People who work in one-on-one fields like medicine often experience what is termed burnout, after a certain period of time. Any job which requires empathy, compassion, a desire to help others plus the recipients sense of satisfaction thereof on a daily basis can drain the reservoir of kindness that is essential to the work. It is sometimes referred to as compassion fatigue and is felt by doctors, nurses, caretakers of chronically ill people, firefighters, police officers, mental health therapists, substance abuse counselors and more.
Those who work in such jobs are exposed to people’s physical and emotional troubles on a daily basis and must provide support, encouragement, education and a host of other forms of help. It can leave a person feeling drained and in need of rejuvenation. Working in an office, retail store or at an outdoor job such as construction does not require a person to draw on emotional reserves in order to get the job done. However, a firefighter rescuing people from a burning building; an intensive care nurse providing care for terminally ill people; a surgeon performing a delicate procedure or a therapist treating a person with a mental health disorder or substance abuse problem must draw on specialized internal knowledge. These individuals must stretch a banner of compassion and empathy over people in their care who are often vulnerable and completely reliant on them.
Dr. Kirk Bowden, president of the National Association for Alcoholism and Drug Abuse Counselors (NAADAC) pointed out that “People end up taking home the work that they do.” He says internalizing sometimes “serious and heartbreaking” things can lead to a lack of self-care, which he says can manifest itself in physical illness, insomnia and signs of anxiety and depression.
The prevalence of burnout
Burnout in the behavioral health and medical professions is not uncommon and has been an ongoing problem. Quite a bit of research has been carried out on so-called compassion fatigue amongst neurologists, nurses and physicians. Not as much research has been done regarding those in the field of behavioral health specialties such as addiction counseling and therapists who treat mental health disorders.
Marieke Ledingham, a lecturer at the University of Notre Dame Australia, conducted a study to discover what mental health workers thought about burnout. In the first study of its kind, she found that 55 mental health nurses, psychologists, occupational therapists, social workers, psychiatrists and counselors overestimated their ability to cope with stress and experienced difficulty recognizing their own burnout symptoms.
Many of them said that they would blame themselves for burnout and would consider it a sign of weakness, incompetence or even failure. They did not like to talk about the subject, feeling they might be stigmatized. Some liked the illusion of control, while others thought they were outright infallible. Caretaker identity is strong and causes some to think they should be able to cope better than other people.
Ledingham says “Burnout is the endpoint of chronic stress. When work is intense and unrelenting and the worker doesn’t have sufficient time and resources to recover adequately, they start to feel a lack of compassion and empathy for their client, as though they have nothing more to give.” This affects their decisions, ethics and ultimately, their patients. Bowden says “It wears on a lot of people. They’ll change jobs frequently as a way to deal with compassion fatigue or burnout.”
Richard Buckman is a member of the board of directors and staff of Faces and Voices of Recovery. He has worked in addiction treatment for 25 years and is also in long-term recovery. He says there are observable burnout symptoms such as depression, increased frustration, poor attendance and decreased self-care. In his own experience, he noticed it in himself most acutely when he lived in an inpatient treatment facility and was constantly available.
Recovering addicts and burnout
Many counselors blame overwork or poor managerial support as causes of burnout. Bowden says at least 50 percent of substance abuse counselors are former addicts — but this has a pro and con. The ability to relate to a patient who is an addict is an advantage; but the possibility of burnout is greater for recovering addicts, now counselors, who have the possibility of relapse.
Recovering addicts go into the field of counseling due to a desire to help others achieve what they have achieved. Unfortunately, the relapse rate for counselors in recovery is one in every five. Apparently, it is difficult for a helper to admit they need help themselves, perhaps making them feel they are inadequate to the job. Many organizations now ask counselors not to discuss the fact that they’re in recovery with their patients.
Bowden thinks addicts who become counselors won’t last long in the field due to compassion fatigue being particularly difficult for recovering people. He says self-care is the key to preventing burnout and recommends leaving work at work, constant self monitoring and learning appropriate limits for oneself. Patients cannot be treated at the expense of personal well being so things like enjoying a full life outside work, exercising regularly and doing things one cares about will also be helpful in preventing burnout. As always too individuals should turn to colleagues and supervisors for support when it is needed.
Private practitioners may not have office peers for support, but they do have the ability to limit the number of patients they see. Burnout should be seen for what it is, an occupational hazard not a sign of incompetence.
Patients deserve the best possible treatment for either their addiction or a mental health disorder. If a therapist is suffering from burnout, their clients may not receive the standard of treatment they need. No one is immune from work related stress and counselors taking steps to take proper care of themselves benefits both them and their clients.
For details on upcoming events which will help edify and educate you on workplace wellness, you can call a member of the Sovereign Health team at 855-969-5557.
Written by Veronica McNamara, Sovereign Health Group writer