049. Fear and Burnout

Speaker A: Welcome to the Therapist Myrna podcast, episode 49.

Hey, therapist. This is take two. For me today, I recorded a whole episode. Actually, it was yesterday.

And so when I have a recording that goes into the ethers, it’s really hard for me to get started. So, thankfully, I listened to my coach, who started with can I just.

That was on her podcast today, and she had actually shared about losing a recording and having to do it again. And I was like, okay, thank you very much. So for me today is, can I just turn on the microphone, even while my family is listening in the other room, to something very loudly that I don’t care to watch right now?

So it’s fine. So here I am, take two, and I was talking on that failed recording about agency.

And maybe I’ll get back to that. Maybe my recording will come back. That’s what I’m hopeful for, that the recording ninjas behind my podcast hosting can find it. We shall see.

However, today I want to talk about fear. And so I’m doing a little series. I’m calling this the things that are holding you back from change. As a therapist.

Number one is fear. And I think the segue into agency is that I think a lot of therapists feel like they don’t have agency after burnout or during burnout, the whole process of it, because they don’t trust themselves.

Right. I am going to go back in the way back machine. So for myself, when I hit kind of peak burnout in 2021, I talked about this. Probably not as recent as maybe some of you guys who just started listening to the podcast.

So I cried some really hot te tears in 2021, going through 2020 as a therapist, and really, it just started stacking. Everything started stacking. I developed panic attacks, and I really didn’t realize what was happening until I was in it.

Uh, I think it was the stress of having two young children. One in kindergarten, one in preschool. Gosh. And they are. I got one nearly in middle school now, next year, so that’s crazy.

I’ll have a middle schooler in the fall of 2025. And we’re about to go into that.

So at the time, I had a kindergartner.

Time goes by, guys. And so that was just a lot to hold. You know, it was a lot to hold being a therapist and not having childcare and doing all those things that it was just too much.

And now I can see that. Now I can see it was too much. And of course you burn out, and it’s really not so much about you burning out, but just you didn’t have any more to give.

And that’s how I see it now. But I didn’t see it then that way. And so part of what prevented me from changing was fear. So I remember in 2021 having a session with my own therapist and saying, I don’t want to be a therapist anymore.

I really don’t think I can do this because I was trying to make it work, reduce my schedule, get off some insurance panel. Maybe that didn’t happen till the end of 2021.

Actually, I started coming off insurance panels because that’s right, because I think a big payer anthem, I’ll just shout it out did not pay me for probably six months. So yeah, I was done with not getting paid and working as hard as I’ve ever worked.

So I think fear was part of it. And there were so many layers to that.

The fear of losing my practice after I built it. So my private practice, I again started from a fear based decision because my son had heart surgery when he was five days old and I did not go back to my agency job.

They told me I could not come back less than 32 hours a week and I could not leave that baby at the time, who was. He’s 11 now and he’s doing well.

At the time I couldn’t leave him. So that’s what started me on my private practice journey where I said, okay, there were no telehealth companies, so that wasn’t a choice to kind of join one of these telehealth platforms.

So that was pre all of that. I didn’t even try telehealth. But I think one time before the pandemic and I didn’t really see any other options out there for therapists besides doing testing.

And I’d just done a ton of testing in agency and I was kind of burning out of doing so much testing and the way they were doing it because it really was only the only thing that I was doing and there wasn’t a lot of collaboration.

So I contract now for schools and there’s a lot of collaboration in that testing that I’m doing now. So working in special education, I actually really like it and I meet with team members, I collaborate on all kinds of things.

I do risk assessments. There’s just a lot of variety there in that work that I really do enjoy.

But at the agency it was kind of like we call report mill, you know, not similar cases all the time. But I think it was just really monotonous for Me and not a lot of collaboration, which is kind of my secret sauce of what makes me happy.

I’m trying to remember where I’m going here.

So no options. So I think the first thing we fear is that we have no options. So, okay, I close this practice, I leave my job. I. What am I doing?

Like, what am I going to do for work if I’m not a therapist? And I think even more so for folks who aren’t a psychologist. So I have, you know, I could do assessment, right?

I can do some other things.

And that’s also true for actually master’s level clinicians. So you, you can do assessment only if you want to. You could retrain in some psychological assessments. So, yeah, I, I wish I had someone kind of to help me sometimes with doing my assessment stuff, but I don’t.

I might hire someone soon, actually talk to me. Maybe I’ll. Maybe I’ll hire you.

So I think we feel like we have no options, and that’s a big part of that fear. What are we going to do?

And we can’t see that there are a lot of options for us because maybe it’s not been modeled for us.

We went to school, you know, for a very, very long time. And, you know, I talk a lot about, I talked a lot about this in my career series in the summer.

So if you didn’t check out that career series, Those were episodes 28 where I talked about how to three steps to pivot your career away from one to one. Therapy episode 27, which is probably my favorite title, while why therapists fantasize about working at Target.

One of my, one of my top LinkedIn posts, by the way. I post over on LinkedIn if you find me Dr. Jen Blanchett. Two T’s and a E.

And then probably my most popular episodes was episode 26. What other jobs can therapists do other than therapy? So if that’s your question, check out those episodes that I did in July.

I think that’s going to be kind of my cadence with doing career focused episodes. I’ll kind of do that in the summer, mapping out my podcast plans for the year in 2025.

And also episode 25, the Passion Paradox in therapist careers. Why following your passion is not the answer, because we already did that.

And I think that’s where the fear comes from. Right? The fear comes from I followed my passion and it got me to feeling totally depleted and at the end of myself.

So how can I trust following my passion again, which I don’t recommend. I don’t recommend your next job. Be a job that’s a passion job. Like, oh my gosh, I want to make quilts.

That’s one of my previous passions. I don’t quilt anymore. Or fitness instructing, which I do as well. I am a fitness instructor and a personal trainer and a yoga teacher.

I have that skill, but it’s not something that I’m going to do career wise because it’s not lucrative enough for me to do that. I wish it were. Maybe I’ll find a way to incorporate the yoga, the personal training in this work that I do with therapists.

More so someone who’s one of my coaching clients who’s listening to the Ms. We’re going to have a session where I’m just doing personal training with you. It’s happening.

I do dream about that, like, of maybe having a membership and doing like a yoga class for you once a week or something. Could be awesome.

So I just can continue to dream about all those little offerings that I want therapists to have, but it’s not happening at all. Present moment.

All right, so episode 25 through 28. Were those episodes for career. Okay, so you. Number number one is you have no options. So check out those episodes. Those are great resources for you to think about if it’s a career beyond therapy.

And I’m just thinking of a client I’m working with who I just wrapped up with and they had the privilege to take a break. So they are. They close their practice and they’re not doing anything.

And I think actually for another client of mine, it felt weird for them not to be working as a therapist or weird to be working at all.

And I thought about, I’m from the south originally, but you don’t hear that in my voice because I’ve lived pretty much in the D.C. metro or now I live in Maine in the United States.

Sorry for you folks that are across the pond or in other parts of the world. So down south in the United States, we have a Southern twine that it’s a fake one.

And I’m shopping with my mom over Thanksgiving break and my mom paid for my clothes at this place. And I was like, moms don’t. Don’t pay for no. She’s like, I’m doing it.

You’re. And she’s like fighting me with her credit card and stuff.

And this woman, she’s just like, don’t you steal her blessing.

So I think a lot of us have trouble resting as therapists. We have trouble accepting if we do have that privilege if we do have the opportunity to rest, that we take it.

So a lot of times I’m helping my therapist clients find permission for rest, taking their rest and figuring out their options.

The second one is a big one, which is letting people down.

So I think there. I think with everyone I’ve worked with, all the therapist clients I’ve worked with, they talked about letting down their clients by either closing their practice or if they’re trying to manage their caseload differently, maybe they’re discharging some clients.

It was difficult because they felt like they were going to disappoint their clients, they were going to harm their clients even by making the decision, close their practice or just because that client was done with therapy.

And I’ve talked a lot about termination on the podcast. So again, there’s all. There’s. There’s episodes.

Let me shout out my termination episode.

Yeah, so episode 35 is where I. I talk about unspoken endings, navigating unilateral terminations.

So I think that’s a big one that comes up for therapists is that they.

Or we don’t get that training in grad school to navigate when we, as the therapists need to terminate therapy. So I just have. You think through.

It is really normal as a therapist that we’re going to terminate with our clients. It is.

We. We can expect that. However, we also have a human brain. We have a human brain that is basically doing life with these people. We under. We hear their stories week in and week out, and we’re invested in it.

Right? And even when it’s dysfunctional for us to stay in that relationship, our human brains want us to stay in it because it’s easier in the moment to keep that client than it is to do the work to discharge them.

And I’ve seen this time and time again in the clients that I work with. My therapist clients, they tell me, oh, yeah, I’ve been holding onto this client. I don’t even know what we’re doing really in therapy.

I needed to discharge them a long time ago, and they almost feel guilty for it. And I’m like, listen, I am definitely a culprit in keeping a client too long.

It really takes looking at your caseload regularly and having some kind of supervision.

I mean, like real supervision, where you talk to people at your cases.

And I didn’t really get that in again until I did EMDR consultation. So towards the end of my practice, I got my EMDR certification, and I’m about to get my consultant certification because I was already in process on the way when I was closing.

So I hope to offer.

I don’t know what I’m gonna do with that. My EMDR consultant certification. Maybe it’s just like, I got that yay me.

Paid a lot of money for that credential anyway. I don’t, I don’t feel any type of way about paying therapists for, for, for that consultation. So I digress. So I think therapists are really so worried and fearful, so fear really grabs them for I’m going to harm my client.

I’m doing something wrong by closing, by doing it the wrong way, by telling clients the wrong way. A lot of times they want to work with me and say, like, okay, so how many days do I have to give my client?

And I’ve talked about this on that termination episode. There’s really no nothing in our ethical code that tells us you need to discharge with a client, you know, in 60 days or 90 days or whatever.

I think insurance gives up, gives. Gives us a little bit of guidance. And so insurance will tell you, if, like, you were paneled, right, that you needed to get the client between six months.

And that is really on the top end. Six months to two months. So 60 days to six months to go through the termination process with them and give referrals and make sure that they are taken care of, essentially, and they have that continuity of care.

I’m hearing children in the background. You might hear that in the recording. It’s going to add to the magic. I know it will.

So I think they’re fearful of harming some. We’re feel. We’re fearful of harming our clients and letting people down. Really.

I think we forget just how important we are to some of our clients and to how emotional it can be.

So me going through this, closing a practice, I did not realize how emotional the ending of a practice would be of terminating with multiple clients at once would be for me.

And so if you can take more time to have that be a more protracted termination for some of your clients. So if you have that Runway to say, okay, I’m going to take six months, because I have six months, then I’m going to do that.

I didn’t take that much time. So I, I told clients in December that I was closing end of March. So I pretty much gave them 90 days. So I gave clients 90 days.

And then some clients decided to leave right away.

So they wanted maybe one to two sessions where they would wrap up.

Okay. And so the last point, I’m going to tell you so Number one, you have no options. Number two, you’re fearful of harming someone.

And I think in that, like letting people down, hurting someone, abandoning a client is all kind of wrapped into that point. And then lastly of just the change in general.

I’ve talked a lot about this on the podcast. Therapists are the hardest people to get to change.

I think of many of us who like our offices cozy. We, I could imagine like a therapist who has been entrenched in there office for years, right? They love their plants, they love their furnishings.

And you know, you took a long time to create that office, to recreate that environment. Even if it’s a virtual environment, you take pride in that. And for me, like for my office that I made, it was like the one space that I feel like I created my own.

Like, I think I had an apartment in my twenties for just like a year. And that was the only experience where I had, where I decorated my own place. I always had roommates or I had a partner or something like that.

And so my office really was partly reflection of me and the healing space that I wanted to create for others and myself.

So we’re also like really attached to this place. And so I think fear can come in of like, what does that even mean? What am I doing?

Um, and we, I think the last point is that we are fearful of this change because we have a human brain. Our brain tells us like, oh, it’s not that bad, or, you know, we can keep going or we can change this and that because it’s easier to stay the same than it is to change.

So you have a human brain.

And why do I say this? I say this because I think therapists often forget about that. We forget that we are human. We have similar difficulties as our client.

And so while we know all of these things, we understand cbt. We maybe we’re EMDR certified, maybe we have, you know, pen credentials. I don’t know.

We still have difficulties with. When we have those thoughts come in, we don’t always do the work on ourselves or we’re not always in therapy. Even if you’re in therapy like I am, you still struggle with that.

Maybe you’re prone to some depression. Maybe you’re prone to people pleasing, of wanting people not to suffer. And so I think if that is your bent, especially for helpers, because we often take things on ourselves as opposed to thinking about other, as opposed to pushing back.

I think it can be a default for therapists not too regularly look at their caseload to be challenging in therapy. Unless, you know, you’re my partner.

He just has no problem with that.

He would. He tells me, well, he doesn’t do therapy anymore. But when he was doing therapy, he would talk to me all about, like, challenging people and just. Yep, I just said that.

And I’m like, wow, that just. People just do that. Okay, great.

And it was great at that in some contexts, I think.

But I think I did fear, like imparting harm on people. And then that might have led me not to be as aware of maybe when I needed to discharge a client or if that client was perhaps not a great fit for me as a therapist to treat them, and that wasn’t the best fit for them.

So what do we do with that?

I just, I wrote a note because I. I said CBT that ****.

I might take that out, you know, put it in a frame, write it down.

I think a lot of times we are guilty of just letting these things run around our head. We don’t take time to look at it. We get into patterns with people and into the Groundhog Day that is often mid career, midlife.

If you’re in that phase of life, you know, maybe you have kids, maybe you, you know, have fur, babies, whatever you have. It’s like you’re in this routine of life and you don’t think about the pattern disrupt about why am I actually doing what I’m doing in therapy?

Is this even something I want to do so regularly, regularly reassessing that. And some of my clients say, I love being a therapist. It’s just not working for me in the way I’m doing it.

So we have to figure out a different way to do that. And that’s totally okay.

And I think from my clients who are beyond crispy and burnout and have known they’re done, it’s the fear of those things I talked about. It’s feeling like I have no options, feeling like I’m letting people down.

And for other folks, I think it’s the fear of putting up boundaries and discharging clients that they have been seeing for quite some time that are no longer benefiting from the service.

Again, check out that termination episode. I talk a lot about a lot of strategies for that. So I think we forget that we often want to be in a state of homeostasis, even if that state of homeostasis does not really work for us.

It’s familiar, it’s normal. So if we’re prone to staying in that state, then we’re going to default to that state. And it takes work for us to get out of that sometimes a lot of work, believe me, I know from experience of changing things in my practice, going off of insurance panels and ultimately closing and doing something completely different.

But therapy adjacent is what I do now. And I coach y’all, which is great, which I enjoy.

But I. I can’t stress enough of how important it is to really look at and write down your thoughts, have a therapeutic space of reflection. And I would recommend peer supervision consultation.

I think if I was still in it, I would just pay for EMDR consultation because I. I loved emdr, still love emdr and hope to eventually do some kind of work with therapists in that space with vicarious trauma.

I would love to do a retreat here in Maine where we work on some of that stuff with you guys. So that’s a dream. I hope that that does happen.

At any rate, I.

That’s all I have for you today. So I think strategies to overcome fear would be really first to regulate your nervous system.

Sometimes just telling yourself out loud, I am. I am fearful. I’m fearful of what clients are going to say, what they’re going to do.

So really kind of putting that into, like a CBT frame. What is the worst case scenario? What is the worst thing that could actually happen? Write it down if it is really distressing.

So sometimes if we write it down, we kind of look at, you know, is that. Do we really think it’s going to happen? What’s a more balanced thought about that potential situation?

We realize that it’s not something that we necessarily have to work through. So maybe just writing it down is enough. And sometimes we loop, right? We get. We get caught in that cognitive loop of really ruminating and thinking about that.

So perhaps we need to think about some other strategies, bringing that to therapy, bringing that to, you know, a more focused time or consultation with someone. I think a lot of times in my work with other therapists, it’s these really hard conversations with clients that feel like we don’t talk to other colleagues about.

Because, number one, it’s vulnerable to feel like you don’t know what you’re doing. And I feel like that’s a common experience with a lot of the therapists I work with.

They’re like, you know, I. I feel competency and maybe some areas of my work, but there’s some areas of my work where I don’t feel that. And that’s really normal.

So it’s normal to get support for that. So I would just have you think through it and know you’re not alone. I think that’s the biggest thing I would take away is that you’re not alone in feeling like you’re struggling in this.

With that, I will leave you therapist and I hope that that has been helpful.

I am starting a group in January so I’m going to announce that next week. I’m announcing, I’m announcing it to some of the consult calls that I’m doing this week.

I only have a few consult calls left for the end of December and early January. I’m going to update my calendar. So if you get in here real early, it may not be updated for January but I am going to kind of be closing, taking on new clients until the spring because I am getting pretty busy with therapist clients.

And so I’m starting a group and I’m starting one to one session. So if you have thought about the time of this recording at the end of 2024 wanting my support either with a group of therapists or with me one to one, then grab one of my last console calls spots and I hope to talk with you soon.

If not, there will be a note in the. In your show notes to just a way to connect with me. Okay, bye.