Speaker A: Welcome to the Therapist Burnout podcast, episode 42. Hey, therapists. Welcome back. Today, I have Karen Conlon. I am so excited to have you on. It’s great to reconnect. We just reconnected for about 30 minutes before this, so that was awesome. So just introduce yourself and tell us a little bit about your burnout story.
Speaker B: Thanks, Jen. Super stoked to be here. As you mentioned, I’m Karen Conlon, and I’m a therapist who specializes with working with anxiety and trauma. My burnout has a few stages that I’ve gone through. I just realized it, really, that I realized the need to do something about it that was more long term after you and I worked together. You know, I’ve been listening to your podcast, and I was like, gosh, I really, you know, everything you were saying but resonated with me so much. There was one particular guest that you had that I was like, oh, my gosh, this woman’s, like, telling my story. And, like, so many things that you were saying. And then I reached out to you. We worked together, and that was kind of like, you know, it didn’t take much, right? Like, we would meet, and you’d be like, okay, I’ll see you in two weeks, and whatever. And then I’d see you in two weeks. You’re like, so how’s that? I thought I did it. Oh, okay. You know, like, that was like, you know, I needed. Like, you were giving me the permission that I needed to, you know, get things done. But in terms of burnout, one of the things that I realized was that I’ve gone through probably four stages of burnout. The first one that started actually in grad school with my very first internship. But I didn’t know what that was about. I had no idea. Now, looking back, of course. Wow, thank goodness for this one professor who noticed changes in my behavior. Like, I wasn’t participating in a classroom and stuff like that. She took me aside. She’s like, hey, what’s going on with you? And talked to me a little bit about setting boundaries and explaining to me, like, hey, our jobs are not to fix people’s lives. Which was, like, a mind blowing thing for me. I said, what do you mean? Then why are we doing this? And she’s like, well, no, think about it, right? How do you fix someone’s lives if someone’s life, if you are not really in control of anything that they do think, say, right? I mean, even when they’re in session with you, you don’t. You don’t even know if people are telling you the full truth of what’s happening, right?
Speaker A: Or the full.
Speaker B: So how do you do? So she really gave me this beautiful, and she’s, you know, she was a trauma therapist, and, you know, she recognized the vicarious trauma that I was going through and stuff there. And she just really set me up for what I felt was a wonderful way of practicing. And it’s probably helped me get, not get so far into burnout, actually, throughout the years because she really set me up with that message. Right. Of, like, it’s not your job to fix people. You know, you can coach, you can teach, you can help reflect, you can help observe, you can provide observation, reflections, all these things. But you must liberate yourself from the thought that it’s your job to fix people’s lives because you can’t and you shouldn’t, and you need to get away from that so that you can be a more effective therapist and clinician or whatever it is that you decide to do if you’re working with people.
Speaker A: Yeah. Why do you think we, even though no one said it, we feel like we need to fix our clients, even though we’d never out loud say, I need to fix my client. I think we feel that.
Speaker B: Yeah. You know, I thought about that question for myself for many years. I think one of the, we all know this, right? Like, it’s kind of like the joke in this faith that a lot of us go into this work because we’re still kind of working through our own stuff. And sometimes, or maybe you’ve worked through your own stuff and then you want to help other people. Right. With that stuff. And so I think I recognize that in myself many, many times, you know, as much as I had, you know, pretty decent boundaries, I think, for myself and with people, like, I was never the person that would take, I could hear really, and I have heard really horrific things, but I didn’t take it home. I was able to disconnect from that. But there is a feeling with some people, especially, I think, those most vulnerable ones, the ones that, man, you hear their stories and you’re like, wow, you never really even had a chance, did you?
Speaker A: Yeah.
Speaker B: Right. And you really, when you’re working with them and, you know, it doesn’t matter what they do on the outside. I’m talking about people who can be like, you know, who are in very high level positions that you would and public figures and people who you’d never thank. Right. But, but, but when you’re working in this space, you see the wounded child. You get the privilege. And when I say that, very humbly, the privilege that they’re letting you into their lives in a way where many people, or most people know I don’t get to see them. And so you really are working with that wounded child. And so you see that. You see that and you experience that, and you’re helping them through that. And so it’s, you know, you really have to check yourself. Right. With transference encounter transference that happens in the space. And that tendency then, of wanting to, like, oh, I really want to protect you somehow.
Speaker A: Yeah. And. And that’s human, that we want to do that, that we want to to **** suffering in our clients, and we want to try to protect them from that, yet we can’t. And I think that’s the paradox. We feel all these things. We have real feelings towards our clients. We really care for them, yet we’re not in their lives.
Speaker B: Yeah, yeah. Well, and that’s the thing. We are not in their lives, but we are. That’s the thing. Right? Like, we. We actually. We are such an instrumental part, you know? I mean, how many times haven’t I heard, right? Like, oh, my gosh, Karen, this was happening. And I heard you in my head say to you, saying to myself, like, wait, how do I really feel in this moment? Right, so when you hear clients say things like that to you, like, gosh, and you were in my head in this moment where I really needed, you know, to dig into my resources, and you are literally one of their resources. Right. You know, you realize that you’re not just a person that they enjoy coming to, or sometimes they don’t enjoy, but they need to. Right. Or they want to.
Speaker A: Right. But I know I’ve had a lot of clients that say, like, you know, I don’t like coming here. You’re all right, but I don’t like coming here.
Speaker B: Yeah, yeah. I don’t really want to talk about it. Do we have to talk about. Yeah. But then, you know, that comes with this huge sense of sort of, at least for me, a realization, like, oh, wow. Like, what I say really matters. What I say. Even something that’s, like, maybe in passing. Wow. I really have to think about what I’m saying here because even something that I’m saying in passing is something that could really stick.
Speaker A: Yeah. So, yeah, we are. You’re right. We are not in their lives, like, part of their relational circle. However, we become part of them. You know, I think of psyche.
Speaker B: Yeah. Emotional psych.
Speaker A: Psyche. And I think about even some research on memories, how, like, memories of our loved ones, even though, you know, we’re living as their therapists, but we remember memories of a person. So even after they’re there, they’ve passed, they still have parts of their loved one with them. So I think often that of what pieces of us are they carrying with them? Which is kind of a beautiful thing to think about, that we are kind of with them in many, many ways.
Speaker B: Yeah, absolutely. 100%. And so just kind of going back to, like, the burnout stages, you know, I started out with that in grad school. Luckily, I had this professor that recognized it right away and talked me through it. My next job was an adolescent health center where I was seeing between 92, 120 teens per month and very high risk, a lot of high risk behaviors. A lot, you know, issues with, you know, parenting and parents, because a lot of times, they just were trying to do the best they can. Working, working Orlando, you know, struggling with drug use or whatever it was that was going on. And so, you know, child protective services oftentimes, you know, so there was that experience of dealing with child protective services and negotiating that discussion with the kids beforehand so they wouldn’t lose trust in me. And, like, look, I have to do this, and, you know, but I’m. I’m not gonna leave you out of it. Right? Like, let’s do this together. And then, you know, dealing with parents who are very, very upset and angry. And then after that, I worked at a Mount Sinai hospital working with chronic illness. That was such a rewarding, rewarding job and work, but that also had its challenges as well as, you know, the job changed, and there was definite burnout there. And here we are in private practice, you know, years later and beautiful, many beautiful years in private practice, but, you know, also still experiencing, at some certain point, burnout, especially post pandemic. I, you know, I describe it as, you know, like post pandemic. What did I say the other day? I forget what I called it, but it’s just like a post pandemic reaction. The delayed reaction. That’s what I call it. Like, I’m having a post pandemic delayed reaction because I spent so much of the pandemic putting out fires, hiring. I had a group practice at the time and just wanting to try to make sure to get my clinicians trained and everybody supervised and, you know, our clients cared for, and I was not really paying attention to what was happening with me.
Speaker A: Yeah, I think I keep talking more and more on the podcast of people’s reactions post pandemic.
Speaker B: Yeah.
Speaker A: And, you know, I think early on, you know, we were just, you know, in that kind of initial crisis phase. You know, we’re just like, okay, I just got to keep going, keep going, keep going. And of course, I think many therapists, I think nearly all of them that I’ve talked to, you know, hit some kind of burnout wall. Most of my friends around me who are clinicians hit that in some way or shape or form. But I don’t think we really talk about, like, okay, yeah, I hit that, but we don’t talk about really, how did you get through it? Or if you’re still in it, like, what are you doing? How are you maintaining that high level of arousal and cortisol that’s running through your body?
Speaker B: Yeah.
Speaker A: And I think my last guest, that’s actually dropped today, but our recording will be on later, talked about just feeling like a sense of loss, of sense of self because that constant giving, so kind of human giver syndrome. Like, I give, I give, I give. And then what is left for me? Like, who am I now? Because all I’ve been doing is giving.
Speaker B: What lands. Yeah, that does land. I think that. I mean, obviously, I’m not the first. Not going to be the last woman to say this, right? I think that, generally speaking, we as women are conditioned to give of ourselves and think of others, and that if we think about ourselves or put ourselves first, you know, there’s something bad about you or, you know, or you have to make up for it in other ways. I have certain. I have certainly not been an exception to that value system that was given to me. And so I find that a lot of the things that I have done and the way that I do interact and do things, I’m not a people pleaser, necessarily. I’m nothing. I wouldn’t say that I’m that, but I definitely like to see people doing well and, you know, I don’t know, being a better version of themselves and seeing them happy to have done that. And so in one way or another, I’ve always been trying to help people do that, but it’s resulted in me constantly of sometimes being constantly in that space and not really a lot of stopping happening. You know, the burnout, it’s interesting. It makes me wonder if I’ve burned out, you know, even before being in therapy.
Speaker A: Right?
Speaker B: Like, have I other, you know, have I had other spaces times when I burn out and just didn’t realize it? I know that for me, dealing with burnout has been. The way that I dealt with burnout has been by starting something new. Right. Either I look for a new job or a new thing to do, or I have a new project that’s exciting. Oh, my gosh. You know, now I have to learn. I have to research. I love my research, you know, and that seeking out that stimulation and just being able to look elsewhere, that’s not where I have to be, if that makes sense. Yeah.
Speaker A: Oh, my gosh, that makes so much sense. And so part of my story was, you know, I have to, like, find the escape hatch from whatever, the burnout thing that I needed to leave. Okay, so it was foster care. I can’t work with kids anymore, so let’s just start a doctoral program. Doctoral program was like, oh, my gosh, that had an end date. So I feel like that was all right. It was still hard.
Speaker B: Yeah.
Speaker A: But then, you know, passing the agency and then private practice, I think. I think that it just kind of keeps catching up with us. And then, you know, as we get older, you know, especially for, you know, therapists who are around that midlife time getting your license, and then a lot of us who are female identifying, we’re also birthing people, we’re having children. And so add more complexity to giving and to the demands on us. And then I think at the end of the day, we kind of look at our lives and we’re like, yes, this giving that I’m doing as a therapist is important, but where really do I need to put my first level of giving? And that would, for me, be the people that are in my immediate circle, like, in my real life, my children, my spouse, my friends. And I think the burn of what it does is it has become more untethered to our natural supports because we’re constantly giving, giving that we. We then, look, when we’re in burnout, we’re like, where are the people? Where are my lasagnas? Why are people, like, helping me out?
Speaker B: Yeah. You know, it’s. It’s interesting, right? Because it’s an interesting thing you’re bringing up here, because in the therapy space. Right. I mean, if you think about it, it is a one way relationship in many ways, and it should be. Right? No, I mean, it’s. Right. It’s. I mean, yes, it’s a two way relationship, but in terms of what we think about traditionally or what conventional relationship is. Right. Which is a two way street, whether it’s a friendship or. Right, an intimate relationship, it’s a two way street. You know, you give and you get. You give and. Yeah, but with, you know, with your therapy clients, it is. And like you said, there should be, you know, a one way. Really? Right now, I am not a believer of that whole old school. I find it to be old school that, you know, you just sit there like a blindface and, like, you know, you don’t disclose. Right? Like, I know I’ve always been a person that feels like. No, my clients need to understand that I’m a person, right? Like, I have a kid, right? Like, all my clients always know that I have a child, that I have a family. They, you know, they know that sometimes, like, oh, I drive to whatever. To the game, right? I’m driving. I’m doing carpooling. Right? Like, the little chitchat that happens to let people know because they ask you, like, how was your weekend? What did you do? Right. So I’m not gonna be like, well, you know, how was your weekend? You know, like, oh, yeah, that would.
Speaker A: Appropriate for me to share about my weekend. I think I can do it.
Speaker B: Why is that. Is that. Why is that important? You know, like, yeah, what is that?
Speaker A: You know?
Speaker B: And so for me, that’s always been a very important part of my practice, is to let people know that I am also a human being because I’m. Because it’s important for them to know that I’m fallible, because I do make mistakes, and I will make mistakes also in session. And so it’s a wonderful way of also understanding that there’s also repair and that we can work through this. Right. Because this is a real relationship in many ways, but. Yeah, but. But in the ethical ways, it’s a very, very much a one way relationship because you’re not there to, like, tell your clients about, like, what you’re doing. Like, you’re your friends and, like, what your mom said or, you know, what this and that. No, you know, this.
Speaker A: Yeah.
Speaker B: These sessions are not about you. And so if that is all you’re doing and you’re not surrounding yourself with friends and family members and other people who, by the way, are not treating you as a therapist, I mean, that’s a whole nother conversation. Right. Setting those boundaries. But then this can become a very, very isolating profession, and that it is a surefire way towards not just burnout, but, like, really possibly crossing those boundaries with your clients. That’s all. All you have. Right?
Speaker A: Yeah. Yeah.
Speaker B: So.
Speaker A: And we’ve heard those stories. Right. And part of me, you know, maybe we’ll. We’ll take a little sidebar on Facebook groups and Reddit threads and things like that, of situations where they’ve heard of therapists, you know, you know, like, we’ll hear clients tell us, like, this therapist asked me to, you know, pick up their laundry. I had a client tell me that, and I wanted to report that therapist, but client really strongly felt that they did not want, and it’s, I’m, it’s a different situation, actually. It’s not the laundry, but I’m making that up just to.
Speaker B: Yeah, yeah, yeah, yeah.
Speaker A: Protected clinical information. But they’ll say it was an errand, and they became part of their, their clinician’s life. And I was like, oh, well, actually, we’re not allowed to do that. And that would be something that’s reportable for that particular therapist. And they felt strongly they did not want that therapist reported, they did not want it brought up. And so we processed that, went through that whole thing, and I just had to go over ethical code. So we, we hear about these situations. I heard about it firsthand from a client of mine at one point when I was seeing clients. And I think the initial reaction from most therapists is to bash that therapist, that therapist an ethical, they’re, they’re, you know, so inappropriate. How could they ever do that? And I think that is a reaction we have. And, yes, they shouldn’t have done that, but we have to think about, like, why are, what got them there.
Speaker B: Mm hmm. Yeah.
Speaker A: What made them think that that was OKAY?
Speaker B: Yeah, yeah. Where there’s support, there’s context. Right. I mean, without context, words are just words. So that’s important. That is, there’s conteXt. But, you know, I MEAN, yeah, that’s that.
Speaker A: But talk to me in the preview, we talked a little bit about, you know, your experience in these Reddit threads and Facebook groups when you were dealing with stuff. So talk to me a little bit about that.
Speaker B: So it’s BEen interesting. I did a lot of work around, when I was born into private practice, around money mindset. I did. I always engage as much as possible in supervision and consultation. I also, I’m a big believer in, I don’t need to reinvent the wheel. There are people who have done it very well before me. And so in that way, I’ve always liked to invest in myself by investing in other people who have done it before me and get coached, get trained, get business consulting. And so because of that, I was able to learn a lot of really great strategies to get my business up and running very quickly. And what I, for me, what I call successfully and what I started to find as I started doing more, like, Facebook Groups and then, like Reddit and, you know, all these areas that, you know, you’re basically looking for support and, you know, just kind of to have other people that get you.
Speaker A: Yeah.
Speaker B: Hoping. What I started to realize was that there’s actually such a huge divide and a lot of righteousness around, you know, what you, what you charge, what you should charge, what you don’t charge. You know, sometimes I think about it, gosh, like, if I go to my doctor, my specialist, and I say to him, you know, you’ve got some gall for charging what you charged. I don’t know, for my colonoscopy. How dare you? Or whatever. Right? Like, over some service that’s not covered. Like, I would never think of saying that. But yet in this profession, not only do sometimes clients say to us, you know, but, like, what I found is in a lot of these threads, people say it to therapists say to each other, and, you know, there, there’s a, I think there’s a group of people who are very much about, like, no, you know, like, look, you’re not meant to service everyone, and I’m a back group because I’m not going to be good with everyone.
Speaker A: Yeah.
Speaker B: I need to know myself and know what I like and what I’m good at. That’s how I’m going to service people. But I also need to be able to make a living and pay for my kids school. And I, you know, we need to have two cars where we live. And, you know, I want to go on a vacation once a year. Like, I have the right to want to do those things, and that’s going to require me charging x amount so that I can make a living. And by the way, you know, not only was it graduate school, there’s, like, tons of continuing education courses that, you know, I spent thousands of dollars on that my clients also received the benefit of. Right, right. But there’s, I think, you know, there’s also a group of folks that have a mindset around, like, well, you know, to that, so sad. Like, you should not, you know, you should not be having any of those things that. Or if you have to have them by charging people what you feel you’re worth, which. How dare you? You know? So I find that if you haven’t done the work around money mindset as a therapist and become very strong and clear about what your values are. And by the way, I don’t think that there is good or bad in any of those. What I find incredibly hurtful and inappropriate is for people to bash either way, by the way, because you also have those therapists that are saying to people, like, you know, you’re bringing down the profession by charging so little. And, you know, I’ve seen that, too, and that is not okay.
Speaker A: Yeah.
Speaker B: As far as I’m concerned. Right. But you hear it more the other way. And I think that that also contributes to burnout, because then there’s this pressure around, like, oh, well, you know, charge less and then see more people. You know, I want you to think about your clients, right? If you think about this, right? If you’re seeing 30 to 40 clients per week and you’re meeting with each of them 45 to, let’s say, 15 minutes on average, right? Do you really want to be that middle or last person on that therapist’s roster for the day? How much of that therapist do you think you’re getting? How much quality are you? Do you think you’re getting? I mean, think about that. So, you know, my thought is I. For me, I want to give as much quality as possible. I have a friend who very successfully sees, on average, 30 clients per week, and she loves it. And she has divided up her days in ways that she goes, and she does her, like, workouts in between. Like, she. I don’t know. She has figured it out.
Speaker A: Tell her to become on the podcast.
Speaker B: I know. And it’s, like, amazing people. And she loves it.
Speaker A: Has. Does anyone, like, is anyone doing it right? Like, yes. There are many therapists who are, I’m sure are thriving, and, like, they figured it out. And so I’m wanting to have a couple of them on the podcast as well.
Speaker B: Just, I mean, she. Look, she looks. She loved it, you know? But she said she fell. I was like, how do you do it? She’s like, well, you know, 45 minutes. I don’t go over the 45 minutes. She’s like, very much like, I think.
Speaker A: They’Re bound as hell. Yeah. They’re just like, time’s up.
Speaker B: Bye. And, you know, she’s like, and I’ve got, you know, if I. If I have to go do my zumba in between, you know, my morning sessions, my afternoon sessions. That’s what she does, you know? Look, nothing is perfect, right? Because when you. So you have children, then, you know, like, yeah, if you’re going to see that many people. So something’s got to give, right, though, you know? Something’s got to give. And your children, maybe they have to be a little bit more self sufficient in certain ways, because, again, you can’t do it all super successfully. Right?
Speaker A: Yeah. You know, what’s interesting that I. So I read this anxious, anxious generation book. I don’t know if you saw it yet, but they talked about how much extra time that our generation is actually mothering due to not having family support. Also with, you know, kids need to be monitored. You know, like, we need to keep them safe. Whereas, like, I walked home at first grade.
Speaker B: Oh, my God.
Speaker A: I mean, I was just talking to my parenting.
Speaker B: Yeah. I was just talking to my husband about, like, oh, my gosh, I remember my favorite thing in the world was going in the back of a station wagon with, like, no seat belts because every time, like, you stopped short, you’d, like, tumble around, like. Like, dice, you know, like, hard in the bath. That was not. There was none of that, you know? But, yeah, you’re right. You know, there is. There’s finding this. Finding a balance. Right. Trying to find that balance, and it’s really. It’s really hard. I mean, I’m a parent to a teen also. And, you know, I. I’ve worked with many teens now a parenting. I wrote a book on it, and I am still, at the end of the day, just a mom. Right. Trying to figure out, oh, my gosh, you know, this is actually happening now. How do I talk to her about this? Even though, like, I talked to, you know, hundreds of teens about whatever that is. Right. But now it’s my. Now it’s my kid. Right.
Speaker A: It’s different.
Speaker B: It is. It is.
Speaker A: Yeah.
Speaker B: It’s different.
Speaker A: So I wanted to get to talking a little bit more if we can pivot back to kind of private practice stuff. So you talked. We talked a little bit on the pre interview about how these longer term relationships can contribute to maybe it was your fourth phase of burnout or your fifth phase of burnout, but. And that’s, you know, at the end of your private practice is when we work together, but maybe share a little bit about just the nature of, like, longer term therapy relationships and why that contributes to burnout, maybe what we need, all the things on that topic.
Speaker B: So I’ve had. I’ve had the pleasure of having really. Or having had very long term compliance. I know that for some people saying, oh, you know, you’ve worked some good for six years, eight years. That’s not right or whatever. But, you know, the thing is that I agree with that. If there is no progress, I’m not right. Like, I very much like to see that we’re working, and it doesn’t mean that we have to work single. Right. But, you know, part of the reward at least that I get from this work or have gotten in the past was, you know, seeing the changes, the subtle changes, seeing that retraining of their brains. Right? I’m very, very neuroscience oriented. And so a lot of my work was very much based on changes that happen in the brain and neuroplasticity. And I would teach my clients about that. I really wanted them to be empowered. So those clients that I worked with for so many years, I worked with them because we started out one place, and then it was like, I, you know, anybody who knows, knows this thing, new level, new double. Like, you’ve heard me say it. And it’s because, wow, now you’ve achieved mastery in this space, right, or in this place that we’ve been working on now. And now we’re coming up with new things, right? And it’s not because we’re coming up with new things for the heck of it. It’s because, wow, like, now you’ve reached this level of mastery, and this whole new world has opened up for you, whether it’s in a relationships or a relationship or career or resilience. And so now those things that were working for you at this other level, maybe not working so much in this new one.
Speaker A: Yeah.
Speaker B: And, you know, you. In many instances, you, again, like I was telling you before, you’re working a lot when you’re working with trauma and anxiety, right? You’re working a lot with that child, with that wounded child that that, that comes up a lot. So in a very weird way, it’s like watching people grow up and into themselves. Like it’s this. I mean, I guess I get goosebumps as I think about it and talk about it now because it, you know, I’m thinking I’m having this, like, number of people that throughout the years, I’ve experienced that with watching them let go of those coping mechanisms, those dispense mechanisms that they had to take on as children and let go of them. Right. And feel confident and safe that even if they make a mistake, it’s not the end of the world. Like, that’s okay.
Speaker A: Yeah.
Speaker B: And so you care, right? Like you’re a human being. You care about these folks. You. I think for me, I can’t speak for anybody else, but sometimes you do. You become very invested in their lives and what’s going on and how they’re coping. And this is where I think, for me, it’s having worked with the longer term clients, ironically, in private practice, that had contributed more to this latest burnout than the. Not because number one, I, like I said before, I wasn’t really paying attention to what was going on for me. I had a bunch of health issues that none of my clients really knew about, all related to not taking care of myself. But I was having some health issues that were, you know, becoming serious, and none of them had any clue, of course. And so I found myself having less. I think I found myself having a harder time, you know, Jen, just putting into perspective those internal boundaries around, like, okay, so that’s their decision. Let me help them kind of think through that. And I found myself more kind of, like, thinking to myself, like, no, why are you doing that? No, no, no. Like, what, what, you know, and having those types of thoughts versus.
Speaker A: I remember, you know, when we were, you know, and this also was true for me.
Speaker B: Yeah.
Speaker A: And it’s kind of part of the burnout. You know, it’s part of the classic definition is that resentment and kind of the sometimes anger or I really kind of, like, depleting emotions that come out. And I think of, like, that counter transference with the client of feeling, like, at the end of yourself and you’re asking x, y and z to move your session or to accommodate this and don’t see my humidity. I wonder if you can speak to that when you’re in these relationships with folks that struggle. Relationship with folks.
Speaker B: I mean, it’s really, really hard because you’re struggling yourself. And oftentimes, for the first time with these relationships, I mean, this last phase for me, this was the first time that I can tell you that I really struggled with those relationships, because I didn’t realize that then, but I was experiencing compassion fatigue, and I wasn’t recognizing what was happening. I didn’t realize it, but I always try to be self aware and just say to myself, hey, why did you think that? What happened to you? What was going on for you in session? Why were you, you know, why were you feeling like that? I would always ask myself, like, why are you feeling agitated? Or why were you getting irritated? Like, what’s, you know, what’s going on with you, Karen? I would always ask myself, they know he’s having answer.
Speaker A: I remember you saying, like, one thing, like, I’m just, like, I’m starting to care less. Like, I can feel in myself, which is hallmark compassion fatigue. Right. That we are our karo meter.
Speaker B: Yeah. Yeah.
Speaker A: Is not working as well.
Speaker B: Yeah. And then, and then that felt really awful. Had so much built around that. Because, like, you know, when you get to the point where you say that out loud, first you say to yourself, if this be happening, then when you get to a point, like, when you and I were working together, that you say, I say that out loud, it was like, wow, that. And so then you go, you know, at least for me, I went down, started going down that rabbit hole, like, well, what does that mean about me? Like, am I just, like, am I actually a bad person? What’s happening? But it was at that point also where I said, you know, I don’t want to practice like this. This is not who I am, and this is not who I want to be. As a practitioner. I’ve always. I’ve always prided myself in being as, you know, showing up as best as I could, and I don’t want to stop doing that now, and I think I really need to. Something was different about this burnout, though, Jen. Something was very different. Yeah, I think that that’s what it was. Like. I, in all the burnout that I’ve ever had in the past, I never felt the compassion fatigue. This time was different. And that. And it scared me because I was like, I don’t want to stop caring like that. That’s not who I am. And maybe this is a big red flag that I need to pause this or put a stop to it, because I always want to care.
Speaker A: Yeah. I think it feels like we’re losing parts of ourselves. I always identify someone who is caring, who, you know, sees the good in people. And I think all the literature kind of supports that. If we hear a bunch of traumatic material, of course it changes our worldview. It changes the way we see the world. And so a break can help to see more goodness again. And I think it’s that permission that you likely need a break for that stuff to come back in because you’re in that trauma bathe still. And, of course, you’re not like, but I used to see the sunshine. And I’m like, oh, yeah, you did. But it’s hard. It’s hard when you’re still in it to feel like I can get to that place where I can just turn the page. It makes so much sense. But again, while you’re in it, it’s hard to see it, and it’s hard to, I think, have that perspective change that is necessary.
Speaker B: Yeah. And also the other thing, too, that with long term clients, I want to. I think it’s, at least for me, it’s important to talk about termination. That was, like, a really big thing. I really struggled with terminating clients that I felt like, listen, I feel like you’re good. Or I feel like, you know, I think my work is done here, if you want to continue. I feel like maybe somebody with a different scope or a different approach, you know, and when I would, let’s say, try to bring that up and, you know, listen, I probably was not as effective at it either, because there was. I just. I didn’t want to hurt people’s feelings. So I probably skirted around it the way, you know, much more than I should have. And then the response was typically like, oh, no, yeah, no, this is over. This is great. You know? And I would say, okay, well, how. What’s. What’s changed? Like, what’s different? What would you say? You know, and what do you think we still need to work on? You know, so there was always something new in it. And so I just felt like, okay, well, if you’re feeling like there’s something new, even though in my heart of hearts, I was like, I think we’re okay, though. I think our work is done. I don’t think your work is necessarily.
Speaker A: Done, but maybe like, yeah, my part of your. Your journey is done.
Speaker B: Yeah.
Speaker A: And so I talk so much about a whole episode on unilateral termination and how when it’s come the perspective of the therapist initiating that termination, we really don’t have great examples or training or supervision. So I feel like I have. I’m definitely talking about that all the time. And I just think we need so much support that it is totally okay if you, number one, no longer feel effective as the therapist in that relationship. Number two, the client is no making. No longer making progress. And number three, we forget about directly from ethical code if they would be further harmed by the work. And we don’t think through those three ethical imperatives when we’re considering termination, because, again, you can’t see the label if you’re in the drawer. And so I think it does take really intentional consultation and supervision. So with that, we have to start wrapping up, which is so sad, because I could talk to you forever.
Speaker B: But thank you.
Speaker A: We wanted to get to two things. So my last question, which is joyous, before that, you told me you wanted to offer, like, if I were to. Were to do it all again, I would do this. So can you share that?
Speaker B: Yeah. So if I were to do it all again, number one is I would not put any pauses on having supervision or clinical consultation because there have been times where I’ve been like, oh, you know what? I’m pretty good. Let me. You know, I’m fine. And it’s not that it hasn’t been, but in hindsight, I always do wonder, I was like, I wonder if maybe if I continued with having clinical consultation or supervision, if maybe I would have been able to work through some of those things. You know, we’re humans, and a lot of times without realizing we are reenacting things with clients. So this is not a deficit in you. This is you recognizing that, you know, you’re assuming of the person that you’re working with. And then the other thing, too, is about termination. You know, in graduate school, they talk to us and they always say, right, termination starts with the first session. Sure. You know, but they don’t really tell you how to do that and how to approach that. So if I could do it all again and, you know, if I were training somebody new, one of the things that I would really recommend and that I would do myself is have that first, those first sessions, one first or second session, and how to talk about termination and say, look, you know, we have work to do, but we need to, I think, look at what the ending will look like for you and what, how do we know when we’ve reached it? And sure, everybody talks about, yeah, well, that’s where you have, like, a treatment plan for and this and that. But, you know, I’m talking about really being very intentional about, okay, well, having it with you, checking in every other session. Let’s look at our treatment plan. How are we doing? Because it tends to veer off. And this is how sometimes you go into these places where you’re just like, well, I feel like we should terminate, but, but we haven’t. And we’re not. And there’s, and then you feel like you have no good reason. So if you could have some things that are a little bit more concrete to say, so how are we doing? Do you feel like we’ve accomplished that? That’s one thing that I would do. And I would encourage newer clinicians to, you know, to kind of get around the mindset because it also gives you something to hold on to if you feel like, you know what, I’m not being effective anymore. Or I feel like this person really could do with EMDR or, or, you know, a different approach that I can offer and you’re not hurting their feelings. We’re talking about, like, look, this is what we talked about, and, you know, why are they reaching them or we’re not or we have reached them and, yeah, you know, how are we doing? Is it time to make a pause on it?
Speaker A: Yeah, I’ve heard of some therapists even saying, like, I work with clients for six months or two a year, and that’s my max, that I work with a client. So I think that’s another way to kind of help protect yourself from, like, getting into these stagnant places where we’re not doing our best work. Again, that has. That bumps up against your theoretical orientation, you know, like, for analysts, which I don’t know anybody who practices as an analyst, really.
Speaker B: Yeah.
Speaker A: But I think part of that being an analyst is that you have your own analyst. So I think they’re, like, kind of doing that stuff all the time if they’re in that model. So I digressed. Those are great.
Speaker B: I agree. Yeah, no, that. I agree. I actually like that model about, you know, kind of having to say, let’s give ourselves, you know, six months and see how this goes, and then after that, you know, another six months, and then that’s, you know, if we haven’t reached our goal to that, you know, so, like, you know, you have the right to do that and set your practice policy.
Speaker A: Yeah. I mean, setting that. Setting that self up for yourself at the outset and knowing.
Speaker B: Yeah.
Speaker A: That if I don’t do that, then I might have difficulty. And I would add on another one is that please, please do consult calls and figure out who you can and cannot work with. Because we get in situations, a lot of times, clinically, with clients with whom we really struggle with, and we likely should not see them because we are not effective with that particular clinical issue, or it bumps up against our kind of transference or their personality just is hard for our personality to kind of mesh with. So consider that really having that consult call be a interview also for you as the therapist to see if you can be effective in that relationship.
Speaker B: Yeah, don’t skip that process a hundred. I mean, 100%. It is so important to have somebody else give you a bird’s eye view of the work you’re doing just so.
Speaker A: And then, Karen, how are you finding joy today?
Speaker B: Oh, man. So I’m finding joy these days. Going to my kids games, actually taking the time to, I mean, I went to her games, of course, before and things like that, but just being very present, like, I’m not thinking about, like, oh, my gosh, I’m here. But now, you know, I have to think about that schedule and tomorrow, you know, just being very present, driving to. Driving her here and there. Believe it or not, this one time I’m finding joy in finding my health. I have appointments and getting myself all good, and I feel great. I feel so happy about that. So I’m actually really finding so much joy in getting my health back, if I’m going to be completely honest.
Speaker A: That’s great.
Speaker B: Yeah. So that’s the best answer I could give you on that one. That’s for real.
Speaker A: I love it. Oh, I so enjoyed working with you when we worked together. Just so funny and vibrant. And I just feel like there’s going to be more collaborations with us on here. So where can the good people reach out to you if they want to talk more with you and maybe just a little bit about your book, just so they know about that?
Speaker B: Oh, sure. So I wrote a book. It’s targeting 13 to 17 year olds, but actually I wrote it with parents and teachers and adults in mind. So if you are a parent or teacher or someone who works with teenagers, you can read it. I read it with you all in mine too. But it’s called the teenager’s guide to adulting skills. Skills and lighthouse. You can find it on Amazon. It’s on audible as well. If you’re a big audio fan. I’m a big audible fan. Kindle, all that good stuff. And I’ve actually been doing coaching instead of therapy for the last few months. So if you want to get in touch with me, you can email me@karenxpressivetalks.com or you can go on my website.
Speaker A: Expressive talk and I’ll put those links in the show notes. Thank you so much.
Speaker B: Thanks Jen. Thanks for having me. So fun to see you.
Speaker A: Love seeing you always. Yes, we’ll talk soon.
Speaker B: All right, my dear, I’ll talk to you soon.
Speaker A: Hey therapist, thanks for listening to the episode today. If you love this podcast, send it to a therapist friend who may need it. Also consider leaving a rating and review on on Apple Podcast. It lets the podcast player know that this is a great podcast. We should send it to more people. I’d love to hear from you. So I have included my pen pal list for other therapists. Yes, I do write back and I’d love to hear from you request for podcast topics to know how you’re doing in these therapy streets. So I’m here for all of it. So I, I would love to hear from you and we’ll talk soon.
