myself hitting, the meltdowns, and the feeling that I was going to a place in which I didn’t recognise myself. That was scary.

It wasn’t a surprise in that I had known for some time that I wanted to stop the particular job I was doing, but I didn’t know how to. I was working in a Child and Family project working with refugees who had been recently resettled in the UK. It seemed to tick all my boxes, but I was struggling with it.

I had even done a self-test questionnaire that was going around the office, which suggested I was highly vulnerable to both burnout and vicarious trauma. I remember thinking “Oh, right”. But I didn’t act.

Why not? For many reasons, some good, some bad. I was attached to the clients I was working with. I enjoyed the work when I was actually doing it (there was a lot of travel involved). There was supervision and peer support, though I was getting less and less from it.

But, most of all, I couldn't bear the idea of saying I needed to stop.  

My colleagues all seemed to be getting on fine, so what was wrong with me? I felt lonely, trapped by my shame, and old scripts that said “I have to do this on my own” and “my parents don’t get me: there is something wrong with me.”
 
Once I did stop it was a great relief. It was also deeply shaming to burst into tears in front of the team and say that I needed a break, that I needed to stop, and then go through the process of handing over my clients to colleagues. It is not a place that I ever wish to go again.
 
On reflection, I can see that there were other options, other ways of approaching the situation, and I can also see many of the contributing factors. I'm going to summarise here some of the lessons that I learnt, in case they are of relevance to anyone else.

1. Acknowledge that this is happening

If you notice you are feeling more and more tired, relieved when clients cancel, bored and fed up, increasingly anxious, or starting to get annoyed with your clients, it is time to take some action. If you do a quiz and it tells you that you are on the road to burnout, or susceptible to vicarious trauma, act on it!

2. Tell someone

Talk to your supervisor. If your work supervision tends to focus more on clients than your own process, talk to another therapist or supervisor who knows you well.

3. Consider taking a short break

i.e. see your GP and get signed off for a couple of weeks. It never occurred to me that this was an option, which was part of my all or nothing thinking that kicks in with the “I have to do this alone” script.

4. Identify the source

This is where it may be helpful to assess whether you are suffering the effects of vicarious trauma, or more generally burnt out.

I realised that I had got very attached to two young people, both with a highly traumatic history, both of whom were having huge struggles with secondary school, after making good progress in Year 6. I was attached to them, and I was attached to the idea of making them better, which is a sure sign that they had got under my skin.

For me, it was quite clear that it was a particular role that I needed to end. My work in private practice seemed fine, though, as this grew, it also removed recovery time from my more challenging role.
 
This role also involved large amounts of travelling between schools, stressful arrangements to see each child, encountering stressed teachers, stressed parents and a high degree of powerlessness. However, possibly the most powerful bit was the feeling that what I was doing (particularly with the two above) would never be the key to their recovery: the family work in both instances was what was needed, and I wasn’t a family therapist. This feeling of inadequacy aligned my powerlessness with that of my clients: a lethal combination.

5. Plan your recovery

I had been thinking about going back into therapy for a while: this was the time, and it was invaluable. So much of the destructive energy came from the transferential relationships I was experiencing with colleagues, which amplified normal human flaws into overwhelming messages from parent figures to my smaller self.  

Having withdrawn myself, the task was to get to a point where I could re-engage as an adult, able to see projections but not react to them. It became clear that I didn’t want to actually leave the organisation, so we agreed on a limited on-going relationship, that has since grown again in a positive way.

This period coincided with lockdown, so I made the most of spring: exercise, gardening, learning about the body’s energy, and eventually eating more healthily, losing weight and getting a bit fitter.

6. Come to terms with your vulnerability

Overall, this has been the biggest learning for me. I struggle to admit that I am vulnerable, that I can’t do everything, I do have my limits. I have realised that I didn’t like that part of me very much and that I have been intolerant of it (the vulnerable part) in other people. Offering myself compassion for my own vulnerability and accepting this is work in progress, but getting easier.

Overall, burnout is a sign that we need to stop, take stock, and regroup. If you are on the road to burning out it will seem that your options are becoming limited and very black and white. But this won’t be the case, as there will be many solutions and options open to you once you are able to acknowledge what is going on and ask for help.