I’ll briefly mention a few different things that – in my experience – helps with avoiding burnout when working as a therapist.
The obvious one is to reduce the number of clients to a manageable level, and perhaps outsource the non-therapy parts of the process.
Another important factor is which modalities we use. Staying at the story-level tends to create burnout and may also not be the best approach for trauma clients. (I realize that, in some settings, the modalities we use is not a choice.)
It helps to keep the story-level interactions to a minimum and focus on approaches that work on other levels. For instance, dismantling how the mind creates its own experience of the trauma or emotional issue (inquiry, cognitive therapy), somatic work (releasing trauma from the body), energy work (Vortex Healing, Craniosacral etc.), or even heart-centered practices (ho’oponopno, tonglen). Forms of mindfulness can also be helpful if done in a trauma-informed way.
Burnout typically means we are burnt out from having our own emotional issues and struggles with the world (clients and their stories) triggered. This means it’s important for us to notice what’s triggered in us, take it seriously, and address it. Often, there are some recurrent issues which means that taking of these can help us a lot. And it often helps to have someone else facilitating us in identifying and working on these issues.
What type of issues may be triggered in us? It may be unresolved issues brought alive by similar issues in our clients, being overly invested with a helper role and wanting to “fix” the client, not feeling good enough or up to the task, having guilt, sadness, or anxiety come up, or feeling traumatized through exposure to the trauma of the clients (usually because it triggers existing issues in us).
In all of these cases, our own stressful beliefs and emotional issues are triggered by working with clients, the clients do us a favor by helping us see what’s left in us to work on, and the situation requires us to go deeper and address our own issues so we don’t burn out.
One recipe for burnout is to have way too many clients, do everything ourselves, stay at a (stressful) story level with the clients, and not address the issues triggered in ourselves. And a recipe for avoiding burnout is to do the reverse.
There is obviously something else that’s important when it comes to burnout, and that’s our work situation and social and economic factors. If we work for someone else, we may not be able to reduce the number of clients or schedule in enough breaks. We may also not be able to chose which modalities we use (which may mean we are stuck with talk therapy). And if we work independently, the way society is set up and functions may require us to have more clients than we feel is appropriate for financial reasons.
When I worked with clients on a daily basis, I didn’t burn out and didn’t notice signs of burnout – even if I worked with alcoholics, drug addicts, and people with trauma.
Why is that? I think it’s a few different reasons.
Our approach was to question and examine how our minds creates it’s own experience of the trauma and addiction and anything related to it. We quickly moved from the conventional story level to examining mental images, words, and body sensations and how they combine. (Living Inquiries.)
I also used a somatic approach called Tension and Trauma Release Exercises (TRE) which again is not dependent on the story level.
And although I could have done this more and more systematically (can’t we always?), I noticed when something got triggered in me and explored it through my own inquiry – often guided by someone else.
Why do some therapists burn out?
I assume it has to do with (at least) two things.
One is that if we stay at the story level (talk therapy), it’s almost bound to trigger issues in us, make us tired, and perhaps eventually burnt out. It’s much easier on us as therapists to help the client dismantle their experience of the trauma and whatever else goes on (inquiry), and work with the trauma in the body.
Another is the importance of noticing what’s triggered in us and take care of it. The less is triggered in us – of pity, guilt, compulsive helping, anxiety, sadness, memories and so on – the less likely we are to burn out.
Note: It’s not quite accurate to say I didn’t notice signs of burnout in myself. I did in periods, although it had to do with the management and not the clients. (The boss had a “use and discard” approach to the therapists, committed serious insurance fraud, lied to the clients about the effectiveness of the program, and much more. I repeatedly got in hot water when I spoke up about this, and although everyone working there talked about it when the boss was not around they didn’t speak up to him as I did so I felt vulnerable and isolated.)
My experience – will be different depending on the setting + modalities used
If possible, reduce the story level to a minimum (some is obviously necessary)
Investigate the story, work with energy, body, simple pointers
Notice what is triggered in me, investigate, change orientation to, find resolution for
In essence: work on what’s triggered in me, investigate the stories, work with body
Burnout: stay at story level + belive it or believe what it triggers in me (recipe for burnout)