Nothing Left to Give: A Psychologist's Path Back from Burnout

• Journal 1: Warning Signs-15 January 2021
• Journal 3: Severely Burnt Out-3 March 2021
• Journal 4: Letting People Down-10 March 2021
• Journal 5: Uncertainty-16 March 2021
• Gap Year Rule

Journal 1: Warning Signs-15 January 2021

I have nothing left to give anymore. I thought the break over Christmas may have helped, but it hasn’t. I am still exhausted, more than ever, and I can’t believe I am saying this, but I feel like I am just going through the motions of caring, that I am “pretending to care,” which is so horrific to say. I do care for my clients; I’m just finding it hard to do this work.

It gets worse. I had a session today with a client. A client with multiple current crises and past traumas still left unprocessed, a presentation making up most of my caseload. This session has floored me. 

I am ashamed to admit that my mind was almost completely disconnected from the client throughout the session. My mind was all over the place:

I don’t know if I can help this client anymore.

I wish this client would do what will help instead of just talking about it all the time.

I feel so out of my depth.

I don’t know if I can keep doing this kind of work.

I can’t leave; so many people depend on me.

I feel so trapped.

I need to focus on my client right now. It’s not okay that I’m caught up in my shit.

It is one crisis to the next for this client.

It will never end.

I don’t have anything more to give to this person.

I feel like I’m on autopilot. I'm here, but I’m not here.

It’s hard to know that this client will be safe.

This client deserves a psychologist that can help.  

I want this session to end.

I have never been that detached before, and I know I have let her down. A thought popped into my head soon after her session with me ended – you are this client!

I was immediately taken aback as, on paper; we are nothing alike, and we don’t share similar pasts, current life situations, personalities, traumas, or even approaches to life. Despite my immediate disagreement with this thought, it repeated itself. . . you are this client!  

Right here, right now, while reflecting on this session, I still find myself rejecting this thought, this knowing. I’m not this client. My mind is saying: 

This client’s experiences, past and present, are a lot more complex than mine.

This client has experienced multiple traumas, depression, and work-life stressors.

I don’t even have half of that…but maybe the similarities lie in how the suffering presents, not the causal events.   

Now, this has made me stand up and listen. Despite our notable differences, our suffering does have similarities. We are both going around in circles, staying stuck in situations that are not healthy for us. We both have lost pleasure in our lives in what we do. We withdraw, keep busy or turn to substances (food for me) to cope. We both continue to push ourselves to do better and be better both professionally and personally. We both find it hard to talk about our problems to others. We keep it hidden. We are constantly irritable and exhausted. We both have very high standards and expectations of ourselves. Our worth is caught up in what we do for a living or who we are for other people. We are profoundly insecure and, at the same time, desire safe and supportive connections. We both feel disconnected from who we are. We both suffer from bouts of depression and anxiety. We both dream of escaping, breaking free from our suffering. And we are both beyond burnt out and have no more fucks to give. We are both feeling trapped in our lives.

Shit! We are alike.

Well, what do I do with that now?  

I know what I have advised the client to do, and if our sufferings are similar, I need to either step back from my career as a clinical psychologist or make some significant changes to how I’m doing things right now. I need to prioritise care for myself.

But am I that bad?

Maybe this is all just in my head.

It’s just too much even to fathom right now.

Too many people need my help; I need to keep pushing through.

I need to focus on doing what is best for the clients.

Wellness Practice

Don’t shove down any insights you may be experiencing. Don’t question it. Sit with it. Pay attention. You can do so with a daily check-in.

Daily Check-in

Answer the following questions to help you check in with yourself: What is happening for me right now? What am I feeling? What is on my mind? How is my body feeling? Do this regularly to help you gain self-awareness and be in a better position to respond to any difficulties. You can even start a journal to capture these daily check-in insights.  

Journal

Start a journal to record your wellness practices throughout this book. The writing process in and of itself can offer therapeutic qualities, and it helps us slow down, pay attention, look in, engage with ourselves, and process our experiences. 

Journal 3: Severely Burnt Out-3 March 2021

Since my last journal entry, I have left my job and career behind. I feel deeply ashamed and guilty for leaving my job as I did. It happened so suddenly, so quickly; no one saw it coming. In some ways, even I didn’t, although I had thought about it quite a bit. A week ago, on February 25, 2021, my mind and body spoke for me—“I can’t do it anymore.”

You are not well enough to take care of others right now. Leave this for those who can. Your job is to take care of yourself, and leaving your work is caring for yourself and others.

On that day, I showed up to work at the psychology practice where I had been working for almost five years, Zest Infusion. Like many preceding days, I felt completely and utterly exhausted, emotionally, mentally, and physically. Along with this feeling, I felt a sense of dread, hopelessness, fear, anxiety, self-doubt, and a lack of care to give to anyone.

I had set up a meeting to talk to the practice director, Dr Ilze Grobler regarding the need to change my schedule to support my well-being. I was still struggling with what I wanted to do. Reducing my client load or leaving meant that clients would suffer, but if I kept working the way I was, I would suffer. Both decisions involved suffering; no one would win. I remember feeling very anxious to talk with Ilze about it all, not because of what she’d say (she’d always been compassionate) but my fears of what this meant for everyone—for clients, me, and Ilze’s business.

My heart was heavy, and my mind was too. I knew I wasn’t okay, and something needed to change, but I was battling my need to care for others and myself. I didn’t realise how bad my health was until I was in front of Ilze, letting her know what was going on. Ilze’s compassion made me feel safe enough to connect with the depths of my suffering and listen to what I needed. She mentioned that she knew of a psychologist in a similar position who needed to take time away from the profession to care for herself. At that moment, I admitted I couldn’t do it anymore. I couldn’t push. I couldn’t be present for my clients. I couldn’t adequately put my pain aside and be present; worse, doing so would create more suffering for everyone. I had to stop, and I had to stop then. Ilze’s compassion helped me to find what I needed at that moment and to express it.

I recognise that my awakening to the depths of the pain and suffering I am experiencing has happened because of two compassionate women in my life, Dr Ilze Grobler and Dr Hayley D. Quinn. Without these women, I wouldn’t have been able to take the steps I have made so far. It was Hayley and Ilze who told me…   

You are not well enough to take care of others right now. Leave this for those who can. Your job is to take care of yourself, and leaving your work is caring for yourself and others. 

Maybe I can believe, in time, that it is okay to take care of me.

Wellness Practice

Surround yourself with empathic, non-judgmental, warm, kind and empowering people. If you haven’t got them, find them. You will know you’ve found one when you can be yourself around them. If there is not someone in your immediate environment (friends or family), seek out a professional. A mental health professional (e.g., psychologist, counsellor) is trained to provide a safe, secure and supportive environment, so you can be free to be yourself, to share your pain and suffering.

It will depend where you are in the world with how you go about this and what professional to see. In Australia, it can be helpful to see your doctor first, a doctor who specialises in mental health, who can do an assessment and assist with referrals to appropriately trained professionals. You can also visit the following link https://www.healthdirect.gov.au/mental-health-where-to-get-help. This page will help guide Australian readers on the next steps to link with a professional. 

If you find this whole process daunting, that’s okay, it is. Bring a friend, someone you trust, so they can support you through the process. They don’t need to know what to do; you can find out together. This way, you don’t have to be alone.

Journal 4: Letting People Down-10 March 2021

I see my burning out and inability to work as being pushed off the side of a cliff, free-falling into the space below with microscopic moments of being lifted, flying to somewhere unknown, feeling scared and free simultaneously.

The past couple of weeks have been extremely challenging. I have spiraled in and out of feeling relief, quickly followed by crippling fear, guilt, and shame. I constantly think that I have let others down (Ryan, colleagues, and former clients) and that I’m selfish for prioritising my care over others. The fear, guilt, and shame are currently overtaking any feelings of relief.

The feelings of fear, guilt, and shame were most substantial when people I care about started to find out I was sick and no longer working. The day the email to my clients and colleagues went out to let them know I had left was particularly gut-wrenching. At first, I couldn’t look at the emails from clients and colleagues. The shame and fear I felt then wouldn’t allow me to read them. I feared they would hate me. I feared harm would come to them; I believed I failed them.

Further, I felt guilty for the position I put them in—not having regular, familiar, and reliable psychological care. I feared they would be angry with me, hurt, and that they’d believe I abandoned them. Or I felt like I had abandoned them. I can’t shake these feelings and thoughts; they are constant companions.

Despite how I feel or think, I must confront this fallout in a way that supports both myself and those affected. I don’t want to hide. I’ve done that before. In my late teens and early 20s, I was experiencing what I later came to recognise as clinical depression. During this time, I worked at a local restaurant fulfilling both waitressing and administrative roles. One day, I upped and left and never returned. I didn’t speak to anyone from work, friends, or family. Those close to me at the time knew something was up, but I didn’t talk; I didn’t know how back then. I felt deeply ashamed for being sick; I believed I had no reason to be. The shame kept me silent. I’ve learnt a lot since then. I’ve learnt to speak up, front up, and recognise that anyone can become mentally unwell and that there is no shame in being mentally ill. I’m thankful for the experience of clinical depression for this learning experience.

This time I want to be the person who fronts up to the fallout, speaks up, and honours the responses from colleagues and clients for my abrupt departure, doing what I couldn’t do all those years before. With this intent, I told Ryan and my family that I was sick and started reading emails from clients and colleagues.  

Reading my former clients’ email responses has been particularly tough. I have felt many emotions—grief, loss, gratitude, support, compassion, kindness, and despair. Most of the responses were compassionate, demonstrating concern for me, sadness for not receiving psychological care from me anymore, and non-judgmental support; very few clients responded with what I feared (i.e., feeling abandoned, angry, and let down by me). I wasn’t mad at those who felt this way; I was glad they could express their feelings. It was a difficult time for all. 

Despite the overwhelmingly compassionate responses from everyone, right at this moment, I still feel weighed down by it all. I still believe I have let my former clients down; I should be capable enough to support them and hold up my end of the relationship. I want it all to be over. I want to crawl into bed and not deal with it. I still worry about the potential harm that may come to my former clients due to not having a psychologist until they secure a new one. I worry about the workload now on the Zest Infusion team, and I feel bad for no longer financially providing for my family. I feel overwhelmingly responsible for everyone’s pain and suffering at the hands of my actions. I feel like I’m drowning. It’s like it will never end.

What keeps my head above water is the continual support from those who genuinely love and care for me—Ryan, Jayd, Hayley, and Ilze. I love when a message pops up from Hayley or Ilze to check in to see how I am going and knowing I can speak with Ryan and Jayd when I am having a bad moment. I am fortunate to have their support. It gives me the strength to continue putting my needs first, back away from being the carer for others, and allow others to care for me. It helps me to acknowledge that I’m sick and not in a position to care for anyone right now, and it would be wrong for me to do so. They are helping me focus on my choice to care for myself while also doing what is needed to finalise work. For example, setting and sticking to a workable schedule for doing the background work necessary to assist clients in being seen by another psychologist (i.e., writing reports to their doctors, handovers to new psychologists, and answering client emails) and scheduling an appointment for myself as soon as possible with a psychologist. I’m focusing on what is necessary to finalise the care for others whilst also taking care of myself.

[editquote;I’m in awe of the overwhelming support from former clients for my health and well-being]I’m in awe of the overwhelming support from former clients for my health and well-being. Many of them have said in their messages to me something to the effect of “if there is anything you have taught me, Shannon, it is the need to prioritise care for self.” I’m so happy they have learned this from me; it helps me to know that they have learned a valuable healthcare strategy, care for themselves. More than this, everyone’s responses (including the clients) showed me that even when what you have to do affects them, it doesn’t mean they will hate you. They may express their hurt but also offer care and kindness. I’m grateful to have been surrounded by such wonderful human beings. The free-falling stopped in these moments, and I felt lifted and supported in this place of the great unknown.

Wellness Practice

You can’t change what has happened. Your illness will impact others. This doesn’t mean you are a “bad” person; it means you are human.

Acknowledge and show compassion for any undue impact on others. For example, “I'm sorry for the impact leaving work has had on you.” Don’t sacrifice your needs to take care of others right now. You will only do further harm to yourself and to the very people you don’t want to hurt.

Turn your attention to your recovery. Do the work so that this doesn’t happen again. What is one small step you can take today in service of your recovery? For example, make an appointment with your doctor to discuss a referral to see a mental health professional, prioritise rest, make time to catch up with a trusted friend, or spend time in nature.  

Journal 5: Uncertainty-16 March 2021

At some point recently, I lost that lift and started to free fall again, and this time I was aware I had no place to land. I was fucking freaked out. I was staring into the abyss, and there was nothing. I have never jumped off a cliff; I always have a destination. I’m a planner; I always have a plan.

The free-falling recommenced when I was wrapping up the last bit of administrative work I had to do for my former job. This work has taken a few weeks, working full-time hours to complete, and it has filled my days and kept me from seeing the naked abyss of my life, a protector in some ways.

So, of course, I started to look for work frantically. Honestly, I have been looking for work on and off before then. If you were a fly on the wall for the past few weeks, you would have seen me sitting at my desk, editing my resume, signing up to major job sites, and applying for jobs after finishing a full day of client report writing. You would have heard a few thoughts about what I should do inside my mind. One of them was to do something within my expertise. Another was to do something entirely different with little to no responsibilities. I even thought about not working. My favourite idea was to take off in a van around Australia. At some point, I recognised that my mind and body were busy finding a place to land (i.e., a plan).

I talked about this with Ryan just the other day. I promised to talk more with him, especially when I get caught up in my head about something and take actions that are not helpful to me. Talking with him helps. I know he cares for me and has no qualms about being honest with me if what I do is not in service of that. I wouldn’t share with him or anyone in the past, and I would end up with a messy yarn of irrational thoughts, beliefs, and behaviours that only made me sicker. Talking it out with him helps untangle some of that yarn and keeps me from losing my shit. This time was no different. 

On one of our daily walks with our puppy Hana, I shared with him what was happening in my mind and that I had been frantically looking for work, feeling the pressure to earn a living and pull my weight. Just voicing what was going on in my head helped. His words of encouragement, love, and support to do whatever helps me be healthy and happy have helped untangle some of this story and guided me to the firm decision to take 12 months off from working in the mental health field, stepping away from a caring role. I’m very thankful I decided to talk with him about my current messy thoughts; it has led to a critical decision.

This decision felt so good. A weight was lifted from my shoulders. My gap year began. A gap year with a stark difference; one focused on getting better and doing what is necessary to heal.  

Gap Year Rule

To engage in activities that meet my needs. Care for self without engaging in work involving providing mental health care to others for at least 12 months.

 While this decision and Ryan’s support have helped significantly, I realised I still didn’t have any place to land; I didn’t have a plan. I was still free falling into the unknown, uncertain where I might land. The view was cloudy, messy, unclear, scary, and foreign.

At some point (not sure when), the clouds cleared. I don’t know why; maybe a combination of journaling, talking with Ryan, and time. Whatever the reason, it became clear that I was pushing myself to find land (i.e., a work plan) because I believed doing so would help me feel safe, secure, and in control. I was looking for certainty. However, pushing myself to find a work plan only created more suffering. I needed to stop pushing myself to have a plan and instead let go, be present in the sky, this place of uncertainty, the great unknown. If I remain still, present in this place, I believe the answers will come at some point, and the plan will unfold. A plan that will likely be healthier and much wiser than the one made from pushing.

So, the plan is to be still and ignore the urge to push; to focus on caring for myself— meditating, spending time in nature, hanging with loved ones, stand-up paddle boarding, hiking, and stretching, whatever supports me at that moment.  

Wellness Practice

When everything stops, it can be unnerving. Sending you into a tailspin of complicated feelings, thoughts and body sensations, often unexpectedly, especially if you are a high achiever.

Uncertainty is a tough place to be in, and reaching certainty in a moment isn’t always possible.

Instead of dealing with this all alone, talk about it with trusted friends, family or a professional. Speak it out loud. When we voice what is going on, it supports processing our experiences.  

Have you ever talked something out with someone, and they haven’t said anything particular back to you, just sat there and listened, and afterwards, you have felt better, maybe even knew what to do next?

Talk with someone. If you don’t have someone, talk it out with a therapist, or write it in your journal.

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As the sole rights holder and author of Nothing Left to Give: A Psychologist's Path Back from Burnout, I Shannon Swales hereby grant permission to Psychotherapy.net to reprint the journal entries dated 1/15/21, 3/3/21, 3/10/21, and 3/16/21.   

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