I burnt out in my first job as a qualified clinical psychologist but I don’t think I recognised it as burnout until the second time this started happening to me. At the time, I knew I was exhausted all the time, was experiencing a few other physical symptoms and just wanted something to make me feel better and more energised. I used to have more time for exercise, intense yoga and eating well but with a long commute, compressed hours to try to make the parking situation more bearable, and full clinic days, I just didn’t have the time or energy to do the things that I knew could be helpful. None of it seemed realistic and, whilst I put everything into my job to give my patients and team the best experience of me, I had nothing left at the end of the day and spent my weekends recovering. I was also starting to worry that my relationship with my partner wouldn’t survive this as I wasn’t exactly good company.
What is burnout?
Chances are, if you’ve read this far, you might be experiencing burnout or are close to it. If this doesn’t apply to you, including if you are exhausted because of a chronic health condition, your mental health or other significant challenges, you might want to skip to the section on the soothing section, as it applies to everyone.
Burnout is often characterised by:
- Chronic / persistent fatigue*, always being exhausted, having no energy (can be emotional and physical)
- Feeling overwhelmed by all your responsibilities and growing to-do lists
- Feeling detached from your life
- It tends to creep up slowly rather than having a sudden onset
- It can lead to compassion fatigue when therapists stop caring about their patients’ problems
- It is often associated with work-related stressors such as lack of control, high workload, and lack of resources. And unfortunately, it is an occupational hazard for therapists, counsellors and other types of helping professionals but we don’t always see it coming and no-one seems to talk openly about it.
None of this is your fault, and you’re not weak if you burn out but your colleagues don’t. You didn’t cause your burnout, and you’re probably working in a system that needs to change. I’m not going to pretend that isn’t the biggest problem but I’m also not going to pretend that it’s easy to change the system. You matter too much to let things continue as they are, so let’s think about practical ways you can start recharging your batteries.
What can you do about it if you think you are burning out / have already burnt out?
Chronic fatigue* can be a symptom of a range of medical conditions, so it is important to have significant issues medically ruled out first. It can be challenging to know when to stop testing but having too many tests can also add to stress so I would advise you to trust your GP on this one, especially if you suspect your job or lifestyle might be playing a role.
(*In this article, I am only referring to chronic fatigue as a symptom, not chronic fatigue syndrome or ME which are recognised as medical conditions. The information on the soothing system below and lifestyle changes may still be helpful if you have ME/CFS or another medical condition. Please respect your own needs and ignore any of the information in this article which does not seem helpful for you.)
I was pretty annoyed when I first spoke to a GP about my symptoms and they asked me if I was stressed, because well, how many psychologists or therapists do you know who aren’t stressed?! The question felt out of place, especially as I just wanted to know if something was medically wrong but it was actually an important seed of doubt that had been planted in my mind, leading to me asking: “Can I honestly cope with being this stressed and busy all the time, even for a job I love and have worked so hard for?” I started wondering whether I would have to quit my job, which was the last thing I wanted to do.
Having consulted Dr Google, listened to various podcasts and read loads of self-help books and articles, the penny finally dropped when I saw how often mindfulness was mentioned. I realised I already had all the answers I needed: using the tools that work so well for my patients! And this included applying the tools with a large dose of self-compassion to acknowledge that I was having a hard time, to recognise that we all experience some kind of struggle in life (and don’t need to compare ourselves with others who have it worse), and that whilst there were lots of things I couldn’t do, there were some things I could manage if I made them realistic enough for my circumstances. I’m not suggesting one thing is going to solve all your problems (we’d all be out of a job if that were the case) but I’m hoping the following will give you a starting point to think more clearly about what you might need.
The soothing system
We have a soothing system, also known as the parasympathetic nervous system or rest and digest system, in our bodies to allow us to rebalance from stress and high levels of activity. If you’re looking for detailed information on the soothing system, I would recommend looking at compassion focused therapy materials by Professor Paul Gilbert, such as the resources on the Compassionate Mind website.
Unfortunately, effective use of the soothe system is not something that our society tends to focus on, and is rarely something that we are taught to fit into our jobs. So we tend to focus on doing more or working harder at the things that are feeling impossible, e.g. “If I just start eating well and exercising every day, I’ll feel much better”, or we compare our situation with others “I need to get a grip because everyone else seems to be coping fine so I must be doing something wrong”. All of these unhelpful thinking loops keep us stuck in fight or flight mode, and talking about it sometimes further adds to our stress if we keep focusing on the things we cannot change.
How to activate the soothe system
I tell you what it’s not: scrolling on social media or watching the news! These things can be valuable in small doses but they are not going to soothe your nervous system (unless you’re watching cat videos!)
Mindfulness is one of the main tools that can be used in a variety of settings, as it is primarily about being present and noticing things exactly as they are. However, we often think of mindfulness as observing our thoughts and sitting down for 10–20 minutes, maybe even more. I’ve been meditating for years but I know that when life gets complicated or my routines change, my longer morning meditations do tend to slip so I have to use something more realistic that doesn’t feel like a lot of effort when I’m exhausted. This is where grounding techniques come in.
As you’re a therapist, you’ve maybe already recommended the 5,4,3,2,1 technique to your patients, a form of grounding. I think this is a fantastic tool, especially for anyone who struggles with breathing exercises for whatever reason. If you know what it is and like it, please use it regularly through the day.
If you’re not sure what it is or don’t tend to use the 5,4,3,2,1 technique, I’m going to explain the version I use and teach to my patients and yoga students:
– focus on the feeling of your feet or other body parts on the ground
– notice the parts of your body that are touching a chair or other body parts
– notice the temperature and texture of whatever your hands are touching
– now start noticing any sounds you hear
– and smells (maybe you can’t smell anything, which is ok)
– and tastes (as above)
– and then start noticing the details of what you can see (the colour, shape, patterns, imperfections, light and shadows)
– notice how it makes your mind and body feel.
You can do this with your eyes closed if it feels comfortable for you or with your eyes open looking softly on the ground before you start focusing on what you can see.
You can pick and choose which ones you focus on, and how long you do this for. There is no right or wrong order, and the reason I don’t use the numbers is I can rarely remember which one is supposed to be 3 or 4. There can also be plenty of other reasons why focusing on all the senses doesn’t suit someone so I like to encourage people to use whichever parts they find most helpful. It really doesn’t matter as the purpose is to get out of your thinking loops and into your body, so that you can then problem solve more effectively and have a better chance of making choices that are in line with your values rather than impulsively reacting when you are in threat mode.
Once you have finished the grounding exercise, if you are in a situation where you can reflect, try asking yourself what feels like a realistic next course of action for you and your values. Sometimes this will involve removing something off your to-do list if you have come to realise it isn’t that important.
I also think grounding has an important role to play in helping us reconnect with joy by being more present with loved ones and during activities that make us feel good.
When you can use grounding techniques
– as soon as you wake up
– before, during and after meetings
– before, during (briefly to refocus!) and after patients / therapy clients
– after work
– when taking a walk
– anytime that it is safe to do so.
And if you are really struggling for time, could you try it for just 10 seconds? That might sound pointless or ridiculous but it all counts and adds up. Even if you’re not convinced, would you be willing to try it to see what the experience is like? If you forget one day, just start again as soon as you remember. The point is to make it such a small step to start with and at really busy times so that it’s reasonable to ask yourself to do it. You’re always free to do more when you want and are able to. I apply this principle to lots of areas of my life because I know that 1% changes can create important shifts in the long term.
If it feels safe enough for you and you haven’t already done so, I would recommend talking about burnout in your clinical supervision. You might need further support, including your own therapy to build up more self-compassion and to clarify your values but not everyone needs therapy. A good supervisor will encourage this if it sounds like it might be helpful; however, I appreciate how hard it can be to take that step and I also believe that a mindbody practice, such as mindfulness or gentle yoga, is essential as part of any treatment plan for burnout so what I have described above is a good place to start. Give it a go and let me know if this was helpful in the comments.
If you are interested in trying yin yoga as a way of practising tuning into sensation and finding a balance between activity and soothing, you may want to try my online yin yoga classes.