Compassion fatigue, vicarious trauma, and caregiver burnout are common among helping professionals, including psychotherapists. Psychologist Herbert Freudenberger, who coined the word burnout, defines it as ‘‘the extinction of motivation or incentive, especially where one’s devotion to a cause or relationship fails to produce the desired results” (source). Many of us come into the field with devotion to helping others and idealized expectations about our ability influence other's lives. Once we enter the field we come face-to-face with the realization of our own impotence - that we can't take away our client's pain or help them quickly solve the complex situations they face. Have you felt an "extinction of motivation or incentive" in your clinical work? I sure have.
After having been in the mental health field for twenty years, most of those years in a private practice setting, I've learned a few things about the importance of self-care. Here are a few things I've learned from my own experience and from the experiences of private practice therapists I've worked with in my consulting practice.
1) Feel and express a broad range of emotions
Take of your "therapist hat" off every day and allow yourself to feel your feelings. Helping others manage their life crises can get us out of the habit of acknowledging and feeling our deepest feelings. Tune in and allow yourself the freedom to express whatever you are feeling. Journaling, meditation, and prayer can be helpful in acknowledging your own experiences.
2) Nurture your physical self during your work day
Don't give away your self-care time to your clients. Every time you go over your allotted session time you are giving away your self-care time. Over the long-run, this is actually a disservice to your clients. Have water and food handy so you don't go too long without eating or drinking. Take regular bathroom breaks. Take a quick walk around the block.
3) Practice daily self-compassion
Allow yourself to make mistakes, professionally and personally. In Dr. Kristin Neff's book Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind (2011) she defines self-compassion as having three components: self-kindness, common humanity, and mindfulness. Self-kindness is simply treating yourself as you would treat another person who is suffering. Common humanity is the concept that, while human tendency is to shrink from others when we have made mistakes or are faced with imperfection, suffering is the common experience of all humanity. We are not alone in our suffering. Mindfulness is the ability to experience what is present, without judgement.
4) Reclaim child-like joy
Childlike joy is the antidote to burnout. Think of something that you loved to do as a child -- something that allowed you to be in the moment and full of joy. Find a way to bring that activity back into your life. It can be as simple as blowing bubbles, hiking, laying on the grass, playing the piano. Recreate the child-like happiness in your adult life on a regular basis.
5) Consult regularly with other professionals
Isolation is the universal form of torture. Where are dangerous or unruly prisoners sent? They are put in solitary confinement. Many a solo practitioner is in self-imposed isolation because it takes effort to seek out other professionals. We know from attachment theory that we are wired to connect with others. In addition to our familial relationships, this also applies to our professional relationships. We need to know that we are not alone. We need to feel emotionally supported.
6) Have clinical back up so you can take time off
Many therapists I've consulted with haven't taken the needed maternity leave or sick time because they had no one to cover their clients in an extended absence. Reach out to other practitioners and find someone with whom you trust clinically. Work out an arrangement where you are willing to cover each other's clients in the event of an emergency, illness, or vacation. Build in the support you need so you don't have to worry about taking time off.
7) Prioritize your close relationships
It's much easier to help clients with their relationship problems than to work on our own. Part of self-care is nurturing our own intimate relationships with family and friends. Build in time to spend with your partner or child or friend and make sure that your relationships are thriving.
8) Get your own therapist
Therapists need emotional support, an objective perspective and a place to vent. I recommend to therapists that I train and consult with to find a therapist and check in with periodically as part of a self-care plan. Some areas have therapist support groups. Honor the psychological toll that being a therapist can have on our own emotions and psyche.
9) Diversify your professional activities
Burnout and compassion fatigue can be prevented by adding variety to your professional life. If you are seeing a lot of intense clients with abuse histories, for example, change up your schedule by some teaching university students, writing your first book, or offering professional trainings.
10) Charge more than you feel you are worth
The best way to take care of your self is to make sure that your own needs are met. Part of this process is valuing your time, your education, and your expertise by charging more for your services. I have yet to consult with a therapist who in private practice where I've recommended lowering their fee. Most therapists charge too little and give away too much of their time and energy.
Find out more about my book The Burnout Cure: An Emotional Survival Guide for Overwhelmed Women