The Case of the Burned Out Therapist

I know it’s hard to believe, but Polly is worse than usual this week. Her solipsism finally got the better of her. You knew it was going to happen. Responding to a woman who is facing severe job-related burn-out, Polly droned on for paragraph after painful paragraph with a paean to herself, to her wonderful, glorious, happy self.

You have to read it to believe it.

Does a woman whose life is unraveling really need to hear how great Polly’s life is? Even someone who has as little empathy as yours truly knows better than to… rub it in.

I understand that Polly intends to offer some hope, but she is insufficiently sensitive to understand that bragging about your great life to someone whose life is falling apart produces hopelessness. Funnily enough, she learned it all in therapy.

When Polly gets around to saying that she herself is now doing great work, one cringes to imagine what would constitute bad work by her standards.

Anyway, here are some excerpts from the letter, written by a woman who calls herself “Drained:”

Right now, I am a therapist who does home-based counseling with very poor people with very complicated and difficult issues. The problem is that I really feel like I am the blind leading the blind….

Many of my clients tell me that I help them tremendously, and my entire case load has followed me from one agency to another, so I do feel like I am effective in my job in many ways. However, I feel very stressed, overwhelmed, and frustrated most of the time. In addition to my job being very difficult and heart-wrenching, I struggle very much with my own mental-health issues and history of trauma. There are days (most days!) that I come home feeling like my soul was just sucked out of my body and I have nothing left to give. Naturally, this affects my relationship with family members and my boyfriend. I am very snappy and moody and often feel very depressed and bitter that my job takes so much out of me. I am in therapy myself and on medication, but this only seems to take the edge off my frustration and irritability. I engage in various activities that are designed to be an outlet such as exercise, sports, and trivia nights, but nothing seems to make me fully relax. I feel like my job is slowly killing me. Part of the problem is that I care too much. I think about my clients all the time, and I have a hard time putting up boundaries with them/resisting the urge to bend over backward to do anything I can to help them….

As much as I try to argue against negative self-talk about it, I cannot help but feel like I am falling apart in so many ways. Part of me thinks that I should get out of this line of work because of my own mental-health struggles, but the other part of me feels trapped because I don’t know what else I can do to pay my bills and all of the college loans that are drowning and choking me.

Drained

You might be thinking that Drained needs some career counseling. You might be thinking that she needs to reconsider her work. We do not know how good she is at her job, but I suspect that, even if she is good, her clientele may be beyond help. If she is a social worker with a local government agency she will be visiting families that are brutally dysfunctional. There’s only so much of that that any person can tolerate.

Therapists and other medical professionals who work with patients that never get better, at times for reasons that have nothing to do with the therapy, often suffer burnout.

If Drained is a licensed, credentialed, registered therapist, then perhaps she can find a different job, perhaps in a clinic or a hospital, one that does not require home visits with people who are untreatable. If she were part of a team in a clinic she would have colleagues and co-workers. They could all compare notes. She would not feel that she is alone facing long odds.

One must also suggest that if she works for a city government agency the pay scale and benefits might be far superior to those she could find in the private sector.

Of course, she is in therapy. Of course, her therapist is not helping her.Such are some quick thoughts.

Then, along came Polly. Having done gobs of therapy herself Polly answers a woman whose life is falling apart with this:

This morning when I woke up, I felt good. I’ve felt good most mornings for a while now, but it’s still totally foreign to me, after a lifetime of waking up and feeling ambivalent or avoidant or anxious or depressed about what I had to face each day. And even though I could list a million reasons why I feel good now — I mean, I’ve examined this stuff, I’ve worked hard on it, and also I’ve been incredibly lucky — one reason stuck in my head: I’m good to myself.

Keep in mind, Polly presents herself as a perfectly well-adjusted, totally happy therapy patient. If this does not cause you to abandon therapy, I do not know what would.

Incapable of addressing Drained’s concerns, feeling no empathy for a woman whose life is out of control, Polly regales us with tales of her own life. Why does she think anyone cares?

And, Polly tacks on her own psychobabble, telling this woman to get back into her mind, to try to discover what she wants, to feel her feelings… and so on. Can you be more insensitive?

Part of being good to yourself means asking really strange, sweeping questions about what you truly want, and resisting the urge to factor in what some outdated version of yourself wants and what anyone else wants. 

And of course, all roads lead back to Polly:

This is what it boiled down to for me: You have to stop wanting to be heroic and impressive, and you have to start wanting to feel good. You have to stop wanting to be better for everyone else and start wanting to be good to yourself. And you have to believe that you deserve that.

If this woman was feeling that she was doing a better job, then perhaps she would feel better about herself. Telling her to lie to herself is counterproductive.

Finally, as something of an afterthought, Polly offers a few words about perhaps getting a different job.

If I were you, I’d start researching new career paths that might sustain you instead of draining you, and I’d think about reducing your load to half-time and then filling in the financial gap with something that’s less emotionally exhausting. I know that the money is a big issue. But you can’t let your guilt over lack of money and past fuck-ups constrain your vision of what’s possible. One of the terrible side effects of poverty and also ingested dysfunction is that nothing feels like your choice. But you have a degree and job experience and you’re smart and good at what you do. You do have choices. Believe me.

We do have the choice of believing or not believing Polly. We don’t.